Papers by Tommaso Salgarello
Transvenous Sclerotherapy of the Gonadal Veins for Treatment of Varicocele: Long-Term Results
Angiology, 1990
Percutaneous occlusion of the spermatic vein has been performed on 136 consecutive patients with ... more Percutaneous occlusion of the spermatic vein has been performed on 136 consecutive patients with varicocele scroti during the last six years. The authors report their long-term results on the first 119 cases to have a follow-up of at least six months. Occlusion of the insufficient gonadal vein is induced by the selective transcatheter injection of sclerosing agent with local anesthesia. Their patients are always evaluated before and after the procedure by Doppler examination. A spermiogram is done before the procedure and after six months. In this series they registered only 4 recurrences with no major complications.
Amniotic membrane transplantation associated with a corneal patch in a paediatric corneal perforation
Acta Ophthalmologica, 2010
... Correspondence: Gustavo Savino Department of Ophthalmology Catholic University of the Sacred ... more ... Correspondence: Gustavo Savino Department of Ophthalmology Catholic University of the Sacred Heart Largo Francesco Vito 1 00168 Rome Italy Tel: + 39 06 3015 4929 Fax: + 39 06 305 1274 Email: [email protected]. Publication History. ...
To determine whether tonometric readings of increases in intraocular pressure (IOP) during the wa... more To determine whether tonometric readings of increases in intraocular pressure (IOP) during the water-drinking test (WDT) are affected by variations in central corneal thickness (CCT) induced by photorefractive keratectomy (PRK). METHODS. Data from 30 randomly selected eyes of 30 patients (18 men and 12 women; mean age, Ϯ SD: 33.9 Ϯ 7.6 years) undergoing bilateral PRK for myopia (Ϫ6.57 Ϯ 2.39 D) were obtained. Objective refraction, anterior radius of corneal curvature (R), CCT, and IOP measurements at baseline and at different time intervals after ingestion of 1 L of water within 5 minutes, were performed before and 6 months after PRK. All measured IOPs were recalculated by a correction factor for R and CCT and expressed as corrected intraocular pressure (IOPC) measurements.
To assess whether tonometric measurements of the drop in intraocular pressure (IOP) induced by 0.... more To assess whether tonometric measurements of the drop in intraocular pressure (IOP) induced by 0.005% latanoprost are modified after photorefractive keratectomy (PRK). METHODS. Data from 24 randomly selected eyes of 24 patients (12 men and 12 women, mean age Ϯ SD: 31.7 Ϯ 6.2 years) who were undergoing bilateral PRK for myopia (Ϫ6.38 Ϯ 2.26 D) were obtained. Objective refraction, central corneal thickness (CCT), anterior radius of corneal curvature (R), and IOP measurements at baseline and 24 hours after 1 drop of 0.005% latanoprost, were performed before and 6 months after PRK. All measured IOPs were recalculated by a correction factor for CCT and R and expressed as true IOP (IOPT) measurements. RESULTS. The mean CCT Ϯ SD was 544.58 Ϯ 36.03 and 463.21 Ϯ 38.59 m, and the anterior radius of corneal curvature was 7.73 Ϯ 0.26 and 8.33 Ϯ 0.37 mm, before and after PRK, respectively. The mean IOP at baseline was 15.8 Ϯ 2.92 and 12.23 Ϯ 2.37 mm Hg, and after latanoprost administration was 12.54 Ϯ 1.97 and 10.19 Ϯ 1.47 mm Hg, before and after PRK, respectively. The mean IOPT at baseline was 15.46 Ϯ 1.08 and 16.18 Ϯ 2.31 mm Hg, and after latanoprost administration was 11.85 Ϯ 1.56 and 12.96 Ϯ 1.71 mm Hg, before and after PRK, respectively. The mean IOP and IOPT reductions after latanoprost administration were, respectively, 3.25 Ϯ 1.66 and 3.61 Ϯ 1.7 mm Hg before PRK, and 2.03 Ϯ 1.42 and 3.22 Ϯ 1.79 mm Hg after PRK. Pre-and postoperative IOP reduction significantly differed (P Ͻ 0.001), but not IOPT. CONCLUSIONS. The effect of hypotensive drugs on IOP readings may be underestimated because of measurement errors due to CCT reduction and R increase after PRK for myopia. Misdiagnosis of reduced pharmacologic efficacy may be avoided if the measured IOP is corrected by a proper nomogram. (Invest Ophthalmol Vis Sci. 2004;45:846 -850)
Journal of Neuro-ophthalmology, 1997
Choroidal blood flow and retinal ganglion cell function in early glaucoma
Acta Ophthalmologica, 2009
Purpose To assess subfoveal choroidal blood flow in patients with early manifest glaucoma (EMG) a... more Purpose To assess subfoveal choroidal blood flow in patients with early manifest glaucoma (EMG) and to compare blood flow with functional measures of retinal ganglion cell (RGC) integrity.Methods Subfoveal choroidal blood flow was determined by confocal, real-time laser Doppler flowmetry in 25 EMG patients (<-6 dB Humphrey mean deviation, age range: 42-64 years, visual acuity: 0.8-1.0) and in 20 age-matched controls. All patients had a therapeutically (topical beta-blockers with or without a prostaglandin) controlled intraocular pressure (IOP <20 mmHg). Subfoveal choroidal blood volume (ChBVol), velocity (ChBVel) and flow (ChBF) were determined as the average of three 60 sec recordings with changes in the DC < 10% between the recordings (DC measures the intensity of the light scattered by the tissue and red blood cells in the illuminated volume). In all patients and controls pattern electroretinograms (PERGs) were recorded according to a standardized protocol.Results In EMG patients, average ChBVel and ChBF were reduced by 31 and 35%, respectively (p <0.01) compared to control values. No significant difference in ChBVol was found between the two groups. PERG amplitudes were reduced by 40% (p <0.01) in EMG patients compared to controls. No correlation was found between anyone of the choroidal flow parameters and PERG data or IOP values.Conclusion The results suggest a significant alteration of subfoveal choroidal hemodynamics in EMG patients, involving both ChBVel and ChBF. These changes do not appear to be associated with the severity of functional retinal ganglion cell loss. Our findings may have implications for the pathophysiology of early glaucomatous damage and its treatment.
Ophthalmology, 1999
Objective: To develop a reliable inexpensive device for teaching ocular surgical procedures and p... more Objective: To develop a reliable inexpensive device for teaching ocular surgical procedures and practicing experimental techniques on enucleated eyes.
To determine the reproducibility and accuracy of ultrasonographic (US) measurements of distances ... more To determine the reproducibility and accuracy of ultrasonographic (US) measurements of distances between the corneoscleral limbus and the insertion site of the medial (MR) or lateral rectus (LR) muscle compared with intraoperative measurements in patients with strabismus. METHODS. One eye in each of 17 patients with postoperative secondary strabismus caused by over-or undercorrected esoand exotropia and one eye of each of 19 patients with previously untreated strabismus underwent five repeated measurements by high-resolution ultrasonography of the distance from the corneoscleral limbus to the muscle insertion and three actual intraoperative measurements. Reproducibility, expressed as the coefficient of variation, accuracy (relative error) of US measurements, and the agreement with intraoperative measurements were assessed. RESULTS. The coefficients of variation for US data were 2.02% and 3.18% for the MR and 7.33% and 11.77% for the LR, in the surgical and untreated groups, respectively. The relative error was 6.15% Ϯ 8.14% (mean Ϯ SD) and 3.66% Ϯ 12.83% for the MR muscle, and 12.21% Ϯ 10.66% and Ϫ7.69% Ϯ 7.83% for the LR muscle, in the surgical and untreated groups, respectively. The 95% limits of agreement (mean Ϯ 2 SD) between the US and intraoperative measurements were 0.65 Ϯ 1.82 and 0.15 Ϯ 1.42 mm for the MR muscle, and 1.12 Ϯ 2.01 and Ϫ0.49 Ϯ 0.98 mm for the LR muscle, in the surgical and untreated groups, respectively.
To determine in patients with ocular hypertension (OHT) or early glaucoma (EOAG) the change in bl... more To determine in patients with ocular hypertension (OHT) or early glaucoma (EOAG) the change in blood flow measured at the neuroretinal rim of the optic disc in response to a 15-Hz diffuse green luminance flicker, a stimulus that activates predominantly the ganglion cell magnocellular pathway.
Graefes Archive for Clinical and Experimental Ophthalmology, 2009
Background Epigallocatechin-gallate (EGCG) is a powerful antioxidant with suggested neuroprotecti... more Background Epigallocatechin-gallate (EGCG) is a powerful antioxidant with suggested neuroprotective action. The aim of this study was to evaluate the effect of short-term supplementation of EGCG on inner retinal function in ocular hypertension (OHT) and open-angle glaucoma (OAG). Methods Eighteen OHT and 18 OAG patients (perimetric mean deviation: >−10 dB) were randomly assigned to assume oral placebo or EGCG over a 3-month period in a randomized, placebo-controlled, double-blind, cross-over design clinical trial (clinicaltrials.gov identifier: NCT00476138). Pattern-evoked electroretinograms (PERGs) to 1.6 cycles/degree square-wave gratings, counterphased at 16 reversals/second, and standard automated perimetry (Humphrey 30–2) were assessed at the study entry (baseline), and after 3 months of placebo or EGCG. Results After EGCG, PERGs of OAG, but not OHT patients were increased in amplitude, compared either to baseline values (mean amplitude change: 0.06 log μV, p < 0.05) or to PERG amplitude values found in the same patients after placebo administration (mean change: −0.02 log μV, p not significant; difference between EGCG and placebo: 0.08 log μV, p < 0.05). In both OHT and OAG patients, standard automated perimetry did not show significant changes after either EGCG or placebo. In individual OAG patients, the magnitude of PERG amplitude increment after EGCG was inversely related (r = −0.8, p < 0.01) to corresponding baseline amplitudes. Conclusions Although this study cannot provide evidence for long-term benefit of EGCG supplementation in OAG, and the observed effect is small, the results suggest that EGCG might favourably influence inner retinal function in eyes with early to moderately advanced glaucomatous damage.
Acta Ophthalmologica Scandinavica, 2009
Morpho-Functional Follow-Up of the Optic Nerve in Treated Ocular Hypertension: Disc Morphometry and Steady-State Pattern Electroretinogram
Current Eye Research, 2008
To examine longitudinally optic disc structure and inner retinal function in treated ocular hyper... more To examine longitudinally optic disc structure and inner retinal function in treated ocular hypertension (OHT). A morphometric (Heidelberg Retina Tomograph, HRT) and functional (steady-state pattern electroretinogram, PERG) evaluation of 27 OHT patients treated with topical beta-blockers and/or prostaglandin analogues and prospectively followed over a 24 +/- 6 month period. Compared with baseline, mean final PERG amplitude tended to increase (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), while HRT was stable. Individual PERG amplitude increase was large (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or= 100%) in some patients (5/27), and unexplained by clinical parameters at baseline. In treated OHT, functional responses may improve while disc structure remains stable. The findings suggest that OHT-associated inner retinal dysfunction is at least in part reversible with therapeutic intraocular pressure control.
Acta Ophthalmologica Scandinavica, 2009
It is known that changes in pattern electroretinogram (PERG) and optic disk morphology may both p... more It is known that changes in pattern electroretinogram (PERG) and optic disk morphology may both precede the onset of visual field damage in glaucomatous disease. However, the relationship between PERG and optic disk morphometry in ocular hypertension (OHT) has not yet been evaluated in detail. This study of PERG amplitude in a group of OHT patients indicates its significant correlation with various optic disk morphometric parameters, in particular, those of optic disk sectors considered at risk for early glaucomatous damage. Analysis of individual data points to the possibility that, while functional abnormalities may often precede optic disk morphologic changes, in a much lower number of cases it seems to be the other way around.
To determine the accuracy and reproducibility of ultrasonographic (US) readings of optic disc ele... more To determine the accuracy and reproducibility of ultrasonographic (US) readings of optic disc elevations in patients with papilledema compared with confocal scanning laser ophthalmoscope (CSLO) measurements.
To quantify the relationship between optic nerve head tomography and perimetric sensitivity in pa... more To quantify the relationship between optic nerve head tomography and perimetric sensitivity in patients with papilledema. METHODS. Eight patients with variable degrees of recently diagnosed papilledema associated with idiopathic intracranial hypertension (IIH) were evaluated with confocal scanning laser ophthalmoscopy (CSLO) and automated perimetry. Patients were followed up with serial measurements over a period of 5 to 30 months (mean Ϯ SD, 17.1 Ϯ 9), while under medical treatment (acetazolamide). The tomographic parameters, volume above reference (VAR), volume above surface (VAS), effective mean height (EMH), and maximum height in contour (MxHC), were obtained by tomography, either globally or from predefined disc sectors. The perimetric indices, mean deviation (MD) and pattern SD (PSD), were evaluated. The results from patients' right eyes and the individual intereye differences in both tomographic and perimetric parameters, were statistically evaluated by nonparametric correlational (Spearman) and repeated measures (Wilcoxon) analyses. RESULTS. At baseline, all tomographic parameters were negatively correlated with MD in global (r ϭ Ϫ0.8) and sectorial (r ϭ Ϫ0.6) evaluations. The interocular differences in overall tomographic parameters were correlated with corresponding differences in perimetric MD (r ϭ Ϫ0.8) and PSD (r ϭ 0.6). During the follow-up period, volumetric disc parameters decreased (P Ͻ 0.02), whereas perimetric MD increased (P ϭ 0.02) at comparable times. CONCLUSIONS. In patients with recently diagnosed papilledema, optic nerve head tomographic abnormalities are quantitatively correlated with visual field sensitivity losses. Therapeutic improvement of volumetric parameters may be paralleled by recovery in perimetric sensitivity. The data support the possible use of both techniques in combination to monitor the amount of papilledema and the effectiveness of treatments designed to reduce intracranial hypertension. (Invest Ophthal-
To evaluate the correlation of pattern electroretinogram (PERG), an index of inner retinal functi... more To evaluate the correlation of pattern electroretinogram (PERG), an index of inner retinal function, with confocal scanning laser (CSLO) optic disc structural parameters in ocular hypertension (OHT).
European Journal of Neurology, 1999
In normal subjects, the steady-state electroretinograrn in response to contrast reversing grating... more In normal subjects, the steady-state electroretinograrn in response to contrast reversing gratings (PERG), is spatially band-pass tuned in amplitude, with a maximum at intermediate spatial frequencies and an attenuation at lower and higher ones. The amplitude attenuation at low spatial frequencies is believed to reflect centre-surround antagonistic interactions in the receptive fields of inner retinal neurons. The aim of this study was to evaluate the PERG spatial tuning in multiple sclerosis (MS) patients without a previous optic neuritis history. Steady-state PERGs in response to counterphase-modulated (8 Hz) sinusoidal gratings of variable spatial frequency (0.6, 1.0, 1.4, 2.2 and 4.8 c/deg), were recorded from 18 patients with definite or probable MS and no history of optic neuritis (ON-). Nine of them had no signs of subclinical optic nerve demyelination (asymptomatic) in either eye, while nine had symptoms or signs of optic pathways involvement (symptomatic) in one or both eyes. Results were compared with those obtained from 10 MS patients with a previous history of optic neuritis (ON+) in one or both eyes, as well as from 21 age-matched controls. The amplitudes and phases of the responses' 2nd harmonics were measured. Compared with the controls, asymptomatic ON- patients showed selective losses in mean PERG amplitudes at medium and high (1.0–4.8 c/deg) spatial frequencies. Symptomatic ON-patients and ON+ patients had reductions in mean PERG amplitudes, with respect to controls, involving the whole spatial frequency range, but with greater losses at medium-high (1.0–4.8 c/deg) than at lower spatial frequencies. In all patients' groups, the average PERG spatial tuning function differed significantly from that of the controls, assuming a low-pass instead of the normal band-pass shape. The PERG phase was delayed in ON+ but not in ON- patients, as compared to controls. However, the phase delay was independent of spatial frequency. In both ON- and ON+ patients, losses in PERG amplitude and spatial tuning tended to be associated with corresponding abnormalities in perimetric sensitivity, visual acuity, colour vision and transient visual evoked potential (WP) latency. The results indicate that abnormalities of the spatial tuning of steady-state PERG can be found in MS patients without either optic neuritis or signs of subclinical optic nerve demyelination. These changes may reflect a retinal dysfunction, developing early in the course of MS, due to a loss of specific subpopulations of inner neurons, changes in lateral interactions of their receptive fields, or both.
British Journal of Ophthalmology, 1996
Pattern Electroretinogram in Treated Ocular Hypertension: A Cross-Sectional Study after Timolol Maleate Therapy
Ophthalmic Research, 1995
To investigate pattern electroretinogram changes in treated ocular hypertension, we evaluated pat... more To investigate pattern electroretinogram changes in treated ocular hypertension, we evaluated pattern electroretinogram recordings of 48 hypertensive eyes following an 8-month timolol maleate therapy. During treatment, 27 of 48 eyes had normalized intraocular pressures (15-18 mm Hg), while 21 retained elevated values (21-25 mm Hg). Twenty-eight eyes with untreated hypertension (22-25 mm Hg) lasting at least 8 months, as well as 32 untreated, normotensive eyes served as controls. When compared to untreated normotensive controls, timolol-treated eyes with either elevated or normalized intraocular pressures showed reductions in the mean electroretinographic amplitudes. However, these amplitude reductions were substantially greater in treated eyes with elevated pressures as compared to those with normalized ones. Untreated hypertensive controls showed pattern electroretinogram reductions, with respect to normal values, that were comparable to those of treated hypertensive eyes, but larger than those of treated normotensive ones. These results indicate that, in treated ocular hypertension, pattern electroretinogram losses tend to be associated with moderately increased intraocular pressures in the range of 21-25 mm Hg. Electroretinographic abnormalities may be, at least in part, prevented only by lowering intraocular pressure into a normal range.
Acta Ophthalmologica Scandinavica, 2002
In 2001, for the first time in its life, the AISG is holding its Annual Meeting far away from its... more In 2001, for the first time in its life, the AISG is holding its Annual Meeting far away from its traditional venue, i.e. Rapallo.
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Papers by Tommaso Salgarello