Subretinal Injection in Ophthalmic Surgery

I am pleased to share with you our latest publication on the subretinal delivery of therapeutic agents for gene therapy, for subretinal haemorrhage and for injection of fluid to induce a controlled and localized macular detachment. The growing interest in this technique is mainly related to its suitability to deliver gene therapy in direct contact with target tissues. In the light of the increasing importance of this maneuver in vitreoretinal surgery as well as of the lack of a standardized surgical approach, we conducted a comprehensive overview on the current indications for subretinal injection, surgical technique with the available variations, and the potential complications.
#subretinalinjection #genetherapy #subretinalhaemorrhage #vitreoretinalsurgery

@DomenicoTripepi @AssadJalil @NaseerAlly @MatildeBuzzi @GeorgeMoussa @Pierre-RaphaëlRothschild  @TommasoRossi  @MariantoniaFerrara @MarioRomano 

How to Set Up Genetic Counselling for Inherited Macular Dystrophies: Focus on Genetic Characterization

I am happy to share our recent publication on how to create a center for the treatment of Inherited macular dystrophies (IMD), which takes advantage of a multidisciplinary experience for an adequate global evaluation of the patient and of possible therapies. Recent therapeutic possibilities point to a clear need for genetic assessment services in tertiary referral hospitals. However, establishing such a service can be a complex task due to the diverse skills required and multiple professionals involved. This review aims to provide comprehensive guidelines to enhance the genetic characterization of patients and improve counseling efficacy by combining updated literature with our own experiences. Through this review, we hope to contribute to the establishment of state-of-the-art genetic counseling services for inherited macular dystrophies.

#retina #genetherapy #inheritedmaculardystrophies #vitreoretina #IMD

Optical-Quality Assessment of a Miniaturized Intraocular Telescope

I am pleased to share with you our recently published article on the optical quality of implanting a miniaturized microscope (SING IMT) for age-related macular degeneration. Specifically, we measured the optical transmission in the spectral range 350–750 nm of the implantable telescope with a fiber-optic spectrometer. Wavefront aberrations were studied by measuring the wavefront of a laser beam after passing through the telescope and expanding the measured wavefront into a Zernike polynomial basis. Wavefront concavity indicated that the SING IMTTM behaves as a diverging lens with a focal length of −111 mm. The device exhibited even optical transmission in the whole visible spectrum and effective curvature suitable for retinal images magnification with negligible geometrical aberrations. Optical spectrometry and in vitro wavefront analysis provide evidence supporting the feasibility of miniaturized telescopes as high-quality optical elements and a favorable option for AMD visual impairment treatments.

Sono lieto di condividere con voi il nostro articolo recentemente pubblicato sulla qualità ottica dell’impianto di un microscopio miniaturizzato (SING IMT) per la degenerazione maculare senile. Nello specifico, abbiamo misurato la trasmissione ottica nell’intervallo spettrale 350–750 nm del telescopio impiantabile con uno spettrometro a fibre ottiche. Le aberrazioni del fronte d’onda sono state studiate misurando il fronte d’onda di un raggio laser dopo essere passato attraverso il telescopio ed espandendo il fronte d’onda misurato in una base polinomiale di Zernike. La concavità del fronte d’onda ha indicato che SING IMTTM si comporta come una lente divergente con una lunghezza focale di -111 mm. Il dispositivo ha mostrato una trasmissione ottica uniforme nell’intero spettro visibile e una curvatura effettiva adatta per l’ingrandimento di immagini retiniche con aberrazioni geometriche trascurabili. La spettrometria ottica e l’analisi del fronte d’onda in vitro forniscono prove a sostegno della fattibilità di telescopi miniaturizzati come elementi ottici di alta qualità, opzione potenziale per i trattamenti di disabilità visiva da AMD.

#agerelatedmaculardegeneration #AMD #cataract #degenerazionemacularesenile #cataratta


Autologous Platelet-Rich Plasma

We are pleased to share our paper on Autologous Platelet-Rich Plasma (a-PRP) as an adjuvant in the treatment of macular holes.
The use of a-PRP has not only the aim of improving the anatomical success, but also the functional one by reducing the fibrotic phenomena and favoring the regeneration.
The a-PRP, consisting of a portion of the plasma obtained by the centrifugation of the peripheral blood, is characterized by a platelet concentration and, thus, growth factors content, significantly higher compared with that of the original sample.
The a-PRP have been shown to exert a modulating effect on tissue inflammation as well as a promoting effect on tissue repair and regeneration, with beneficial effects on retinal pigment epithelium (RPE) cells and Müller cells.
Our prospective, non-randomized study included eyes refractory full-thickness macular holes, with a failed first surgery. The included macular holes had different aetiologies: large, myopic and secondary to optic pit holes. At six months after surgery, our closure rate was 92.9% by applying a-PRP. We are working on different ways of intraocular administration of PRP at different concentrations and with different carriers, furthermore the application can be applied in different pathologies, with the aim of promoting cell regeneration and healing without inducing fibrosis.
Siamo lieti di condividere il nostro articolo su Autologous Platelet-Rich Plasma (a-PRP) come coadiuvante nel trattamento dei fori maculari.
L’utilizzo dell’a-PRP ha lo scopo non solo di migliorare il successo anatomico, ma anche quello funzionale riducendo i fenomeni fibrotici e favorendo la rigenerazione.
L’a-PRP, costituito da una porzione di plasma ottenuto per centrifugazione del sangue periferico, è caratterizzato da una concentrazione piastrinica e, quindi, contenuto di fattori di crescita, significativamente più elevata rispetto a quella del campione originario.
È stato dimostrato che l’a-PRP esercita un effetto modulante sull’infiammazione dei tessuti e un effetto di promozione sulla riparazione e rigenerazione dei tessuti, con effetti benefici sulle cellule dell’epitelio pigmentato retinico (RPE) e sulle cellule di Müller.
Il nostro studio prospettico, non randomizzato, ha incluso fori maculari a tutto spessore refrattari agli occhi, con un primo intervento chirurgico fallito. I fori maculari inclusi avevano diverse eziologie: grandi, miopi e secondari a pit del nervo ottico. A sei mesi dall’intervento, il nostro tasso di chiusura è stato del 92,9% applicando a-PRP. Stiamo lavorando su diverse modalità di somministrazione intraoculare di PRP a diverse concentrazioni e con diversi vettori, inoltre l’applicazione può essere applicata in diverse patologie, con l’obiettivo di promuovere la rigenerazione cellulare e la guarigione senza indurre fibrosi.


Secondary intraocular lens implants in complicated cataracts

We are pleased to share our recent publication on the management of intraocular lens implants in the presence of capsular rupture, one of the most common and serious complications of cataract surgery. In our evaluation we consider implanted lenses in AC, with iris and scleral support, sutured or intrascleral sutureless. We also comparatively evaluated the inflammatory, haemorrhagic and traction complications induced by the different implants, and reported in the literature. As a result, intrascleral lenses appear to be very promising implants, providing favorable functional results with a low rate of postoperative complications.