Preliminary study on electrophysiological changes after cellular autograft in age-related macular degeneration

Background: Evolving atrophic macular degeneration represents at least 80% of all macular degenerations and is currently without a standardized care. Autologous fat transplantation (AFT) efficacy was demonstrated by several studies, since these cells are able to produce growth factors. The aim of the work was to demonstrate possible therapeutic effect of the joined suprachoroidal graft of adipocytes, adipose derived stem-cells (ADSCs) in tissue adipose’s stromal vascular fractions (SVF), and platelet rich plasma (PRP). Methods: Twelve eyes in 12 dry age macular degeneration (AMD) patients, aged 71.25 (SD ± 6.8) between 62 and 80 years, were analyzed. A complete ocular evaluation was performed using: best corrected visual acuity (BCVA), retinographic analysis, spectral-domain optical coherence tomography, microperimetry, computerized visual field, and standard electroretinogram (ERG). Each eye received a cell in graft between choroid and sclera by means of the variant second Limoli, grafting of mature fat cells and ADSCs in SVF enriched with PRP (LRRT). In order to test if the differences pre- and post-treatment were significant the Wilcoxon signed rank test has been performed. Results: Adverse effects were not reported in the patients. After surgery with LRRT the most significant increase in the ERG values was recorded by scotopic rod-ERG (answer coming from the rods), from 41.26 to 60.83 μVolts (µV) with an average increase of 47.44% highly significant (p<0.05). Moderately significant was the one recorded by scotopic maximal ERG (answer coming from the rods and cones), from 112.22 to 129.68 μV with an average increase of 15.56% (p<0.1). Conclusions: Cell-mediated therapy based on growth factors used appears interesting because it can improve the retinal functionality responses in the short term. The ERG could, therefore, be used to monitor the effect of cell-mediated regenerative therapies

The Mozart effect in biofeedback visual rehabilitation: a case report

Purpose: To evaluate the usefulness of acoustic biofeedback by means of Mozart's Sonata for Two Pianos in D Major K. 448 to maintain and/or restore visual performance in a patient with macular pucker and glaucoma. Methods: A 74-year-old patient with open angle glaucoma in both eyes and macular pucker in the right eye (RE) underwent visual rehabilitation with acoustic biofeedback by means of the MAIA™ Vision Training Module (Centervue, Padova, Italy) 10 minutes each eye once a week for 5 weeks. The patient was asked to move his eyes according to a sound which changed into Mozart's Sonata for Two Pianos when the patient locked the fixation target. Results: Best-corrected visual acuity improved in his right eye (RE) and was stable in the left eye (LE). Fixation stability improved in both eyes, and retinal sensitivity decreased in the RE and improved in the LE. The characteristic of the macular pucker did not change during the training as demonstrated with optical coherence tomography. The patient was very satisfied with the training, as demonstrated by a 25-item questionnaire (National Eye Institute - Visual Functioning Questionnaire, NEI-VFQ-25). The patient's reading speed and the character size which he was able to read improved in his RE. Conclusion: Music could enhance synaptic plasticity and affect neural learning and fixation training by means of MAIA vision training. Therefore it can improve visual performance in patients with macular pucker, postpone the surgical time, and assure a better quality of life for the patient. © 2011 Salvatore et al

Clinical features, prognosis, and long-term response to ranibizumab of macular CNVs in pattern dystrophies spectrum: a pilot study

Introduction. To analyze the morphological and functional features of choroidal neovascularizations (CNVs) in eyes affected by pattern dystrophies (PD), evaluating their long-term response to intravitreal ranibizumab, and comparing them with CNVs in age-related macular degeneration (AMD). The mean goal is to identify possible disease biomarkers and to evaluate the long-term prognosis of CNVs in PD. Materials and Methods. A retrospective study of 42 patients with naïve CNV (26 PD and 16 AMD), for a total of 47 eyes (29 eyes in the PD group and 18 eyes in the AMD group). Each patient received a loading dose of ranibizumab (one monthly for three months) followed by pro re nata (PRN) reinjection protocol for a period of at least three years. Morphological OCT parameters (CRT, central retinal thickness; SRF, subretinal fluid; IRF, intraretinal fluid; SHRM, subretinal hyperreflective material; HRF, hyperreflective foci; HCD, hyperreflective crystalline deposits; cCT, central choroidal thickness; slCT, sublesional choroidal thickness; EZd, ellipsoid zone disruption; and best corrected visual acuity (BCVA in logMAR scale)) were reported at baseline and last follow-up. Results. At baseline, no significant differences were found between the two groups, except for choroidal thickness parameters that were significantly greater in the PD group ( = 0.009). Longitudinal PD analysis demonstrated reduction in BCVA ( = 0.009), decrease in CRT ( = 0.046), resolution of SRF in 61.6% of cases ( = 0.004) and SHRM in 30% ( = 0.034), and choroidal thinning both centrally ( = 0.004) and sublesional ( = 0.011) compared to baseline. At 3 years, the PD group received significantly more injections than the AMD ( = 0.011) and showed significantly thicker choroid ( = 0.033) and more frequent HRF ( = 0.006). Regarding the PD group, we found a negative correlation between age and choroidal thicknesses at baseline and at 3 years ( < 0.05); significant positive correlations were found between baseline BCVA and at 3 years ( < 0.001), BCVA at 3 years and IRF ( = 0.003) and SHRM at 3 years ( = 0.003); CRT baseline and CRT 3 years ( = 0.017); HCD at 3 years was associated with greater CRT ( = 0.04) and IRF at 3 years ( = 0.019). Conclusions. Early and long-term morphofunctional features of CNVs in PD and in AMD are overlapping. CNVs in PD have poorer long-term response to ranibizumab and higher choroidal thickness suggesting different pathogenetic and evolutionary mechanisms

Cystic Fibrosis: new trends in ophthalmological evaluation

Cystic fibrosis is characterized by hypoxia that affects several organic tissues.. Twenty-two eyes in CF patients were analyzed. The oxygen supply alterations might determine hypoxia of the ganglion cells causing a decrease of receptive activit

Aminaphtone in the treatment of pseudophakic cystoid macular edema: a case report.

Cystoid macular edema (CME) following cataract surgery has been recognized for over 50 years as an important cause of suboptimal post-operative vision. The incidence of CME varies widely, but is likely in the range of 1-2% using modern cataract extraction techniques. We report the case of resolution of post-operative CME after treatment with aminaphtone 75 mg three time a day for one month. A 74-year-old causasian woman presented with reduced vision in the left eye after one month from uneventful cataract phacoemulsification. She underwent a complete ophthalmological examination comprehensive of spectral domain optical coherence tomography (SD-OCT) which showed CME and a central foveal thickness (CFT) of 703 micron. The patient was treated with aminaphtone for one month. CME disappeared, the CFT was within normal limits when aminaphtone was ceased, and best corrected visual acuity was 20/20 at the end of the treatment. Aminaphtone is a novel proposal in the treatment of pseudophakic cystoid macular edema

"Prevenzioni delle lesioni corneali da elettrodo per elettroretinografia con soluzione di idrossipropilcellulosa 0,4%".

In this study, a statisthical analysis of 100 patients undergone to electroretinogram shows the opportuneness to use an artificial tears solution to prevent the electrode damage of the cornea

Isotretinoin, vitamin A derivates and Psychopathology: Making the point

Isotretinoin (13-cis retinoic acid, a retinoid receptor agonist) is a synthetic oral retinoid that has great efficacy against severe cystic or recalcitrant acne vulgaris. The growing number of reported cases of depression and suicide associated with isotretinoin use in patients with acne has prompted concern among dermatologists, patients, and their relatives and has triggered new warnings from regulators including depression-related, patient-informed consent forms. Despite this increasing number of reports in medical journals the association between isotretinoin and depression has received little attention in the psychiatric literature. The purpose of this critical review is to highlight this association, examine the possible link and review the clinical implications. A search was made of the MEDLINE, EMBASE, COCHRANE and PsychINFO databases using the search terms 'isotretinoin', 'depression' and 'suicide'. At the present time there is no evidence that use of isotretinoin is associated with an increased risk for depression, suicide, or other psychiatric disorders. Although the current literature does not support a causative association between isotretinoin use and depression, there are important limitations to many of the studies: the available data are insufficient and , at the present time, there is no known pharmacological mechanism that would account for psychiatric symptomatology, however, retinoid receptors are widely distributed in the brain and more research is needed to ascertain whether they have a role in depression. © 2011 by Nova Science Publishers, Inc. All rights reserved

Retinitis Pigmentosa (RP): The Role of Oxidative Stress in the Degenerative Process Progression

Purpose: Retinitis Pigmentosa is a term that includes a group of inherited bilateral and progressive retinal degenerations, with the involvement of rod photoreceptors, which frequently leads to blindness; oxidative stress may be involved in the degeneration progression as proposed by several recent studies. The goal of this study is to evaluate whether circulating free radicals taken from capillary blood are related to one of the most important features of Retinitis pigmentosa that can affect frequently patients: cystoid macular oedema (CME). Materials: A total of 186 patients with Retinitis Pigmentosa (range: 25–69 years) were enrolled; all patients completed an ophthalmologic examination and SD-OCT at baseline and were divided into three subgroups according to the SD-OCT features. ROS blood levels were determined using FORT with monitoring of free oxygen radicals. Results: Test levels of free oxygen radicals were significantly increased, almost twice, in RP patients showing cystoid macular oedema and significantly increased compared to the control group. (p < 0.001). Discussion: Our findings suggest that oxidative stress may speed cone photoreceptors’ morphological damage (CMT); because long lasting oxidative stress in the RP may cause oxidative damage, with animal models of RP suggesting this is a micromolecular mechanism of photoreceptors’ (cone) death, it can be similar to cone damage in human RP eyes. The limitations of this paper are the relatively small sample, the horizontal design of the study, and the lack of data about the levels of ROS in the vitreous body