Paolo Turchetti - Academia.edu (original) (raw)

Papers by Paolo Turchetti

. The objectives of this observational study are to evaluate the occurrence of A.K. in patients a... more . The objectives of this observational study are to evaluate the occurrence of A.K. in patients accessing the Department of Special Senses of the Teaching Hospital "Policlinico Umberto I" of Rome with ocular infections during the period from 2005 to 2011, and the role played by risk factors which included contact lenses, TRAUMA, sex and age.

La Clinica terapeutica

Aim. This observational study was performed to evaluate the efficacy and safety of intra-vitreal ... more Aim. This observational study was performed to evaluate the efficacy and safety of intra-vitreal injections of pegaptanib during a 12-month follow-up period.

La Clinica terapeutica

Macular myopic degeneration (MMD) tends to progress in approximately 40% of highly myopic eyes (1... more Macular myopic degeneration (MMD) tends to progress in approximately 40% of highly myopic eyes (1). Pathologic myopia is a leading cause of visual impairment, and is the Abstract Purpose. To evaluate the effectiveness of biofeedback treatment for low-vision rehabilitation in patients affected by macular disease.

La Clinica terapeutica

Purpose: A double-blind placebo-controlled study on 68 patients suffering by Diabetic Retinopathy... more Purpose: A double-blind placebo-controlled study on 68 patients suffering by Diabetic Retinopathy was aimed in order to evaluate the effectiveness of Mesoglycan in this pathology. This drug is particularly interested in treatment of disorders of microcirculation. Materials and methods: The two treatments were randomly assigned to each patient, using a 100 mg/day dosage of Mesoglycan, and both treatments were prescribed for 6 months. The efficacy of both treatments was based on clinical and instrumental check.

Ophthalmology and Eye Diseases, 2014

European Journal of Medical Research, 2012

Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual pat... more Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual patient with severe vision loss who had received previous antibiotics treatment. Syphilis-related ocular manifestation is more common in the early stages of the disease and it can be associated with a central nervous system localization. In this patient, neurosyphilis was diagnosed on the basis of clinical and laboratory findings. Optical examination revealed unilateral papillitis in the left eye and no relative afferent pupillary defects. The patient underwent visual field examinations with conventional perimetry using the 30-2 program of the Humphrey Visual Field Analyzer, which indicated a blind spot enlargement in the left eye. Optical coherence tomography, visual evoked potentials (VEP), and fluorescein angiograms revealed inflammation of the optic nerve head with edematous and blurred margins. A reactive T. pallidum hemagglutination assay with low rapid plasma reagin (RPR) serum titer was performed; an HIV antibody test and MRI of the orbits and head with contrast gave negative results. Resolution of the ocular inflammation after intravenous penicillin treatment was obtained. The reported case illustrates the importance of early recognition of this treatable disease. The rise of syphilis, especially in urban areas, necessitates a high level of suspicion when dealing with patients with intraocular inflammation of unknown origin. Lues serology should be incorporated into routine laboratory diagnostics to aid in the detection of such cases. Considering the re-emergence of syphilis, screening of migrants from countries with high syphilis seroprevalences should be recommended.

Ophthalmology and Eye Diseases, 2015

To investigate possible age-related changes in glycosaminoglycans (GAGs) in the human cornea. he ... more To investigate possible age-related changes in glycosaminoglycans (GAGs) in the human cornea. he substances today called GAGs were previously referred to as mucopolysaccharides. METHODS: Samples of human cornea were taken from 12 younger (age 21 ± 1.2) and 12 older (age 72 ± 1.6) male subjects. Samples were weighed, homogenized, and used for biochemical and molecular analyses. All the quantitative results were statistically analyzed. R ESULTS: he human cornea appears to undergo age-related changes, as evidenced by our biochemical and molecular results. he total GAG and hyaluronic acid counts were signiicantly higher in the younger subjects than in the older subjects. he sulfated heavy GAGs, such as chondroitin, dermatan, keratan, and heparan sulfate, were lower in the younger subjects than in the older subjects. DISCUSSION: GAGs of the human cornea undergo numerous age-related changes. heir quantity is signiicantly altered in the elderly in comparison with younger subjects. GAGs play an important role in age-related diseases of the human cornea.

European Journal of Epidemiology, 2013

Age-related macular degeneration (AMD) is the leading cause of severe visual loss among people ag... more Age-related macular degeneration (AMD) is the leading cause of severe visual loss among people aged 50 years and older in the developed world . Cigarette smoking, hypertension, inflammation and alcohol consumption, have been shown to be associated with AMD in some, but not all studies . In our study we have evaluated the synergistic effect of alcohol and tobacco smoking with other risk factors in the risk of developing AMD.

Clinical Ophthalmology, 2013

Background: This randomized double-blind study examined the use of a new anesthetic agent, levobu... more Background: This randomized double-blind study examined the use of a new anesthetic agent, levobupivacaine 0.5%, which is the S()-enantiomer of a racemic mixture of bupivacaine, for peribulbar anesthesia and compared it with racemic bupivacaine 0.5% alone or in combination with hyaluronidase 10 IU/mL. Methods: A total of 160 patients undergoing ophthalmic surgery were randomized into four groups (n = 40 each) to receive inferotemporal peribulbar injection of levobupivacaine 0.5% (group L), racemic bupivacaine 0.5% (group B), levobupivacaine + hyaluronidase 10 IU/mL (group LH), or racemic bupivacaine + hyaluronidase 10 IU/mL (group BH) by two anesthetists and two ophthalmologists in a ratio of 25% each. Ocular akinesia and orbicularis oculi function were evaluated using a three-point scale; a value , 5 points was considered as requiring surgery, and movements were re-evaluated the day following surgery to confirm regression of the block. Results: The time to onset (12 ± 2.6 minutes versus 13 ± 2.8 minutes) and duration of anesthesia (185 ± 33.2 minutes versus 188 ± 35.7 minutes) were similar between groups L and B. Complete akinesia (score 0) was obtained more frequently when hyaluronidase was used in addition to the anesthetic, with occurrences of 72.5% versus 57.5% in group LH versus L, respectively, and 67.5% versus 45% in group BH versus B. Moderate hypotension (,30% of baseline) was observed in four patients (10%) in group L, two (5.0%) in group B, one (2.5%) in group LH, and three (7.5%) in group BH. The time to onset was significantly different between groups L and BH, B and BH, and LH and BH, and the duration of anesthesia differed significantly between groups B and LH, B and BH, and L and LH. The akinesia score differed significantly between groups L and LH and between groups B and LH (P = 0.043 and P = 0.018, respectively), and the number of patients with a score of 0 differed significantly between groups B and LH and between groups B and BH (P = 0.004 and P = 0.017, respectively). Conclusion: Levobupivacaine is a long-lasting local anesthetic with limited cardiotoxicity and neurotoxicity, and may be considered the landmark for vitreoretinal surgery in elderly patients.

Clinical Ophthalmology, 2013

Background: To evaluate the efficacy and safety of an intravitreal dexamethasone implant (Ozurdex... more Background: To evaluate the efficacy and safety of an intravitreal dexamethasone implant (Ozurdex ® ; Allergan Inc, Irvine, CA, USA) in patients with persistent diabetic macular edema (DME) over a 6-month follow-up period. Methods: Seventeen patients (20 eyes) affected by DME were selected. The mean age was 67 ± 8 years, and the mean duration of DME was 46.3 ± 18.6 months. The eligibility criteria were: age 18,abest−correctedvisualacuitybetween5and40letters,andmacularedemawithathicknessof18, a best-corrected visual acuity between 5 and 40 letters, and macular edema with a thickness of 18,abest−correctedvisualacuitybetween5and40letters,andmacularedemawithathicknessof275 µm. Thirteen patients had also previously been treated with anti-vascular endothelial growth factor medication. Results: The mean ETDRS (Early Treatment Diabetic Retinopathy Study) value went from 18.80 ± 11.06 (T0) to 26.15 ± 11.03 (P = 0.04), 28.15 ± 10.29 (P = 0.0087), 25.95 ± 10.74 (P = 0.045), 21.25 ± 11.46 (P = 0.5) in month 1, 3, 4, and 6, respectively. The mean logMAR (logarithm of the minimum angle of resolution) value went from 0.67 ± 0.23 (at T0) to 0.525 ± 0.190 (P = 0.03), 0.53 ± 0.20 (P = 0.034), and 0.56 ± 0.22 (P = 0.12) in month 1, 3, and 4, respectively, to finally reach 0.67 ± 0.23 in month 6. The mean central macular thickness value improved from 518.80 ± 224.75 µm (at T0) to 412.75 ± 176.23 µm, 292.0 ± 140.8 µm (P , 0.0001), and 346.95 ± 135.70 (P = 0.0018) on day 3 and in month 1 and 3, respectively, to then increase to 476.55 ± 163.14 µm (P = 0.45) and 494.25 ± 182.70 µm (P = 0.67) in month 4 and 6. Conclusion: The slow-release intravitreal dexamethasone implant, Ozurdex, produced significant improvements in best-corrected visual acuity and central macular thickness from the third day of implant in DME sufferers, and this improvement was sustained until the third month.

Clinical Ophthalmology, 2012

The purpose of this study was to demonstrate the hypotensive efficacy and tolerability of latanop... more The purpose of this study was to demonstrate the hypotensive efficacy and tolerability of latanoprost when used as monotherapy and as polytherapy associated with antiglaucomatous medication proven to be ineffective in keeping intraocular pressure under control. Methods: Three hundred and thirty-seven patients (672 eyes) affected by primary open-angle glaucoma and intraocular hypertension were recruited over a period of 10 years from the Glaucoma Centre, Department of Ophthalmological Sciences, University of Rome "Sapienza", and treated, subject to informed consent, with latanoprost 0.005% alone or in combination with other ocular hypotensive drugs. The patients were followed during this period at regular intervals, with determination of visual field, fundus oculi, visual acuity, and eventual onset of local and systemic side effects. Results: Latanoprost used as monotherapy and as polytherapy renders possible optimal and durable control of intraocular pressure in the form of one antiglaucomatous drug because it can substitute for one or more drugs and obtain the same hypotensive effect. Conclusion: Latanoprost can be described as the ideal hypotensive drug, not only because of its ideal compliance profile (only one daily dose in the evening), excellent hypotensive effect, and, above all, few systemic side effects.

Introduction: Antiangiogenic agents are often administered for treatment of Branch Retinal Vein

. The objectives of this observational study are to evaluate the occurrence of A.K. in patients a... more . The objectives of this observational study are to evaluate the occurrence of A.K. in patients accessing the Department of Special Senses of the Teaching Hospital "Policlinico Umberto I" of Rome with ocular infections during the period from 2005 to 2011, and the role played by risk factors which included contact lenses, TRAUMA, sex and age.

La Clinica terapeutica

Aim. This observational study was performed to evaluate the efficacy and safety of intra-vitreal ... more Aim. This observational study was performed to evaluate the efficacy and safety of intra-vitreal injections of pegaptanib during a 12-month follow-up period.

La Clinica terapeutica

Macular myopic degeneration (MMD) tends to progress in approximately 40% of highly myopic eyes (1... more Macular myopic degeneration (MMD) tends to progress in approximately 40% of highly myopic eyes (1). Pathologic myopia is a leading cause of visual impairment, and is the Abstract Purpose. To evaluate the effectiveness of biofeedback treatment for low-vision rehabilitation in patients affected by macular disease.

La Clinica terapeutica

Purpose: A double-blind placebo-controlled study on 68 patients suffering by Diabetic Retinopathy... more Purpose: A double-blind placebo-controlled study on 68 patients suffering by Diabetic Retinopathy was aimed in order to evaluate the effectiveness of Mesoglycan in this pathology. This drug is particularly interested in treatment of disorders of microcirculation. Materials and methods: The two treatments were randomly assigned to each patient, using a 100 mg/day dosage of Mesoglycan, and both treatments were prescribed for 6 months. The efficacy of both treatments was based on clinical and instrumental check.

Ophthalmology and Eye Diseases, 2014

European Journal of Medical Research, 2012

Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual pat... more Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual patient with severe vision loss who had received previous antibiotics treatment. Syphilis-related ocular manifestation is more common in the early stages of the disease and it can be associated with a central nervous system localization. In this patient, neurosyphilis was diagnosed on the basis of clinical and laboratory findings. Optical examination revealed unilateral papillitis in the left eye and no relative afferent pupillary defects. The patient underwent visual field examinations with conventional perimetry using the 30-2 program of the Humphrey Visual Field Analyzer, which indicated a blind spot enlargement in the left eye. Optical coherence tomography, visual evoked potentials (VEP), and fluorescein angiograms revealed inflammation of the optic nerve head with edematous and blurred margins. A reactive T. pallidum hemagglutination assay with low rapid plasma reagin (RPR) serum titer was performed; an HIV antibody test and MRI of the orbits and head with contrast gave negative results. Resolution of the ocular inflammation after intravenous penicillin treatment was obtained. The reported case illustrates the importance of early recognition of this treatable disease. The rise of syphilis, especially in urban areas, necessitates a high level of suspicion when dealing with patients with intraocular inflammation of unknown origin. Lues serology should be incorporated into routine laboratory diagnostics to aid in the detection of such cases. Considering the re-emergence of syphilis, screening of migrants from countries with high syphilis seroprevalences should be recommended.

Ophthalmology and Eye Diseases, 2015

To investigate possible age-related changes in glycosaminoglycans (GAGs) in the human cornea. he ... more To investigate possible age-related changes in glycosaminoglycans (GAGs) in the human cornea. he substances today called GAGs were previously referred to as mucopolysaccharides. METHODS: Samples of human cornea were taken from 12 younger (age 21 ± 1.2) and 12 older (age 72 ± 1.6) male subjects. Samples were weighed, homogenized, and used for biochemical and molecular analyses. All the quantitative results were statistically analyzed. R ESULTS: he human cornea appears to undergo age-related changes, as evidenced by our biochemical and molecular results. he total GAG and hyaluronic acid counts were signiicantly higher in the younger subjects than in the older subjects. he sulfated heavy GAGs, such as chondroitin, dermatan, keratan, and heparan sulfate, were lower in the younger subjects than in the older subjects. DISCUSSION: GAGs of the human cornea undergo numerous age-related changes. heir quantity is signiicantly altered in the elderly in comparison with younger subjects. GAGs play an important role in age-related diseases of the human cornea.

European Journal of Epidemiology, 2013

Age-related macular degeneration (AMD) is the leading cause of severe visual loss among people ag... more Age-related macular degeneration (AMD) is the leading cause of severe visual loss among people aged 50 years and older in the developed world . Cigarette smoking, hypertension, inflammation and alcohol consumption, have been shown to be associated with AMD in some, but not all studies . In our study we have evaluated the synergistic effect of alcohol and tobacco smoking with other risk factors in the risk of developing AMD.

Clinical Ophthalmology, 2013

Background: This randomized double-blind study examined the use of a new anesthetic agent, levobu... more Background: This randomized double-blind study examined the use of a new anesthetic agent, levobupivacaine 0.5%, which is the S()-enantiomer of a racemic mixture of bupivacaine, for peribulbar anesthesia and compared it with racemic bupivacaine 0.5% alone or in combination with hyaluronidase 10 IU/mL. Methods: A total of 160 patients undergoing ophthalmic surgery were randomized into four groups (n = 40 each) to receive inferotemporal peribulbar injection of levobupivacaine 0.5% (group L), racemic bupivacaine 0.5% (group B), levobupivacaine + hyaluronidase 10 IU/mL (group LH), or racemic bupivacaine + hyaluronidase 10 IU/mL (group BH) by two anesthetists and two ophthalmologists in a ratio of 25% each. Ocular akinesia and orbicularis oculi function were evaluated using a three-point scale; a value , 5 points was considered as requiring surgery, and movements were re-evaluated the day following surgery to confirm regression of the block. Results: The time to onset (12 ± 2.6 minutes versus 13 ± 2.8 minutes) and duration of anesthesia (185 ± 33.2 minutes versus 188 ± 35.7 minutes) were similar between groups L and B. Complete akinesia (score 0) was obtained more frequently when hyaluronidase was used in addition to the anesthetic, with occurrences of 72.5% versus 57.5% in group LH versus L, respectively, and 67.5% versus 45% in group BH versus B. Moderate hypotension (,30% of baseline) was observed in four patients (10%) in group L, two (5.0%) in group B, one (2.5%) in group LH, and three (7.5%) in group BH. The time to onset was significantly different between groups L and BH, B and BH, and LH and BH, and the duration of anesthesia differed significantly between groups B and LH, B and BH, and L and LH. The akinesia score differed significantly between groups L and LH and between groups B and LH (P = 0.043 and P = 0.018, respectively), and the number of patients with a score of 0 differed significantly between groups B and LH and between groups B and BH (P = 0.004 and P = 0.017, respectively). Conclusion: Levobupivacaine is a long-lasting local anesthetic with limited cardiotoxicity and neurotoxicity, and may be considered the landmark for vitreoretinal surgery in elderly patients.

Clinical Ophthalmology, 2013

Background: To evaluate the efficacy and safety of an intravitreal dexamethasone implant (Ozurdex... more Background: To evaluate the efficacy and safety of an intravitreal dexamethasone implant (Ozurdex ® ; Allergan Inc, Irvine, CA, USA) in patients with persistent diabetic macular edema (DME) over a 6-month follow-up period. Methods: Seventeen patients (20 eyes) affected by DME were selected. The mean age was 67 ± 8 years, and the mean duration of DME was 46.3 ± 18.6 months. The eligibility criteria were: age 18,abest−correctedvisualacuitybetween5and40letters,andmacularedemawithathicknessof18, a best-corrected visual acuity between 5 and 40 letters, and macular edema with a thickness of 18,abest−correctedvisualacuitybetween5and40letters,andmacularedemawithathicknessof275 µm. Thirteen patients had also previously been treated with anti-vascular endothelial growth factor medication. Results: The mean ETDRS (Early Treatment Diabetic Retinopathy Study) value went from 18.80 ± 11.06 (T0) to 26.15 ± 11.03 (P = 0.04), 28.15 ± 10.29 (P = 0.0087), 25.95 ± 10.74 (P = 0.045), 21.25 ± 11.46 (P = 0.5) in month 1, 3, 4, and 6, respectively. The mean logMAR (logarithm of the minimum angle of resolution) value went from 0.67 ± 0.23 (at T0) to 0.525 ± 0.190 (P = 0.03), 0.53 ± 0.20 (P = 0.034), and 0.56 ± 0.22 (P = 0.12) in month 1, 3, and 4, respectively, to finally reach 0.67 ± 0.23 in month 6. The mean central macular thickness value improved from 518.80 ± 224.75 µm (at T0) to 412.75 ± 176.23 µm, 292.0 ± 140.8 µm (P , 0.0001), and 346.95 ± 135.70 (P = 0.0018) on day 3 and in month 1 and 3, respectively, to then increase to 476.55 ± 163.14 µm (P = 0.45) and 494.25 ± 182.70 µm (P = 0.67) in month 4 and 6. Conclusion: The slow-release intravitreal dexamethasone implant, Ozurdex, produced significant improvements in best-corrected visual acuity and central macular thickness from the third day of implant in DME sufferers, and this improvement was sustained until the third month.

Clinical Ophthalmology, 2012

The purpose of this study was to demonstrate the hypotensive efficacy and tolerability of latanop... more The purpose of this study was to demonstrate the hypotensive efficacy and tolerability of latanoprost when used as monotherapy and as polytherapy associated with antiglaucomatous medication proven to be ineffective in keeping intraocular pressure under control. Methods: Three hundred and thirty-seven patients (672 eyes) affected by primary open-angle glaucoma and intraocular hypertension were recruited over a period of 10 years from the Glaucoma Centre, Department of Ophthalmological Sciences, University of Rome "Sapienza", and treated, subject to informed consent, with latanoprost 0.005% alone or in combination with other ocular hypotensive drugs. The patients were followed during this period at regular intervals, with determination of visual field, fundus oculi, visual acuity, and eventual onset of local and systemic side effects. Results: Latanoprost used as monotherapy and as polytherapy renders possible optimal and durable control of intraocular pressure in the form of one antiglaucomatous drug because it can substitute for one or more drugs and obtain the same hypotensive effect. Conclusion: Latanoprost can be described as the ideal hypotensive drug, not only because of its ideal compliance profile (only one daily dose in the evening), excellent hypotensive effect, and, above all, few systemic side effects.

Introduction: Antiangiogenic agents are often administered for treatment of Branch Retinal Vein