Papers by Vincenzo Scorcia
British Journal of Ophthalmology, 2010
Objectives Haemorheological variables influence endothelial function through the release of sever... more Objectives Haemorheological variables influence endothelial function through the release of several factors. Clinical studies have described an association among blood viscosity, haematocrit, haemoglobin and macro-angiopathy. Few data are reported about the association between haemorheological variables and micro-angiopathy. The aim of the present study was to evaluate the association between these variables and retinopathy in subjects with type 2 diabetes. Methods 111 men, 79 postmenopausal women, and 95 healthy age-and sex-matched controls were recruited. Haematocrit and haemoglobin were measured by standard methods. Blood viscosity was calculated according to the formula (0.123 haematocrit)+ (0.173 (plasma proteinsÀ2.07)). Subjects were grouped according to the presence or absence of diabetic retinopathy, while the severity of retinopathy was classified according to the Early Treatment Diabetic Retinopathy Study scale. Results Haemoglobin, haematocrit and whole blood viscosity were significantly lower in subjects with retinopathy compared to subjects without retinopathy in both sexes. These variables significantly decreased with increasing severity of retinopathy. A multiple logistic regression analysis confirmed the independent inverse association among viscosity, haematocrit, haemoglobin and retinopathy (p<0.01). Conclusion Results demonstrate the association among low viscosity, haemoglobin, haematocrit and diabetic retinopathy. The mechanisms responsible for this association can be hypothesised. Reduced haemoglobin might cause direct organ damage. Low blood viscosity, through the reduction of shear stress, might inhibit the anti-atherogenic functions of endothelial cells.
The British journal of ophthalmology
Acta Ophthalmologica Scandinavica, 2007
ABSTRACT Purpose: To compare ERG b-wave amplitude differences before and after treatment with sod... more ABSTRACT Purpose: To compare ERG b-wave amplitude differences before and after treatment with sodium pegaptanib intra-vitreal injection.Methods: 14 patients all affected by exudative AMD were submitted to scotopic, combined and fotopic full field ERG, to estimate photoreceptorial electric activity through b-wave amplitude. All patients have then been treated with 1 to 4 intravitreal injections of 0,3 ml sodium pegaptanib. Time between each injection was 2-4 weeks. After one and two months than first injection all patients were again submitted to full field ERG. Data were related with ERGs obtained before first injection.Results: In 6 patients we found a b-wave amplitude increase of about 20% two months after first injection. Remaining 8 patients showed no valuable differences in ERG amplitude before and after treatment.Conclusions: In a valuable number of subjects, sodium pegaptanib intravitreal injection, seem to emprove photoreceptorial electric activity. Other studies are needed to confirm this hypothesis.
Acta Ophthalmologica, 2014
Cornea, 2015
Purpose: The aim of this study was to determine the mutation associated with X-linked megalocorne... more Purpose: The aim of this study was to determine the mutation associated with X-linked megalocornea (MGC1) found in 2 patients from the same area in southern Italy.
Cornea, 2015
The aim of this study was to describe clinical outcomes and histopathologic findings in a case of... more The aim of this study was to describe clinical outcomes and histopathologic findings in a case of repeat deep anterior lamellar keratoplasty (DALK) performed because of inadvertent inversion of the donor button at the time of primary surgery. A 34-year-old woman underwent big-bubble DALK for keratoconus in her right eye; 4 days postoperatively, slit-lamp examination revealed the presence of several inclusions in the interface, whereas anterior segment optical coherence tomography (AS-OCT) showed pathologically marked wrinkling of the posterior stroma; inadvertent intraoperative inversion of the graft was diagnosed and the interface inclusions were assumed to be of epithelial origin. Repeat surgery was performed: donor tissue was removed and submitted to histological examination, marking the external surface of the lamella; the recipient residual bed was carefully washed and a new lamellar graft was sutured into position. Three months postoperatively, the patient underwent a complete...
Journal of Pharmacology and Pharmacotherapeutics, 2013
Macular degeneration is the leading cause of blindness in developed countries. In the treatment o... more Macular degeneration is the leading cause of blindness in developed countries. In the treatment of neovascular age-related macular degeneration, vascular endothelial growth factor (VEGF) has emerged as a key target for therapy. The intravitreal injection of anti-VEGF drugs has been widely employed to reduce the disease progression and improve the visual outcomes of the affected patients. However, each intravitreal inoculation poses a risk of several complications as infection, inflammation, endophthalmitis, intraocular inflammation, increase of intraocular pressure and vitreous hemorrhage. This short review evaluates the efficacy and the incidence of adverse drug reactions related to intravitreal administration of the main anti-VEGF drugs actually available: Bevacizumab, ranibizumab and aflibercept.
JAMA Ophthalmology, 2014
Stromal disease (ectasia, opacities, scars, or melting) that occurs after penetrating keratoplast... more Stromal disease (ectasia, opacities, scars, or melting) that occurs after penetrating keratoplasty (PK) can variously affect visual outcome. 1,2 To date, even in the presence of healthy endothelium, this type of complication has been treated with subsequent PK. 3 Instead, the selective replacement of the diseased stroma by means of deep anterior lamellar keratoplasty (DALK) using pneumatic dissection (big bubble) has not been attempted, mainly because of the extreme likelihood of breaking the descemetic scar at the junction between the donor and host cornea. We describe a new surgical technique (small-bubble DALK) that uses pneumatic dissection to bare Descemet membrane (DM) only in a central optical zone and predescemetic manual dissection to remove the surrounding peripheral stroma.
Saudi Journal of Ophthalmology, 2011
Objective: To report the outcome of mushroom keratoplasty for the treatment of full thickness cor... more Objective: To report the outcome of mushroom keratoplasty for the treatment of full thickness corneal disease in pediatric patients with healthy endothelium. Methods: A retrospective analysis of pediatric patients who underwent mushroom keratoplasty. The medical records of pediatric patients suffering from full thickness corneal stromal disease with normal endothelium who underwent mushroom keratoplasty at our Institution were included. A two-piece donor graft consisting of a large anterior stromal lamella (9.0 mm in diameter and ±250 lm in thickness) and a small posterior lamella (5-6.5 mm in diameter) including deep stroma and endothelium, prepared with the aid of a microkeratome had been transplanted in all cases. Ophthalmic examination including slit lamp examination, best corrected visual acuity, and corneal topography was performed preoperatively and at each postoperative visit on all patients. The endothelial cells were assessed by specular microscopy in these patients. Results: Six eyes of six patients (five males and one female) were included. The mean age was 9.3 years (range 5-15 years). Average follow-up was 17.8 months (range 9-48 months).
Ophthalmology, 2009
Purpose: To evaluate changes in posterior corneal curvature as a possible cause of the hyperopic ... more Purpose: To evaluate changes in posterior corneal curvature as a possible cause of the hyperopic refractive shift observed after Descemet's stripping automated endothelial keratoplasty (DSAEK).
Cornea, Jan 20, 2015
The aim of this study was to describe a surgical technique for repeat deep anterior lamellar kera... more The aim of this study was to describe a surgical technique for repeat deep anterior lamellar keratoplasty (DALK) by baring Descemet membrane again in eyes affected by stromal opacity of the donor lamella. Repeat DALK was performed in 5 eyes of 5 patients affected by central stromal opacity not involving the endothelium; indications for repeat surgery were postbacterial or postherpetic corneal scars (n = 3), postphotorefractive keratectomy haze (n = 1), and recurrence of granular dystrophy (n = 1). The surgical procedure consisted of the following: (1) superficial trephination, 250 μm in depth, on the original peripheral scar; (2) blunt detachment of the donor graft completed by means of corneal forceps; (3) apposition of the new lamella. Best spectacle-corrected visual acuity, topographic astigmatism, and endothelial cell density were evaluated preoperatively, as well as 3, 6, 9, 12, and 18 months after surgery. At the latest follow-up examination, with all sutures removed from all ...
Ophthalmology, 2013
Purpose: To evaluate the outcomes and graft survival rates after ultrathin (UT) Descemet's stripp... more Purpose: To evaluate the outcomes and graft survival rates after ultrathin (UT) Descemet's stripping automated endothelial keratoplasty (DSAEK) using the microkeratome-assisted double-pass technique.
Journal of Cataract & Refractive Surgery, 2013
PURPOSE: To evaluate the efficacy of epithelial-disruption collagen crosslinking (CXL) for progre... more PURPOSE: To evaluate the efficacy of epithelial-disruption collagen crosslinking (CXL) for progressive keratoconus using a corneal disruptor device and a riboflavin solution designed for a transepithelial technique.
Investigative Ophthalmology & Visual Science, 2012
To compare three microkeratome-assisted techniques for the preparation of ultrathin (UT) grafts f... more To compare three microkeratome-assisted techniques for the preparation of ultrathin (UT) grafts for Descemet stripping automated endothelial keratoplasty. After dissection with a 300-μm microkeratome head in 40 donor tissues, a second cut was performed with a 130-μm head either after manual stromal hydration (group A, n = 10) or osmotic hydration at the eye bank (group B, n = 10) or with a 50- or 90-μm head, depending on residual bed thickness (group C, n = 10); no further dissection was performed in the control group (group D, n = 10). Corneal thickness and endothelial cell (EC) count were determined at all appropriate stages. Statistical analysis was performed using a Fisher exact test. Final graft thicknesses in groups A (89.1 ± 34.1μm), B (84.1 ± 18.6 μm), and C (72.1 ± 10.1 μm) were significantly lower than in group D (201.9 ± 25.3 μm) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). EC loss did not differ significantly among the groups. Multiple areas of Descemet detachment were seen in 4 of 10 corneas of group A. All methods proved equally efficient in producing UT grafts, but stromal hydration induced tissue structural changes. EC loss was unaffected by the additional manipulation required to prepare UT grafts.
Experimental and Clinical Endocrinology & Diabetes, 2008
The present study was aimed to investigate optic nerve involvement by computerized perimetry in 4... more The present study was aimed to investigate optic nerve involvement by computerized perimetry in 40 (29 women, 11 men) consecutive GO patients not showing definite dysthyroid optic neuropathy (DON). All patients presenting visual acuity defects, pallor or swelling of the optic nerve, concomitant eye disease, evidence of apical crowding or optic nerve stretching at either MRI or CT imaging were excluded. Normal perimetry occurred in 7 patients (17.5%), 5 patients (12.5%) had &amp;amp;amp;amp;quot;indeterminate&amp;amp;amp;amp;quot; results and 28 patients (70%) presented abnormal perimetry. Particularly, 7 isolated paracentral, 5 pericentral and 16 combined peri and paracentral scotomas were found. On the contrary, 15/20 patients in the group without GO had normal perimetry, isolated scotomas were found in 5 cases (1 pericentral and 4 paracentral) and no case of combined scotoma occurred. The difference between the 2 groups was statistically significant (x2 = 9.17; p = 0.025). Overall, the sensitivity resulted 70%, the specificity 75% and the positive predictive value 84.8%. In patients with GO, the proportion of visual field alterations was significantly increased for Clinical Activity Score &amp;amp;amp;amp;gt; or = 3 (p = 0.0005), while no relationship occurred with proptosis degree (p = 0.115). In conclusion, a great proportion of GO patients without clinically evident DON presents visual field defects, mainly related to GO activity.
British Journal of Ophthalmology, 2011
British Journal of Ophthalmology, 2011
Objectives: Hemorheological variables influence endothelial function through the release of sever... more Objectives: Hemorheological variables influence endothelial function through the release of several factors. Clinical studies have described an association between blood viscosity, hematocrit, hemoglobin and macro-angiopathy. Few data are reported about the association between hemorheological variables and micro-angiopathy. Aim of the present study was to evaluate the association between these variables and retinopathy in subjects with type 2 diabetes.
Archives of Ophthalmology, 2011
Archives of Ophthalmology, 2012
To improve visual and refractive outcomes, microkeratome-assisted lamellar keratoplasty for the t... more To improve visual and refractive outcomes, microkeratome-assisted lamellar keratoplasty for the treatment of keratoconus (exchange of a 9.0-mm anterior recipient lamella with a 9.0-mm donor lamella, using a 200-μm head for the former and a 300-μm head for the latter) was modified by adding a 6.5-mm incomplete full-thickness incision in the recipient bed before suturing the donor graft in place. After complete suture removal, 1 year postoperatively, best spectacle-corrected visual acuity was 20/40 or better in 92 of 97 eyes and 20/25 or better in 67 of 97 eyes; regular astigmatism was 4.5 diopters or worse in 86 of 97 eyes; endothelial cell loss averaged 20.4%. The disruption of the recipient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s architecture induced by the full-thickness circular incision makes the final corneal shape closely resemble the physiologic curvature of the donor cornea, thus optimizing postoperative refractive error and spectacle-corrected visual acuity.
American Journal of Ophthalmology, 2012
PURPOSE: To report the visual outcomes and graft survival rates of mushroom keratoplasty for the ... more PURPOSE: To report the visual outcomes and graft survival rates of mushroom keratoplasty for the treatment of postinfectious corneal scars.
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Papers by Vincenzo Scorcia