Luca Migliavacca

In vivo confocal microscopy in Terrien marginal corneal degeneration: a case report.

Purpose: To report an advanced case of Terrien marginal corneal degeneration (TMD) analyzed by means of confocal microscopy. Methods: A 62-year-old woman with TMD underwent a routine ophthalmological examination and was evaluated for the disease by using in vivo laser scanning confocal microscopy with the Heidelberg Retina Tomograph 2 Rostock Cornea Module. Results: The slit-lamp examination of the right eye showed an upper peripheral cornea thinning associated with a deposition of refractile yellow-white materials in the anterior stroma. Superficial radial vessels in the upper peripheral cornea were the only pathological findings of the left eye. Confocal microscopy of the right eye lesion showed deposition of hyperreflective material, and the stroma below presented a honeycomb-like pattern. Inflammatory cell infiltration, abnormal subbasal nerve plexus, epithelial basal membrane defects, irregular Bowman membrane, and the presence of activated keratocytes were observed in the cornea of both eyes. Conclusions: In vivo confocal microscopy can detect subtle corneal changes in an advanced case of TMD, which may be signs of subclinical inflammation.

Trends in cataract surgery in Milan (Italy) from 1956 to 1987; Relationship to age and visual acuity

Abstract. In order to test whether the mean age at cataract surgery has changed over the course of the last 30 years, a hospital series of 5443 patients undergoing cataract extraction between 1956 and 1987 is reviewed. All cases attended the same University Eye Clinic of Milan and most were resident in the same geographical area. Cases with macular or optic nerve diseases were excluded. Results show that mean age at cataract surgery progressively increased from 67.5 to 71.5 years (slope = + 0.096 years of age per year, p = 0.0001) as did visual acuity at surgery (patients with visual acuity levels ≥1/10 at time of cataract surgery rose from 3.2% to 47.9%). These results can be interpreted in terms of a change in age composition of the Italian population, improved access to health services for the elderly, and an improvement in surgical and rehabilitation techniques.

Structure|[ndash]|function relationship in early diabetic retinopathy: a spatial correlation analysis with OCT and microperimetry

PurposeTo study the correlation of the local ganglion cell layer—inner plexiform layer (GCL-IPL) thickness with corresponding retinal sensitivity as studied with microperimetry in patients with Type 2 diabetes and no signs of diabetic retinopathy.Patients and methodsWe analyzed 35 healthy subjects (68 eyes) and 26 Type 2 diabetic patients (48 eyes) with no signs of diabetic retinopathy. We tested best corrected visual acuity (BCVA), monocular and binocular constrast sensitivity (CS, Pelli – Robson chart) and retinal sensitivity with microperimetry, and acquired dense macular SD-OCT scans. We then studied the correlation between local GCL-IPL thickness and local sensitivity.ResultsMean BCVA was 1.09 (±1.03) decimals in diabetic subjects and 1.02 (±0.15) decimals in healthy subjects. Only binocular CS was significantly higher in healthy subjects (1.18±0.42 for healthy subjects, 1.62±0.63 for diabetic subjects). In both local and global analysis we observed higher GCL-IPL thickness and higher sensitivity in normal compared with diabetic subjects, but no difference reached significance (p<0.05). Using a mixed multivariate linear model, we found a significant correlation between retinal sensitivity and the correspondent GCL-IPL thickness in diabetic subjects (0.022±0.006 dB/μm, p=0.0007) but not in healthy subjects (−0.002±0.006 dB/μm, p=0.77).Conclusiondespite close similarities between the two groups, we found a significant difference in the structure–function relationship in diabetic subjects without diabetic retinopathy, suggesting that diabetes might act as an additional effect in the normal deterioration of the visual function related to the inner retina.

The Effect of Naphthalene on the Retina of Rabbit

Naphthalene has been known to be a cataractogenic agent for more than a century. The first report concerning its effect on the lens was presented at the French Academy of Medicine by Bouchard and Charrin (1886), and was subsequently experimentally proved in animals such as rabbits, cats, rats, guinea-pigs and chickens. Ocular toxicity in man has also been reported following accidental ingestion of the poison (for a review of the literature see Duke Elder, 1966).

The Nature of Newly Formed Capillaries in Experimental Naphthalene-Induced Retinal Degeneration in Rabbit

Papers relating to previous experimental and clinicopathologic studies have reported contradictory results concerning the “maturity” of subretinal new vessels, and the development and evolution of new morphological features related to changes in the permeability of subretinal membranes.