Silvana Guerriero | Università degli Studi di Bari (original) (raw)
Papers by Silvana Guerriero
Ocular Adnexa Non Hodgkin Lymphomas : A Single Centre Retrospective Study of Clinicopathologic Features, Treatment and Clinical Outcome
A Boy With Visual Loss
Pediatric Infectious Disease Journal
Spectral Domain Optical Coherence Tomography Evaluation Of Peripapillary Retinal Nerve Fiber Layer In Multiple Sclerosis, Clinically Isolated Syndrome And Control Patients
Investigative Ophthalmology & Visual Science, Mar 26, 2012
To investigate the influence of glaucoma and myopia on the cross-sectional configuration of the β... more To investigate the influence of glaucoma and myopia on the cross-sectional configuration of the β-zone of peripapillary atrophy (PPA-β) using spectral-domain optical coherence tomography (SD-OCT). Cross-sectional B-scan images of PPA-β obtained with SD-OCT were evaluated in 100 eyes of 100 consecutive patients with POAG, regardless of intraocular pressure level, and in 100 eyes of 100 normal subjects. PPA bed configurations were classified, and associated factors were studied with multivariate analysis. In 147 eyes with PPA-β (84 POAG and 63 normal eyes; P = 0.0012), the PPA bed was composed of straight (14 POAG and 27 normal eyes) or downward-curved (19 and 8 eyes) Bruch's membrane (BM) or of a downward-bending slope lacking BM (BM defect; 51 and 28 eyes). Multivariate analysis revealed that absence of POAG (odds ratio [OR], 0.36; P = 0.034) and less myopic refractive error (OR, 1.43; P = 0.009) were significantly associated with straight-BM-type, presence of POAG (OR, 5.74; P ...
Bacterial isolates and antimicrobial susceptibility pattern of ocular infection at a tertiary referral hospital in the South of Italy
European Journal of Ophthalmology, May 31, 2022
Clinical and Experimental Ophthalmology, Apr 21, 2011
Purpose: To report the clinical features of Vogt-Koyanagi-Harada syndrome presented with bilatera... more Purpose: To report the clinical features of Vogt-Koyanagi-Harada syndrome presented with bilateral acute angle closure glaucoma in 4 Chinese patients. Methods: The medical records were retrospectively reviewed. Results: Visual acuity ranged from counting fingers before the eye to 6/30. Intraocular pressure ranged from 22.2 to 29.7 mmHg with or without anterior chamber inflammation. Mild vitritis and massive exudative retinal detachment were seen. B scan and fundus fluorescein angiography supported the diagnosis. After corticosteroid treatment, the increased intraocular pressure was resolved with deepened anterior chamber and open angle. Inflammation was controlled and visual acuity was improved. Conclusions: Bilateral acute angle closure glaucoma could be the initial symptom of Vogt-Koyanagi-Harada syndrome. Mild increased intraocular pressure in association with moderate to severe visual disturbance in both eyes is an important sign of this diagnosis. Careful fundus examination and B scan are helpful in diagnosis.
: Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic infl... more : Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic inflammation in CAPS patients. Clinicians must balance potential benefits of pneumococcal immunisation against safety concerns. References: [1] Kuemmerle-Deschner JB, et al. Safety and Efficacy of Canakinumab in Patients with CAPS: Interim Results from the Beta-Confident Registry [abstract].
Eye & Contact Lens-science and Clinical Practice, 2011
To describe ultrasound biomicroscopy (UBM) features in a patient with Axenfeld-Rieger syndrome (A... more To describe ultrasound biomicroscopy (UBM) features in a patient with Axenfeld-Rieger syndrome (ARS) and cataract before and after anterior segment surgery using intraocular lens (IOL) and aniridic ring implantation (Morcher Aniridia rings 50 D). Methods: Visual acuity, subjective glare disability, intraocular pressure, endothelial cell density, and UBM imaging were reviewed over a period of 1 year. Results: One month after surgery, the operated eye showed improved visual acuity and visual comfort, and UBM examination showed a wellcentered IOL and well-aligned aniridic ring fins. After 8 months, UBM examination showed contraction of the capsular bag, which appeared wrinkled, fibrous, and thickened. The capsular bag comprised the aniridic ring fins, causing misalignment. The glare disability had dropped from grade 0 to 3. The same outcome was present at 1 year. Conclusion: Ultrasound biomicroscopy is a useful noninvasive diagnostic means to picture anatomic details before and after surgery; it suggested that capsular bag shrinking caused migration of the aniridic rings, 8 months after surgery.
In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SAR... more In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SARCOGEAS) of patients with sarcoidosis. Sarcoidosis was diagnosed in agreement with the criteria proposed by the ATS/ERS/WASOG 1999 statement, and extrathoracic disease was classified with the 2014 WASOG instrument. Results: The cohort consisted of 1082 patients (82% biopsy-proven), including 618 (57%) women and 464 (43%) men, with a mean age at diagnosis of 47yrs; 140 (13%) patients were born outside Spain, 965 (89%) were White, 69 (6%) Hispanic, 30 (3%) Black/African American and 18 (2%) Asian. Thoracic involvement was present at diagnosis in 979 (90%) patients, including 437 (40%) patients with stage I, 374 (35%) with stage II, 123 (11%) with stage III and 26 (2%) with stage IV. The most frequently reported extrathoracic involvements at diagnosis were cutaneous in 385 (36%) patients, extrathoracic lymph nodes in 218 (20%), liver involvement in 151 (14%) and ocular involvement in 118 (11%). Potentially life-threatening WASOG involvements were reported in frequencies less than 10%, including neurological involvement in 77 (7%) patients, kidney involvement in 59 (5%) or cardiac involvement in 21 (2%). Therapeutic approaches at diagnosis included the use of oral glucocorticosteroids in 637 (59%) patients, immunosuppressive agents in 84 (8%, mainly methotrexate in 63 patients) and biological agents in 15 (1%, mainly infliximab in 10 cases). Conclusions: In this large series of sarcoidosis from Southern Europe, clinical presentation is dominated by adenopathies (both thoracic and extrathoracic) and cutaneous involvement (erythema nodosum), with lower frequencies in the main extrathoracic involvements than that reported in US and Japanese series.
Ciliochoroidal effusion syndrome associated with mebendazole systemic treatment
Canadian journal of ophthalmology, Feb 1, 2023
To determine the cause of angle-closure glaucoma in a case of posterior scleritis. The patient wa... more To determine the cause of angle-closure glaucoma in a case of posterior scleritis. The patient was a 65-year-old woman with unilateral acute angle-closure glaucoma who did not respond to laser iridotomy. Slit-lamp examination demonstrated a shallow anterior chamber in the left eye. Intraocular pressure was 22 mmHg even after application of two antiglaucoma eye-drop preparations. B-scan ultrasonography demonstrated scleral thickening and choroidal detachment in the left eye. Ultrasound biomicroscopy showed a shallow anterior chamber with angle closure, annular ciliochoroidal effusion with ciliary body edema, and an anterior rotation of the ciliary body. After instillation of cycloplegics, the ciliary body and ciliary processes rotated posteriorly, resulting in the release of the pressure on the iris. These changes led to the opening of the angle and subsequent normalization of intraocular pressure. A diagnosis was made of ciliochoroidal effusion syndrome associated with posterior scleritis. Patients with posterior scleritis can develop ciliochoroidal effusion syndrome, which can lead to angle-closure glaucoma. The therapeutic strategy for acute angle-closure glaucoma induced by ciliochoroidal effusion syndrome differs completely from that for acute angle-closure glaucoma with pupillary block. In the case of ciliochoroidal effusion syndrome, it is important to relieve the compression of the angle by the iris by displacing the lens-iris diaphragm posteriorly by cycloplegics.
Frontiers in Medicine
IntroductionThis paper describes the creation and preliminary results of a patient-driven registr... more IntroductionThis paper describes the creation and preliminary results of a patient-driven registry for the collection of patient-reported outcomes (PROs) and patient-reported experiences (PREs) in Behçet’s disease (BD).MethodsThe project was coordinated by the University of Siena and the Italian patient advocacy organization SIMBA (Associazione Italiana Sindrome e Malattia di Behçet), in the context of the AIDA (AutoInflammatory Diseases Alliance) Network programme. Quality of life, fatigue, socioeconomic impact of the disease and therapeutic adherence were selected as core domains to include in the registry.ResultsRespondents were reached via SIMBA communication channels in 167 cases (83.5%) and the AIDA Network affiliated clinical centers in 33 cases (16.5%). The median value of the Behçet’s Disease Quality of Life (BDQoL) score was 14 (IQR 11, range 0–30), indicating a medium quality of life, and the median Global Fatigue Index (GFI) was 38.7 (IQR 10.9, range 1–50), expressing a ...
Scientific Abstracts
BackgroundEvidence about the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA... more BackgroundEvidence about the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious intermediate uveitis/pars planitis, posterior uveitis and panuveitis is still limited.ObjectivesAim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis.MethodsThis is an international multicenter study based on real-life data from pediatric patients treated with ADA due to non-anterior uveitis. Data were drawn from the retrospective branch of the AutoInflammatory Disease Alliance (AIDA) registry dedicated to uveitis. Figure 1 provides the flow diagram describing the selection of the patients enrolled on October 1st, 2022.Results21 patients (36 affected eyes) were enrolled. Eleven patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a partial response with reduced frequency of relapses (3 cases), re...
Internal and Emergency Medicine, Mar 7, 2023
This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet's syndro... more This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet's syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behçet's Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behçet's Syndrome Overall Damage Index was 0 (range 0-4). Colchicine was inefficacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p = 0.46) or the concomitant therapy (p = 0.30 for cDMARDs, p = 1.00 for glucocorticoids); cDMARDs and bDMARDs were inefficacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefficacy (p = 0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono-or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively affects response to biologic therapies. ClinicalTrials.gov Identifier: NCT05200715 (registered on December 18, 2021).
Efficacy of monoclonal anti-tumour necrosis factor-α antibodies in uveitic macular oedema
Clinical and experimental rheumatology, 2019
OBJECTIVES To assess the efficacy of anti-tumour necrosis factor (TNF)-α agents in the treatment ... more OBJECTIVES To assess the efficacy of anti-tumour necrosis factor (TNF)-α agents in the treatment of refractory uveitic macular oedema (UME). METHODS Patients with refractory UME treated with TNF-α blockers were retrospectively enrolled. Central macular thickness (CMT) was assessed at optical coherence tomography (OCT) at the start of TNF-α inhibition, after 3 and 12 months, and at the last follow-up visit. RESULTS Thirty-six patients (56 eyes with UME) were enrolled. The mean follow-up period was 29.9±40.8 (4-184) months. A statistically significant decrease was observed in the frequency of UME (p<0.0001) and in the mean CMT values (p<0.0001) during the study period. Best corrected visual acuity improved in 35 eyes (62.5%), remained stable in 12 eyes (21.4%), reduced in 9 eyes (16.1%). The mean corticosteroid dosage significantly decreased during the study period (p=0.016). CONCLUSIONS TNF-α inhibitors represent a useful treatment in patients with severe or resistant UME.
Mitochondrial ND5 geme nucleotide variants in a patient with ptical atrophy and renal involvement
Clinical and experimental rheumatology, 2019
OBJECTIVES The aim of the study was to evaluate the efficacy of golimumab (GOL) and certolizumab ... more OBJECTIVES The aim of the study was to evaluate the efficacy of golimumab (GOL) and certolizumab pegol (CZP) as additional treatment options for the treatment of uveitis. METHODS Patients with longstanding uveitis receiving either GOL or CZP were retrospectively evaluated in terms of frequency of ocular flares, drug survival, changes in best corrected visual acuity (BCVA) and steroid-sparing effect. RESULTS Twenty-one patients (30 eyes), 17 of whom being female, were enrolled in the study; 16 out of 21 patients had been previously treated with other tumour necrosis factor (TNF)-α blockers. A significant reduction in ocular flares (from 128.6 bouts for 100 patients-year to 42.9 events for 100 patients-year) was observed between the 12 months prior to the start of GOL or CZP and the 12 months thereafter (p=0.01). The 36-month drug survival was 54.5% for CZP and 50.0% for GOL with no statistically significant differences between the two biologic agents. No differences were detected con...
Abstracts Accepted for Publication, 2017
not any dose GCs group. Case 1-3 took NSAIDs. Case 2 received mPSL pulse therapy (mPSL 1 g x 3 da... more not any dose GCs group. Case 1-3 took NSAIDs. Case 2 received mPSL pulse therapy (mPSL 1 g x 3 days). Case 1 and 2 developed SDPs within 3 months from initiating GCs. Case 1 recurred SDPs at 17 and 63 months from initiating GCs. Case 2 was prescribed Tacrolimus as a concurrent medication. All four patients were operated to remove the perforated segment, and case 2 and 4 were created artificial anus. Although they were clinically diagnosed as SDPs only case 4 clarified perforation in pathological findings. We should take care of developing SDPs in patients described high dose GCs. [1] Mpofu S, Mpofu CM, Hutchinson D, Maier AE, Dodd SR, Moots RJ. Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheu-matic conditions. Ann Rheum Dis 2004; 63: 588-590. [2] Humes DJ, Fleming KM, Spiller RC, West J. Concurrent drug use and the risk of perforated colonic diverticular dis-ease: a population-based case-control study. Gut 2011; 60: 219-224.
From computer-assisted echography to a multielement linear curtain ultrasonic system
Documenta Ophthalmologica Proceedings Series, 1993
This paper describes research within the CNR’s Progetto Finalizzato ‘Tecnologie Biomediche e Sani... more This paper describes research within the CNR’s Progetto Finalizzato ‘Tecnologie Biomediche e Sanitarie’, subproject ‘ultrasounds’. The aims of this study were as follows: (1) in the field of digital processing of B-scan images, aimed at tissue characterization by means of texture analysis; and (2) in the design and implementation of an echographic unit for ophthalmology, with advanced technical features. The prototype of the electronic interface between a 64-element linear curtain transducer, at 10 MHz, and the videofrequency section of the last unit is working actually, included in a commercial echograph produced by ESAOTE-Biomedica. In this paper, experimental results obtained with the developed hardware are shown. The integration of hardware and software modules within a single advanced unit is currently in progress. It will be based on a personal computer, supported by a video interface and by the hardware modules now under test.
Possibility of ocular tissue differentiation by means of false-color assisted echography
Documenta Ophthalmologica Proceedings Series, 1987
The Eye Clinic of the Bari University and the Signal and Image Processing Institute (I.E.S.I.) of... more The Eye Clinic of the Bari University and the Signal and Image Processing Institute (I.E.S.I.) of C.N.R. in the framework of the ‘Progetto Finalizzato Tecnologie Biomediche’ of C.N.R. are carrying out research on diagnostic methodologies of eye echography through the introduction of digital image processing. This is being done in order to develop techniques capable of extracting the maximum amount of information possible from echo patterns.
Improvements to computer assisted echography
Documenta Ophthalmologica Proceedings Series, 1988
The authors report their continuing research aimed at computer aided echography by processing B-s... more The authors report their continuing research aimed at computer aided echography by processing B-scan videofrequency images with SGLD method. They find a reduction of subjectivity of diagnosis of pathology.
Ocular Adnexa Non Hodgkin Lymphomas : A Single Centre Retrospective Study of Clinicopathologic Features, Treatment and Clinical Outcome
A Boy With Visual Loss
Pediatric Infectious Disease Journal
Spectral Domain Optical Coherence Tomography Evaluation Of Peripapillary Retinal Nerve Fiber Layer In Multiple Sclerosis, Clinically Isolated Syndrome And Control Patients
Investigative Ophthalmology & Visual Science, Mar 26, 2012
To investigate the influence of glaucoma and myopia on the cross-sectional configuration of the β... more To investigate the influence of glaucoma and myopia on the cross-sectional configuration of the β-zone of peripapillary atrophy (PPA-β) using spectral-domain optical coherence tomography (SD-OCT). Cross-sectional B-scan images of PPA-β obtained with SD-OCT were evaluated in 100 eyes of 100 consecutive patients with POAG, regardless of intraocular pressure level, and in 100 eyes of 100 normal subjects. PPA bed configurations were classified, and associated factors were studied with multivariate analysis. In 147 eyes with PPA-β (84 POAG and 63 normal eyes; P = 0.0012), the PPA bed was composed of straight (14 POAG and 27 normal eyes) or downward-curved (19 and 8 eyes) Bruch&amp;#39;s membrane (BM) or of a downward-bending slope lacking BM (BM defect; 51 and 28 eyes). Multivariate analysis revealed that absence of POAG (odds ratio [OR], 0.36; P = 0.034) and less myopic refractive error (OR, 1.43; P = 0.009) were significantly associated with straight-BM-type, presence of POAG (OR, 5.74; P ...
Bacterial isolates and antimicrobial susceptibility pattern of ocular infection at a tertiary referral hospital in the South of Italy
European Journal of Ophthalmology, May 31, 2022
Clinical and Experimental Ophthalmology, Apr 21, 2011
Purpose: To report the clinical features of Vogt-Koyanagi-Harada syndrome presented with bilatera... more Purpose: To report the clinical features of Vogt-Koyanagi-Harada syndrome presented with bilateral acute angle closure glaucoma in 4 Chinese patients. Methods: The medical records were retrospectively reviewed. Results: Visual acuity ranged from counting fingers before the eye to 6/30. Intraocular pressure ranged from 22.2 to 29.7 mmHg with or without anterior chamber inflammation. Mild vitritis and massive exudative retinal detachment were seen. B scan and fundus fluorescein angiography supported the diagnosis. After corticosteroid treatment, the increased intraocular pressure was resolved with deepened anterior chamber and open angle. Inflammation was controlled and visual acuity was improved. Conclusions: Bilateral acute angle closure glaucoma could be the initial symptom of Vogt-Koyanagi-Harada syndrome. Mild increased intraocular pressure in association with moderate to severe visual disturbance in both eyes is an important sign of this diagnosis. Careful fundus examination and B scan are helpful in diagnosis.
: Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic infl... more : Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic inflammation in CAPS patients. Clinicians must balance potential benefits of pneumococcal immunisation against safety concerns. References: [1] Kuemmerle-Deschner JB, et al. Safety and Efficacy of Canakinumab in Patients with CAPS: Interim Results from the Beta-Confident Registry [abstract].
Eye & Contact Lens-science and Clinical Practice, 2011
To describe ultrasound biomicroscopy (UBM) features in a patient with Axenfeld-Rieger syndrome (A... more To describe ultrasound biomicroscopy (UBM) features in a patient with Axenfeld-Rieger syndrome (ARS) and cataract before and after anterior segment surgery using intraocular lens (IOL) and aniridic ring implantation (Morcher Aniridia rings 50 D). Methods: Visual acuity, subjective glare disability, intraocular pressure, endothelial cell density, and UBM imaging were reviewed over a period of 1 year. Results: One month after surgery, the operated eye showed improved visual acuity and visual comfort, and UBM examination showed a wellcentered IOL and well-aligned aniridic ring fins. After 8 months, UBM examination showed contraction of the capsular bag, which appeared wrinkled, fibrous, and thickened. The capsular bag comprised the aniridic ring fins, causing misalignment. The glare disability had dropped from grade 0 to 3. The same outcome was present at 1 year. Conclusion: Ultrasound biomicroscopy is a useful noninvasive diagnostic means to picture anatomic details before and after surgery; it suggested that capsular bag shrinking caused migration of the aniridic rings, 8 months after surgery.
In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SAR... more In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SARCOGEAS) of patients with sarcoidosis. Sarcoidosis was diagnosed in agreement with the criteria proposed by the ATS/ERS/WASOG 1999 statement, and extrathoracic disease was classified with the 2014 WASOG instrument. Results: The cohort consisted of 1082 patients (82% biopsy-proven), including 618 (57%) women and 464 (43%) men, with a mean age at diagnosis of 47yrs; 140 (13%) patients were born outside Spain, 965 (89%) were White, 69 (6%) Hispanic, 30 (3%) Black/African American and 18 (2%) Asian. Thoracic involvement was present at diagnosis in 979 (90%) patients, including 437 (40%) patients with stage I, 374 (35%) with stage II, 123 (11%) with stage III and 26 (2%) with stage IV. The most frequently reported extrathoracic involvements at diagnosis were cutaneous in 385 (36%) patients, extrathoracic lymph nodes in 218 (20%), liver involvement in 151 (14%) and ocular involvement in 118 (11%). Potentially life-threatening WASOG involvements were reported in frequencies less than 10%, including neurological involvement in 77 (7%) patients, kidney involvement in 59 (5%) or cardiac involvement in 21 (2%). Therapeutic approaches at diagnosis included the use of oral glucocorticosteroids in 637 (59%) patients, immunosuppressive agents in 84 (8%, mainly methotrexate in 63 patients) and biological agents in 15 (1%, mainly infliximab in 10 cases). Conclusions: In this large series of sarcoidosis from Southern Europe, clinical presentation is dominated by adenopathies (both thoracic and extrathoracic) and cutaneous involvement (erythema nodosum), with lower frequencies in the main extrathoracic involvements than that reported in US and Japanese series.
Ciliochoroidal effusion syndrome associated with mebendazole systemic treatment
Canadian journal of ophthalmology, Feb 1, 2023
To determine the cause of angle-closure glaucoma in a case of posterior scleritis. The patient wa... more To determine the cause of angle-closure glaucoma in a case of posterior scleritis. The patient was a 65-year-old woman with unilateral acute angle-closure glaucoma who did not respond to laser iridotomy. Slit-lamp examination demonstrated a shallow anterior chamber in the left eye. Intraocular pressure was 22 mmHg even after application of two antiglaucoma eye-drop preparations. B-scan ultrasonography demonstrated scleral thickening and choroidal detachment in the left eye. Ultrasound biomicroscopy showed a shallow anterior chamber with angle closure, annular ciliochoroidal effusion with ciliary body edema, and an anterior rotation of the ciliary body. After instillation of cycloplegics, the ciliary body and ciliary processes rotated posteriorly, resulting in the release of the pressure on the iris. These changes led to the opening of the angle and subsequent normalization of intraocular pressure. A diagnosis was made of ciliochoroidal effusion syndrome associated with posterior scleritis. Patients with posterior scleritis can develop ciliochoroidal effusion syndrome, which can lead to angle-closure glaucoma. The therapeutic strategy for acute angle-closure glaucoma induced by ciliochoroidal effusion syndrome differs completely from that for acute angle-closure glaucoma with pupillary block. In the case of ciliochoroidal effusion syndrome, it is important to relieve the compression of the angle by the iris by displacing the lens-iris diaphragm posteriorly by cycloplegics.
Frontiers in Medicine
IntroductionThis paper describes the creation and preliminary results of a patient-driven registr... more IntroductionThis paper describes the creation and preliminary results of a patient-driven registry for the collection of patient-reported outcomes (PROs) and patient-reported experiences (PREs) in Behçet’s disease (BD).MethodsThe project was coordinated by the University of Siena and the Italian patient advocacy organization SIMBA (Associazione Italiana Sindrome e Malattia di Behçet), in the context of the AIDA (AutoInflammatory Diseases Alliance) Network programme. Quality of life, fatigue, socioeconomic impact of the disease and therapeutic adherence were selected as core domains to include in the registry.ResultsRespondents were reached via SIMBA communication channels in 167 cases (83.5%) and the AIDA Network affiliated clinical centers in 33 cases (16.5%). The median value of the Behçet’s Disease Quality of Life (BDQoL) score was 14 (IQR 11, range 0–30), indicating a medium quality of life, and the median Global Fatigue Index (GFI) was 38.7 (IQR 10.9, range 1–50), expressing a ...
Scientific Abstracts
BackgroundEvidence about the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA... more BackgroundEvidence about the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious intermediate uveitis/pars planitis, posterior uveitis and panuveitis is still limited.ObjectivesAim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis.MethodsThis is an international multicenter study based on real-life data from pediatric patients treated with ADA due to non-anterior uveitis. Data were drawn from the retrospective branch of the AutoInflammatory Disease Alliance (AIDA) registry dedicated to uveitis. Figure 1 provides the flow diagram describing the selection of the patients enrolled on October 1st, 2022.Results21 patients (36 affected eyes) were enrolled. Eleven patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a partial response with reduced frequency of relapses (3 cases), re...
Internal and Emergency Medicine, Mar 7, 2023
This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet's syndro... more This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet's syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behçet's Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behçet's Syndrome Overall Damage Index was 0 (range 0-4). Colchicine was inefficacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p = 0.46) or the concomitant therapy (p = 0.30 for cDMARDs, p = 1.00 for glucocorticoids); cDMARDs and bDMARDs were inefficacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefficacy (p = 0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono-or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively affects response to biologic therapies. ClinicalTrials.gov Identifier: NCT05200715 (registered on December 18, 2021).
Efficacy of monoclonal anti-tumour necrosis factor-α antibodies in uveitic macular oedema
Clinical and experimental rheumatology, 2019
OBJECTIVES To assess the efficacy of anti-tumour necrosis factor (TNF)-α agents in the treatment ... more OBJECTIVES To assess the efficacy of anti-tumour necrosis factor (TNF)-α agents in the treatment of refractory uveitic macular oedema (UME). METHODS Patients with refractory UME treated with TNF-α blockers were retrospectively enrolled. Central macular thickness (CMT) was assessed at optical coherence tomography (OCT) at the start of TNF-α inhibition, after 3 and 12 months, and at the last follow-up visit. RESULTS Thirty-six patients (56 eyes with UME) were enrolled. The mean follow-up period was 29.9±40.8 (4-184) months. A statistically significant decrease was observed in the frequency of UME (p<0.0001) and in the mean CMT values (p<0.0001) during the study period. Best corrected visual acuity improved in 35 eyes (62.5%), remained stable in 12 eyes (21.4%), reduced in 9 eyes (16.1%). The mean corticosteroid dosage significantly decreased during the study period (p=0.016). CONCLUSIONS TNF-α inhibitors represent a useful treatment in patients with severe or resistant UME.
Mitochondrial ND5 geme nucleotide variants in a patient with ptical atrophy and renal involvement
Clinical and experimental rheumatology, 2019
OBJECTIVES The aim of the study was to evaluate the efficacy of golimumab (GOL) and certolizumab ... more OBJECTIVES The aim of the study was to evaluate the efficacy of golimumab (GOL) and certolizumab pegol (CZP) as additional treatment options for the treatment of uveitis. METHODS Patients with longstanding uveitis receiving either GOL or CZP were retrospectively evaluated in terms of frequency of ocular flares, drug survival, changes in best corrected visual acuity (BCVA) and steroid-sparing effect. RESULTS Twenty-one patients (30 eyes), 17 of whom being female, were enrolled in the study; 16 out of 21 patients had been previously treated with other tumour necrosis factor (TNF)-α blockers. A significant reduction in ocular flares (from 128.6 bouts for 100 patients-year to 42.9 events for 100 patients-year) was observed between the 12 months prior to the start of GOL or CZP and the 12 months thereafter (p=0.01). The 36-month drug survival was 54.5% for CZP and 50.0% for GOL with no statistically significant differences between the two biologic agents. No differences were detected con...
Abstracts Accepted for Publication, 2017
not any dose GCs group. Case 1-3 took NSAIDs. Case 2 received mPSL pulse therapy (mPSL 1 g x 3 da... more not any dose GCs group. Case 1-3 took NSAIDs. Case 2 received mPSL pulse therapy (mPSL 1 g x 3 days). Case 1 and 2 developed SDPs within 3 months from initiating GCs. Case 1 recurred SDPs at 17 and 63 months from initiating GCs. Case 2 was prescribed Tacrolimus as a concurrent medication. All four patients were operated to remove the perforated segment, and case 2 and 4 were created artificial anus. Although they were clinically diagnosed as SDPs only case 4 clarified perforation in pathological findings. We should take care of developing SDPs in patients described high dose GCs. [1] Mpofu S, Mpofu CM, Hutchinson D, Maier AE, Dodd SR, Moots RJ. Steroids, non-steroidal anti-inflammatory drugs, and sigmoid diverticular abscess perforation in rheu-matic conditions. Ann Rheum Dis 2004; 63: 588-590. [2] Humes DJ, Fleming KM, Spiller RC, West J. Concurrent drug use and the risk of perforated colonic diverticular dis-ease: a population-based case-control study. Gut 2011; 60: 219-224.
From computer-assisted echography to a multielement linear curtain ultrasonic system
Documenta Ophthalmologica Proceedings Series, 1993
This paper describes research within the CNR’s Progetto Finalizzato ‘Tecnologie Biomediche e Sani... more This paper describes research within the CNR’s Progetto Finalizzato ‘Tecnologie Biomediche e Sanitarie’, subproject ‘ultrasounds’. The aims of this study were as follows: (1) in the field of digital processing of B-scan images, aimed at tissue characterization by means of texture analysis; and (2) in the design and implementation of an echographic unit for ophthalmology, with advanced technical features. The prototype of the electronic interface between a 64-element linear curtain transducer, at 10 MHz, and the videofrequency section of the last unit is working actually, included in a commercial echograph produced by ESAOTE-Biomedica. In this paper, experimental results obtained with the developed hardware are shown. The integration of hardware and software modules within a single advanced unit is currently in progress. It will be based on a personal computer, supported by a video interface and by the hardware modules now under test.
Possibility of ocular tissue differentiation by means of false-color assisted echography
Documenta Ophthalmologica Proceedings Series, 1987
The Eye Clinic of the Bari University and the Signal and Image Processing Institute (I.E.S.I.) of... more The Eye Clinic of the Bari University and the Signal and Image Processing Institute (I.E.S.I.) of C.N.R. in the framework of the ‘Progetto Finalizzato Tecnologie Biomediche’ of C.N.R. are carrying out research on diagnostic methodologies of eye echography through the introduction of digital image processing. This is being done in order to develop techniques capable of extracting the maximum amount of information possible from echo patterns.
Improvements to computer assisted echography
Documenta Ophthalmologica Proceedings Series, 1988
The authors report their continuing research aimed at computer aided echography by processing B-s... more The authors report their continuing research aimed at computer aided echography by processing B-scan videofrequency images with SGLD method. They find a reduction of subjectivity of diagnosis of pathology.