The prevalence of vitreomacular adhesion in eyes with macular oedema secondary to retinal vein occlusion selected for intravitreal injections

Purpose: To assess the prevalence of vitreomacular adhesion (VMA) in consecutive naïve eyes diagnosed with macular oedema (ME) secondary to retinal vein occlusion (RVO) and to longitudinally evaluate the incidence of vitreomacular interface changes over time and the influence on response to treatment. Design: Retrospective cross-sectional analysis and longitudinal cohort study conducted at two Italian tertiary referral centres. Methods: A total of 295 eyes, treated with intravitreal ranibizumab and/or dexamethasone for ME secondary to RVO between June 2008 and May 2018, were enrolled in the study. 280 fellow eyes met the inclusion criteria and were included as control group. The vitreomacular interface status was evaluated by spectral domain optical coherence tomography (OCT) and graded according to the OCT-based International Classification System developed by the International Vitreomacular Traction Study (IVTS) group. Results: At baseline, VMA was present in 130 (44.07%) RVO eyes and 142 (50.7%) control eyes (no statistically significant difference was found; p = 0.455). Mean follow-up (FU) was 35.98 months (min 6 – max 112). Throughout the FU, the incidence of spontaneous release of VMA (RVMA) in RVO eyes was significantly higher in comparison with that of the control group [59 (41.84%) RVO eyes versus 18 (12.33%) control eyes; p < 0.0001]. The number of injections in VMA+ eyes was significantly higher when compared with VMA− eyes. No significant difference was found between VMA+ and VMA− eyes regarding their mean best-corrected visual acuity (BCVA) at baseline and at each annual time point (p = 0.2). Differences in central macular thickness (CMT) were significant only at the baseline evaluation (p = 0.0303). Conclusions: Vitreomacular adhesion (VMA) was not found to be more prevalent in eyes with RVO compared to healthy fellow eyes, and RVO, in turn, did not result in a higher persistence of VMA over time. This suggests that VMA and RVO might be two independent retinal phenomena, with no mutual pathogenetic influence. Vitreomacular adhesion (VMA) might have an impact on the response to treatment, since it was found to result in a more intensive treatment regimen; however, it did not affect visual and anatomic outcomes. These results do not support vitrectomy or PVD induction in the prevention, nor the treatment, of RVO

Validity and reliability of the Italian version of the Measure Of Parental Style (MOPS). / Validità e affidabilità della versione italiana della Measure Of Parental Style (MOPS)

Objective The links between parenting and mental health are a major topic of research in psychiatry. Research on the correlates of dysfunctional or inadequate parenting relies on the availability of valid and reliable measures of parental style. Our main aim was to develop and validate the Italian version of the Measure Of Parental Style (MOPS). A secondary aim was to test the reliability of an Italian version of the Parental Bonding Instrument (PBI) that was specifically designed for this study. Methods An Italian version of the MOPS and PBI was produced using multiple independent bilingual translators. The questionnaires were administered to a non-clinical sample of adults (N = 154). A sub-sample (N = 73) completed the instruments again one month later. Results As expected, MOPS maternal and paternal Indifference were moderately to highly negatively correlated with PBI maternal and paternal Care, respectively. Also, MOPS Overcontrol was moderately to highly correlated with PBI maternal and paternal Overprotection, respectively. Moreover, MOPS maternal and paternal Abuse displayed a moderate negative correlation with PBI maternal and paternal Care, and a small though significant correlation with PBI maternal and paternal Overprotection. Furthermore, the MOPS and the PBI subscales were found to be reliable in terms of internal consistency and absolute as well as relative stability. Conclusions Given their satisfactory psychometric properties, the MOPS and PBI hold promise for clinicians and researchers interested in the links between quality of parenting and mental health

N-3 fatty acids in patients with multiple cardiovascular risk factors

BACKGROUND: Trials have shown a beneficial effect of n-3 polyunsaturated fatty acids in patients with a previous myocardial infarction or heart failure. We evaluated the potential benefit of such therapy in patients with multiple cardiovascular risk factors or atherosclerotic vascular disease who had not had a myocardial infarction. METHODS: In this double-blind, placebo-controlled clinical trial, we enrolled a cohort of patients who were followed by a network of 860 general practitioners in Italy. Eligible patients were men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease but not myocardial infarction. Patients were randomly assigned to n-3 fatty acids (1 g daily) or placebo (olive oil). The initially specified primary end point was the cumulative rate of death, nonfatal myocardial infarction, and nonfatal stroke. At 1 year, after the event rate was found to be lower than anticipated, the primary end point was revised as time to death from cardiovascular causes or admission to the hospital for cardiovascular causes. RESULTS: Of the 12,513 patients enrolled, 6244 were randomly assigned to n-3 fatty acids and 6269 to placebo. With a median of 5 years of follow-up, the primary end point occurred in 1478 of 12,505 patients included in the analysis (11.8%), of whom 733 of 6239 (11.7%) had received n-3 fatty acids and 745 of 6266 (11.9%) had received placebo (adjusted hazard ratio with n-3 fatty acids, 0.97; 95% confidence interval, 0.88 to 1.08; P=0.58). The same null results were observed for all the secondary end points. CONCLUSIONS: In a large general-practice cohort of patients with multiple cardiovascular risk factors, daily treatment with n-3 fatty acids did not reduce cardiovascular mortality and morbidity. Copyright © 2013 Massachusetts Medical Society