Publications by authors named "Nicola Delle Noci"

45 Publications

Early treatment with dexamethasone intravitreal implants in diabetic macular edema: Naïve versus refractory patients.

Eur J Ophthalmol 2021 Jun 12:11206721211024804. Epub 2021 Jun 12.

Department of Ophthalmology, Ospedali Riuniti, University of Foggia, Foggia, Italy.

Purpose: To assess the efficacy and safety of dexamethasone 0.7 mg implants (DEX-I) in patients with diabetic macular edema (DME) either naïve to therapy or refractory to anti-VEGF treatment, in a single-center, real-world setting.

Methods: Patients diagnosed with DME and treated with DEX-I were retrospectively enrolled in the study and split in two groups: naïve (Group 1,  = 64) and refractory (Group 2,  = 64) to treatment. Patients were evaluated at baseline, at 1 month, and every 3 months after each DEX-I implant. Main outcome measures were change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline to follow-up visits.

Results: Significant improvements in BCVA were observed in treatment-naïve patients at 6 months following the first and second DEX-I injection ( = 0.0023 and  = 0.0063, respectively), with significant reductions in mean CMT at 6 months after all DEX implants. In treatment-refractory patients, mean CMT was significantly reduced from baseline to 6 months ( < 0.05) after all DEX-I injections, although no changes were observed in BCVA.

Conclusions: DEX-I improved visual acuity and macular edema mostly in treatment-naïve patients, suggesting DEX-I may be a viable first-line treatment option in DME.
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http://dx.doi.org/10.1177/11206721211024804DOI Listing
June 2021

Sporadic Burkitt's lymphoma/acute B-cell leukaemia presenting with progressive proptosis and orbital mass in a child.

Neuroradiol J 2016 Jun 22;29(3):231-5. Epub 2016 Mar 22.

Department of Diagnostic Imaging, Ospedali Riuniti, University of Foggia, Italy.

Burkitt's lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma that is found predominantly in children, with the highest incidence occurring in Africa. The sporadic form occurs in non-endemic areas and typically involves the ileo-caecum and the bowel, whereas orbital and paranasal sinus involvement is rare. Here, we present an unusual case of sporadic BL in a Caucasian male child with rapidly progressive painful proptosis of the right eye. Magnetic resonance imaging showed an oval-shaped, extraconal mass in the supero-lateral part of the right orbit that deformed and dislocated the eyeball antero-inferiorly. The patient underwent anterior orbitotomy, and a biopsy of the excised tissue revealed a starry-sky appearance characteristic of BL. Postoperative aggressive chemotherapy was initiated with a good response after one week.
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http://dx.doi.org/10.1177/1971400916639964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977928PMC
June 2016

OUTER RETINAL TUBULATION: Characteristics in Patients With Neovascular Age-Related Macular Degeneration.

Retina 2015 Oct;35(10):1979-84

Department of Ophthalmology, Policlinico di Foggia, University of Foggia, Foggia, Italy.

Purpose: To assess the incidence, characteristics, best-corrected visual acuity (BCVA), central macular thickness (CMT), and retinal sensitivity correlations in patients with and without outer retinal tubulation (ORT) affected by subfoveal choroidal neovascularization due to neovascular age-related macular degeneration.

Methods: Prospective case series including 78 eyes of 78 consecutive patients with subfoveal choroidal neovascularization due to neovascular age-related macular degeneration. Baseline and follow-up visits included BCVA, intraocular pressure, ophthalmoscopic examination, CMT as measured by spectral domain optical coherence tomography, and retinal sensitivity tested with fundus-related perimetry (MP-1). Fluorescent angiography was performed at baseline.

Results: At the end of the follow-up period, the mean BCVA and CMT of patients with ORT were statistically different from those without ORT (BCVA: 0.61 ± 0.13 vs. 0.37 ± 1.59, P < 0.0001; CMT: 290 ± 26.7 vs. 215.2 ± 33.5 μm; P < 0.0001). Patients with ORT showed a decreased mean retinal sensitivity compared with patients without ORT (6.31 ± 2.5 dB vs. 9.89 ± 5.43 dB; P < 0.0001).

Conclusion: The results of this study investigating the BCVA, CMT, and retinal sensitivity detected by MP-1 between patients with and without ORT in neovascular age-related macular degeneration suggest that these parameters are statistically different in patients with ORT; this may be due to the pathogenesis of ORT formation, secondary to retinal pigment epithelial tears or photoreceptor damage. MP-1 microperimeter is a noninvasive instrument that provides useful information to better characterize the functional aspect of ORT in patients with age-related macular degeneration.
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http://dx.doi.org/10.1097/IAE.0000000000000609DOI Listing
October 2015

Ruthenium-106 brachytherapy and intravitreal bevacizumab for retinal capillary hemangioma.

Int Ophthalmol 2012 Feb 22;32(1):71-5. Epub 2012 Jan 22.

Institute of Ophthalmology, University of Foggia, viale Luigi Pinto, 71100 Foggia, Italy.

The purpose of this study is to report a case of retinal capillary hemangioma treated with ruthenium-106 brachytherapy combined with intravitreal bevacizumab. A 58-year-old woman presented with blurred vision in her left eye for 15 days. Best-corrected visual acuity (BCVA) was counting fingers at 3 m in her left eye. Examination showed a peripheral endophytic retinal capillary hemangioma, with associated macular edema and diffuse hard exudates in a macular star pattern. B-scan ultrasonography revealed a solid, highly reflective retinal tumor measuring 7.1 × 7.5 mm in basal dimension and 3.5 mm in thickness. The hemangioma and macular edema were treated with ruthenium-106 brachytherapy (500 Gy) followed 1 month later with an intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. After 10 months of follow-up, examination demonstrated involution of the hemangioma, resolution of the macular edema, less hard exudates, and improvement of BCVA to 20/25. Ruthenium-106 brachytherapy combined with intravitreal bevacizumab was associated with significant involution of the choroidal hemangioma with resolution of the macular edema and improvement in visual acuity.
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http://dx.doi.org/10.1007/s10792-011-9513-1DOI Listing
February 2012

Lamellar macular hole following intravitreal pegaptanib sodium (Macugen) injection for diabetic macular edema.

Int Ophthalmol 2011 Dec 28;31(6):525-7. Epub 2011 Dec 28.

Department of Ophthalmology, Ospedali Riuniti, University of Foggia, Foggia, Italy.

To report on a patient who developed a lamellar macular hole 1 month after an intravitreal pegaptanib sodium injection. Interventional case report. A 66 year old patient developed a lamellar macular hole 1 month after an intravitreal pegaptanib sodium injection for diabetic macular edema (DME). The pathogenesis of the lamellar macular hole in our case can be attributed to the intravitreal injection that may have induced vitreous incarceration, causing vitreoretinal traction at the macula and development of a lamellar macular hole. Alternatively or in association, pegaptanib itself may have caused the lamellar macular hole by inducing sudden reduction of the DME and exacerbation of tangential traction of the posterior vitreous on the overlying macular retina. Lamellar macular hole seems to be a potential complication of pegaptanib injection even in patients without pretreatment clinically detectable vitreomacular traction.
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http://dx.doi.org/10.1007/s10792-011-9493-1DOI Listing
December 2011

Risk factors for graft failure after penetrating keratoplasty: 5-year follow-up from the corneal transplant epidemiological study.

Cornea 2011 Dec;30(12):1328-35

Fondazione Banca degli Occhi del Veneto, Venezia, Italy.

Purpose: To evaluate corneal graft survival over a 5-year period and to investigate whether factors related to the donor, eye bank practices, the recipient, surgery, and postoperative course influenced the outcome.

Methods: Nine hundred ninety-eight patients were randomly selected and monitored in the subsequent 3 years from a cohort of 4500 recipients who underwent penetrating keratoplasty between 2001 and 2004. Cox univariate regression analysis was used to select variables to be included in a multivariate Cox proportional hazards model with a backward selection procedure to identify potential risk factors for graft failure. Graft survival curves were obtained from Kaplan-Meier estimates.

Results: Ectasia/thinning was the most common indication (49.1%), followed by regraft (16.1%) and pseudophakic corneal edema (PCE) (9.4%). The overall rate of graft failure was 10.7% with 6 cases of primary graft failure. Adverse reactions and complications (other than graft failure) were reported in 2.7% of patients in the first postoperative week and in 22.8% during the full follow-up period. The probability of 5-year survival was 83.0%, best in eyes with ectasia/thinning (96.0%) and less favorable in PCE (67.0%) and regraft (64.0%). Multivariate analyses showed the following variables to be linked to an increased risk of graft failure: regraft for any reason, all clinical indication except PCE, history of ocular inflammation/infection, pseudophakic/aphakic eye, vitrectomy, graft Descemet folds, adverse reactions/complications, and surgeons' low caseload.

Conclusions: Penetrating keratoplasty shows an overall positive prognosis in the long-term. However, the probability of graft survival is largely dependent on the preoperative clinical condition and the lack of complications during follow-up.
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http://dx.doi.org/10.1097/ICO.0b013e318206895aDOI Listing
December 2011

Intravitreal avastin for choroidal neovascularization associated with stargardt-like retinal abnormalities in pseudoxanthoma elasticum.

Middle East Afr J Ophthalmol 2010 Oct;17(4):387-9

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

The aim of the study was to describe a patient with pseudoxanthoma elasticum (PXE), showing Stargardt-like retinal abnormalities, who underwent treatment with intravitreal bevacizumab for subfoveal choroidal neovascularization (CNV) of the right eye (RE). A 57-year-old woman with diagnosis of angioid streaks, retinal flecks, and chorioretinal Stargardt-like atrophy due to PXE was referred to our department for sudden decreased vision in her RE (20/160). Upon a complete ophthalmologic examination, including fluorescein angiography (FA), and optical coherence tomography (OCT), the patient was diagnosed with subfoveal CNV of the RE. Owing to the subfoveal localization of the CNV, the patient was submitted to intravitreal bevacizumab injection. At the 1-month follow-up, visual acuity (VA) improved (20/40), and FA and OCT revealed the CNV closure. Twelve months after the treatment, the patient's VA remained stable with no recurrence of active CNV. On the basis of our findings, a single intravitreal bevacizumab injection seems to induce total regression of CNV complicating PXE, in a patient showing Stargardt-like retinal abnormalities. Further investigations are required to confirm our results.
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http://dx.doi.org/10.4103/0974-9233.71586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991464PMC
October 2010

Late-onset Leber hereditary optic neuropathy mimicking Susac's syndrome.

J Neurol 2010 Dec 15;257(12):1999-2003. Epub 2010 Jul 15.

Clinic of Nervous System Diseases, Department of Medical and Occupational Sciences, University of Foggia, Viale Luigi Pinto, 71100, Foggia, Italy.

Leber hereditary optic neuropathy (LHON) is a mitochondrial disorder characterized by bilateral painless optic atrophy and blindness. It usually occurs in young men in association with three major mutations in the mitochondrial genome (mtDNA). We report a patient with a history of alcohol abuse who developed at age 63 years visual impairment, sensorineural hearing loss, and memory dysfunction, suggestive of Susac's syndrome. The patient carried the heteroplasmic mt. 11778G>A mutation on the T2e mtDNA haplogroup. It remains unclear if chronic alcohol abuse combined with the mitochondrial genetic background prompted an aged-related neurodegeneration or deferred the onset of the LHON disease.
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http://dx.doi.org/10.1007/s00415-010-5649-6DOI Listing
December 2010

Very Large Bilateral Lesions Obscuring Diagnosis of Adult-Onset Foveomacular Vitelliform Dystrophy.

Ophthalmic Surg Lasers Imaging 2010 Mar 9:1-3. Epub 2010 Mar 9.

Adult-onset foveomacular vitelliform dystrophy (AFVD) is a clinically heterogeneous and pleomorphic disease originally described by Gass as bilateral with symmetrical, solitary, round or oval, slightly elevated, yellowish subretinal lesions, one third to one disc diameter in size, often with a central pigmented spot. A possible AFVD patient showing very large bilateral macular lesions was reported.
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http://dx.doi.org/10.3928/15428877-20100215-19DOI Listing
March 2010

Functional and clinical data of Best vitelliform macular dystrophy patients with mutations in the BEST1 gene.

Mol Vis 2009 Dec 31;15:2960-72. Epub 2009 Dec 31.

Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris XII, Paris, France.

Purpose: To analyze functional and clinical data of Best vitelliform macular dystrophy (VMD) patients with mutations in the BEST1 gene.

Methods: Best VMD patients with BEST1 mutations were evaluated prospectively regarding age, age of onset, best-corrected visual acuity (BCVA), fundus autofluorescence, fluorescein angiography, optical coherence tomography, and electro-oculography. Mutations in BEST1 were established by direct sequencing.

Results: Forty-six eyes of 23 patients (10 male, 13 female) were included in the study. We identified nine different BEST1 mutations (3/9 novel), in ten unrelated families. The age of patients ranged between 3 and 75 years; age of onset varied between 2 and 67 years. BCVA ranged between 20/20 and 20/200. On the basis of fundus biomicroscopy with direct illumination, using one widely accepted classification, the macular lesions could be counted as follows: 1. no lesion (normal fovea): eight eyes, five patients carrying a mutation on the BEST1 gene; 2. previtelliform lesions: six eyes, three affected patients; 3. vitelliform lesions: four eyes, two affected patients; 4. pseudohypopyon: three eyes, three affected patients; 5. vitelliruptive lesions (scrambled egg aspect with dispersion of the vitelliform material without sign of atrophy or fibrosis): ten eyes, six affected patients; 6. atrophic lesions (atrophy with or without residual dispersed material): seven eyes, five patients; 7. fibrotic lesions: eight eyes, five patients. Two patients presented unilateral Best VMD. Both eyes of two patients presented multifocal Best VMD features on fundus examination. Six eyes of four patients have been treated for choroidal neovascularization by thermic photocoagulation [one eye], photodynamic therapy [three eyes], and intravitreal ranibizumab injection [two eyes]. Comparison of interfamilial and intrafamilial clinical data between patients did not reveal differences in age, BCVA, and stage of the disease as evaluated by fundus autofluorescence, fluorescein angiography, and optical coherence tomography (p>0.05). Mean BCVA impairment showed a statistically significant correlation to a more advanced stage of the disease (p<0.001).

Conclusions: BEST1 mutations were not correlated with the severity of the functional and clinical data in the Best VMD patients examined.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802291PMC
December 2009

High-Definition OCT Findings in Acute Posterior Multifocal Placoid Pigment Epitheliopathy.

Ophthalmic Surg Lasers Imaging 2010 Feb 15;41:e1-6. Epub 2010 Feb 15.

The authors report a case of acute posterior multifocal placoid pigment epitheliopathy evaluated by autofluorescence, fluorescein angiography, indocyanine green angiography, high-definition optical coherence tomography, and microperimetry in both the acute and the post-acute phase. Based on the integrated findings, the authors believe that acute posterior multifocal placoid pigment epitheliopathy is an inflammatory disease that primarily affects the choroid and that the retinal pigment epithelium is secondarily involved in the course of the disease.
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http://dx.doi.org/10.3928/15428877-20130213-01DOI Listing
February 2010

Local resection versus combined local resection and plaque radiotherapy in the treatment of choroidal melanoma.

Eur J Ophthalmol 2010 Jan-Feb;20(1):194-200

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

Purpose: To evaluate the outcome of local resection versus combined local resection and plaque radiotherapy in the treatment of choroidal melanoma.

Methods: We retrospectively analyzed the records of 60 patients (60 eyes) managed by local resection (group 1, 30 patients, external or internal local resection) or combined local resection and plaque radiotherapy (group 2, 30 patients, both Ruthenium-106 or Cobalt-60), among the 364 melanomas treated at our Department of Ophthalmology, between January 1980 and December 2006. Main outcomes measures were postsurgical complications, visual acuity, local recurrence, reasons for enucleation, and development of metastasis.

Results: The 2 groups of patients were considered sufficiently homogeneous as regards location, cell type, and age. Mean follow-up was 7 years. The median largest basal tumor diameter was 9.8 mm and 10.1, and the median tumor thickness was 7.9 mm and 8, respectively, in groups 1 and 2. No statistically significant differences resulted between group 1 and group 2 as regards postsurgical complications (vitreous hemorrhage, retinal detachment, maculopathy, cataract, and optic neuropathy) (p>0.05), visual acuity (p>0.05), local recurrence (p>0.05), reasons for enucleation (p>0.05), or development of metastasis (p>0.05).

Conclusions: No adjunctive benefits from the combined local resection and plaque radiotherapy can be ruled out from our study.
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http://dx.doi.org/10.1177/112067211002000127DOI Listing
April 2010

Foveal geographic atrophy following intravitreal pegaptanib sodium (Macugen) for drusenoid pigment epithelium detachment.

Eur J Ophthalmol 2009 Sep-Oct;19(5):890-3

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia - Italy.

Purpose: To describe a patient with nonexudative age-related macular degeneration (AMD) who underwent intravitreal pegaptanib sodium injection for drusenoid pigment epithelium detachment (PED).

Methods: A 66-year-old woman, who underwent intravitreal pegaptanib sodium injection in her right eye (RE) for chronic serous drusenoid PED, was submitted to a complete ophthalmologic examination, including fundus biomicroscopy, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT-3, Humphrey-Zeiss, San Leandro, CA), 3 days and 1 month after the treatment.

Results: Three days after the intravitreal pegaptanib sodium injection, best-corrected visual acuity (BCVA) was 20/32 in the RE. One month later, the patient's BCVA dropped to 20/200 in the RE. Interestingly, fundus biomicroscopy, FA, OCT, and ICGA revealed the development of foveal geographic atrophy. Fundus-related perimetry (MP-1 Micro Perimeter, Nidek Technologies, Padova, Italy) revealed an eccentric and unstable fixation within 2 degrees with central absolute scotoma and pericentral diffuse reduction of sensitivity.

Conclusions: The rapid development of foveal geographic atrophy in our patient may be related to the antivascular endothelial growth factor treatment, in part because of the reduced neuroprotective effect, and in part because of the adjunctive decreased blood flow in an already imbalanced foveal choroidal circulation due to AMD complicated by chronic serous drusenoid PED.
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http://dx.doi.org/10.1177/112067210901900535DOI Listing
November 2009

Diagnostic and therapeutic challenges.

Retina 2009 Sep;29(8):1195-200

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

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http://dx.doi.org/10.1097/IAE.0b013e3181ac23c1DOI Listing
September 2009

Short-term fluctuation of diabetic macular edema after intravitreal ranibizumab injection.

Retina 2009 Oct;29(9):1274-81

Department of Ophthalmology, Ospedali Riuniti, University of Foggia, Foggia, Italy.

Purpose: To examine the short-term fluctuation of diabetic macular edema (DME) after one intravitreal ranibizumab injection.

Methods: Twenty consecutive patients with DME received an intravitreal injection of ranibizumab (0.05 mL/0.5 mg). Assessment of best-corrected visual acuity (BCVA), fundus biomicroscopy, MP-1 fundus-related perimetry using follow-up strategy (pattern macula 8 degrees 0 dB with threshold strategy 4-2), and optical coherence tomography central macular thickness (CMT),were performed at baseline and 1 hour, 24 hours, 14 days, 28 days, and 56 days after intravitreal injection of ranibizumab.

Results: A total of 18 eyes of 18 patients (9 male, 9 female; mean age, 62.28 +/- 8.08 years; range, 48-75 years) who completed the 56-day follow-up were included for analysis. Intravitreal ranibizumab was found to produce significant improvements in mean BCVA and MP-1 sensitivity, as well as reduction in mean CMT, after one injection. This anatomical and functional improvement, which compared with baseline was evident as soon as the 1-hour follow-up (mean CMT reduction: t= 1.7899, P = 0.045; mean MP-1 sensitivity improvement: t = -1.9891, P 0.0315), and lasted until the 56-day follow-up (mean BCVA improvement: t= 2.26, P < 0.05; mean CMT reduction: t = 3.61, P < 0.05; MP-1 sensitivity improvement: t = -5.21, P < 0.05).

Conclusion: These short-term observations give insights into the physiopathology of DME treated with a intravitreal ranibizumab injection.
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http://dx.doi.org/10.1097/IAE.0b013e3181aa8e50DOI Listing
October 2009

Selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with uncontrolled open-angle glaucoma.

Eur J Ophthalmol 2009 May-Jun;19(3):429-34

Institute of Ophthalmology, University of Foggia, Foggia, Italy.

Purpose: To compare the efficacy of selective laser trabeculoplasty (SLT) to argon laser trabeculoplasty (ALT) as treatment and retreatment to lower intraocular pressure (IOP) in patients with uncontrolled open-angle glaucoma (OAG) on maximally tolerated medication therapy with a follow-up of 12 months.

Methods: A total of 120 eyes of 120 patients with uncontrolled OAG were enrolled in the study. Group A included patients with IOP >22 mmHg on maximal medical therapy. A total of 43 eyes underwent SLT treatment and 41 eyes underwent ALT treatment. At the end of the follow-up IOP was <18 mmHg. Group B included patients with IOP >20 mmHg at 3 months follow-up after SLT or ALT treatment. These patients were retreated randomly, 18 with SLT and 18 with ALT.

Results: In Group A at the end of the follow-up there was no statistically significant difference in IOP lowering between SLT (6.01 mmHg) and ALT (6.12) (p=0.794). In Group B at the end of the follow-up patients undergoing SLT presented IOP lowering statistically significant to ALT treatment (6.24 mmHg and 4.65 mmHg, respectively, p<0.01).

Discussion: SLT is effective as treatment for patients with OAG and appears to be equivalent to ALT in IOP lowering at 12 months only in patients without a prior treatment. In case of retreatment SLT appears to be better than ALT in IOP lowering.
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http://dx.doi.org/10.1177/112067210901900317DOI Listing
June 2009

Clinical efficacy of a Ginkgo biloba extract in the topical treatment of allergic conjunctivitis.

Eur J Ophthalmol 2009 May-Jun;19(3):331-6

Ophthalmological Clinic, University of Foggia Medical School, Foggia - Italy.

Purpose: To investigate the clinical efficacy of a Ginkgo biloba extract associated with hyaluronic acid ophthalmic solution (GB-HA, Trium, SOOFT, Italy), compared to hyaluronic acid ophthalmic solution (HA) alone, in seasonal allergic conjunctivitis (AC).

Methods: A total of 60 patients with symptomatic AC were enrolled and randomly assigned to the two treatment regimens. After a washout period of 15 days, the treatment with GB-HA eyedrops or HA ophthalmic solution alone was initiated and continued for 1 month. The clinical symptoms such as conjunctival hyperemia, conjunctival discharge, and chemosis, and subjective signs as itching, photophobia, stinging, and lacrimation, were evaluated before and after the treatment. A 0-4 score was used by an independent clinical observer to quantify the above parameters.

Results: Patients treated with GB-HA, compared to patients treated with HA alone, showed a significant decrease in the appearance of conjunctival hyperemia, conjunctival discharge, and chemosis. Furthermore, all patients treated with GB-HA showed a significant improvement of subjective symptoms, compared to HA patients. Compared to their baseline values, patients treated with HA alone showed a small but not significant improvement in only some of the clinical and subjective symptoms.

Conclusions: The results suggest that Ginkgo biloba extract may exert therapeutic activity in the treatment of seasonal allergic conjunctivitis. Hyaluronic acid did not exert any valuable effect on this pathology.
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http://dx.doi.org/10.1177/112067210901900301DOI Listing
June 2009

Bevacizumab compared with macular laser grid photocoagulation for cystoid macular edema in branch retinal vein occlusion.

Retina 2009 Apr;29(4):511-5

Department of Ophthalmology, Policlinico di Foggia, University of Foggia, Foggia, Italy.

Introduction: To evaluate the outcome of cystoid macular edema treated with intravitreal injections of bevacizumab and macular grid laser photocoagulation (GLP), in patients with perfused branch retinal vein occlusion.

Methods: Thirty eyes of 30 consecutive patients with cystoid macular edema secondary to nonischemic branch retinal vein occlusion were assigned to either GLP group or to intravitreal bevacizumab (IB) group. Complete ophthalmologic examinations were performed just before GLP and IB injection at 1, 3, 6, and 12 months after treatment. Changes in logarithm of minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), central macular thickness (CMT) shown by optical coherence tomography-3 were evaluated.

Results: Baseline BCVA (logMAR) and CMT were, respectively, 0.89 +/- 0.13 and 650 +/- 140 microm for the GLP group, 0.87 +/- 0.16 and 690 +/- 120 microm for the IB group. After the treatment, at 1, 3, 6, and 12 months in the GLP group, BCVA had improved by 0.19, 0.22, 0.21, and 0.20 logMAR, CMT had decreased by 40%, 41.3%, 40.5%, and 42%. In the IB group, BCVA had improved by 0.31, 0.32, 0.30, and 0.31 logMAR and CMT had decreased by 59.5%, 59%, 60%, and 60.3%. The group receiving bevacizumab had better BCVA and lower CMT values at all time points (P < 0.05).

Conclusion: Intravitreal bevacizumab injection improves BCVA and reduces CMT more than GLP. Intravitreal bevacizumab injection was well tolerated and could be used as primary treatment in patients with cystoid macular edema secondary to perfused branch retinal vein occlusion.
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http://dx.doi.org/10.1097/IAE.0b013e318195ca65DOI Listing
April 2009

Isolated foveal hypoplasia.

Retina 2008 Nov-Dec;28(10):1552-3

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

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http://dx.doi.org/10.1097/IAE.0b013e3181819679DOI Listing
January 2009

Linkage analysis in keratoconus: replication of locus 5q21.2 and identification of other suggestive Loci.

Invest Ophthalmol Vis Sci 2009 Mar 31;50(3):1081-6. Epub 2008 Oct 31.

Medical Genetics Service,San Giovanni Rotondo, Italy.

Purpose: Keratoconus (KC) is the most common indication for corneal transplantation in the Western world, with etiologic mechanisms still poorly understood. The disease prevalence in the general population is approximately 1:2000, and familial aggregation, together with increased familial risk, suggests important genetic influences on its pathogenesis. To date, several loci for familial keratoconus have been described, without the identification of any responsible gene in the respective mapped intervals. The aim of this study was to identify causative/susceptibility genes for keratoconus.

Methods: A total of 133 individuals (77 affected and 59 unaffected) of 25 families from southern Italy were genotyped using microsatellite markers and included in a genome-wide scan. Nonparametric and parametric analysis using an affected-only strategy were calculated by using genetic algorithm software.

Results: The chromosomal regions 5q32-q33, 5q21.2, 14q11.2, 15q2.32 exhibited the strongest evidence of linkage by nonparametric analysis (NPL = 3.22, 2.73, 2.62, and 2.32, respectively). The regions 5q32-q33 and 14q11.2 were also supported by multipoint parametric analysis, for which heterogeneity LOD (HLOD) scores of 2.45 (alpha = 0.54) and 2.09 (alpha = 0.46), respectively, were obtained under an affected-only dominant model.

Conclusions: This study represents the first KC linkage replication study on the chromosomal region 5q21.2 and reports evidence of suggestive linkage in several regions for which suggestive or significant linkage has been previously detected in different populations.
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http://dx.doi.org/10.1167/iovs.08-2382DOI Listing
March 2009

Short-term safety and efficacy of intravitreal bevacizumab for pseudophakic cystoid macular edema.

Retina 2009 Jan;29(1):33-7

Department of Ophthalmology, Policlinico di Foggia, University of Foggia, Foggia, Italy.

Purpose: : To determine the feasibility, safety, and clinical effect of intravitreal bevacizumab (Avastin) in patients with refractory cystoid macular edema after uncomplicated cataract surgery.

Methods: : Ten eyes of 10 patients affected by pseudophakic cystoid macular edema refractory to medical treatment treated with at least one intravitreal injection of 1.25 mg of bevacizumab were enrolled in the study. Follow-up visits included Early Treatment Diabetic Retinopathy Study visual acuity testing, optical coherence tomography imaging, and ophthalmoscopic examination.

Results: : The follow-up was 6 months. All eyes had improved best corrected visual acuity, and no eye had worse visual acuity (>/=2 Early Treatment Diabetic Retinopathy Study lines). The mean baseline best corrected visual acuity was 20/80 and the mean final best corrected visual acuity 20/32, the difference was statistically significant (P < 0.0001). The mean central macular thickness at baseline (546.8 mm; range, 359-720 mm) decreased significantly (228.7 mm; range, 190-280 mm) by the end of follow-up (P < 0.0001). No ocular or systemic adverse events were observed.

Conclusions: : Short-term results suggest that intravitreal bevacizumab is safe and well tolerated in patients with pseudophakic cystoid macular edema. Treated eyes had a significant improvement in best corrected visual acuity and decrease in macular thickness by optical coherence tomography.
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http://dx.doi.org/10.1097/IAE.0b013e31818a1fbcDOI Listing
January 2009

Vitreomacular traction syndrome with an outer macular hole.

Retin Cases Brief Rep 2008 ;2(4):266-8

From the Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

Purpose: To describe a patient with a large idiopathic partial-thickness macular hole involving the outer layers of the retina.

Methods: We performed complete ophthalmologic examination, including fluorescein angiography, B-scan ultrasonography, and optical coherence tomography, on an 81-year-old woman who was referred to our department with the clinical suspicion of a stage 3 full-thickness macular hole in the left eye.

Results: After complete ophthalmologic examination, the patient was diagnosed with vitreomacular traction syndrome due to a prefoveal partial posterior vitreous detachment causing tangential outward traction on the fovea. In this case, vitreomacular traction was associated with macular detachment and was complicated by retinoschisis and an idiopathic partial-thickness macular hole, in the absence of either high myopia or an optic nerve pit.

Conclusion: To our knowledge, this is the first reported case of a large idiopathic partial-thickness macular hole sharing common features with macular schisis, in the absence of either high myopia or an optic disk pit.
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http://dx.doi.org/10.1097/ICB.0b013e318074c316DOI Listing
November 2014

Juxtafoveal telangiectasias.

Ophthalmology 2008 Sep;115(9):1636; author reply 1636

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http://dx.doi.org/10.1016/j.ophtha.2008.03.029DOI Listing
September 2008

Successful treatment of pseudophakic cystoid macular edema with intravitreal bevacizumab.

J Cataract Refract Surg 2008 Jul;34(7):1210-2

Department of Ophthalmology, Policlinico di Foggia, University di Foggia, Foggia, Italy.

A 67-year-old woman developed refractory pseudophakic cystoid macular edema (CME) after uneventful phacoemulsification. Three months after an intravitreal injection of bevacizumab (1.25 mg), the CME was completely resolved, with resultant improvement in visual acuity.
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http://dx.doi.org/10.1016/j.jcrs.2008.02.037DOI Listing
July 2008

Correlation of visual function impairment and optical coherence tomography findings in patients with adult-onset foveomacular vitelliform macular dystrophy.

Am J Ophthalmol 2008 Jul 24;146(1):135-142. Epub 2008 Apr 24.

Department of Ophthalmology, Ospedali Riuniti, University of Foggia, Viale Pinto 1, Foggia, Italy.

Purpose: To investigate the relationship between morphologic and functional abnormalities in patients affected with adult-onset foveomacular vitelliform macular dystrophy (AFVD).

Design: Prospective, noncomparative observational study.

Methods: A complete ophthalmologic examination, including best-corrected visual acuity (BCVA), fundus examination, fundus-related perimetry, and optical coherence tomography (OCT), was performed in 20 consecutive AFVD patients. The stage of the disease and the thickness of the neuroepithelium at the foveola (neurosensory retina) were compared with the BCVA as well as with the type of scotoma, the average retinal sensitivity, and the location and stability of fixation.

Results: Thirty-five eyes of 20 consecutive patients (10 men and 10 women; mean age, 58.2 years) were graded as follows: 10 had vitelliform stage (stage 1), nine had pseudohypopyon stage (stage 2), 10 had vitelliruptive (stage 3), and six had atrophic stage (stage 4) disease. Reduced thickness of the neuroepithelium at the foveola and BCVA were statistically correlated to an advanced stage of the disease (P = .001 and P = .0062, respectively). Moreover, worse BCVA was correlated statistically to reduced thickness of the neuroepithelium at the foveola (r = 0.14; P = .02). Reduced thickness of the neuroepithelium at the foveola was correlated statistically to the development of absolute scotoma (P = .03), eccentric fixation (P = .01), and unstable fixation (P = .03).

Conclusions: OCT and fundus-related perimetry allow a correlation to be defined between foveal thickness and visual function and are useful tools to define better the degree of anatomic and functional impairment in AFVD patients.
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http://dx.doi.org/10.1016/j.ajo.2008.02.017DOI Listing
July 2008

Isolated foveal hypoplasia.

Int Ophthalmol 2009 Aug 10;29(4):271-4. Epub 2008 Apr 10.

Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Viale Pinto 1, Foggia, Italy.

Purpose: To describe a patient with isolated foveal hypoplasia.

Methods: A 55-year-old man with the clinical suspicion of foveal hypoplasia was given a complete ophthalmological examination, including optical coherence tomography (OCT), fluorescein angiography (FA) and fundus-related perimetry (FRP). Mutation screening for oculocutaneous albinism and aniridia was also performed, but the results were negative for both.

Results: Following a complete ophthalmological examination and genetic studies, we were able to confirm the clinical suspicion of isolated foveal hypoplasia in this otherwise healthy patient.

Conclusions: With this report we want to highlight the roles of OCT, FA and FRP in the diagnosis of such a singular condition as isolated foveal hypoplasia.
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http://dx.doi.org/10.1007/s10792-008-9215-5DOI Listing
August 2009

Residual bubble of oxane hd: a study by optical coherence tomography and fundus-related perimetry.

Retin Cases Brief Rep 2008 ;2(2):106-8

From the Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy.

Purpose: Oxane HD is a mixture of silicone oil and a mixed fluorinated and hydrocarbonated olefin. The authors report a complication of Oxane HD as internal tamponade after removal of all visible heavy silicone oil.

Methods: A 71-year-old man who underwent vitrectomy with Oxane HD presented with adherence of a residual bubble of Oxane HD in the macula after removal of all visible heavy silicone oil. In this patient OCT displayed an optical artifact due to the residual bubble, and fundus-related perimetry revealed a predominantly eccentric and relatively unstable fixation and very low macular sensitivity.

Results: After surgical removal of the residual bubble, metamorphopsia resolved, sensitivity improved as revealed by fundus-related perimetry, and fixation became predominantly central and more stable.

Conclusion: The authors suggest a way to manage this rare complication of Oxane HD as internal tamponade after removal of all visible heavy silicone oil.
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http://dx.doi.org/10.1097/IAE.0b013e31802be807DOI Listing
November 2014