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Biomedical subjects

R Brancato

Publications and source records attributed to R Brancato.

At least 145 records · Page 8Linked to original sources
PubMed1990

Argon versus krypton panretinal photocoagulation side effects on the anterior segment.

The modification of corneal sensitivity, accommodation, pupillary diameter and endothelial cell density after argon versus krypton panretinal photocoagulation were studied prospectively in 88 eyes of 64 diabetic patients with proliferative diabetic retinopathy, randomized for one of the two laser treatments. In both groups a marked internal ophthalmoplegia and reduction of corneal sensitivity occurred after laser photocoagulation. At no time, 2, 90 and 180 days after PRP, were these parameters significantly different. Endothelial cell loss was non significantly greater in the krypton group. The results indicated that the side effects commonly observed on the anterior segment after PRP are comparable using argon or krypton lasers.

Accommodation, Ocular↗
PubMed1990

[Medical treatment of diabetic retinopathy].

The pathogenesis of diabetic retinopathy (DR) consists of a complex patch-work of factors correlated and independent on one another at the same time. It is therefore difficult to find pharmaceuticals able to produce different, or even mutually contrasting effects. Another difficulty are the intrinsic characteristics of the disease which after developing to a "critical" stage, evolves with independent mechanism to the most advanced stages. In spite of that, a great deal of medicaments has been suggested so far, all providing therapeutical logic to interfere with one or more pathogenetical stages of the lesions. Although several clinical trials have been performed, survey and follow-up are still limited and insufficient to draw conclusion on the effectiveness of medical therapy. In recent times new types of medicaments such as aldose-reductase inhibitors and carbonic anhydrase-inhibitors have been suggested. The preliminary results present encouraging perspectives for their use, although caution, until long-term results are available with greater surveys and longer follow-up periods, is advised.

Diabetic Retinopathy↗
PubMed1990

[Degenerative myopia: recurrence of subretinal neovessels after laser photocoagulation].

Macular subretinal neovascularization is one of the most important causes of impaired vision in eyes affected by pathologic myopia. Results of studies concerning the natural history of subretinal neovascularization are inconclusive and contradictory. Like in other macular degenerations, laser photocoagulation could be useful in treating neovascular membranes. Available results indicate that laser treatment can reduce the risk of severe visual loss. However recurrent neovascularization may complicate laser treatment with further visual loss. The authors have reviewed the records of 98 eyes affected by pathologic myopia (axial length à 26.5 mm) and macular subretinal neovascularization that underwent laser photocoagulation. 41 eyes (42%) developed one or more recurrences during a 12 months follow-up period. No relationship was found between sex, age, axial length, distance from the center of the foveal avascular zone or size of neovascular membrane, and recurrence rate. Eyes that experienced recurrences had a final visual acuity significantly worse than the others (p = 0.02). 65% of recurrences was observed in the first 3 months after treatment. 67% of such neovascularizations was located at the foveal side of the laser scar. These data underscore the necessity for close, careful follow-up of all patients who have undergone treatment of a subretinal neovascularization.

Adult↗
PubMed1990

[Bilateral choroidal osteoma in an aged patient].

The authors report a case of choroidal osteoma in an elderly patient. The affection was bilateral and multifocal. This rare benign tumor mostly affects young females. We report the outcome of the clinical and instrumental examinations leading to the diagnosis of choroidal osteoma. The patient underwent retinal fluoroangiography, A and B-scan ocular ultrasonography, Computerized Axial Tomography (CAT) with and without dye, orbit RNM, and electroretinography. The same investigations were performed 6-7 months after the first control. No changes in the findings were found except for retinal fluoroangiograms that revealed an increased area of the most central lesion in the right eye. Particularly relevant among these diagnostic techniques were ocular ultrasonography and CAT, which revealed the osseous nature of the tumor. Contact B-scan ultrasound examination showed a small number of dense opacities in both eyes. In the retrobulbar area the tumor caused diminution in echo amplitude. A-scan examination showed high reflectivity peaks (100%) corresponding to the lesion that were detectable even with reduced sensitivity of the system and, in the orbit, low reflectivity that confirmed the tumor's enhanced ultrasound absorption. CAT detected small calcified areas corresponding to the location of the lesions. Haematochemical examinations performed at each control to measure blood calcium, phosphate and alcaline phosphatase were in the normal range. Urinalysis also excluded possible systemic affections underlying the chorioretinal pathology. We discuss possible pathogenetical hypothesis focusing on the age and sex of the patient. These factors in fact, rule out both the hypothesis of a osteogenesis inhibiting factor present in the last 20-30 years of age and the hypothesis of endocrine stimulation in female patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Iris vascular anomalies: angiographic aspects].

The authors report five cases of abnormal iris vessels observed in patients, without evident local or systemic pathology. These vessels, are dilated channels. On iris fluorescein angiography their filling appeared earlier than in normal stromal vasculature and was synchronous with that of conjunctival vessels. No dye leakage was present. Two functional angiographic pictures are observable: 1) vessels with abnormal diameter and path, approximately following normal iris vessel arrangement (case 1 and 2); 2) atypical vessels with wide communicating shunt between artery and vein without collaterals (cases 3, 4 and 5). These vessels are very tortuous and do not show any abnormality. The authors suggest to consider these anomalous vessels as anatomic abnormalities comparable with the arterio-venous communications of the retina.

Aged↗
PubMed1990

Clinical measures of central differential sensitivity in glaucoma.

To verify whether central threshold testing with a common automated perimeter could detect glaucomatous damage, we selected 40 eyes with primary open-angle glaucoma and 43 eyes of age-matched normal subjects. The glaucomatous eyes were free from visual field defects within the central 5 degrees. They underwent the Macula Threshold Test of the Humphrey perimeter, using white and blue targets. Differential sensitivities to both white and blue were significantly depressed in the glaucoma group (p less than 0.001). Blue thresholds of glaucomatous subjects and normal subjects were distributed in two quite separate domains, with a mean difference of 4.51 dB. Sensitivities to blue stimuli were related to age in the normal group (r = 0.62; p less than 0.001), while in the glaucoma group they were related to horizontal cup/disc ratios (r = 0.63; p less than 0.001). These results suggest that threshold testing with an automated perimeter and its built-in colour filters can be of help in detecting early central functional disturbances from glaucoma.

Color Perception Tests↗
PubMed1989

Normal exophthalmometric values in children.

We used a Hertel exophthalmometer to measure the degree of ocular protrusion in 852 subjects who had no history of orbital trauma or disease, endocrine disease, severe myopia, buphthalmos, or craniofacial deformities. The subjects ranged in age from 3 to 10 years. No statistically significant difference was observed between boys and girls or between right and left eyes in each age group. The mean normal protrusion values ranged from 9.11 mm in the 3-year-old group to 11.67 mm in the 10-year-old group. The mean outer orbital margin distance ranged from 78.7 mm in the 3-year-old group to 89.1 mm in the 10-year-old group. The data obtained were tabulated to plot percentile distribution curves of normal exophthalmometric values and outer orbital margin distance in children. No subject had more than 2 mm of asymmetry between the eyes.

Age Factors↗
PubMed1989

Prevalence of retinopathy in diabetic subjects from out-patient clinics in Lombardy (Italy), and associated risk factors. A multicentre epidemiologic study.

There is little information on the prevalence of diabetic complications in Italy. For this reason, a multicentre population-based study was carried out in 1983-1985 in 12 representative out-patient clinics for the treatment of diabetes in the Lombardy region. Out of a total population of 17,704 patients 1160 diabetic subjects were randomly selected within strata based on their duration of disease (less than or equal to 5; 6-10; 11-20; greater than 20 years). Eight hundred and thirty-eight responders were examined using standardised protocols. The estimated prevalences (adjusted for duration of disease) for the total population involved in the study were 29.7% and 7.6% for background and proliferative retinopathy respectively. The overall standardised rates were higher in insulin-dependent diabetes mellitus (IDDM) (53.6%) than in non-insulin-dependent diabetes mellitus (NIDDM) (34.7%) for both background (41.1%, 28.4% respectively) and proliferative (12.5%, 6.2% respectively) retinopathy, and increased with the duration of disease. The analysis of the relationship between diabetic retinopathy and the calculated risk factors did not show any association with hypertension or metabolic control, except for post-prandial blood glucose in subjects with durations 6-10 and greater than 20 years; an association with azotaemia was found in subjects with durations less than or equal to 5 and 11-20 years. Diabetic retinopathy appeared to be independently associated with the type of treatment and not with the type of diabetes, metabolic control, or hypertension.

Diabetic Retinopathy↗
PubMed1989

Clinical detection of early glaucomatous foveal involvement.

The aim of our study was to verify whether threshold testing of the central area with a common automated perimeter could detect early glaucomatous damage. We selected 9 eyes of 9 patients with suspected primary open angle glaucoma and normal visual fields and 18 eyes of 18 age-matched normal subjects. They underwent the Macula Threshold Test of the Humphrey Field Analyzer using white and blue targets. We found no significant difference in retinal sensitivity to white targets between the two groups. Sensitivity to blue targets was significantly lower among glaucoma suspects (18.43 +/- 1.14 dB) than in the control group (22.37 +/- 0.94 dB) p less than 0.001). Blue thresholds related significantly to age only in normals (p = 0.028) while in glaucoma suspects they were strongly related to vertical cup/disc ratios (p less than 0.001). These results suggest that it is possible to detect early central visual disturbances from glaucoma using an automated perimeter and its built-in color filters.

Aged↗
PubMed1989

Clinical evaluation of the effect of acetylcholine on the corneal endothelium.

A transient corneal edema is often seen after the injection of acetylcholine solution in the anterior chamber during cataract surgery. Ninety eyes of 90 patients scheduled for extracapsular cataract extraction with posterior chamber intraocular lens implantation were randomly assigned to two groups: one which received acetylcholine solution in the anterior chamber and one, a control group, which received only external conjunctival pilocarpine drops as a miotic. At three days, endothelial folds (P = .04) and corneal edema (P = .01) were more pronounced in the acetylcholine group; at seven days, endothelial folds were more severe (P = .04) in the acetylcholine group. At 30 days, the acetylcholine group showed a 37.2% increase (P = .01) of the endothelial cell area, whereas the control group showed a 7.08% increase. The difference between the groups was statistically significant (P = .05). Anterior chamber fluorophotometry at 30 days showed an increase of the corneal transfer coefficient that was higher but not significant in the acetylcholine group. We suggest caution in the intraoperative use of acetylcholine solution, particularly in those eyes showing a preoperative compromise of the endothelium.

Acetylcholine↗
PubMed1989

Contact transscleral irradiation of the human chorioretina with continuous-wave Nd:YAG laser.

We performed contact transscleral chorioretinal photocoagulations with a continuous-wave Nd:YAG laser on two human eyes affected by choroidal melanomas. An optical-fiber system without any focalization tip was used to deliver the laser energy by placing the fiber in contact with the sclera in the position corresponding to the chorioretinal area to be photocoagulated. With a power of 4 W and an exposure time of 0.5 s, frank white coagulations were obtained. Histological and ultrastructural examination evidenced that the choroidal pigment and the retinal pigment epithelium were the target structures of the radiation. No substantial alterations of the sclera were noted while a good adhesion between the retina and the pigment epithelium cells was observed. The results obtained show that transscleral contact lasers may be safely used in the treatment of some pathologies of the ocular fundus.

Choroid↗
PubMed1989

[Laser treatment of macular subretinal neovascularization in angioid streaks].

The authors examined 17 eyes with macular subretinal neovascularization in angioid streaks treated by direct laser photocoagulation. Two eyes were treated with dye laser (590 nm), two with blue-green argon, three with green argon and ten with red krypton laser. At twelve-month follow-up, the visual acuity was of 0.21, a statistically significant decrease respect to the presenting vision. Poor functional results are due to the frequent recurrences of neovascularization.

Adult↗
PubMed1989

[Threshold testing of the macular area in glaucoma].

The purpose of this study has been to verify whether threshold testing of the central area with a common automated perimeter could detect glaucomatous damage. We selected 31 eyes of 31 patients with primary open angle glaucoma free from defects within the central 5 degrees of the field and 32 eyes of 32 age-matched normal subjects. They underwent the Macula Threshold Test of the Humphrey Field Analyzer using white and blue targets. Statistical analysis of the results obtained showed that threshold sensitivities to both white and blue targets were significantly depressed in glaucomatous eyes (t = 2.44, p = 0.018 and t = 12.59, p less than 0.001 respectively), but only blue thresholds distributed really differently in glaucomatous and normals. Sensitivities to blue stimuli related to age only in normals (r = 0.58; p = 0.0005), while in glaucomatous they were related to cup/disc ratios (r = 0.70, p less than 0.0001 for horizontal C/D; r = 0.52, p = 0.0027 for vertical C/D). These results suggest that it is possible to detect early central functional disturbances from glaucoma using an automated perimeter and its built-in color filters.

Adult↗
PubMed1989

[Laser treatment of subretinal macular neovascularization in pathologic myopia].

The authors evaluated retrospectively 100 eyes with pathological myopia and a macular subretinal neovascular membranes (SRNV) which was treated with direct laser photocoagulation. Argon green, krypton red and orange dye (590 nm) laser were used to treat, respectively, 19, 63 and 18 eyes. The follow-up period was of 12 months. Mean initial visual acuity was 0.33 and mean final visual acuity was 0.31, with no statistically significative difference between them. One or more recurrence was observed in 44% of the eyes. Recurrences could be treated in 80% of cases. At the end of the follow-up period SRNV had disappeared in 83 eyes and extended into the foveola in the remaining 17.

Adult↗
PubMed1989

[Comparative evaluation of echography and C.A.T. in diagnosing retinoblastoma].

The comparative efficiency of sonography and computerised axial tomography on the diagnosis of retinoblastoma was assessed in 8 consecutive cases. Ocular echography revealed a 100% sensitivity whereas CT scans gave false negatives in 2 out of the 8 cases (80% sensitivity). The value of ultrasound scanning as the diagnostic test of first choice for suspected retinoblastoma is therefore emphasised.

Child, Preschool↗