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Biomedical subjects

L Lobefalo

Publications and source records attributed to L Lobefalo.

34 records · Page 2Linked to original sources
PubMed1997

Flicker perimetry in diabetic children without retinopathy.

OBJECTIVE: To determine the flicker fusion frequency in children and adolescents with insulin-dependent diabetes mellitus (IDDM) who did not have fluorescein angiographic signs of retinopathy. DESIGN: Cross-sectional study. SETTING: Antidiabetic Centre, departments of Ophthalmology and Pediatrics, University of Chieti, Chieti, Italy. PATIENTS: Forty-five patients aged 9 to 18 years with IDDM without fluorescein angiographic signs of retinopathy. Forty-five healthy subjects matched for sex and age constituted the control group. The patients were classified into two subgroups according to their metabolic control: good (percentage hemoglobin Alc 9% or less) or poor (percentage hemoglobin Alc greater than 9%). OUTCOME MEASURES: Retinal flicker fusion frequency, evaluated with an automated flicker perimeter in the central 30 degrees of the visual field. RESULTS: The subjects with poor metabolic control had a significantly lower mean flicker fusion frequency than the control subjects (27.43 Hz [standard deviation (SD) 5.16 Hz] vs. 38.72 Hz [SD 4.27 Hz]) and the patients with good metabolic control (33.94 Hz [SD 5.54 Hz]) (p < 0.001). There was a significant relation between flicker fusion frequency and the percentage of hemoglobin Alc (r = -0.533, p < 0.001). CONCLUSIONS: Our results show that children with poorly controlled IDDM without fluorescein angiographic signs of retinopathy have an impairment of retinal flicker sensitivity in the central 30 degrees of the central visual field and that this impairment is related to the degree of metabolic control. Flicker perimetry is a simple, noninvasive tool that may be useful to evaluate the eye function of diabetic children.

Adolescent↗
PubMed1996

Are VEP abnormalities in optic neuritis (ON) dependent on plaque size? A reappraisal of the physiopathology of ON based on improved MRI and multiple-lead recordings.

Twenty patients with optic neuritis (ON) described in the previous study [23] underwent serial VEP recordings (using multiple electrode arrays) for two years. The VEPs could be correlated with the lesions revealed by MRI, Visual Field tests and other clinical findings. On the basis of their scalp distribution, they were classified as "really delayed" VEPs and "pseudo-delayed" VEPs. Real delays could be recorded at the onset of ON or shortly afterwards, and their appearance indicated the recovery of visual function and a good prognosis. Pseudo-delays indicated an alteration in the visual field and, unless a breakthrough of normal or delayed components appeared in the first three months, following acute ON, indicate a poor prognosis for the recovery of visual function. The pseudo-delayed VEPs were mainly observed in patients with longer lesions revealed by means of LTE-STIR MRI [23]; there was no correlation between VEP latency and the length of plaques. Our findings contradict previous theories on the timing of conduction alterations in ON and multiple sclerosis.

Adult↗
PubMed1996

Macular recovery time in diabetic children without retinopathy.

The aim of this study was to evaluate whether patients with initial diabetic nephropathy (defined as persistent microalbuminuria) have an impairment of macular recovery time and if this impairment changes in a long-term follow-up. Eighty insulin-dependent diabetic children without fluorescein angiographic signs of retinopathy and 80 controls were included in the study. All patients underwent nyctometry at the beginning of the study; diabetic children repeated the same test after 7 years. Diabetics were divided into two subgroups as regards presence of persistent microalbuminuria (albumin excretion rate > 20 micrograms/min/1.73 m2). At the beginning of the study, diabetics as a whole and normoalbuminuric patients showed similar data to controls, while microalbuminuric ones showed worse data at nyctometry (initial recovery time (IRT): 44.89 +/- 12.50; Summation method (SM): 509.1 +/- 312.0) in comparison with normoalbuminuric (IRT: 38.12 +/- 10.31, P = 0.010; SM 648.6 +/- 272.2, P = 0.036) and control subjects (IRT: 37.77 +/- 11.82, P = 0.004; SM: 661.5 +/- 297.5, P = 0.013). After 7 years, normoalbuminuric subjects showed a slight, but not significant worsening of nyctometry, while in microalbuminuric ones a significant difference between baseline and the end of follow-up was found (IRT: 44.89 +/- 12.50 vs. 52.91 +/- 13.9, P < 0.01; SM: 509.1 +/- 312.0 vs. 374.8 +/- 271.9, P < 0.05). Diabetic patients had a higher rate of abnormal IRT and SM than controls (P = 0.0004 and P = 0.0006, respectively). A higher number of patients in microalbuminuric subgroup than in normoalbuminuric one were found (both at baseline and at the end of follow-up) above the 95th centile of IRT (baseline 3 vs. 15; P = 0.0002; end of follow-up 5 vs. 23; P < 0.0001) and below the 5th centile of SM (baseline 5 vs. 14; P = 0.004; end of follow-up 5 vs. 19; P < 0.0001). Nyctometry was found more altered in microalbuminuric patients than in normoalbuminuric and controls. Unfortunately, there is a large overlap between the two diabetic subgroups and between diabetics and controls; for this reason, this technique is not suited for everyday practice.

Adolescent↗
PubMed1996

Effect of dapiprazole, an alpha-adrenergic blocking agent, on aqueous humor dynamics in pigmentary glaucoma.

PURPOSE: In this investigation the authors studied the effect of dapiprazole, an alpha-adrenergic blocking agent, on aqueous humor dynamics in patients affected with pigmentary glaucoma. METHODS: Dapiprazole 0.5% eye drops were administered 3 times daily as adjunctive therapy to 16 pigmentary glaucoma patients in addition to timolol 0.5% eye drops twice daily. Computerized tonography was performed before and 3, 12 and 36 months after dapiprazole treatment. Sixteen sex- and age-matched pigmentary glaucoma patients treated with timolol 0.5% eye drops alone were used as a control group. RESULTS: After 36 months of follow-up, the dapiprazole-treated group showed a significant increase in total outflow facility (C, from 0.17 +/- 0.04 to 0.22 +/- 0.07 ml min-1 mm Hg-1; p = 0.010, paired t test) and Po/C ratio (Q) significantly decreased from 113.39 +/- 31.02 to 89.22 +/- 51.66 (p = 0.036, paired t test). CONCLUSIONS: Our results show that the introduction of dapiprazole in the therapy of pigmentary glaucoma may be useful in the long-term management of these patients. Its mechanism of action is likely to be due to iridoplegia; in fact, a decrease in the shedding of pigment occurs, with time, the outflow facility increases and the pigment clearance from the trabecular meshwork is enhanced.

Administration, Topical↗
PubMed1995

Colour vision and persistent microalbuminuria in children with type-1 (insulin-dependent) diabetes mellitus: a longitudinal study.

In an attempt to elucidate colour vision in children with type 1 (insulin-dependent) diabetes mellitus without fluorescein angiographic signs of retinopathy, we studied a group of 50 patients of mean age + or - SD 10.27 + or - 2.89 (range 8.1-13.0 years). Results were compared with a sex-and age-matched control group. The Farnsworth-Munsell 100-hue test showed a significantly higher value in total error score (TES) in diabetics than in controls (64.07 + or - 18.32 and 54.27 + or - 12.87, respectively: P = 0.0004). Diabetic patients were divided in two groups as regards presence of persistent microalbuminuria and followed for 7 years. The HbAlc values of the two groups were: normoalbuminuric 7.10 +/- 2.92%, microalbuminuric 9.79 + or - 1.41 (P = 0.004). Microalbuminuric patients showed a significantly higher TES than normoalbuminuric subjects both at the beginning (94.79 + or - 13.98 vs. 58.10 + or - 11.98) and end of the study (103.07 + or - 14.61 vs. 61.04 + or - 13.36: P < 0.0001), and after follow-up they had a worse TES than at the beginning of the study (P = 0.01); no change in TES was found in normoalbuminuric patients during the study. The results suggest that a deficit in colour vision occurs in diabetic children before the onset of fluorescein angiographic signs of retinopathy. Our follow-up shows that microalbuminuric patients present a significant worsening of colour vision. When a patient shows persistent microalbuminuria, colour vision must be carefully evaluated, also in subjects without fluorescein angiographic signs of retinopathy.

Adolescent↗
PubMed1995

Visual field defects in diabetic children without retinopathy. Relation between visual function and microalbuminuria.

The effects of diabetes on retinal function before the onset of clinically detectable retinopathy have been investigated with several methods. Our aim is to evaluate the usefulness of computerized perimetry in early diagnosis of retinal sensitivity impairment in lack of fluorescein angiographic signs of diabetic retinopathy. Seventy diabetic children and adolescents, 39 normoalbuminuric and 31 microalbuminuric patients, and 70 normal subjects were investigated with static computerized perimetry. Normoalbuminuric patients showed functional parameters similar to those of controls, while microalbuminuric patients had a significant reduction of mid-peripheral light sensitivity in comparison with both normoalbuminuric children and controls. Our data suggest that an impaired light sensitivity, in mid-periphery of the visual field, is present in diabetic patients with persistent microalbuminuria.

Adolescent↗
PubMed1994

Iris chafing in pseudophakia.

Iris defects occur in pseudophakic patients with posterior chamber intraocular lens in sulcus. Prevalence of pigmentary dispersion syndrome and pigmentary glaucoma has been evaluated in 920 pseudophakic patients (920 eyes). 16.08% of patients showed pigment dispersion syndrome, while 1.96% developed pigmentary glaucoma. Diabetic patients had a statistically significant greater prevalence of these complications than non-diabetic ones (p < 0.05). The authors suggest the preventive use of alpha-blockers in presence of pigment dispersion syndrome or diabetes mellitus, even in absence of ocular hypertension.

Adrenergic alpha-Antagonists↗
PubMed1994

Polycyclic aromatic hydrocarbons in clear and cataractous human lenses.

In this histochemical study on the ocular lens, the authors test for the presence of various sorts of the (unsaturated) polycyclic aromatic hydrocarbon (PAH) in 66, both clear and cataractous human lenses. A statistically significant greater amount of PAH is found in the cataractous lenses studied (p < 0.01), with two kind of PAH, phenanthrene and 1,2-benzoanthracene, appearing exclusively in lenses with cataracts. The authors put forward a hypothesis on the cataractogenic effect of PAH on the basis of its interference with lens metabolism and the subsequent production and release of free-radicals.

Cataract↗
PubMed1994

Aqueous misdirection syndrome: a complication of neodymium: YAG posterior capsulotomy.

A 50-year-old, white, pseudophakic man who had a neodymium:YAG (Nd:YAG) posterior capsulotomy for capsule opacification developed a persistent rise in intraocular pressure (IOP) associated with a flat anterior chamber. Full-thickness patent iridotomy performed with an Nd:YAG laser did not reduce IOP. A-scan ultrasonography showed aqueous pockets in the vitreous, leading to a diagnosis of malignant glaucoma. Medical therapy comprising atropine, phenylephrine, mannitol, and acetazolamide normalized IOP and resolved the clinical findings.

Anterior Chamber↗
PubMed1994

Effectiveness of intraoperative mitomycin C in the treatment of recurrent pterygium.

The effectiveness of intraoperative administration of mitomycin C and the occurrence of postoperative complications have been evaluated in 30 white patients with one recurrence of pterygium. The authors employed the 'bare-sclera technique' and, intraoperatively, placed in the episcleral space for 3 min a sterile sponge soaked in a 4% mitomycin C solution. The control group (30 patients with one recurrent pterygium) underwent only surgical excision. Statistical analysis performed using the chi-square test showed a significant (p = 0.024) reduction of recurrences of pterygium in the group treated intraoperatively with mitomycin C. No heavy side effects occurred during the follow-up period. Mitomycin C, administered intraoperatively, may be considered an effective treatment to improve the success rate after surgical excision.

Adult↗
PubMed1994

Diabetic retinopathy. Relationship with nephropathy in pediatric age.

In order to evaluate the relationship between diabetic retinopathy and diabetic nephropathy we studied 55 (25 females, 30 males) retinopathic diabetic children and adolescents: their age ranged from 9.0 to 17.3 (mean +/- SD 13.9 + 3.8) years and the duration of disease from 4.8 to 10.0 (6.9 +/- 3.1) years. The mean glycosilated haemoglobin (HbA1c) was 10.4 + 2.7%. Patient distribution in relation to retinal grading showed that the greatest number of patients (34: 61.82%) were in 14-20 retinopathy level (with minimal signs of retinopathy), 9 patients showed 31 retinopathy level (16.36%) and 12 (21.82%) were in the other classes. Comparison between retinal grading of retinopathy and presence/absence of microalbuminuria showed a significant difference between the evaluated subgroups (p < 0.0001). In fact, only 6 patients out of 34 (17.64%) in class 14-20 retinopathy level, 8 patients out of 16 (50%) in 31-41 retinopathy level and 5 patients out of 5 (100%) in 51 retinopathy level had microalbuminuria. Our study shows that the presence of persistent microalbuminuria is an important risk factor for diabetic retinopathy. In conclusion, we suggest that when diabetic children have persistent microalbuminuria, the eye should be carefully examined, in order to prevent a deterioration of the eye function.

Adolescent↗
PubMed1991

Patterns of cytomegalovirus retinitis in immunocompromised patients treated with 9-(2-hydroxy-1-(hydroxymethyl)ethoxymethyl) guanine (ganciclovir).

Five immunocompromised patients, four with AIDS and one who had undergone bone marrow transplantation, showing ocular signs of cytomegalovirus retinitis, were treated with 9-(2-hydroxy-1-(hydroxymethyl)ethoxymethyl) guanine (Ganciclovir), given intravenously at the dose of 5 mg/kg twice daily for a period ranging from 10 to 20 days. At the end of the treatment, in 4 of 5 patients, the ophthalmoscopic picture had improved, with reduced exudation and an arrest in the progression of retinal necrosis, the pattern clearly indicating a trend towards organization and scarring. Complete resolution of the retinitis without subsequent relapse was observed only in the bone marrow transplant patient, who recovered immunologically, whereas improvement of the eye involvement was only transient in the three AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prevalence of myopia in open angle glaucoma.

In this study concerning the prevalence of myopia in patients with open angle glaucoma, its distribution was analyzed within the sample tested in relation to the refraction defect size, compared with a control group of non-glaucomatous myopic subjects. The overall myopic rate was 17.2% of the glaucomatous patients; high myopia was more frequent in the subjects with open angle glaucoma (p less than 0.001) than in the myopic patients, thus appearing as a possible risk factor for the development of glaucoma.

Adult↗
PubMedDate not supplied

Dry eye in allergic conjunctivitis: role of inflammatory infiltrate.

Dry-eye associated symptoms are frequently present in patients affected with allergic conjunctivitis. We evaluated the relationship between ocular inflammation and the tear film parameters in patients affected with chronic allergic conjunctivitis. Eighty-two subjects (age 23.00 &#x00B1; 7.61: range 10-40) affected with chronic allergic conjunctivitis and thirty age- and sex matched healthy controls were enrolled. In all patients tear film qualitative and quantitative tests were performed. To determine the immune activation state, conjunctival biopsies were obtained from the inferior conjunctival fornix. Immunocytochemical markers for CD45RO, CD8, CD20 and EG2 (monoclonal antibody binding eosinophil cationic protein) were evaluated semiquantitatively. All tear film tests were found altered. They were reduced in allergic patients (p&#x003C;0.001). In conjunctival biopsies of allergic patients a very high number of CD45RO+ and EG2+ cells were found (p&#x003C;0.001): a lower number of CD45RO+ cells and no EG2+ cells in control biopsies were found. Multivariate analysis showed a significant relationship between tear tests and conjunctival infiltrate (CD45RO+ and EG2+): The tear film alterations are strictly related to the conjunctival immune infiltration. In particular, the reduction of the mucin-related component of tear film can be related to the toxic effect of the granule cationic proteins released by the conjunctival activated eosinophils (EG2+ cells).

Journal Article↗
PubMedDate not supplied

Allergen immunotherapy: an effective immune-modifier.

Allergen-specific immunotherapy (IT) consists in administering gradually increasing doses of an allergen extract to sensitive patients. This practice results in ameliorating symptoms associated with the subsequent exposure to the causative allergen. Presently, the lack of therapies which affect the pathogenesis of the disease make IT the only treatment that may improve the natural course of allergic diseases.

Journal Article↗