Umberto De Vico | Università Cattolica del Sacro Cuore (Catholic University of the Sacred Heart) (original) (raw)

Papers by Umberto De Vico

Diagnostics, Sep 24, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

American Journal of Ophthalmology, Aug 1, 2022

PURPOSE To report the 1-year results of human amniotic membrane patch implantation for optic disc... more PURPOSE To report the 1-year results of human amniotic membrane patch implantation for optic disc pit maculopathy. DESIGN This is a prospective, consecutive, interventional study. METHODS • Setting: Single institution. • Patient: We included 11 eyes of 11 patients affected by optic disc pit maculopathy associated with sub/intra retinal fluid. • Intervention: A 25-gauge pars plana vitrectomy was performed in all cases, with an implant of a human amniotic membrane patch into the optic disc pit and air was injected as endotamponade.• Main outcomes and measures: The primary study outcome was the subretinal and intraretinal fluid reabsorption. Secondary outcomes were the visual acuity improvement and postoperative complications. RESULTS Mean central retinal thickness gradually diminished from 512 ± 137 µm to 243 ± 19 µm, at the 12-months follow-up. The mean visual acuity improved form 20/80 at baseline to 20/32 at the 12-months follow-up. A complete fluid resorption occurred in 9 eyes on 11 (81.8%) and a partial resorption in 2 eyes (18%). We did not observe any subretinal fluid recurrence during the 12 months follow-up. No intraoperative nor postoperative complications were reported during the follow-ups. The amniotic membrane patch remained detectable inside the pit for the entire follow-up time. CONCLUSION An amniotic membrane plug may be effective to improve optic disc pit maculopathy. All cases had an anatomical improvement and an encouraging visual acuity recovery.

European Journal of Ophthalmology, Oct 9, 2022

Introduction To report a case of a 57-years-old female patient who presented with prominent bilat... more Introduction To report a case of a 57-years-old female patient who presented with prominent bilateral proptosis and swollen disks. Case description A 57-year-old obese patient admitted to our ophthalmic department complaining of bilateral sense of eye swelling and mild blurring vision. The anterior segment and pupillary reflex were normal on ophthalmological testing. Likewise, eye movements were preserved and she did not report diplopia in any position of gaze. Dilated fundus examination revealed bilateral hemorrhagic papilledema, pre-retinal hemorrhages in both eyes, dot and blot hemorrhages in the peripheral retina. Visual acuity was 20/20 in both eyes. Routine hematological investigations revealed increased both Von Willebrand factor and ristocetin factor and LAC positivity. The lumbar puncture (LP) showed elevated cerebrospinal fluid (CSF) proteins. Magnetic resonance imaging (MRI) with contrast of brain and spinal cord showed signs of intracranial hypertension and the presence of two lesions in continuity with each other respectively located at T12-L1 and L1-L2. Radiologic features were compatible with the diagnosis of ependymoma. A surgical procedure was conducted and confirmed the diagnosis after anatomical pathology analysis. Conclusion Although rare, bilateral hemorrhagic swollen disks could be an early sign of spinal cord tumors, in particular ependymomas.

Retina-the Journal of Retinal and Vitreous Diseases, Nov 1, 2021

PURPOSE To describe and evaluate the effectiveness of the modified Carlevale IOL fixation techniq... more PURPOSE To describe and evaluate the effectiveness of the modified Carlevale IOL fixation technique, using two vitrectomy ports as lens plug fixation sites. MATERIALS AND METHODS This prospective, consecutive, interventional study examined 60 eyes in 60 patients, who underwent 25- or 23-gauge vitrectomy for an intraocular lens (IOL) subluxation/luxation, lens dislocation, or aphakia, with Carlevale IOL implantation. RESULTS Postoperatively, transient ocular hypotension was observed in 4 eyes. The mean refractive prediction error was -0.27 ± 0.78 diopters. No postoperative complications, such as retinal detachment, endophthalmitis, or IOL dislocation were observed in the 4-month follow-up. CONCLUSION This new technique may be simple, fast, and effective due to fewer scleral wounds, as well as fewer postoperative complications.

Cornea, Dec 22, 2020

Purpose: This is a cohort study to evaluate the presence of objective signs and subjective sympto... more Purpose: This is a cohort study to evaluate the presence of objective signs and subjective symptoms of dry eye disease in postcoronavirus disease 2019 (COVID-19) patients compared with the control. Methods: Prospective, observational, single-ctenter, cohort study. Sixty-four post-COVID-19 patients and 50 control were recruited. All participants underwent a complete ophthalmological examination including Ocular Surface Disease Index Questionnaire (OSDI), best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination, Schirmer test type 1, tear break-up time test (tBUT), evaluation of conjunctival hyperemia, corneal staining, and tear film osmolarity test. Results: The OSDI score was higher in the post-COVID-19 group in the quantitative and qualitative analysis (P < 0.001 and P =0.012, respectively). The mean tBUT in post-COVID-19 patients was 6.95 ± 4.07 seconds compared with a mean tBUT of 10.12 ± 3.90 seconds in the control group. The post-COVID-19 group showed a higher number of patients with a simultaneous impairment of the OSDI score and tBUT (P = 0.019). The Schirmer test results were strikingly significant both in the quantitative analysis and qualitative analysis (P <0.001 and P = 0.0014, respectively). Both quantitative analysis and qualitative analysis revealed a significant difference in tear osmolarity in the 2 groups. Conclusions: Comparing the ocular surface assessment of post-COVID-19 patients with heathy control, a statistically significant increase of dry eye disease has emerged both in subjective and objective evaluations. Our clinical results support the findings that suggested a susceptibility of the ocular surface to the virus, and it underlines the importance of the ocular surface assessment in post-COVID-19 patients for a correct diagnosis and therapy.

Journal of Clinical Medicine, Sep 8, 2020

The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 s) to cause multi-orga... more The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 s) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.

Diagnostics, Mar 17, 2022

Vision, Feb 9, 2022

International Ophthalmology, Sep 21, 2022

to a postoperative value of 318.1 (IQR = 166.6) µm (p < 0.001), with a median increase of + 87.7 ... more to a postoperative value of 318.1 (IQR = 166.6) µm (p < 0.001), with a median increase of + 87.7 µm (+ 26.4%). PCT increased from 157.2 (IQR = 109.1) µm before surgery to 206.0 (IQR = 136.1) µm after surgery (p < 0.001). Moreover, we found a significant post-operative decrease in cup depth (median reduction of − 29.3 µm, p < 0.001) and an increase in PLT (median increase of 27.3 µm, p = 0.028). On the other side, LCD reduction 24 h after surgery didn't reach any statistical significance. Conclusion PreserFlo implantation determines retinal structural changes which appear similar to those caused by traditional filtering surgery, confirming the effectiveness of this device, meantime carrying a much smaller complications rate when compared to trabeculectomy. Keywords Glaucoma • Preserflo Microshunt • Choroidal thickness • MIGS • Lamina cribrosa depth • Pre-laminar thickness lution of choroid and anterior surface of lamina cribrosa [1]. Hence, it has been used to investigate choroid and lamina cribrosa displacement following trabeculectomy and deep sclerectomy [2, 3].

Retinal Cases & Brief Reports, Aug 16, 2022

Graefes Archive for Clinical and Experimental Ophthalmology, Sep 6, 2020

Purpose To evaluate the efficacy of intraoperative slow-release dexamethasone implant (DEX) combi... more Purpose To evaluate the efficacy of intraoperative slow-release dexamethasone implant (DEX) combined with removal of idiopathic epiretinal membrane (ERM). Methods In this observational retrospective study, data of 40 patients with phakic eyes affected by idiopathic ERM were analysed. All patients underwent cataract phacoemulsification, 25-gauge (G) pars plana vitrectomy (PPV), ERM removal with DEX implant ("DEX YES" group, #20) or without DEX implant ("DEX NO" group, #20). We collected data on best-corrected visual acuity (BCVA) < 20/40 Snellen charts, central macular thickness (CMT) ≤ 400 μm (measured by SD-OCT) and integrity of sub-foveal ellipsoid/myoid zone. BCVA, CMT and intraocular pressure (IOP) were evaluated at baseline as well as 15, 30 and 90 days after surgery. Results In the "DEX YES" group, statistically significant BCVA improvement was observed at 15, 30 and 90 days (p < 0.001), while in the "DEX NO" group, improvements were observed only at 30 and 90 days (p < 0.001). In both groups, CMT significantly decreased at each follow-up visit (p < 0.001), and no statistically significant increase of IOP was detected at each follow-up visit. Conclusions In this study, DEX accelerated the improvement of BCVA at 15 days after surgery. However, no evidence of further anatomical (CMT) and functional (BCVA) DEX effectiveness combined with removal of idiopathic ERM by 25-G PPV at 30 and 90 days follow-up was observed.

Advances in Therapy, May 4, 2021

Purpose: To evaluate morpho-functional outcomes of the intravitreal fluocinolone acetonide (FAc) ... more Purpose: To evaluate morpho-functional outcomes of the intravitreal fluocinolone acetonide (FAc) implant. Methods: Retrospective, observational, singlecenter study. Primary endpoint was the mean change in central macular thickness (CMT) from baseline to month 1-3. Secondary endpoints included mean CMT change from baseline to month 4-8 and 9-14 and mean best corrected visual acuity (BCVA), photopic negative response (PhNR) and b-wave of flash fullfield electroretinogram (ERG) changes from baseline to month 1-3, 4-8, and 9-14. Results: Fourteen patients (18 eyes) were included. Mean (standard deviation) CMT decreased from 473 (196) lm at baseline to 371 (163) lm at month 1-3 (mean difference-102.3 ± 98.35 lm, 95% CI ± 46.4 lm; p \ 0.0001) and this decrease tended to endure up to month 9-14. BCVA did not change significantly. There was an improvement in mean PhNR amplitude from 2.76 (1.65) lV at baseline to 3.73 (2.32) lV at month 1-3 (mean difference 0.91 (1.14) lV, 95% CI ± 0.54 lV, p = 0.003); b-wave amplitude improved from 8.83 (4.52) lV at baseline versus 10.05 (5.04) lV at month 1-3 (mean difference 1.22 (2.23) lV, 95% CI ± 1.08 lV, p = 0.0384). These ERG positive changes tended to endure up to month 9-14, although they did not reach statistical significance after month 3. Conclusions: Intravitreal FAc implant significantly improved anatomic as well as functional outcomes related to middle and inner retinal layers, known to be altered in diabetic retinopathy. Our findings support the hypothesis that intravitreal FAc implant may exert a protective effect in diabetic retinas with diabetic macular edema.

Diagnostics, Oct 22, 2021

Ophthalmology Retina, Oct 1, 2022

Japanese Journal of Ophthalmology, Oct 27, 2022

Karger Kompass, 2022

Bei mittelschwerem bis schwerem Glaukom ist die Trabekulektomie nach wie vor der «Goldstandard» f... more Bei mittelschwerem bis schwerem Glaukom ist die Trabekulektomie nach wie vor der «Goldstandard» für die Senkung des Augeninnendrucks (IOP); allerdings erfordert diese Methode eine umfangreiche postoperative Behandlung. Die mikroinvasive Glaukomchirurgie (MIGS) wurde entwickelt, um den intra-und postoperativen Pflegeaufwand zu verringern und gleichzeitig eine akzeptable Senkung des Augeninnendrucks bei Patienten mit leichtem bis mittelschwerem Glaukom zu ermöglichen. Der Preser-Flo ® MicroShunt (früher InnFocus MicroShunt) ist ein 8,5 mm großes Glaukom-Drainagegerät, das aus Poly(styrol-block-isobutylenblock-styrol) (SIBS), einem äußerst biokompatiblen und bioinerten Material, hergestellt wird. Das Lumen ist eng genug, um eine Hypotonie zu verhindern, aber groß genug, um nicht von Zellschuppen oder Pigmenten verstopft zu werden.

Graefes Archive for Clinical and Experimental Ophthalmology, Feb 1, 2021

Background Systemic vascular involvement in COVID-19 has been identified in several patients: not... more Background Systemic vascular involvement in COVID-19 has been identified in several patients: not only endothelial derangement and increased permeability are reported to be early hallmarks of organ damage in patients with COVID-19 but are also the most important cause of worsening of clinical conditions in severe cases of SARS-CoV-2 infection. There are several reasons to hypothesize that the eye, and the retina in particular, could be a target of organ damage in SARS-CoV-2 infection. Methods This cohort observational study analyzes OCT angiography and structural OCT of 70 post-COVID-19 patients evaluated at 1-month hospital discharge and 22 healthy control subjects. Primary outcomes were macular vessel density (VD) and vessel perfusion (VP); structural OCT features were evaluated as secondary outcomes. In addition, patients and healthy volunteers were evaluated for best corrected visual acuity, slit lamp photograph, and fundus photo image. Results VD and VP in 3 × 3 and 6 × 6 mm scans for SCP and DCP showed no significant differences between the groups. Similarly, CMT and GCL did not reveal significant differences between post-COVID-19 and healthy patients. Nine patients (12.9%) featured retinal cotton wool spots and 10 patients had vitreous fibrillary degeneration. The prevalence of epiretinal membrane and macular hole was similar in the two groups. One case of extra papillary focal retinal hemorrhage was reported in the post-COVID-19 group. Conclusions Macula and perimacular vessel density and perfusion resulted unaltered in mild post-COVID-19 patients at 1-month hospital discharge, suggesting no or minimal retinal vascular involvement by SARS-CoV-2.

Vision, May 16, 2022

Vision, Jan 21, 2022

Vision, Jun 24, 2022