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Papers by Alice Bruscolini

Graefes Archive for Clinical and Experimental Ophthalmology, Aug 2, 2011

Gaucher disease (GD) is a rare familial autosomal recessive disorder of lipid metabolism, resulti... more Gaucher disease (GD) is a rare familial autosomal recessive disorder of lipid metabolism, resulting in an accumulation of abnormal glucocerebrosides in the reticulo-endothelial system. Patients with GD may present with hepatosplenomegaly, anemia, thrombocytopenia, and destructive bone disease. An enzyme replacement therapy with intravenous infusions of glycosylceramidase has been successfully proposed for treating the visceral manifestations. Gaucher disease can be divided into three subtypes: non-neuronopathic (type 1) which is the most common, acute neuronopathic (type 2), and subacute neuronopathic (type 3) [1]. Several studies have reported ocular manifestations such as strabismus, conjunctival pterygia, corneal opacities, vitreous opacities and retinal involvement [2–7]. To our knowledge, this is the first reported case of Gaucher disease complicated by branch retinal artery occlusion.

International Journal of Molecular Sciences

Nerve Growth Factor (NGF) and Brain derived Neurotrophic Factor (BDNF) mature/precursor imbalance... more Nerve Growth Factor (NGF) and Brain derived Neurotrophic Factor (BDNF) mature/precursor imbalance in tears and serum is suggested as a risk factor and symptomatology aggravation in ophthalmology and neuropsychiatric disturbances. Cognitive and mood alterations are reported by patients with Graves’ Orbitopathy (GO), indicating neurotrophin alterations might be involved. To address this question, the expression levels of NGF and BDNF and their precursors in serum and tears of GO patients were analyzed and correlated with the ophthalmological and psycho-cognitive symptoms. Hamilton Rating Scale for Anxiety (HAM-A) and Depression (HAM-D), Temperament and Character Inventory (TCI), and Cambridge Neuropsychological Test Automated Battery (CANTAB) test were used as a score. NGF and BDNF levels were measured using ELISA and Western Blot and statistically analyzed for psychiatric/ocular variable trend association. GO patients show memorization time and level of distraction increase, together...

Applied Sciences

Italy is a natural corridor for entry into Europe, receiving thousands of refugees and migrants n... more Italy is a natural corridor for entry into Europe, receiving thousands of refugees and migrants needing socio-economic and health assistance yearly. Impaired vision due to eye disease is estimated to affect at least 2.2 billion people worldwide, especially in this underprivileged population. To overcome this deep disparity, new intervention strategies, such as the PROTECT project, were planned with the aim of assessing, in the context of the head–neck area, the eye health in vulnerable applicants and holders of international protection. A total of 3023 migrants were involved in the project. Demographic factors and eye history were collected using a questionnaire. Using portable diagnostic instruments, an eye screening including monocular visual acuity, intraocular pressure, anterior segment, and ocular fundus was performed. The mean age was 31.6 ± 13.1 years and more than 50% underwent the first eye evaluation. Vision impairment was claimed by 16.6% of subjects and the most frequent...

Applied Sciences

Uveitic glaucoma (UG) is a potentially blinding complication of intraocular inflammation and is o... more Uveitic glaucoma (UG) is a potentially blinding complication of intraocular inflammation and is one of the most common causes of secondary glaucoma in pediatric ophthalmology. Overall management of UG is often challenging and requires a multidisciplinary assessment and careful follow-up. The overlap with steroid-induced glaucoma (SIG) is quite common, as well as the failure of medical and surgical therapy; nevertheless, few recent papers have dealt with this topic. We review the features and the clinical approach to UG in childhood, discussing the treatments available in the pediatric population.

Minerva oftalmologica, Sep 1, 2017

Investigative Ophthalmology & Visual Science, Jun 21, 2021

Autoimmunity Reviews, 2020

Graves' orbitopathy (GO) [1,2] is an ocular inflammatory manifestation of Graves' disease (GD) in... more Graves' orbitopathy (GO) [1,2] is an ocular inflammatory manifestation of Graves' disease (GD) involving retrobulbar connective/ adipose tissues and ocular surface [2,3]. The natural course of GO is divided into an early inflammatory phase (driven by Th 1 cytokines) characterized by a slow remodeling of soft tissues, and in a chronic fibrotic phase (driven by Th2 cytokines) with irreversible functional and aesthetic ocular damage such as restrictive diplopia or proptosis [3,4]. The pathogenetic mechanism underlying the disease progression are not clarified. Experimental reports showed that Interleukin-8 (IL-8, also named CXCL8) blood levels are increased in patients with active GO. Notably, it has also been demonstrated that the modulation of IL-8 pathway in retrobulbar tissues is involved during GO chronic phase. Despite this evidence it's the role of IL-8 axis in disease progression has not yet been clarified [5,6]. The availability of a clinical biomarker able to predict the disease outcome may improve the management of this disease. Therefore, the aim of our study is to evaluate changes of IL-8 pathway in the ocular surface of patients with GO. This observational study included 14 patients with GO according to the activity and severity classification by EUGOGO and 10 healthy subjects [7]. Complete eye exam, including GO activity and severity assessment and tear function, were performed. Tear samples and conjunctival epithelium were collected. IL-8 tear concentration was measured by enzyme-linked immunosorbent assay (ELISA); conjunctival IL-8 was analyzed by Western blot; and conjunctival expression of CXCR1 was evaluated by Western blot as well as by immunohistochemistry. Il-8 and CXCR1 expression in GO patients were compared with healthy controls (HC) and correlated with ocular clinical findings. All patients enrolled in the study have diagnosis of GD and were treated with anti-thyroid drugs (thiamazole); the mean duration after onset of GO was 10.3 months (min 8 month, max 14 months). Epidemiological and clinical characteristics of the studied group of patients with GO are described in Table 1. Western blot analysis reveal that GO individuals, when compared to healthy subjects, display a significant increase in the expression of IL-8 (4.4 ± 1.77 a.u. vs 0.85 ± 0.34 a.u.; P = 0.0098) and of CXCR1 (5.96 ± 2.35 a.u. vs 0.98 ± 0.13 a.u., P = 0.0217) (Fig. 1A). CXCR1 results were also corroborated by immunohistochemical studies, demonstrating that this receptor is barely detectable in healthy controls (32.52 ± 2.15 a.u.),

European Journal of Ophthalmology, 2011

A 42-year-old woman presented to our hospital owing to a history of right-sided proptosis of 4 mo... more A 42-year-old woman presented to our hospital owing to a history of right-sided proptosis of 4 months duration, reporting no previous trauma, fever, or recent sinusitis. Her medical record included a diagnosis of Graves’ disease. The best corrected visual acuity (BCVA) was 20/20 and a 30.2 visual field test was normal. A 3-Tesla magnetic resonance imaging (MRI) revealed an orbital apex meningioma approaching the walls of the sulcus chiasmaticus. A subsequent 60.4 perimetry test showed bilateral nasal visual field defects, thus confirming the involvement of the optic nerve. The reported case focuses on the differential diagnosis with Thyroid Eye Disease (TED) and the subsequent follow-up. Introduction The most common cause of both bilateral and unilateral exophthalmos in the adult population is Thyroid Eye Disease (TED) [1]. The rate of ophthalmopathy cases among hyperthyroid patients reaches up to 90%, with a much lower value among hypothyroid patients ranging between 0.2 and 8.6% [...

Investigative Ophthalmology & Visual Science, 2008

Applied Sciences, 2020

Glaucoma is a neurodegenerative disease and a worldwide leading cause of irreversible vision loss... more Glaucoma is a neurodegenerative disease and a worldwide leading cause of irreversible vision loss. In the last decades, high efforts have been made to develop novel treatments effective in inducing protection and/or recovery of neural function in glaucoma, including neurotrophic factors (NTFs). These approaches have shown encouraging data in preclinical setting; however, the challenge of sustained, targeted delivery to the retina and optic nerve still prevents the clinical translation. In this paper, the authors review and discuss the most recent advances for the use of NTFs treatment in glaucoma, including intraocular delivery. Novel strategies in drug and gene delivery technology for NTFs are proving effective in promoting long-term retinal ganglion cells (RGCs) survival and related functional improvements. Results of experimental and clinical studies evaluating the efficacy and safety of biodegradable slow-release NTF-loaded microparticle devices, encapsulated NTF-secreting cells...

Life, 2020

Background: patients with laryngopharyngeal reflux (LPR) showed detectable levels of tear pepsin ... more Background: patients with laryngopharyngeal reflux (LPR) showed detectable levels of tear pepsin that explain the nasolacrimal obstruction. The purpose of this study was to determine whether patients with LPR show ocular surface changes and to investigate the relationship between lacrimal pepsin concentration and ocular alterations. Methods: Fifty patients with positive endoscopic signs for LPR and an equal or higher score of 13 and 7 for Reflux Symptom Index and Reflux Finding Score were enrolled. Twenty healthy patients with no reflux disease and dry eye were included as the control group. After evaluation of ocular discomfort symptoms, the tear break-up time test, corneal staining, and tear sampling were performed. Tear pepsin levels were measured using Pep-testTM kit. Results: Patients with LPR showed ocular surface changes including epithelial damage (48%) and impairment of lacrimal function (72%). Tear pepsin levels were detectable in 32 out of 50 (64%) patients with LPR (mean...

Documenta Ophthalmologica, 2020

Purpose Myopic foveoschisis (MF) is characterized by the splitting of the retinal layers in the f... more Purpose Myopic foveoschisis (MF) is characterized by the splitting of the retinal layers in the fovea of patients with high myopia (HM). MF may progress into foveal detachment or macular hole formation with consequent loss of central vision. The aim of this study is to investigate morphological and functional changes of the macular region in myopic subjects with and without foveoschisis. Design Observational, cross-sectional, comparative study. Methods Forty-eight patients with HM and 24 healthy controls were evaluated by spectral domainoptical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and microperimetry (MP-1) tests to assess macular thickness, functionality and sensitivity values, respectively. The results of the diagnostic examinations were compared between three groups: HM patients with MF (N = 24), HM patients without MF (N = 24) and control group (CG) (N = 24). All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). One-way analysis of variance (ANOVA) followed by Tukey's post hoc test was used to analyze differences between groups unless specified; p values\ 0.05 were considered as statistically significant. Gender distribution was compared by the Chi square test. Results The statistical analysis with one-way ANOVA followed by Tukey's post hoc test showed a significant increase in macular thickness in HM patients with MF when compared to both HM patients without MF and CG. Morphological changes were associated with functional impairment as demonstrated by the significant decrease in amplitude of the P1 wave and MP-1 sensitivity (p \ 0.05), according to the anatomical landmarks. Conclusions This study showed that the morphological changes observed in the central retina of HM patients with MF are associated with functional alterations. High-tech diagnostic tests such as SD-OCT, mfERG and MP-1 could be useful for management in complications of MF. Keywords High myopia Á Microperimetry (MP-1) Á Multifocal electroretinography (mfERG) Á Myopic foveoschisis Á Pathological myopia Á Retinoschisis Á Spectral domain-optical coherence tomography (SD-OCT)

Seminars in Ophthalmology, 2020

Purpose: To describe the clinical characteristics and visual prognosis of ocular involvement in s... more Purpose: To describe the clinical characteristics and visual prognosis of ocular involvement in syphilis. Design: A retrospective cohort study. Methods: We studied the charts of 24 patients who visited our Ophthalmological Centre in Rome, Italy. All patients with serological evidence of syphilitic infection were included. Results: Ocular involvement was the first manifestation of syphilitic disease in 96% and Human Immunodeficiency Virus (HIV) seropositivity was found in 29% of the cases. The most frequent ocular manifestation was posterior uveitis. Vitreous involvement was frequent. Patients with papillitis at onset showed better visual outcome with antisyphilitic treatment. Posterior uveitis at onset and HIV seropositivity were negative prognostic factors for visual outcome. HIV-positive patients showed more severe and frequent bilateral course of ocular involvement in syphilis. Conclusions: The ophthalmologist should suspect syphilis in patien ts with uveitis or optic neuropathy associated with high-risk sexual behaviour and/or HIV, or in patients with posterior placoid chorioretinitis, necrotising retinitis, or interstitial keratitis.

Current Opinion in Allergy & Clinical Immunology, 2019

Purpose of review During allergic reaction, nervous and immune systems mutually interact through ... more Purpose of review During allergic reaction, nervous and immune systems mutually interact through release of mediators, including neurotrophic factors and nerve growth factor (NGF). These mediators modulate allergic reaction through binding their receptors expressed by immune and structural cells and by stimulating neuropeptide release by nerves. The role of neuropeptides and NGF has been demonstrated in allergic asthma and rhinitis, and, to a lesser extent, in allergic conjunctivitis. The aim of this review are to elucidate the evidence of the role of NGF and neuropeptides in the pathogenesis of allergic conjunctivitis. Recent findings NGF modulates allergic reaction by stimulating release of cytokines, inflammatory mediators and neuropeptides by immune and structural cells and nerve endings at the site of inflammation. Evidence showed that local and systemic NGF levels increase in patients with allergic conjunctivitis, including allergic rhinoconjuncivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. We recently described an increase of conjunctival p75NTR expression in patients with allergic rhinoconjuncivitis, and an increase of tear levels of NGF after conjunctival provocation test with allergen. Summary NGF modulates ocular allergic reaction. Increasing understanding of the role of neuropeptides in allergic conjunctivitis may pave the way to the development of novel therapeutic approaches and improvement of patients' management. Keywords allergic conjunctivitis, nerve growth factor, neuropeptides, substance P, vernal keratoconjunctivitis & ,9]. As the role of neuromediators and neuropeptides has been well characterized in allergic airways diseases, more recently, increasing evidence showed that neuroinflammation plays a role also in ocular surface inflammatory conditions, including allergic

Allergy, 2018

Changes of NGF pathway in allergic rhinoconjunctivitis: a conjunctival allergen challenge study T... more Changes of NGF pathway in allergic rhinoconjunctivitis: a conjunctival allergen challenge study To the Editor, The involvement of neuro-inflammation has been demonstrated in asthma, allergic rhinitis (AR), conjunctivitis and atopic dermatitis 1,2. Allergic reaction is associated with local production and release of neuromediators such as Nerve Growth Factor (NGF), substance P and Calcitonine-gene related peptide 1,3. Patients with allergic diseases showed increased serum and local NGF levels during inflammation or after allergen challenge 4-7. NGF modulates allergic inflammation through binding to its receptors TrkA and p75NTR, which are expressed by mucosal resident cells, B and T lymphocytes, mast cell, basophils and eosinophils 7,8. Experimental studies suggested that NGF inhibition may help in controlling allergic reaction and bronchial hyper-reactivity in asthma 9. However, no evidence of the peculiar involvement of TrkA or p75NTR pathway has been demonstrated in allergic patients. In this study, we evaluated NGF pathway in patients with allergic rhinoconjunctivitis (ARC) before and after specific conjunctival provocation test (CPT).

Seminars in Ophthalmology, 2014

ABSTRACT Aim: To assess the attitude and practice of contact lens (CL) wearers among teenage scho... more ABSTRACT Aim: To assess the attitude and practice of contact lens (CL) wearers among teenage school students and to evaluate how much the teenagers adhere to the CL care procedures according to the proper care of CL guidelines. Methods: A cross-sectional descriptive study of Italian teenagers from high schools in Rome who wear CL. We inquired about the different aspects of CL care through a questionnaire. Results: We investigated 3,106 students from high schools in Rome (2% of all Roman high school students), 293 of whom wore CL (9%); 151 (52%) of participants responded, 42 (27.8%) male and 109 (72.8%) female. The mean age was 16.4 ± 1.6 years. 79.5% of students were daily users. 45.7% wore CL more than nine hours/day. 87.4% wore soft CL. 33.1% wore disposable CL; 7.9% weekly CL, 55% monthly CL. Thirty-four percent wore disposable lenses twice or more. 14.5% of students did not wash their hands before handling CL and 52.3% wore CL after it had fallen in the sink. 39.7% rubbed and cleaned CL before storing it. 10% used expired lens care solutions. Only 31.1% changed CL cases every three months. 38.4% wore CL in a swimming pool. 61.6% were having problems: redness (13.9%), itching (7.9%), and foreign body sensation (29.1%). Conclusion: Many students don't properly care for their CL. Education regarding proper care and management of CL among users is advised in view of frequency of symptoms and complications reported.

Ocular Immunology and Inflammation, 2007

To describe a bilateral ring-shaped corneal opacity associated to immunological bowel and skin di... more To describe a bilateral ring-shaped corneal opacity associated to immunological bowel and skin diseases. Ophthalmic examination, tear film evaluation, ultrasound biomicroscopy (UBM), rheumatologic examination, and haematological screening. A 30-year-old man with psoriatic arthritis and ulcerative rectocolitis showed an unusual bilateral ring keratopathy not responding to topical and oral anti-inflammatory treatment. UBM examination revealed the high reflectivity of lesions distributed in the anterior stroma. Although association with systemic autoimmune diseases together with the ring aspect could suggest the immunological origin of corneal lesions, degenerative keratopathy cannot be excluded because the poor response to therapy alongside the UBM findings.

Graefe's Archive for Clinical and Experimental Ophthalmology, 2011

... with Gaucher disease Alice Bruscolini & Maria Pia Pirraglia & Lucia Restivo & Gio... more ... with Gaucher disease Alice Bruscolini & Maria Pia Pirraglia & Lucia Restivo & Giovanni Spinucci & Alessandro Abbouda ... Humphrey automated threshold perimetry (program 30–2) was also performed to detect any visual field defect. Results ...

Acta Ophthalmologica, 2019

To evaluate the expression of IL8/CXCL8 cytokine and its receptor CXCR1 in tear film and ocular s... more To evaluate the expression of IL8/CXCL8 cytokine and its receptor CXCR1 in tear film and ocular surface of patients with ocular mucous membrane pemphigoid (oMMP). Methods: Ten patients with oMMP in the quiescent phase, 20 patients with primary Sjogren syndrome (pSS) and 13 age-and sex-matched healthy controls (HCs) were included in this study. All patients undergone complete eye examination including lacrimal function tests and ocular surface staining assessed by ocular staining score. Ocular mucous membrane pemphigoid (oMMP) staging according to Mondino classification and dry eye severity grade according to Dry Eye Workshop 2007 classification were recorded. Tear samples and conjunctival epithelium were collected. IL-8 tear concentration was measured by enzyme-linked immunosorbent assay, and conjunctival IL8 was analysed by Western blot; conjunctival expression of CXCR1 was evaluated by immunohistochemistry. Il-8 and CXCR1 expression in oMMP patients were compared with HCand pSS patients and correlated with ocular clinical findings. Results: Tear levels of IL-8 were significantly increased in patients with oMMP (260.1 AE 70 pg/ml) when compared to both HCs (98.5 AE 71.35 pg/ml; p = 0.001) and patients with pSS (96.3 AE 87.5 pg/ml; p = 0.001). Conjunctival expression of IL8 and CXCR1 was significantly increased in oMMP patients when compared to both healthy subjects and pSS patients. Conclusion: The significant increase of tear and conjunctival IL8 and CXCR1 levels in patients with oMMP when compared to healthy subjects and patients with Sjogren syndrome suggests that changes of IL8 pathway are specific of oMMP and may represent a potential biomarker of the disease and/or therapeutic target.

Graefes Archive for Clinical and Experimental Ophthalmology, Aug 2, 2011

Gaucher disease (GD) is a rare familial autosomal recessive disorder of lipid metabolism, resulti... more Gaucher disease (GD) is a rare familial autosomal recessive disorder of lipid metabolism, resulting in an accumulation of abnormal glucocerebrosides in the reticulo-endothelial system. Patients with GD may present with hepatosplenomegaly, anemia, thrombocytopenia, and destructive bone disease. An enzyme replacement therapy with intravenous infusions of glycosylceramidase has been successfully proposed for treating the visceral manifestations. Gaucher disease can be divided into three subtypes: non-neuronopathic (type 1) which is the most common, acute neuronopathic (type 2), and subacute neuronopathic (type 3) [1]. Several studies have reported ocular manifestations such as strabismus, conjunctival pterygia, corneal opacities, vitreous opacities and retinal involvement [2–7]. To our knowledge, this is the first reported case of Gaucher disease complicated by branch retinal artery occlusion.

International Journal of Molecular Sciences

Nerve Growth Factor (NGF) and Brain derived Neurotrophic Factor (BDNF) mature/precursor imbalance... more Nerve Growth Factor (NGF) and Brain derived Neurotrophic Factor (BDNF) mature/precursor imbalance in tears and serum is suggested as a risk factor and symptomatology aggravation in ophthalmology and neuropsychiatric disturbances. Cognitive and mood alterations are reported by patients with Graves’ Orbitopathy (GO), indicating neurotrophin alterations might be involved. To address this question, the expression levels of NGF and BDNF and their precursors in serum and tears of GO patients were analyzed and correlated with the ophthalmological and psycho-cognitive symptoms. Hamilton Rating Scale for Anxiety (HAM-A) and Depression (HAM-D), Temperament and Character Inventory (TCI), and Cambridge Neuropsychological Test Automated Battery (CANTAB) test were used as a score. NGF and BDNF levels were measured using ELISA and Western Blot and statistically analyzed for psychiatric/ocular variable trend association. GO patients show memorization time and level of distraction increase, together...

Applied Sciences

Italy is a natural corridor for entry into Europe, receiving thousands of refugees and migrants n... more Italy is a natural corridor for entry into Europe, receiving thousands of refugees and migrants needing socio-economic and health assistance yearly. Impaired vision due to eye disease is estimated to affect at least 2.2 billion people worldwide, especially in this underprivileged population. To overcome this deep disparity, new intervention strategies, such as the PROTECT project, were planned with the aim of assessing, in the context of the head–neck area, the eye health in vulnerable applicants and holders of international protection. A total of 3023 migrants were involved in the project. Demographic factors and eye history were collected using a questionnaire. Using portable diagnostic instruments, an eye screening including monocular visual acuity, intraocular pressure, anterior segment, and ocular fundus was performed. The mean age was 31.6 ± 13.1 years and more than 50% underwent the first eye evaluation. Vision impairment was claimed by 16.6% of subjects and the most frequent...

Applied Sciences

Uveitic glaucoma (UG) is a potentially blinding complication of intraocular inflammation and is o... more Uveitic glaucoma (UG) is a potentially blinding complication of intraocular inflammation and is one of the most common causes of secondary glaucoma in pediatric ophthalmology. Overall management of UG is often challenging and requires a multidisciplinary assessment and careful follow-up. The overlap with steroid-induced glaucoma (SIG) is quite common, as well as the failure of medical and surgical therapy; nevertheless, few recent papers have dealt with this topic. We review the features and the clinical approach to UG in childhood, discussing the treatments available in the pediatric population.

Minerva oftalmologica, Sep 1, 2017

Investigative Ophthalmology & Visual Science, Jun 21, 2021

Autoimmunity Reviews, 2020

Graves' orbitopathy (GO) [1,2] is an ocular inflammatory manifestation of Graves' disease (GD) in... more Graves' orbitopathy (GO) [1,2] is an ocular inflammatory manifestation of Graves' disease (GD) involving retrobulbar connective/ adipose tissues and ocular surface [2,3]. The natural course of GO is divided into an early inflammatory phase (driven by Th 1 cytokines) characterized by a slow remodeling of soft tissues, and in a chronic fibrotic phase (driven by Th2 cytokines) with irreversible functional and aesthetic ocular damage such as restrictive diplopia or proptosis [3,4]. The pathogenetic mechanism underlying the disease progression are not clarified. Experimental reports showed that Interleukin-8 (IL-8, also named CXCL8) blood levels are increased in patients with active GO. Notably, it has also been demonstrated that the modulation of IL-8 pathway in retrobulbar tissues is involved during GO chronic phase. Despite this evidence it's the role of IL-8 axis in disease progression has not yet been clarified [5,6]. The availability of a clinical biomarker able to predict the disease outcome may improve the management of this disease. Therefore, the aim of our study is to evaluate changes of IL-8 pathway in the ocular surface of patients with GO. This observational study included 14 patients with GO according to the activity and severity classification by EUGOGO and 10 healthy subjects [7]. Complete eye exam, including GO activity and severity assessment and tear function, were performed. Tear samples and conjunctival epithelium were collected. IL-8 tear concentration was measured by enzyme-linked immunosorbent assay (ELISA); conjunctival IL-8 was analyzed by Western blot; and conjunctival expression of CXCR1 was evaluated by Western blot as well as by immunohistochemistry. Il-8 and CXCR1 expression in GO patients were compared with healthy controls (HC) and correlated with ocular clinical findings. All patients enrolled in the study have diagnosis of GD and were treated with anti-thyroid drugs (thiamazole); the mean duration after onset of GO was 10.3 months (min 8 month, max 14 months). Epidemiological and clinical characteristics of the studied group of patients with GO are described in Table 1. Western blot analysis reveal that GO individuals, when compared to healthy subjects, display a significant increase in the expression of IL-8 (4.4 ± 1.77 a.u. vs 0.85 ± 0.34 a.u.; P = 0.0098) and of CXCR1 (5.96 ± 2.35 a.u. vs 0.98 ± 0.13 a.u., P = 0.0217) (Fig. 1A). CXCR1 results were also corroborated by immunohistochemical studies, demonstrating that this receptor is barely detectable in healthy controls (32.52 ± 2.15 a.u.),

European Journal of Ophthalmology, 2011

A 42-year-old woman presented to our hospital owing to a history of right-sided proptosis of 4 mo... more A 42-year-old woman presented to our hospital owing to a history of right-sided proptosis of 4 months duration, reporting no previous trauma, fever, or recent sinusitis. Her medical record included a diagnosis of Graves’ disease. The best corrected visual acuity (BCVA) was 20/20 and a 30.2 visual field test was normal. A 3-Tesla magnetic resonance imaging (MRI) revealed an orbital apex meningioma approaching the walls of the sulcus chiasmaticus. A subsequent 60.4 perimetry test showed bilateral nasal visual field defects, thus confirming the involvement of the optic nerve. The reported case focuses on the differential diagnosis with Thyroid Eye Disease (TED) and the subsequent follow-up. Introduction The most common cause of both bilateral and unilateral exophthalmos in the adult population is Thyroid Eye Disease (TED) [1]. The rate of ophthalmopathy cases among hyperthyroid patients reaches up to 90%, with a much lower value among hypothyroid patients ranging between 0.2 and 8.6% [...

Investigative Ophthalmology & Visual Science, 2008

Applied Sciences, 2020

Glaucoma is a neurodegenerative disease and a worldwide leading cause of irreversible vision loss... more Glaucoma is a neurodegenerative disease and a worldwide leading cause of irreversible vision loss. In the last decades, high efforts have been made to develop novel treatments effective in inducing protection and/or recovery of neural function in glaucoma, including neurotrophic factors (NTFs). These approaches have shown encouraging data in preclinical setting; however, the challenge of sustained, targeted delivery to the retina and optic nerve still prevents the clinical translation. In this paper, the authors review and discuss the most recent advances for the use of NTFs treatment in glaucoma, including intraocular delivery. Novel strategies in drug and gene delivery technology for NTFs are proving effective in promoting long-term retinal ganglion cells (RGCs) survival and related functional improvements. Results of experimental and clinical studies evaluating the efficacy and safety of biodegradable slow-release NTF-loaded microparticle devices, encapsulated NTF-secreting cells...

Life, 2020

Background: patients with laryngopharyngeal reflux (LPR) showed detectable levels of tear pepsin ... more Background: patients with laryngopharyngeal reflux (LPR) showed detectable levels of tear pepsin that explain the nasolacrimal obstruction. The purpose of this study was to determine whether patients with LPR show ocular surface changes and to investigate the relationship between lacrimal pepsin concentration and ocular alterations. Methods: Fifty patients with positive endoscopic signs for LPR and an equal or higher score of 13 and 7 for Reflux Symptom Index and Reflux Finding Score were enrolled. Twenty healthy patients with no reflux disease and dry eye were included as the control group. After evaluation of ocular discomfort symptoms, the tear break-up time test, corneal staining, and tear sampling were performed. Tear pepsin levels were measured using Pep-testTM kit. Results: Patients with LPR showed ocular surface changes including epithelial damage (48%) and impairment of lacrimal function (72%). Tear pepsin levels were detectable in 32 out of 50 (64%) patients with LPR (mean...

Documenta Ophthalmologica, 2020

Purpose Myopic foveoschisis (MF) is characterized by the splitting of the retinal layers in the f... more Purpose Myopic foveoschisis (MF) is characterized by the splitting of the retinal layers in the fovea of patients with high myopia (HM). MF may progress into foveal detachment or macular hole formation with consequent loss of central vision. The aim of this study is to investigate morphological and functional changes of the macular region in myopic subjects with and without foveoschisis. Design Observational, cross-sectional, comparative study. Methods Forty-eight patients with HM and 24 healthy controls were evaluated by spectral domainoptical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and microperimetry (MP-1) tests to assess macular thickness, functionality and sensitivity values, respectively. The results of the diagnostic examinations were compared between three groups: HM patients with MF (N = 24), HM patients without MF (N = 24) and control group (CG) (N = 24). All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). One-way analysis of variance (ANOVA) followed by Tukey's post hoc test was used to analyze differences between groups unless specified; p values\ 0.05 were considered as statistically significant. Gender distribution was compared by the Chi square test. Results The statistical analysis with one-way ANOVA followed by Tukey's post hoc test showed a significant increase in macular thickness in HM patients with MF when compared to both HM patients without MF and CG. Morphological changes were associated with functional impairment as demonstrated by the significant decrease in amplitude of the P1 wave and MP-1 sensitivity (p \ 0.05), according to the anatomical landmarks. Conclusions This study showed that the morphological changes observed in the central retina of HM patients with MF are associated with functional alterations. High-tech diagnostic tests such as SD-OCT, mfERG and MP-1 could be useful for management in complications of MF. Keywords High myopia Á Microperimetry (MP-1) Á Multifocal electroretinography (mfERG) Á Myopic foveoschisis Á Pathological myopia Á Retinoschisis Á Spectral domain-optical coherence tomography (SD-OCT)

Seminars in Ophthalmology, 2020

Purpose: To describe the clinical characteristics and visual prognosis of ocular involvement in s... more Purpose: To describe the clinical characteristics and visual prognosis of ocular involvement in syphilis. Design: A retrospective cohort study. Methods: We studied the charts of 24 patients who visited our Ophthalmological Centre in Rome, Italy. All patients with serological evidence of syphilitic infection were included. Results: Ocular involvement was the first manifestation of syphilitic disease in 96% and Human Immunodeficiency Virus (HIV) seropositivity was found in 29% of the cases. The most frequent ocular manifestation was posterior uveitis. Vitreous involvement was frequent. Patients with papillitis at onset showed better visual outcome with antisyphilitic treatment. Posterior uveitis at onset and HIV seropositivity were negative prognostic factors for visual outcome. HIV-positive patients showed more severe and frequent bilateral course of ocular involvement in syphilis. Conclusions: The ophthalmologist should suspect syphilis in patien ts with uveitis or optic neuropathy associated with high-risk sexual behaviour and/or HIV, or in patients with posterior placoid chorioretinitis, necrotising retinitis, or interstitial keratitis.

Current Opinion in Allergy & Clinical Immunology, 2019

Purpose of review During allergic reaction, nervous and immune systems mutually interact through ... more Purpose of review During allergic reaction, nervous and immune systems mutually interact through release of mediators, including neurotrophic factors and nerve growth factor (NGF). These mediators modulate allergic reaction through binding their receptors expressed by immune and structural cells and by stimulating neuropeptide release by nerves. The role of neuropeptides and NGF has been demonstrated in allergic asthma and rhinitis, and, to a lesser extent, in allergic conjunctivitis. The aim of this review are to elucidate the evidence of the role of NGF and neuropeptides in the pathogenesis of allergic conjunctivitis. Recent findings NGF modulates allergic reaction by stimulating release of cytokines, inflammatory mediators and neuropeptides by immune and structural cells and nerve endings at the site of inflammation. Evidence showed that local and systemic NGF levels increase in patients with allergic conjunctivitis, including allergic rhinoconjuncivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. We recently described an increase of conjunctival p75NTR expression in patients with allergic rhinoconjuncivitis, and an increase of tear levels of NGF after conjunctival provocation test with allergen. Summary NGF modulates ocular allergic reaction. Increasing understanding of the role of neuropeptides in allergic conjunctivitis may pave the way to the development of novel therapeutic approaches and improvement of patients' management. Keywords allergic conjunctivitis, nerve growth factor, neuropeptides, substance P, vernal keratoconjunctivitis & ,9]. As the role of neuromediators and neuropeptides has been well characterized in allergic airways diseases, more recently, increasing evidence showed that neuroinflammation plays a role also in ocular surface inflammatory conditions, including allergic

Allergy, 2018

Changes of NGF pathway in allergic rhinoconjunctivitis: a conjunctival allergen challenge study T... more Changes of NGF pathway in allergic rhinoconjunctivitis: a conjunctival allergen challenge study To the Editor, The involvement of neuro-inflammation has been demonstrated in asthma, allergic rhinitis (AR), conjunctivitis and atopic dermatitis 1,2. Allergic reaction is associated with local production and release of neuromediators such as Nerve Growth Factor (NGF), substance P and Calcitonine-gene related peptide 1,3. Patients with allergic diseases showed increased serum and local NGF levels during inflammation or after allergen challenge 4-7. NGF modulates allergic inflammation through binding to its receptors TrkA and p75NTR, which are expressed by mucosal resident cells, B and T lymphocytes, mast cell, basophils and eosinophils 7,8. Experimental studies suggested that NGF inhibition may help in controlling allergic reaction and bronchial hyper-reactivity in asthma 9. However, no evidence of the peculiar involvement of TrkA or p75NTR pathway has been demonstrated in allergic patients. In this study, we evaluated NGF pathway in patients with allergic rhinoconjunctivitis (ARC) before and after specific conjunctival provocation test (CPT).

Seminars in Ophthalmology, 2014

ABSTRACT Aim: To assess the attitude and practice of contact lens (CL) wearers among teenage scho... more ABSTRACT Aim: To assess the attitude and practice of contact lens (CL) wearers among teenage school students and to evaluate how much the teenagers adhere to the CL care procedures according to the proper care of CL guidelines. Methods: A cross-sectional descriptive study of Italian teenagers from high schools in Rome who wear CL. We inquired about the different aspects of CL care through a questionnaire. Results: We investigated 3,106 students from high schools in Rome (2% of all Roman high school students), 293 of whom wore CL (9%); 151 (52%) of participants responded, 42 (27.8%) male and 109 (72.8%) female. The mean age was 16.4 ± 1.6 years. 79.5% of students were daily users. 45.7% wore CL more than nine hours/day. 87.4% wore soft CL. 33.1% wore disposable CL; 7.9% weekly CL, 55% monthly CL. Thirty-four percent wore disposable lenses twice or more. 14.5% of students did not wash their hands before handling CL and 52.3% wore CL after it had fallen in the sink. 39.7% rubbed and cleaned CL before storing it. 10% used expired lens care solutions. Only 31.1% changed CL cases every three months. 38.4% wore CL in a swimming pool. 61.6% were having problems: redness (13.9%), itching (7.9%), and foreign body sensation (29.1%). Conclusion: Many students don't properly care for their CL. Education regarding proper care and management of CL among users is advised in view of frequency of symptoms and complications reported.

Ocular Immunology and Inflammation, 2007

To describe a bilateral ring-shaped corneal opacity associated to immunological bowel and skin di... more To describe a bilateral ring-shaped corneal opacity associated to immunological bowel and skin diseases. Ophthalmic examination, tear film evaluation, ultrasound biomicroscopy (UBM), rheumatologic examination, and haematological screening. A 30-year-old man with psoriatic arthritis and ulcerative rectocolitis showed an unusual bilateral ring keratopathy not responding to topical and oral anti-inflammatory treatment. UBM examination revealed the high reflectivity of lesions distributed in the anterior stroma. Although association with systemic autoimmune diseases together with the ring aspect could suggest the immunological origin of corneal lesions, degenerative keratopathy cannot be excluded because the poor response to therapy alongside the UBM findings.

Graefe's Archive for Clinical and Experimental Ophthalmology, 2011

... with Gaucher disease Alice Bruscolini & Maria Pia Pirraglia & Lucia Restivo & Gio... more ... with Gaucher disease Alice Bruscolini & Maria Pia Pirraglia & Lucia Restivo & Giovanni Spinucci & Alessandro Abbouda ... Humphrey automated threshold perimetry (program 30–2) was also performed to detect any visual field defect. Results ...

Acta Ophthalmologica, 2019

To evaluate the expression of IL8/CXCL8 cytokine and its receptor CXCR1 in tear film and ocular s... more To evaluate the expression of IL8/CXCL8 cytokine and its receptor CXCR1 in tear film and ocular surface of patients with ocular mucous membrane pemphigoid (oMMP). Methods: Ten patients with oMMP in the quiescent phase, 20 patients with primary Sjogren syndrome (pSS) and 13 age-and sex-matched healthy controls (HCs) were included in this study. All patients undergone complete eye examination including lacrimal function tests and ocular surface staining assessed by ocular staining score. Ocular mucous membrane pemphigoid (oMMP) staging according to Mondino classification and dry eye severity grade according to Dry Eye Workshop 2007 classification were recorded. Tear samples and conjunctival epithelium were collected. IL-8 tear concentration was measured by enzyme-linked immunosorbent assay, and conjunctival IL8 was analysed by Western blot; conjunctival expression of CXCR1 was evaluated by immunohistochemistry. Il-8 and CXCR1 expression in oMMP patients were compared with HCand pSS patients and correlated with ocular clinical findings. Results: Tear levels of IL-8 were significantly increased in patients with oMMP (260.1 AE 70 pg/ml) when compared to both HCs (98.5 AE 71.35 pg/ml; p = 0.001) and patients with pSS (96.3 AE 87.5 pg/ml; p = 0.001). Conjunctival expression of IL8 and CXCR1 was significantly increased in oMMP patients when compared to both healthy subjects and pSS patients. Conclusion: The significant increase of tear and conjunctival IL8 and CXCR1 levels in patients with oMMP when compared to healthy subjects and patients with Sjogren syndrome suggests that changes of IL8 pathway are specific of oMMP and may represent a potential biomarker of the disease and/or therapeutic target.