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  1. Article ; Online: The Role of Optical Coherence Tomography and Optical Coherence Tomography Angiography in the Differential Diagnosis of Posterior Uveitis.

    Agarwal, Aniruddha / Invernizzi, Alessandro

    Ocular immunology and inflammation

    2022  Volume 30, Issue 3, Page(s) 682–689

    Abstract: Purpose: Modalities such as optical coherence tomography (OCT) and OCT angiography (OCTA) have improved the diagnostic utility of fundus imaging in management of uveitis. The purpose of this study is to review role of OCT and OCTA in differential ... ...

    Abstract Purpose: Modalities such as optical coherence tomography (OCT) and OCT angiography (OCTA) have improved the diagnostic utility of fundus imaging in management of uveitis. The purpose of this study is to review role of OCT and OCTA in differential diagnosis of certain posterior uveitic entities.
    Methods: Narrative review.
    Results: In this review, we have comprehensively summarized the utility of OCT and OCTA in helping the clinician diagnose common but challenging inflammatory conditions including ocular toxoplasmosis, viral retinitis, and vitreoretinal lymphoma, among others. OCT and OCTA can also be used to assess the choriocapillaris involvement in conditions such as multiple evanescent white dot syndrome, and choroidal granulomas in tubercular and sarcoid uveitis.
    Conclusions: Fundus imaging with OCT and OCTA has assumed a significant role in establishing the diagnosis in uveitis apart from microbiological and other laboratory analysis. Advantages such as rapidity and non-invasiveness make these imaging modalities very useful and convenient.
    MeSH term(s) Diagnosis, Differential ; Fluorescein Angiography/methods ; Humans ; Retinal Neoplasms/diagnosis ; Tomography, Optical Coherence/methods ; Uveitis/diagnosis ; Vitreous Body ; White Dot Syndromes
    Language English
    Publishing date 2022-05-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1193873-0
    ISSN 1744-5078 ; 0927-3948
    ISSN (online) 1744-5078
    ISSN 0927-3948
    DOI 10.1080/09273948.2022.2071743
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  2. Article ; Online: Anterior Segment Optical Coherence Tomography (AS-OCT) Visualization of Anterior Vitritis.

    Zicarelli, Federico / Staurenghi, Giovanni / Invernizzi, Alessandro

    Ocular immunology and inflammation

    2022  Volume 31, Issue 5, Page(s) 1101–1102

    Abstract: The clinical grading of vitreous haze presents some limitations such as subjectivity and intra-grader variability. On the other hand the proposed OCT-based methods only explore the posterior part of the vitreous. Here we describe the inflammatory changes ...

    Abstract The clinical grading of vitreous haze presents some limitations such as subjectivity and intra-grader variability. On the other hand the proposed OCT-based methods only explore the posterior part of the vitreous. Here we describe the inflammatory changes affecting the anterior vitreous imaged by Anterior Segment Optical Coherence, Tomography (AS-OCT) from patients affected by uveitis. The AS-OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) detected vitreous sheets, vitreous lacunae, and formations resembling inflammatory cells, providing an objective characterization of the inflammatory changes in the anterior vitreous as well as their relationships with the other ocular structures.
    MeSH term(s) Humans ; Tomography, Optical Coherence/methods ; Uveitis/diagnosis ; Endophthalmitis ; Orbital Diseases ; Eye
    Language English
    Publishing date 2022-06-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 1193873-0
    ISSN 1744-5078 ; 0927-3948
    ISSN (online) 1744-5078
    ISSN 0927-3948
    DOI 10.1080/09273948.2022.2079535
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  3. Article ; Online: Correlation Between Retinal Vessel Diameters and Uveitis Activity.

    Zicarelli, Federico / Agarwal, Aniruddha / Rizzi, Chiara / Oldani, Marta / Staurenghi, Giovanni / Invernizzi, Alessandro

    Investigative ophthalmology & visual science

    2023  Volume 64, Issue 3, Page(s) 13

    Abstract: Purpose: To assess retinal vein and artery diameters during active and inactive intraocular inflammation in eyes with uveitis.: Methods: Color fundus photographs and clinical data of eyes with uveitis collected during two visits (active disease [i.e., ...

    Abstract Purpose: To assess retinal vein and artery diameters during active and inactive intraocular inflammation in eyes with uveitis.
    Methods: Color fundus photographs and clinical data of eyes with uveitis collected during two visits (active disease [i.e., T0] and inactive stage [i.e., T1]) were reviewed. The images were semi-automatically analyzed to obtain the central retina vein equivalent (CRVE) and central retina artery equivalent (CRAE). Changes of CRVE and CRAE from T0 to T1 were calculated, and their possible correlation with clinical data, including age, gender, ethnicity, uveitis etiology, and visual acuity, were investigated.
    Results: Eighty-nine eyes were enrolled in the study. Both CRVE and CRAE reduced from T0 to T1 (P < 0.0001 and P = 0.01, respectively), with active inflammation being able to influence the CRVE and CRAE (P < 0.0001 and P = 0.0004, respectively) after accounting for all other variables. The degree of venular (∆V) and arteriolar (∆A) dilation was influenced only by time (P = 0.03 and P = 0.04, respectively). Best-corrected visual acuity was influenced by time and ethnicity (P = 0.003 and P = 0.0006).
    Conclusions: CRVE and CRAE are increased in eyes with active intraocular inflammation regardless of the type of uveitis, and they decrease when the inflammation wears off.
    MeSH term(s) Humans ; Uveitis/diagnosis ; Retinal Vessels/diagnostic imaging ; Eye ; Retinal Vein ; Inflammation
    Language English
    Publishing date 2023-03-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391794-0
    ISSN 1552-5783 ; 0146-0404
    ISSN (online) 1552-5783
    ISSN 0146-0404
    DOI 10.1167/iovs.64.3.13
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  4. Article ; Online: Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis.

    Agarwal, Aniruddha / Pichi, Francesco / Invernizzi, Alessandro / Grewal, Dilraj S / Singh, Rohan Bir / Upadhyay, Awaneesh

    Survey of ophthalmology

    2023  Volume 68, Issue 3, Page(s) 446–480

    Abstract: An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for the diagnosis and management of inflammatory disorders such as uveitis. The recent ... ...

    Abstract An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for the diagnosis and management of inflammatory disorders such as uveitis. The recent technological breakthroughs have led to the development of imaging platforms that can evaluate the layers of retina and choroid and the structural and functional alteration in these tissues. Ophthalmologists heavily rely on imaging modalities such as dye-based angiographies (fluorescein angiography and indocyanine green angiography), optical coherence tomography, fundus autofluorescence, as well as dye-less angiography such as optical coherence tomography angiograph,y for establishing a precise diagnosis and understanding the pathophysiology of the diseases. Furthermore, these tools are now being deployed with a 'multimodal' approach for swift and accurate diagnosis. In this comprehensive review, we outline the imaging platforms used for evaluation of posterior uveitis and discuss the organized, algorithmic approach for the assessment of the disorders. Additionally, we provide an insight into disease-specific characteristic pathological changes and the established strategies to rule out disorders with overlapping features on imaging.
    MeSH term(s) Humans ; Multimodal Imaging/methods ; Uveitis, Posterior/diagnosis ; Uveitis/diagnostic imaging ; Fluorescein Angiography/methods ; Fundus Oculi ; Tomography, Optical Coherence/methods ; Choroid
    Language English
    Publishing date 2023-01-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 391346-6
    ISSN 1879-3304 ; 0039-6257
    ISSN (online) 1879-3304
    ISSN 0039-6257
    DOI 10.1016/j.survophthal.2023.01.006
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  5. Article ; Online: OCT Angiography Reveals Bilateral Macular Neovascularization Encircling Macular Atrophy.

    Cozzi, Mariano / Airaldi, Matteo / Invernizzi, Alessandro

    Ophthalmology

    2021  Volume 128, Issue 9, Page(s) 1275

    MeSH term(s) Aged ; Atrophy ; Fluorescein Angiography ; Humans ; Macula Lutea/pathology ; Male ; Retinal Neovascularization/diagnosis ; Tomography, Optical Coherence
    Language English
    Publishing date 2021-06-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2021.02.023
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  6. Article ; Online: Utility of Anterior Segment OCT in the Management of Uveitic Cataract Surgery: A Fibrinoid Syndrome Case Treated with rtPA.

    Muñoz-Solano, Javier / Tondini, Giovanni / Zicarelli, Federico / Staurenghi, Giovanni / Oldani, Marta / Invernizzi, Alessandro

    Ocular immunology and inflammation

    2023  , Page(s) 1–4

    Abstract: Purpose: To highlight the importance of swept-source anterior segment optical coherence tomography (SS-ASOCT) in the peri-surgical management of cataract in uveitis. To describe a case of fibrinoid syndrome in uveitis treated with recombinant tissue ... ...

    Abstract Purpose: To highlight the importance of swept-source anterior segment optical coherence tomography (SS-ASOCT) in the peri-surgical management of cataract in uveitis. To describe a case of fibrinoid syndrome in uveitis treated with recombinant tissue plasminogen activator (rtPA).
    Methods: SS-ASOCT was performed at each follow-up before and after cataract surgery to assess anterior chamber inflammation and assist the clinical management of the patient.
    Results: A patient with idiopathic autoimmune uveitis was scheduled for cataract surgery. SS-ASOCT allowed to correctly plan the surgery timing. The patient developed a severe fibrinoid syndrome. Postsurgical SS-ASOCT allowed to distinguish between anterior chamber cells and fibrin thus guiding the timing for rtPA intracameral injection. Visual acuity improved from 20/400 the day after the surgery to 20/40.
    Conclusion: SS-ASOCT allowed a precise assessment of the inflammatory components (cellular vs fibrinoid) after cataract surgery. Intracameral rtPA was safe and effective in the treatment fibrinoid syndrome in uveitis.
    Language English
    Publishing date 2023-05-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1193873-0
    ISSN 1744-5078 ; 0927-3948
    ISSN (online) 1744-5078
    ISSN 0927-3948
    DOI 10.1080/09273948.2023.2203232
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  7. Article ; Online: Diabetic retinopathy in the pediatric population: Pathophysiology, screening, current and future treatments.

    Invernizzi, Alessandro / Chhablani, Jay / Viola, Francesco / Gabrielle, Pierre Henry / Zarranz-Ventura, Javier / Staurenghi, Giovanni

    Pharmacological research

    2023  Volume 188, Page(s) 106670

    Abstract: Diabetic retinopathy (DR) is a sight threatening complication of diabetes mellitus (DM). The incidence of DR in the pediatric population has increased in the last two decades and it is expected to further rise in the future, following the increase in DM ... ...

    Abstract Diabetic retinopathy (DR) is a sight threatening complication of diabetes mellitus (DM). The incidence of DR in the pediatric population has increased in the last two decades and it is expected to further rise in the future, following the increase in DM prevalence and obesity in youth. As early stages of the retinal disease are asymptomatic, screening programs are of extreme importance to guarantee a prompt diagnosis and avoid progression to more advanced, sight threatening stages. The management of DR comprises a wide range of actions starting from glycemic control, continuing with systemic and local medical treatments, up to para-surgical and surgical approaches to deal with the more aggressive complications. In this review we will describe the pathophysiology of DR trying to understand all the possible targets for currently available or future treatments. We will briefly consider the impact of screening techniques, screening strategies and their social and economic impact. Finally a large part of the review will be dedicated to medical and surgical treatments for DR including both currently available and under development therapies. Most of the available data in the literature on DR are focused on the adult population. The aim of our work is to provide clinicians and researchers with a comprehensive overview of the state of the art regarding DR in the pediatric population, considering the increasing numbers of this diseases in youth and the inevitable consequences that such a chronic disease could have if poorly managed in children.
    MeSH term(s) Adult ; Adolescent ; Humans ; Child ; Diabetic Retinopathy/diagnosis ; Diabetic Retinopathy/epidemiology ; Diabetic Retinopathy/therapy ; Mass Screening/adverse effects ; Mass Screening/methods ; Prevalence ; Incidence ; Diabetes Mellitus
    Language English
    Publishing date 2023-01-18
    Publishing country Netherlands
    Document type Review ; Journal Article
    ZDB-ID 1003347-6
    ISSN 1096-1186 ; 0031-6989 ; 1043-6618
    ISSN (online) 1096-1186
    ISSN 0031-6989 ; 1043-6618
    DOI 10.1016/j.phrs.2023.106670
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  8. Article ; Online: Anterior Segment and Ocular Adnexa OCT Angiography.

    Cozzi, Mariano / Staurenghi, Giovanni / Invernizzi, Alessandro

    Ophthalmology

    2020  Volume 127, Issue 2, Page(s) 220

    MeSH term(s) Angiography ; Anterior Eye Segment/blood supply ; Blood Vessels/diagnostic imaging ; Eyelids/blood supply ; Humans ; Microcirculation ; Skin/blood supply ; Tomography, Optical Coherence
    Language English
    Publishing date 2020-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2019.10.010
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  9. Article ; Online: COVID-19-Related Retinal Micro-vasculopathy - A Review of Current Evidence.

    Teo, Kelvin Yc / Invernizzi, Alessandro / Staurenghi, Giovanni / Cheung, Chui Ming Gemmy

    American journal of ophthalmology

    2021  Volume 235, Page(s) 98–110

    Abstract: Purpose: To evaluate the occurrence of retinal microvasculopathy in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who developed coronavirus disease (COVID-19).: Design: Systematic review and meta-analysis.: ...

    Abstract Purpose: To evaluate the occurrence of retinal microvasculopathy in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who developed coronavirus disease (COVID-19).
    Design: Systematic review and meta-analysis.
    Methods: The Pubmed and Embase databases were comprehensively searched to identify studies that reported retina vascular changes in eyes with COVID-19. Two independent reviewers selected papers and extracted data for analysis. Data of interest were extracted and analyzed in RevMan Web versions 3.3. Quality of evidence was assessed using the National Institute of Health quality assessment tool for a case-control study.
    Results: Thirty-one studies reporting on 1373 subjects (972 COVID-19 and 401 controls) were included. Only case-control studies were included in the pooled analysis. There was a significantly higher likelihood of retinal microvasculopathy in subjects with COVID-19 compared to controls (odds ratio [95% confidence interval], 8.86 [2.54-27.53], P < .01). Optical coherence tomography angiography (OCTA) revealed reduced vessel density and enlarged foveal avascular zone in subjects with COVID-19 compared to controls.
    Conclusions: The results suggested that COVID-19-related retinal microvasculopathy is a significant ocular manifestation of COVID-19 and may herald future retinal complications. These microvascular impairments might have occurred antecedent to clinically visible changes and could be detected earlier by OCTA. These findings are significant, due to the large numbers with COVID-19, and need to be recognized by ophthalmologists as a potential long-term sequalae of the disease.
    MeSH term(s) COVID-19 ; Case-Control Studies ; Fluorescein Angiography/methods ; Fundus Oculi ; Humans ; Retinal Vessels/diagnostic imaging ; SARS-CoV-2 ; Tomography, Optical Coherence/methods
    Language English
    Publishing date 2021-09-26
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ZDB-ID 80030-2
    ISSN 1879-1891 ; 0002-9394
    ISSN (online) 1879-1891
    ISSN 0002-9394
    DOI 10.1016/j.ajo.2021.09.019
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  10. Article ; Online: Photodynamic Therapy for the Treatment of Vascularized Intraretinal Tuberculoma.

    Parrulli, Salvatore / Zicarelli, Federico / Torre, Alessandro / Pellegrini, Marco / Invernizzi, Alessandro

    Ocular immunology and inflammation

    2021  Volume 30, Issue 5, Page(s) 1203–1206

    Abstract: Purpose: To report a case of intraretinal tubercular granuloma successfully treated with photodynamic therapy (PDT).: Methods: Retrospective case report. Multimodal imaging was performed at each follow-up visit.: Results: The tuberculoma did not ... ...

    Abstract Purpose: To report a case of intraretinal tubercular granuloma successfully treated with photodynamic therapy (PDT).
    Methods: Retrospective case report. Multimodal imaging was performed at each follow-up visit.
    Results: The tuberculoma did not regress and did not significantly reduce its exudation after anti-tubercular therapy (ATT), systemic steroid therapy and intravitreal anti-VEGF. Second line treatment with PDT was attempted. The lesion showed a regression with reduced sub-retinal fluid and intra-retinal exudates. A second PDT was performed for reactivation of the lesion 5 months after the first treatment. Further regression of the lesion was observed.
    Conclusion: PDT may be a valuable second-line therapeutic approach for vascularized intraretinal granulomas.
    MeSH term(s) Angiogenesis Inhibitors ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Photochemotherapy/methods ; Photosensitizing Agents/therapeutic use ; Retrospective Studies ; Steroids/therapeutic use ; Tomography, Optical Coherence ; Tuberculoma/diagnosis ; Tuberculoma/drug therapy
    Chemical Substances Angiogenesis Inhibitors ; Photosensitizing Agents ; Steroids
    Language English
    Publishing date 2021-01-21
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1193873-0
    ISSN 1744-5078 ; 0927-3948
    ISSN (online) 1744-5078
    ISSN 0927-3948
    DOI 10.1080/09273948.2020.1869788
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