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Biomedical subjects

S Miglior

Publications and source records attributed to S Miglior.

29 records · Page 2Linked to original sources

Trends in cataract surgery in Milan (Italy) from 1956 to 1987. Relationship to age and visual acuity.

In order to test whether the mean age at cataract surgery has changed over the course of the last 30 years, a hospital series of 5443 patients undergoing cataract extraction between 1956 and 1987 is reviewed. All cases attended the same University Eye Clinic of Milan and most were resident in the same geographical area. Cases with macular or optic nerve diseases were excluded. Results show that mean age at cataract surgery progressively increased from 67.5 to 71.5 years (slope = +0.096 years of age per year, p = 0.0001) as did visual acuity at surgery (patients with visual acuity levels greater than or equal to 1/10 at time of cataract surgery rose from 3.2% to 47.9%). These results can be interpreted in terms of a change in age composition of the Italian population, improved access to health services for the elderly, and an improvement in surgical and rehabilitation techniques.

Adult↗

Suitability of slit lamp retroillumination photographs for classifying cataracts according to 'Lens Opacities Classification System II (LOCS II)'.

The Lens Opacities Classification System II (LOCS II) utilizes photographic standards (two retroilluminated Neitz-CTR and one standard slit lamp Zeiss photographs) for the classification of cortical and posterior subcapsular cataracts, nuclear color and nuclear opalescence. However, dedicated photographic devices, particularly retroillumination cameras, are not always available and this study was aimed at evaluating the suitability of a retroillumination photographic technique with a standard slit lamp camera for cortical and posterior subcapsular cataract classification according to LOCS II. Two observers examined 273 eyes. Kappa statistics demonstrated that agreement between the standard slit lamp, clinical grading (according to published LOCS II methodology) and photographic grading (according to our photographic technique), as well as inter- and intraobserver reproducibility, were excellent (Kappa > 0.74) for the classification of all lenticular regions. The results indicate that a standard slit lamp camera can be as useful as a dedicated retroillumination camera when LOCS II standards are used for cataract classification.

Adult↗

Technical procedures and software for magnification-corrected morphometry of optic disk photography.

In order to obtain a new diagnostic tool for the early diagnosis of glaucoma, we developed a method based on computerized analysis of the optic disk, cup and neuroretinal rim areas. A fundus camera, a personal computer and a graphic tablet are employed. Suitable software was developed for calculating the areas (disk, cup and rim) providing an index, the rim/disk ratio. The method revealed high repeatability and reproducibility. The simplicity and speed of the procedure make this test suitable for routine clinical use in the early diagnosis of glaucoma.

Glaucoma↗

Lens redox fluorometry: pyridine nucleotide fluorescence and analysis of diabetic lens.

We performed both ex vivo and in vivo fluorometric analyses of pyridine nucleotides (PN) in rabbit and rat lenses. Rabbit lens PN fluorescence (99% NADH) was found to have an excitation maximum at 366 nm and an emission maximum at 462 nm (366:462). The only other fluorescent chromophore in that region of the spectrum has excitation and emission peaks at 328 and 460 nm, respectively. Anaerobic glycolysis in the lens was stimulated by KCN, a known inhibitor of mitochondrial respiration, after which a time-study of fluorescence intensities was performed. Over the course of a 3.5 hr period following treatment with KCN, the PN signal showed a statistically significant increase relative to that in the control lenses (those treated with KCl). while the 328:460 signal (which may be due to some protein involved in energy transfer with the PN) had a significantly greater decrease. We also found that fluorescence intensity of NADH in solution is linearly proportional to physiologic-range concentration. Moreover, there was a close correlation between fluorescence intensity of rat lens PN as measured on a specular microscope-coupled redox fluorometer capable of in vivo use, and the lens PN levels as determined by the analytical cycling assay technique. This fluorometer was then employed to assess the redox state in rats with streptozotocin-induced diabetes. The normalized ratio of PN to flavoproteins (Fp) in the lens epithelium increased from 0.96 +/- 0.12 in the normal state to 1.48 +/- 0.30 2 weeks after diabetes induction. In contrast, the ratio in the diabetic lens treated with an aldose reductase inhibitor, sorbinil, did not increase. The increase in the PN:Fp ratio therefore reflects activation of the polyol pathway and its associated metabolic activities, which results in an increase in the NADH:NAD ratio in the diabetic rat lenses. Our results indicate that the non-invasive, real-time method of redox fluorometry may be useful in the early detection and evaluation of cataracts and other disorders in lens metabolism, long before opacities occur. It can be used to monitor the disease process and evaluate the efficacy of such drugs as aldose reductase inhibitors on a biochemical level.

Animals↗

31P NMR studies of the diabetic lens.

Phosphorus-31 (31P) nuclear magnetic resonance (NMR) spectroscopic analyses of the crystalline lens from the experimental diabetic rat were performed. Qualitative and quantitative alterations in the phosphorus-31 NMR metabolic profile were observed over the course of 3 weeks after the induction of diabetes mellitus. Most striking was the appearance of two new, as yet unidentified, metabolites. These metabolites which resonate at 6.6 and 5.8 ppm were not detected in the normal lens. Compared to the normal lens, glycerol-3-phosphate (G3P) underwent an eightfold increase in concentration and phosphorylcholine decreased to one-third its initial level. The phosphodiesters, glycerophosphorylcholine (GPC) and glycerophosphorylethanolamine (GPE), decreased to barely detectable levels. Oral treatment of the diabetic animal with an aldose reductase inhibitor resulted in the preservation of an essentially normal lens 31P NMR spectrum. Except for the changes observed in glycerol-3-phosphate, these alterations have not been previously reported and raise new questions about the metabolic consequences of diabetes mellitus and the dependence of these alterations on the action of a single enzyme, aldose reductase.

Aldehyde Reductase↗

Proton magnetic resonance imaging of the ocular lens.

Several osmotic cataract models as well as human diabetic lenses were tested by nuclear magnetic resonance spectroscopy and imaging. Both longitudinal (T1) and transverse (T2) relaxation times increased with increase in lens hydration. Therefore proton magnetic resonance imaging (MRI) can be used to detect changes of the biophysical environment of water proton in the lens. T2-weighted imaging sequence (spin-echo) can be used to differentiate lenses with hydrational changes since they exhibit higher signal intensity (because of long T2) than normal lenses at the same TE (echo time). A greater contrast can be achieved with the inversion-recovery sequence, which, in addition to contribution from T2, also incorporates T1 and proton density terms. Proton MRI is potentially useful for the detection of pre-cataractous changes.

Aged↗

Vitreous changes after neodymium-YAG laser photodisruption.

We investigated physicochemical changes in the vitreous body after photodisruption with a Q-switched neodymium-YAG laser. In vivo proton nuclear magnetic resonance imaging techniques were employed to assess alterations in the vitreous of irradiated rabbit eyes. Measurements of proton relaxation times (T1 and T2), viscosity, and chromatographic spectra were made in vitro on irradiated bovine and rabbit vitreous, and circular dichroism measurements were used to study changes in an irradiated sodium hyaluronate solution. Statistically significant changes in T1, were observed immediately after irradiation, but the small magnitude and reversibility of those changes, combined with the fact that the other measurements detected no changes, suggest that neodymium-YAG laser photodisruption does not have a direct deleterious effect on the structural integrity of the normal vitreous body.

Animals↗

Early vitreous changes in experimental proliferative vitreoretinopathy.

Proton magnetic resonance imaging (MRI) was employed to obtain information on early vitreal changes preceding ophthalmoscopically visible proliferative vitreoretinopathy. Rabbits were injected close to the posterior pole with a suspension of 250 000 cultured homologous fibroblasts. The MRI was carried out using a 1.4-tesla (T) superconducting imager (at a proton frequency of 61.4 MHz). The images were obtained over a span of six days, prior to any detection of proliferative vitreoretinopathy with ophthalmoscopy. As early as two days after injection, an area of increased spin-spin relaxation time (T2) corresponding to the vitreal injection site became visible. The MRI observations paralleled in vitro changes in proton relaxation times (T1 [spin-lattice relaxation time] and T2) after addition of beta-N-acetylglucosaminidase to the vitreous. Our data suggest that hyaluronate disruption due to the activity of fibroblastic enzymes may result in fibroblast dispersion and movement in the vitreous and that MRI can provide early signs of vitreal changes that lead to retinal detachment.

Animals↗

Corneal thickness and functional damage in patients with ocular hypertension.

PURPOSE: To correlate functional damage over time detected by standard automated perimetry (SAP) and frequency doubling technology (FDT) with central corneal thickness (CCT) in patients with ocular hypertension (OHT). METHODS: Seventy-eight OHT patients underwent CCT measurements, SAP, and FDT (the latter two also after 12 and 18 months). Patients were divided into three equally sized groups of 26 patients each: thin (< 540 microm), normal (540-580 microm), and thick cornea (> 580 microm). The frequency of abnormal FDT and SAP results was analyzed over time (Pearson chi2 test). RESULTS: Six of 26 patients with thin corneas (23.1%) presented an abnormal FDT test at baseline, compared to 1 of 26 (3.8%) in the normal thickness cornea group and 1 of 26 (3.8%) in the thick cornea group. After 12 months, the abnormal FDT tests were as follows, respectively: 9 of 26 (34.6%), 2 of 26 (7.7%), and 2 of 26 (7.7%). For SAP the abnormal results were as follows, respectively: 8 (30.1%), 5 (19.2%), and 2 (7.7%). After 18 months, the abnormal FDT tests were as follows, respectively: 16 (61.5%), 5 (19.2%), and 5 (19.2%). For SAP, the abnormal results were as follows, respectively: 10 (38.5%), 5 (19.2%), and 2 (7.7%). CONCLUSIONS: OHT patients with thinner corneas have a greater risk of developing functional damage over time.

Adult↗