Carlo Incorvaia - Academia.edu (original) (raw)

Papers by Carlo Incorvaia

Annals of the Rheumatic Diseases, 1995

Thrombosis Research, Feb 1, 2010

Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence ... more Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence based treatment recommendations for patients with RVO cannot be made because of the lack of adequate clinical trials. To compare the efficacy and safety of aspirin and of a low molecular weight heparin, parnaparin, in the treatment of RVO. Materials and Methods: In a multicenter, randomized, double blind, controlled trial eligible patients with a delay between symptoms onset and objective diagnosis of less than 15 days were randomized to aspirin 100 mg/day for 3 months or to a fixed daily dose of parnaparin, 12.800 IU for 7 days followed by 6.400 IU for a total of 3 months. Primary end-point of the study was the incidence of functional worsening of the eye with RVO at 6 months, as assessed by fluorescein angiography, visual acuity, and visual field. Study end-points were adjudicated by an independent committee. Results: Sixty-seven patients were enrolled in the study and 58 of them (28 treated with parnaparin, 30 with aspirin) were evaluable for the analysis. Baseline characteristics were well balanced between groups. Functional worsening was adjudicated in 20.7% of patients treated with parnaparin and in 59.4% of patients treated with ASA (p = 0.002). Recurrent RVO was diagnosed in 3 patients, all treated with ASA (p = n.s.). Bleeding rates were similar between the two groups. Conclusions: Parnaparin appears to be more effective than aspirin in preventing functional worsening in patients with RVO. The results of this study need to be confirmed in a larger clinical trial. Trial registration number: Clinical trials.gov NCT00732927.

Investigative Ophthalmology & Visual Science, May 14, 2008

Purpose:To investigate the changes in concentration of vascular endothelial growth factor (VEGF) ... more Purpose:To investigate the changes in concentration of vascular endothelial growth factor (VEGF) in the aqueous humor of patients with choroidal neovascularization (CNV) secondary to age related macular degeneration (AMD) during bevacizumab therapy and to correlate these changes with the modifications of visual acuity and foveal thickness. Methods:7 patients affected by wet AMD (6 with a minimally classic CNV and 1 with an occult CNV) underwent repeated intravitreal injections of bevacizumab (2.00 mg, 0.08 ml) at 30 days intervals. Immediately before each injection visual acuity (by ETDRS charts) and foveal thickness (by OCT) were recorded. Aqueous humor samples (0.05 ml) were obtained straight after each injection through a hypotonizing paracentesis. The VEGF concentration in these samples was measured using an enzyme-linked immunosorbent assay (Quantikine®, R&D Systems). Results:6 patients had 2 bevacizumab injections, while 1 received 3 injections. The mean aqueous humor VEGF concentration at the time of the first and of the second injection was 142.79 (± 79.81) and 37.93 (± 26.06) pg/ml, respectively. This change was statistically significant (p=0.005, paired t test). At the same time checks the mean visual acuity increased from 0.85 (±0.54) to 0.81 (±0.44) logMAR and the mean foveal thickness decreased from 260.57 (± 82.91) to 258.14 (±69.45) µm. In both cases the difference was not statistically significant. 30 days after the anti-angiogenic treatment the VEGF inhibition still ranged between 68 and 83% in all subjects but one. In this patient, who was the only one undergone three injections, the percentage of VEGF inhibition was 37% and 36% 1 month after the first and the second injection, respectively. Conclusions:VEGF has been found to be expressed in the vitreous and aqueous of patients with neovascular ocular diseases and to be temporally, spatially, and quantitatively associated with new vessel formation. Several authors have also demonstrated that aqueous and vitreous levels of VEGF show a strong correlation with each other. Even 30 days after the intravitreal injection of bevacizumab a substantial decrease of VEGF in the aqueous humor of most patients with AMD was observed. This datum suggests that longer intervals between the injections might be considered. In the short follow-up time no correlation was founded between aqueous humor VEGF levels and visual acuity or foveal thickness modifications

Seminars in Ophthalmology, 2001

We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARG... more We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months +/- 9.7 in the light PRP and 21.6 months +/- 9.3 in the classic PRP group (p = 0.727). The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 +/- 0.13 and in the classic PRP group 0.14 +/- 0.15 (p = 0.493). The final mean VA in the former was 0.18 +/- 0.25, and in the latter 0.27 +/- 0.30 (p = 0.231). Median power was 235mW (100-540mW) for light and 420mW (200-950mW) for classic PRP (p < 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 +/- 2.4 for light and 9.9 +/- 2.2 for the classic PRP group (p < 0.001). Complications were more frequent in the classic PRP group. The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.

Diversi studi sperimentali hanno dimostrato che anticorpi monoclonali diretti contro le principal... more Diversi studi sperimentali hanno dimostrato che anticorpi monoclonali diretti contro le principali glicoproteine virali sono in grado di proteggere il topolino dallo sviluppo di cheratite erpetica necrotizzante. Nel coniglio l'immunizzazione passiva è risultata meno efficace dell'immunoprofilassi attiva con vaccino a subunità (gB-1s) precedentemente sperimentato

Abstract: Macular degenerations represent leading causes of central blindness or low vision in de... more Abstract: Macular degenerations represent leading causes of central blindness or low vision in developed countries. Most of these severe visual disabilities are due to age-related OPEN ACCESS Int. J. Mol. Sci. 2015, 16 19797 macular degeneration (AMD) and pathologic myopia (PM), both of which are frequently complicated by subfoveal choroidal neovascularization (CNV). Photodynamic therapy

European Journal of Ophthalmology, 2008

PURPOSE. To evaluate the visual outcome of patients with subfoveal choroidal neovascularization (... more PURPOSE. To evaluate the visual outcome of patients with subfoveal choroidal neovascularization (CNV) secondary to pathologic myopia treated with verteporfin photodynamic therapy (PDT-V) and to verify the predictive role of visual and angiographic parameters. METHODS. This is a retrospective, interventional, consecutive case series study of subjects with subfoveal CNV secondary to pathologic myopia. All patients received PDT-V according to VIP guidelines. A complete ophthalmologic evaluation was performed on all patients and included best-corrected visual acuity (BCVA), fundus examination, and fluorescein angiography (FA, IMAGEnet System, Topcon Corp., Japan). CNV size (mm 2) was directly measured on the early phase of the angiogram using the software included with the IMAGEnet package. All checks were scheduled at 3-month intervals for a period of 1 year. A review of medical and angiographic records was performed and assessed throughout a 12-month follow-up period. RESULTS. A total of 62 patients (62 eyes) were examined. Best-corrected visual acuity (BCVA) moderately decreased without reaching a statistically noticeable level throughout the followup; reduction in lesion size reached a significant level at the second checkup. A significant correlation between higher baseline BCVA and better final visual outcome was detected. CONCLUSIONS. Standardized PDT-V minimizes central vision deterioration in patients with CNV secondary to pathologic myopia. Better BCVA at presentation represents a good predictive sign.

International Journal of Pharmaceutics, 2006

In the present study the preparation, characterization and activity of cationic liposomes contain... more In the present study the preparation, characterization and activity of cationic liposomes containing the secretory form of herpes simplex virus type 1 (HSV-1) glycoprotein B (gB1s) or two related polylysine rich peptides, namely DTK1 and DTK2, were described. The immunotherapeutic potential of these HSV antigens containing liposomes was examined with a rabbit ocular model of HSV-1 infection. Our study indicates that the liposomes (i) are able to encapsulate quantitatively gB1s and around 30% the DTK peptides, (ii) are characterized by dimensions compatible with ocular applications and (iii) can release the peptide comparably to the free solution. In addition, neutralization studies demonstrated that an anti-DTK specific polyclonal antiserum can inhibit HSV-1 infection, indicating that such peptides could be a good immunogen/antigen in an anti-HSV vaccine formulation. Although the vaccination protocol did not induce protection against the eye disease, a significative protection against a lethal ocular challenge was detectable together with the absence of reactivation episodes from latency on the survived animals. In this respect, the use of cationic liposomes coupled to gB1s and DTK peptides, as a local ocular vaccine, could represent an interesting approach in order to obtain a possible efficacy in protecting animals against a subsequent HSV-1 ocular challenge.

Thalassaemic patients with diabetes mellitus are at risk of developing retinopathy. To evaluate t... more Thalassaemic patients with diabetes mellitus are at risk of developing retinopathy. To evaluate the prevalence and the characteristics of diabetic retinopathy in thalassaemics we examined 46 patients with beta-thalassaemia major and insulin-dependent diabetes by fluorescein angiography. The study group was matched for sex, age and diabetes duration with a control group of 46 type 1 diabetic patients. Diabetic retinopathy was detected in 26% (12/46) of thalassaemics and in 50% (23/46) of the controls. In thalassaemics the diabetic retinopathy was significantly less severe than in controls (P < 0.0001). The influence of risk factors for diabetic retinopathy (duration of diabetes and metabolic control) was confirmed in the control group. In thalassaemic patients we found no significant correlation between these risk variables and the presence of diabetic retinopathy. Various factors may protect thalassaemics from diabetic retinopathy: heterogeneity of pancreatic functions; high incidence of hypogonadism; contemporary dysfunction of GH and/or glucagon secretion.

Mediterranean journal of hematology and infectious diseases, 2015

Both insulin and IGF-1 have been implicated in the control of retinal endothelial cell growth, ne... more Both insulin and IGF-1 have been implicated in the control of retinal endothelial cell growth, neovascularization and diabetic retinopathy. Recent findings have established an essential role for IGF-1 in angiogenesis and demonstrated a new target for control of retinopathy that explains why diabetic retinopathy initially increases with the onset of insulin treatment. This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of thalassemia major (TM) patients with insulin dependent diabetes mellitus (IDDM). This relation was not previously evaluated, despite the fact that both diseases co-exist in the same patient. The study also describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM. A population-based cross-sectional study. The study includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients...

Retina (Philadelphia, Pa.), 2008

Dear Editor: We read with interest the article by Matsumoto et al 1 in a recent issue of Retina. ... more Dear Editor: We read with interest the article by Matsumoto et al 1 in a recent issue of Retina. They described three patients with macular edema secondary to retinal vein occlusion who had initial resolution of edema after bevacizumab injection followed by rebound edema. Matsumoto et al hypothesized that blockage of the vascular endothelial growth factor (VEGF) pathway by bevacizumab may inhibit and/or stimulate some molecular processes in the VEGF cascade, resulting in increased edema. In support of this hypothesis, we describe a 74-year-old woman who was diagnosed with branch retinal vein occlusion in the right eye and treated with bevacizumab. It would be of interest to perform molecular studies on ocular fluids from patients undergoing antiangiogenic treatments in an attempt to better identify the phenomenon. Unfortunately, difficulty in accessing the ocular cavities and concerns about the ethicality of this surgical procedure make this task scarcely feasible at this point

Seminars in Ophthalmology, 2001

We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARG... more We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months +/- 9.7 in the light PRP and 21.6 months +/- 9.3 in the classic PRP group (p = 0.727). The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 +/- 0.13 and in the classic PRP group 0.14 +/- 0.15 (p = 0.493). The final mean VA in the former was 0.18 +/- 0.25, and in the latter 0.27 +/- 0.30 (p = 0.231). Median power was 235mW (100-540mW) for light and 420mW (200-950mW) for classic PRP (p < 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 +/- 2.4 for light and 9.9 +/- 2.2 for the classic PRP group (p < 0.001). Complications were more frequent in the classic PRP group. The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.

Vaccine, 2000

A secreted form of gB1 (gB1s), previously shown to protect rabbits against HSV-1 ocular infection... more A secreted form of gB1 (gB1s), previously shown to protect rabbits against HSV-1 ocular infection when inoculated systemically, was delivered to rabbit periocular area to evaluate its vaccine efficacy upon local administration. The efficacy of local or systemic inoculation of a gB1s-DNA-based vaccine in the rabbit model of ocular HSV-1 infection was assessed in parallel flow. Rabbits received four inoculations of the different immunogens, then immune responses and clinical symptoms were evaluated. Both the local protein and the systemic DNA administration elicited a neutralizing antibody response, reduced ocular symptoms with respect to controls (PB0.01), and completely prevented the death of rabbits from encephalitis. Conversely, local DNA vaccination did not induce any detectable antibody response, and could only partially protect rabbits from the development of encephalitis and severe ocular infection.

Thrombosis Research, 2010

Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence ... more Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence based treatment recommendations for patients with RVO cannot be made because of the lack of adequate clinical trials. To compare the efficacy and safety of aspirin and of a low molecular weight heparin, parnaparin, in the treatment of RVO. Materials and Methods: In a multicenter, randomized, double blind, controlled trial eligible patients with a delay between symptoms onset and objective diagnosis of less than 15 days were randomized to aspirin 100 mg/day for 3 months or to a fixed daily dose of parnaparin, 12.800 IU for 7 days followed by 6.400 IU for a total of 3 months. Primary end-point of the study was the incidence of functional worsening of the eye with RVO at 6 months, as assessed by fluorescein angiography, visual acuity, and visual field. Study end-points were adjudicated by an independent committee. Results: Sixty-seven patients were enrolled in the study and 58 of them (28 treated with parnaparin, 30 with aspirin) were evaluable for the analysis. Baseline characteristics were well balanced between groups. Functional worsening was adjudicated in 20.7% of patients treated with parnaparin and in 59.4% of patients treated with ASA (p = 0.002). Recurrent RVO was diagnosed in 3 patients, all treated with ASA (p = n.s.). Bleeding rates were similar between the two groups. Conclusions: Parnaparin appears to be more effective than aspirin in preventing functional worsening in patients with RVO. The results of this study need to be confirmed in a larger clinical trial. Trial registration number: Clinical trials.gov NCT00732927.

Annals of the Rheumatic Diseases, 1995

Thrombosis Research, Feb 1, 2010

Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence ... more Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence based treatment recommendations for patients with RVO cannot be made because of the lack of adequate clinical trials. To compare the efficacy and safety of aspirin and of a low molecular weight heparin, parnaparin, in the treatment of RVO. Materials and Methods: In a multicenter, randomized, double blind, controlled trial eligible patients with a delay between symptoms onset and objective diagnosis of less than 15 days were randomized to aspirin 100 mg/day for 3 months or to a fixed daily dose of parnaparin, 12.800 IU for 7 days followed by 6.400 IU for a total of 3 months. Primary end-point of the study was the incidence of functional worsening of the eye with RVO at 6 months, as assessed by fluorescein angiography, visual acuity, and visual field. Study end-points were adjudicated by an independent committee. Results: Sixty-seven patients were enrolled in the study and 58 of them (28 treated with parnaparin, 30 with aspirin) were evaluable for the analysis. Baseline characteristics were well balanced between groups. Functional worsening was adjudicated in 20.7% of patients treated with parnaparin and in 59.4% of patients treated with ASA (p = 0.002). Recurrent RVO was diagnosed in 3 patients, all treated with ASA (p = n.s.). Bleeding rates were similar between the two groups. Conclusions: Parnaparin appears to be more effective than aspirin in preventing functional worsening in patients with RVO. The results of this study need to be confirmed in a larger clinical trial. Trial registration number: Clinical trials.gov NCT00732927.

Investigative Ophthalmology & Visual Science, May 14, 2008

Purpose:To investigate the changes in concentration of vascular endothelial growth factor (VEGF) ... more Purpose:To investigate the changes in concentration of vascular endothelial growth factor (VEGF) in the aqueous humor of patients with choroidal neovascularization (CNV) secondary to age related macular degeneration (AMD) during bevacizumab therapy and to correlate these changes with the modifications of visual acuity and foveal thickness. Methods:7 patients affected by wet AMD (6 with a minimally classic CNV and 1 with an occult CNV) underwent repeated intravitreal injections of bevacizumab (2.00 mg, 0.08 ml) at 30 days intervals. Immediately before each injection visual acuity (by ETDRS charts) and foveal thickness (by OCT) were recorded. Aqueous humor samples (0.05 ml) were obtained straight after each injection through a hypotonizing paracentesis. The VEGF concentration in these samples was measured using an enzyme-linked immunosorbent assay (Quantikine®, R&D Systems). Results:6 patients had 2 bevacizumab injections, while 1 received 3 injections. The mean aqueous humor VEGF concentration at the time of the first and of the second injection was 142.79 (± 79.81) and 37.93 (± 26.06) pg/ml, respectively. This change was statistically significant (p=0.005, paired t test). At the same time checks the mean visual acuity increased from 0.85 (±0.54) to 0.81 (±0.44) logMAR and the mean foveal thickness decreased from 260.57 (± 82.91) to 258.14 (±69.45) µm. In both cases the difference was not statistically significant. 30 days after the anti-angiogenic treatment the VEGF inhibition still ranged between 68 and 83% in all subjects but one. In this patient, who was the only one undergone three injections, the percentage of VEGF inhibition was 37% and 36% 1 month after the first and the second injection, respectively. Conclusions:VEGF has been found to be expressed in the vitreous and aqueous of patients with neovascular ocular diseases and to be temporally, spatially, and quantitatively associated with new vessel formation. Several authors have also demonstrated that aqueous and vitreous levels of VEGF show a strong correlation with each other. Even 30 days after the intravitreal injection of bevacizumab a substantial decrease of VEGF in the aqueous humor of most patients with AMD was observed. This datum suggests that longer intervals between the injections might be considered. In the short follow-up time no correlation was founded between aqueous humor VEGF levels and visual acuity or foveal thickness modifications

Seminars in Ophthalmology, 2001

We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARG... more We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months +/- 9.7 in the light PRP and 21.6 months +/- 9.3 in the classic PRP group (p = 0.727). The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 +/- 0.13 and in the classic PRP group 0.14 +/- 0.15 (p = 0.493). The final mean VA in the former was 0.18 +/- 0.25, and in the latter 0.27 +/- 0.30 (p = 0.231). Median power was 235mW (100-540mW) for light and 420mW (200-950mW) for classic PRP (p < 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 +/- 2.4 for light and 9.9 +/- 2.2 for the classic PRP group (p < 0.001). Complications were more frequent in the classic PRP group. The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.

Diversi studi sperimentali hanno dimostrato che anticorpi monoclonali diretti contro le principal... more Diversi studi sperimentali hanno dimostrato che anticorpi monoclonali diretti contro le principali glicoproteine virali sono in grado di proteggere il topolino dallo sviluppo di cheratite erpetica necrotizzante. Nel coniglio l'immunizzazione passiva è risultata meno efficace dell'immunoprofilassi attiva con vaccino a subunità (gB-1s) precedentemente sperimentato

Abstract: Macular degenerations represent leading causes of central blindness or low vision in de... more Abstract: Macular degenerations represent leading causes of central blindness or low vision in developed countries. Most of these severe visual disabilities are due to age-related OPEN ACCESS Int. J. Mol. Sci. 2015, 16 19797 macular degeneration (AMD) and pathologic myopia (PM), both of which are frequently complicated by subfoveal choroidal neovascularization (CNV). Photodynamic therapy

European Journal of Ophthalmology, 2008

PURPOSE. To evaluate the visual outcome of patients with subfoveal choroidal neovascularization (... more PURPOSE. To evaluate the visual outcome of patients with subfoveal choroidal neovascularization (CNV) secondary to pathologic myopia treated with verteporfin photodynamic therapy (PDT-V) and to verify the predictive role of visual and angiographic parameters. METHODS. This is a retrospective, interventional, consecutive case series study of subjects with subfoveal CNV secondary to pathologic myopia. All patients received PDT-V according to VIP guidelines. A complete ophthalmologic evaluation was performed on all patients and included best-corrected visual acuity (BCVA), fundus examination, and fluorescein angiography (FA, IMAGEnet System, Topcon Corp., Japan). CNV size (mm 2) was directly measured on the early phase of the angiogram using the software included with the IMAGEnet package. All checks were scheduled at 3-month intervals for a period of 1 year. A review of medical and angiographic records was performed and assessed throughout a 12-month follow-up period. RESULTS. A total of 62 patients (62 eyes) were examined. Best-corrected visual acuity (BCVA) moderately decreased without reaching a statistically noticeable level throughout the followup; reduction in lesion size reached a significant level at the second checkup. A significant correlation between higher baseline BCVA and better final visual outcome was detected. CONCLUSIONS. Standardized PDT-V minimizes central vision deterioration in patients with CNV secondary to pathologic myopia. Better BCVA at presentation represents a good predictive sign.

International Journal of Pharmaceutics, 2006

In the present study the preparation, characterization and activity of cationic liposomes contain... more In the present study the preparation, characterization and activity of cationic liposomes containing the secretory form of herpes simplex virus type 1 (HSV-1) glycoprotein B (gB1s) or two related polylysine rich peptides, namely DTK1 and DTK2, were described. The immunotherapeutic potential of these HSV antigens containing liposomes was examined with a rabbit ocular model of HSV-1 infection. Our study indicates that the liposomes (i) are able to encapsulate quantitatively gB1s and around 30% the DTK peptides, (ii) are characterized by dimensions compatible with ocular applications and (iii) can release the peptide comparably to the free solution. In addition, neutralization studies demonstrated that an anti-DTK specific polyclonal antiserum can inhibit HSV-1 infection, indicating that such peptides could be a good immunogen/antigen in an anti-HSV vaccine formulation. Although the vaccination protocol did not induce protection against the eye disease, a significative protection against a lethal ocular challenge was detectable together with the absence of reactivation episodes from latency on the survived animals. In this respect, the use of cationic liposomes coupled to gB1s and DTK peptides, as a local ocular vaccine, could represent an interesting approach in order to obtain a possible efficacy in protecting animals against a subsequent HSV-1 ocular challenge.

Thalassaemic patients with diabetes mellitus are at risk of developing retinopathy. To evaluate t... more Thalassaemic patients with diabetes mellitus are at risk of developing retinopathy. To evaluate the prevalence and the characteristics of diabetic retinopathy in thalassaemics we examined 46 patients with beta-thalassaemia major and insulin-dependent diabetes by fluorescein angiography. The study group was matched for sex, age and diabetes duration with a control group of 46 type 1 diabetic patients. Diabetic retinopathy was detected in 26% (12/46) of thalassaemics and in 50% (23/46) of the controls. In thalassaemics the diabetic retinopathy was significantly less severe than in controls (P < 0.0001). The influence of risk factors for diabetic retinopathy (duration of diabetes and metabolic control) was confirmed in the control group. In thalassaemic patients we found no significant correlation between these risk variables and the presence of diabetic retinopathy. Various factors may protect thalassaemics from diabetic retinopathy: heterogeneity of pancreatic functions; high incidence of hypogonadism; contemporary dysfunction of GH and/or glucagon secretion.

Mediterranean journal of hematology and infectious diseases, 2015

Both insulin and IGF-1 have been implicated in the control of retinal endothelial cell growth, ne... more Both insulin and IGF-1 have been implicated in the control of retinal endothelial cell growth, neovascularization and diabetic retinopathy. Recent findings have established an essential role for IGF-1 in angiogenesis and demonstrated a new target for control of retinopathy that explains why diabetic retinopathy initially increases with the onset of insulin treatment. This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of thalassemia major (TM) patients with insulin dependent diabetes mellitus (IDDM). This relation was not previously evaluated, despite the fact that both diseases co-exist in the same patient. The study also describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM. A population-based cross-sectional study. The study includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients...

Retina (Philadelphia, Pa.), 2008

Dear Editor: We read with interest the article by Matsumoto et al 1 in a recent issue of Retina. ... more Dear Editor: We read with interest the article by Matsumoto et al 1 in a recent issue of Retina. They described three patients with macular edema secondary to retinal vein occlusion who had initial resolution of edema after bevacizumab injection followed by rebound edema. Matsumoto et al hypothesized that blockage of the vascular endothelial growth factor (VEGF) pathway by bevacizumab may inhibit and/or stimulate some molecular processes in the VEGF cascade, resulting in increased edema. In support of this hypothesis, we describe a 74-year-old woman who was diagnosed with branch retinal vein occlusion in the right eye and treated with bevacizumab. It would be of interest to perform molecular studies on ocular fluids from patients undergoing antiangiogenic treatments in an attempt to better identify the phenomenon. Unfortunately, difficulty in accessing the ocular cavities and concerns about the ethicality of this surgical procedure make this task scarcely feasible at this point

Seminars in Ophthalmology, 2001

We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARG... more We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months +/- 9.7 in the light PRP and 21.6 months +/- 9.3 in the classic PRP group (p = 0.727). The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 +/- 0.13 and in the classic PRP group 0.14 +/- 0.15 (p = 0.493). The final mean VA in the former was 0.18 +/- 0.25, and in the latter 0.27 +/- 0.30 (p = 0.231). Median power was 235mW (100-540mW) for light and 420mW (200-950mW) for classic PRP (p < 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 +/- 2.4 for light and 9.9 +/- 2.2 for the classic PRP group (p < 0.001). Complications were more frequent in the classic PRP group. The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.

Vaccine, 2000

A secreted form of gB1 (gB1s), previously shown to protect rabbits against HSV-1 ocular infection... more A secreted form of gB1 (gB1s), previously shown to protect rabbits against HSV-1 ocular infection when inoculated systemically, was delivered to rabbit periocular area to evaluate its vaccine efficacy upon local administration. The efficacy of local or systemic inoculation of a gB1s-DNA-based vaccine in the rabbit model of ocular HSV-1 infection was assessed in parallel flow. Rabbits received four inoculations of the different immunogens, then immune responses and clinical symptoms were evaluated. Both the local protein and the systemic DNA administration elicited a neutralizing antibody response, reduced ocular symptoms with respect to controls (PB0.01), and completely prevented the death of rabbits from encephalitis. Conversely, local DNA vaccination did not induce any detectable antibody response, and could only partially protect rabbits from the development of encephalitis and severe ocular infection.

Thrombosis Research, 2010

Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence ... more Introduction: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence based treatment recommendations for patients with RVO cannot be made because of the lack of adequate clinical trials. To compare the efficacy and safety of aspirin and of a low molecular weight heparin, parnaparin, in the treatment of RVO. Materials and Methods: In a multicenter, randomized, double blind, controlled trial eligible patients with a delay between symptoms onset and objective diagnosis of less than 15 days were randomized to aspirin 100 mg/day for 3 months or to a fixed daily dose of parnaparin, 12.800 IU for 7 days followed by 6.400 IU for a total of 3 months. Primary end-point of the study was the incidence of functional worsening of the eye with RVO at 6 months, as assessed by fluorescein angiography, visual acuity, and visual field. Study end-points were adjudicated by an independent committee. Results: Sixty-seven patients were enrolled in the study and 58 of them (28 treated with parnaparin, 30 with aspirin) were evaluable for the analysis. Baseline characteristics were well balanced between groups. Functional worsening was adjudicated in 20.7% of patients treated with parnaparin and in 59.4% of patients treated with ASA (p = 0.002). Recurrent RVO was diagnosed in 3 patients, all treated with ASA (p = n.s.). Bleeding rates were similar between the two groups. Conclusions: Parnaparin appears to be more effective than aspirin in preventing functional worsening in patients with RVO. The results of this study need to be confirmed in a larger clinical trial. Trial registration number: Clinical trials.gov NCT00732927.