Alessandra Tavola

Central retinal vein and branch artery occlusion associated with inherited plasminogen deficiency and high lipoprotein(a) levels: A case report

We describe a case of central retinal vein and branch artery occlusion associated with inherited type I plasminogen deficiency (68%) and permanent elevation of Lp(a) (460 mg/l, S2 phenotype) in a 45 year old white woman with no associated local or systemic risk factors. Pedigree analysis revealed inheritance of plasminogen deficiency from the deceased father and of high Lp(a) levels from the mother. Both the patients sons had plasminogen deficiency, but they had normal Lp(a) levels. In a series of 40 consecutive patients with central retinal vein occlusion we previously reported the observation of high Lp(a) levels--consistently associated with the S2 phenotype--in 30% of the patients as compared to a 10% incidence in controls. This case emphasizes the importance of screening patients with occlusion of the retinal vessels and no associated risk factors for coagulation abnormalities predisposing to thrombosis.

Axial Length and Refraction in Retinal Vein Occlusions

To assess whether axial length and refraction are risk factors for retinal vein occlusion, we measured these parameters in 88 consecutive patients with unilateral branch retinal vein occlusion (BRVO), in 58 consecutive patients with unilateral central retinal vein occlusion (CRVO) and in 50 patients selected as a control group. Patients and controls were free or affected by systemic or local predisposing factors. We compared eyes with CRVO with control eyes, eyes with BRVO with control eyes, and eyes with CRVO with eyes with BRVO. Comparing CRVO eyes and controls, none of the investigated variables was shown to be significant. From the analysis of BRVO eyes versus controls, it resulted that refraction was the only variable which played the role of an independent prognostic factor. When comparing BRVO eyes with CRVO eyes, we found that age was slightly related to the development of BRVO. In conclusion, faulty refraction appeared to be a risk factor for the development of BRVO. We did not find any influence of axial length on the occlusion of retinal veins.

Standardized echography, pattern electroretinography and visual-evoked potential and automated perimetry in the early diagnosis of Graves' neuropathy

Twenty-four patients (47 eyes) affected by Graves’ disease were enrolled to evaluate the role of standardized echography, pattern electroretinogram (P-ERG), visual evoked potentials (P-VEPs) and automated perimetry in the early diagnosis of the compressive optic neuropathy (CON). The P-ERG amplitude reduction was the most sensitive parameter to demonstrate an early impairment of the optic nerve (ON) function. We found a significant negative correlation between the ON diameter and the P-ERG amplitude. VEPs responses were also altered, but their ability in detecting an early ON damage was less sensitive and specific than P-ERG. The visual field damage was often aspecific and delayed with respect to electrophysiological alterations.

Alterations of the Internal Reflectivity of Extra-Ocular Muscles Associated with Several Clinical Stages of Graves’ Ophthalmopathy

In the period between February 1992 and June 1996, the authors performed extra-ocular muscle echobiometry on 163 patients with Graves’ disease. The aim of this study is the evaluation of changes occurring in several clinical stages. The authors noted an increase in internal muscular reflectivity in the advanced phases and an irregular structure in the early stages. Controversial results in the literature warrant mastery of the method and further research.

Power Doppler Ultrasonography in Ocular and Orbital Diseases

Purpose: The authors present a preliminary report to test the usefulness of a new technique called power Doppler ultrasonography (PD) in the study of orbital vessels. Material and Methods: The ophthalmic artery and vein as well as the central retinal artery and vein have been examined in 10 patients with a General Electric Logiq 5000 that allows the examination with both color Doppler ultrasonography (CD) and PD. Results: PD does not alias, is relatively angle independent and is able to better detect the pathways of these vessels. Conclusions: PD is a new promising technique that may be superior to CD in detecting orbital and ocular vessels.

Posterior scleritis : Ultrasound findings in two cases

Two cases of posterior inflammatory scleritis are described. The authors show the echographic findings, pointing out the helpfulness of diagnostic ultrasound and the crucial role in monitoring these diseases with A scan examinations to obtain clear results of therapy, even if subjective symptoms disappear.

Extraocular Muscle Size Comparison between Normal and Myopic Eyes Using Standardized A Scan Echography

The aim of this study was to establish the range of diameters of extraocular muscles in myopic patients and to obtain the baseline data to follow progression or regression of pathologies involving them. Standardized A scan and B scan ultrasound was used to measure the thickness of straight extraocular muscles at the muscle belly. No statistical differences were seen between right and left eyes. We found no consistent correlation with age or with axial length in the control or in the myopic patients (p>0.05). Diameters in myopic and control eyes were similar. This lack of difference between myopic and control muscle sizes means that we can obtain accurate measurements also from myopic patients.

Echographic study of the vitreoretinal interface in giant retinal tears.

Vitreous and vitreoretinal interface changes were evaluated in giant retinal tears in order to plan surgical approach. Vitreal sineresis was evident in patients affected by primary giant retinal tears; in patients affected by retinal disinsertion the vitreous was adherent to the edge of the posterior flap, and in giant retinal tears secondary to IOL implantation, posterior vitreous detachment but no sineresis was displayed.

Graves’ Disease: Measurement of the Extraocular Muscle Thickness with the Echobiometer

The authors measured extraocular muscle thickness in normal subjects and in patients affected by Graves’ disease, using a Sonomed A-2000 echobiometer (probe with 10-MHz frequency); Hertel’s exophthalmometry was also performed. Statistically significant differences in muscle thickness between normals and patients were found. This technique seems to be sufficiently useful and reliable in extraocular thickness evaluation, showing data similar to those of the recent literature.

Orbital Metastases: Echographic Findings Our Experience

In this paper the authors examine the echographic findings in 20 patients with metastatic and secondary tumors of the orbit observed at the University Eye Clinic of Ferrara (Italy) between January 1985 and August 1995. The aim of this study is to identify some typical echographic characteristics in these forms and to underline the diagnostic role of orbital echography.