Differential activity and clinical utility of latanoprost in glaucoma and ocular hypertension

Background: The purpose of this study was to demonstrate the hypotensive efficacy and tolerability of latanoprost when used as monotherapy and as polytherapy associated with antiglaucomatous medication proven to be ineffective in keeping intraocular pressure under control. Methods: Three hundred and thirty-seven patients (672 eyes) affected by primary open-angle glaucoma and intraocular hypertension were recruited over a period of 10 years from the Glaucoma Centre, Department of Ophthalmological Sciences, University of Rome "Sapienza", and treated, subject to informed consent, with latanoprost 0.005% alone or in combination with other ocular hypotensive drugs. The patients were followed during this period at regular intervals, with determination of visual field, fundus oculi, visual acuity, and eventual onset of local and systemic side effects. Results: Latanoprost used as monotherapy and as polytherapy renders possible optimal and durable control of intraocular pressure in the form of one antiglaucomatous drug because it can substitute for one or more drugs and obtain the same hypotensive effect. Conclusion: Latanoprost can be described as the ideal hypotensive drug, not only because of its ideal compliance profile (only one daily dose in the evening), excellent hypotensive effect, and, above all, few systemic side effects. © 2012 Pacella et al, publisher and licensee Dove Medical Press Ltd

L'Invecchiamento della cornea

Gli Autori in questo capitolo analizzano e studiano gli aspetti fisiologici che sicuramente sono responsabili di cambiamenti importanti durante il periodo dell’invecchiamento della cornea

L’Invecchiamento dell'Apparato Oculomotore

Gli Autori rilevano che l’apparato oculomotorio subisce, con l’avanzare dell’età, delle modifiche che rientrano in un progressivo rallentamento funzionale. Le alterazioni patologiche più frequenti e più emotivamente coinvolgenti per il paziente affetto sono rappresentate dalla diplopia dovuta ad uno strabismo paralitico conseguente ad alterazioni vascolari centrali. Questa patologia è quella che riveste per l’oculista la causa più frequente di intervento nelle alterazioni oculomotorie. La prognosi è condizionata da una buona coordinazione tra l’oftalmologo e gli altri specialisti per una terapia efficace somministrata nel più breve tempo possibile

Testing the effectiveness of intravitreal Ranibizumab during 12 months of follow-up in venous occlusion treatment

To determine the effectiveness and safety of treatment of intravitreal Ranibizumab for Central Retinal Vein Occlusion. This non-randomized observational clinical study was comprised of a round of therapy with three IVI. Twenty eyes affected by CRVO were recruited. The average age was 65.06 +/- 15 years and criterion for inclusion: age >18 years, best Corrected Visual Acuity (BCVA) from 5 to 40 letters and macular edema with thickness greater than 275 micrometer. The criteria used for reinjection were: CMT> 150 micrometer, ETDRS <10 letters and LogMAR <0.2. The statistical analysis for continuous variables (ETDRS, logMar and CMT) was conducted calculating median and range (min-max), since these variables, due to sample size, were not normally distributed.Time trends of these variables were plotted with boxplot and differences. Events between T0 and T12 were assessed using the analysis of variance (ANOVA) for repeated measurements and the F test (Pillai's trace). The statistical significance was set at p <=0.05. All of the patients showed improvement. In fact, the ETDRS went from a median of 20.00 to 28.50, LogMAR went from a median of 0.75 to 0.55 and the values for CMT went from a median of 556.00 micrometer to 390.00 micrometer. The drug reaches maximum effectiveness after two months of therapy, with T2 remaining constant from the third injection at T3 until the end of 12 months at T12. The results produced by our study indicate that Ranibizumab is a valid treatment for CRVO

The role of contact lenses and ocular TRAUMA in determining Acanthamoeba Keratitis: a case-control study in Italy.

&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;&lt;br /&gt;&lt;strong&gt;Background: &lt;/strong&gt;acanthamoeba keratitis (a.k.) is a rare secondary infection due to acanthamoeba (a) invading the cornea. cofactors of risk may include TrauMa and contact lenses (cL). The objectives of this observational study are to evaluate the occurrence of a.k. in patients accessing the department of Special Senses of the Teaching Hospital “Policlinico umberto I" of rome with ocular infections dur- ing the period from 2005 to 2011, and the role played by risk factors which included contact lenses, TrauMa, sex and age.&lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt;: a case-control study involving 714 subjects was conducted (350 male and 364 female). all of the patients underwent a thorough ocular examination with confocal microscopy and a review of their medical history to outline relevant variables (contact lens and TrauMa). Statistical analysis calculated the frequency distribution and the odds ratio (or) (95%cI) for the risk factors "contact lenses" (cL) and "TrauMa". The odds ratio (95%cI) was adjusted for age and sex trough Logistic regression. &lt;strong&gt;Results&lt;/strong&gt;: out of 714 patients, 11 patients (7 male and 4 female) with a mean age of 34.09 years (19 to 51 years old) were found to be affected by a.k. The age group most afflicted ranged from 30 to 51 years old. Statistical analysis produced a crude or equal to 17.68 (95%cI 2.25-138.89) for cL-a.k. and or equal to 7.71 (95%cI 0.89-66.75) for ocular TrauMa.-a.k. Logistic regression performed to adjust or for age and sex showed the following values, respectively: or*=82.54 (95%cI 3.04-2239.58) and or*=11.52 (95%cI 1.19-111.76).&lt;br /&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: the data highlights an increase in a.k. cases during the 6 year study period. The association between this pathology and the use of contact lenses and/or TrauMa has been statisti- cally proven. The strength of this association increases when the odds ratio (or*) is adjusted for the confounding risk factors of age and sex. When dealing with the topic of acanthamoeba keratitis, it is important to remember that educating patients on proper hygiene practice for contact lenses is the first step towards preventing A.K. The results obtained are important because they are derived from the first Italian case-control study on A.K.&lt;/p&gt

Efficacy and safety of the intravitreal treatment of Diabetic Macular Edema with Pegaptanib: a 12-month follow-up

This observational study was performed to evaluate the efficacy and safety of intra-vitreal injections of pegaptanib during a 12-month follow-up period. Forty eyes (20 patients) affected by diabetic macular edema were monitored. Twenty were subjected to treatment, and 20 were controls. The treatment involved a cycle of three intravitreal injections of pegaptanib (0.3 mg every 6 weeks), at the end of which treated patients were submitted to a monthly follow-up for a period of 12 months. The aim was to evaluate the clinical condition of the eye after therapy and gauge the efficacy of the long-term use of this drug. Specific criteria were used to measure the efficacy and safety of pegaptanib. Regarding efficacy, we considered the following: an average improvement in the power of vision, or visual acuity, of →10 letters (2 lines), equivalent to an average logMAR score of →0.2, and a reduction in the central macular thickness of →250 μm. Regarding safety, we considered the occurrence of undesired eye and systemic side effects correlated to either the drug itself or the injection procedure. The logMAR score for the measurement of visual acuity at T3 (third intra-vitreal injection at week 13) with respect to T0 decreased from 0.7 ± 0.277 to 0.445 ± 0.216, suggesting an improvement, while the mean Early Treatment Diabetic Retinopathy Study (ETDRS) score increased from 25.75 ± 13.046 to 34.300 ± 11.770 letters. The central macular thickness was reduced from the initial value of 746.95 ± 293.601 to 334.050 ± 93.997 μm. In seven controls, we registered a worsening both in terms of visual acuity and macular thickness in some eyes, justifying a continuation of therapy in eight eyes of the control group. Pegaptanib proved to be efficacious and safe for the treatment of diabetic macular edema throughout the 12-month followup. To evaluate its long-term efficacy, further studies are required with larger numbers of patients and longer observational follow-up periods