ABSTRACT
PURPOSE: To evaluate the effectiveness of a single session of micropulse laser trabeculoplasty (MLT) to lower intraocular pressure (IOP) in patients with pseudoexfoliation glaucoma (PEXG). METHODS: In this single-center, one-arm, prospective study patients with PEXG under prostaglandine analogue monotherapy with inadequate IOP control were treated with 360° 532-nm MLT. Patients were evaluated at 1 day, 1 month, 3 months, 6 months, and 12 months post-MLT while they were treated with the same drug regimen as pre-MLT. Mean IOP reduction and percentage of IOP change during the follow-up were calculated. Cases that required any further intervention, like additional hypotensive medication, laser or surgical therapy, throughout the study period were considered failures and removed from the study. RESULTS: Twenty-seven eyes (27 patients, 17 male) were included in the study. The age of the patients was 72.37 ± 6.29 years and the baseline IOP was 20.41 ± 1.87 mmHg. Treatment with MLT resulted in significantly lower IOP at 1, 3, 6, and 12 months after MLT compared to baseline (p < 0.0001 for all comparisons). By the end of the study, 52.17% of the PEXG eyes demonstrated a ≥ 20% IOP reduction compared to baseline. Four eyes (14.81%) did not respond to MLT (three eyes at 3 months and one eye at 6 months after trabeculoplasty) and were considered failures since they required additional intervention. CONCLUSIONS: Micropulse laser trabeculoplasty appears to be an effective method to lower IOP in patients with PEXG up to 12 month of follow-up period. TRIAL REGISTRATION: The study is registered on www.ClinicalTrials.gov with registration number NCT03483402.
Subject(s)
Exfoliation Syndrome/surgery , Intraocular Pressure/physiology , Laser Therapy/methods , Prostaglandins, Synthetic/administration & dosage , Trabeculectomy/methods , Aged , Exfoliation Syndrome/drug therapy , Exfoliation Syndrome/physiopathology , Female , Follow-Up Studies , Humans , Male , Ophthalmic Solutions , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: Deferoxamine (DFO) is one of the most commonly used chelation treatments for transfusional hemosiderosis. Pattern dystrophies constitute a distinct entity of retinal disorders that has been occasionally identified in association with deferoxamine. CASE PRESENTATION: We report two cases of bilateral macular pattern dystrophy in transfusion dependent patients undergoing chronic chelation therapy with deferoxamine due to thalassemias. Our patients were evaluated with multimodal imaging and the results are presented. Both patients had normal cone and rod responses in the full-field electroretinogram and continued the prescribed chelation therapy, after hematology consult. The patients were followed up every 3 months for 2 and 4 years respectively for possible deterioration. Their best corrected visual acuity remained stable with no anatomic change on Optical Coherence Tomography findings. CONCLUSION: Multimodal imaging of our patients allowed a better evaluation and possibly earlier detection of the DFO-related changes. Screening and close follow up of patients under chronic chelating therapy is important in order to promptly diagnose and manage possible toxicity either with discontinuation of the offending agent or dose modification.
Subject(s)
Deferoxamine/adverse effects , Retina/diagnostic imaging , Retinal Degeneration/chemically induced , Thalassemia/drug therapy , Deferoxamine/administration & dosage , Electroretinography , Female , Humans , Infusions, Subcutaneous/adverse effects , Middle Aged , Retinal Degeneration/diagnosis , Siderophores/administration & dosage , Siderophores/adverse effects , Tomography, Optical CoherenceABSTRACT
AIM: To investigate the composition of the microbial community in biodeterioration of two frescoes in St Damian's Monastery in Assisi. METHODS AND RESULTS: A total of 1292 colonies were isolated from the most deteriorated parts, analysed by microbiological, biomolecular and ultrastructural techniques, and taxonomically classified. Molecular biotyping of Staphylococcus cohnii colonies, one of the most prevalent bacterial species, showed a very restricted genome diversity while Bacillus licheniformis were very homogeneous by RFLP, tDNA-PCR and random-amplified polymorphic DNA. Electron microscopy confirmed heterogeneity of the bacterial population in the different sampling areas. CONCLUSIONS: Several of the identified species are widespread in the soil or saprophytes of human skin. Although unable to demonstrate that they are involved in biodeterioration, they may represent trophic elements contributing to fungi-related chromatic alterations when adequate environmental conditions occur. Deterioration may in part be prevented or controlled by adequate air filtering or conditioning of the room.
