Optical Coherence Tomography Angiography of Iris Nevus: A Case Report

Iris nevus is common: 6% of patients with suspected iris melanoma have lesions other than melanoma, and 36% of them are nevi. Iris nevus turns into melanoma in approximately 8% of cases at a mean of 15 years. This case report provides the first description of an iris tumor examined with iris optical coherence tomography angiography (OCTA) compared to iris fluorescein angiography (IFA). A 60-year-old man with a diagnosis of iris nevus in the left eye was referred to our department for IFA and iris OCTA. The iris vasculature in IFA was visible only in the early phases, but not clearly. OCTA, however, gave visualization of the vascular network and very precisely defined the vessels of the whole lesion, except for the pupillary portion, which was masked by superficial pigment accumulations. IFA and iris OCTA can add information about the vascular architecture compared to slit-lamp biomicroscopy, ultrasound biomicroscopy, and anterior-segment OCT. However, IFA is time-consuming and invasive and can – very occasionally – cause serious adverse reactions. In contrast, OCTA defines the texture of the iris vasculature better. In conclusion, OCTA is a new method, easy to execute, needing no dye injection, and provides useful information on the vascular network of iris lesions. It could therefore be helpful in the diagnosis and follow-up of these lesions

Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study

Purpose: The purpose of this study is to make a prospective evaluation of the effect of timolol 0.1% eye gel on short-term intraocular pressure (IOP) after an intravitreal injection (IVI) of ranibizumab. Participants and methods: One hundred and fifty eyes of 150 IVI-naïve patients with macular edema caused by various pathological conditions (age-related macular degeneration, central or branch retinal vein occlusion, and diabetic retinopathy) were scheduled to undergo an IVI of ranibizumab (0.5 mg/0.05 cc). The patients were randomly divided into three groups: 50 were not treated with timolol before the IVI (group 1); 50 received an instillation of timolol 0.1% eye gel the evening before the IVI (group 2); and 50 received an instillation of timolol 0.1% eye gel 2 hours before the IVI (group 3). The incidence of clinically significant intraocular hypertensive spikes (>25 mmHg and >40 mmHg) was then assessed. Results: Our findings showed that mean IOP at baseline was significantly higher than at both 5 and 60 minutes after IVI (P25 mmHg were recorded at either time in 27 patients (54%) in group 1, 23 patients (44%) in group 2, and 24 patients (48%) in group 3. None of the between-group differences were significant. Spikes of >40 mmHg (which were only detected 5 minutes after IVI) were recorded in nine (18%), eight (16%), and one patient (2%) in groups 1, 2, and 3, respectively. The only significant difference was between the control and group 3 (P=0.012). Conclusion: An increase in IOP after antivascular endothelial growth factor IVI is a frequent complication. The prophylactic use of timolol 0.1% gel effectively reduced the mean IOP when administered 2 hours before IVI and was also effective in preventing dangerous IOP spikes of >40 mmHg. It is therefore recommended before IVIs as a means of preventing emergency procedures and preserving the health of the optic nerve

THE 23 JULY 1930 EARTHQUAKE (MS=6.7) IN THE SOUTHERN APENNINES (ITALY): GEOLOGICAL AND HYDROLOGICAL EFFECTS

The 23 July 1930 earthquake (MS=6.7) in the Southern Apennines (Italy) was a catastrophic event that produced many effects such as surface faulting, fractures, landslides, settlements, hydrological changes, variations in chemical/ physical activity related to the volcanic and/or thermal zones and also acoustic and optical phenomena. It is the first great earthquake of the twentieth century that was studied, thanks to the hydrological monitoring network of the Italian Hydrographic Survey (IHS) set up from 1925 to 1929. For this earthquake we analysed the initial IHS hydrometric and pluviometric data, looking for significant anomalies in springs, water wells and mountain streams. Hydrological data relative to rivers, springs and water wells indicate that some changes can be correlated with the earthquake: a post-seismic excess discharge in some streams, pre- and co-seismic decreases in stream flows and water levels in wells, pre- and post-seismic increases in discharges. The pre- and co-seismic stresses and the tectonic deformations were studied in order to find a possible model of interaction between stress state and hydrological variations. The anomalies found in this work can be considered “rebound anomalies”, which are the most common precursor reported by several authors and related to increases in porosity and permeability caused by the fracturing that precedes an earthquake. An estimation of the total excess discharge (0.035 km3) caused by the Ms=6.7 Irpinia earthquake is consistent with the excess discharge of about 0.01 km3 determined for the Mw=6.9 Loma Prieta earthquake. To define the normal hydrodynamic behaviour of the considered aquifers, an analysis of the correlation between rainfalls and water levels and flow rates has been carried out. The delay of significant peaks in the correlograms of figure 7 with respect to the start of the hydrological anomaly and/or its duration, can define the space-time limits of the changes correlated with earthquake

Hydrological anomalies connected to earthquakes in southern Apennines (Italy)

The study of hydrological variations in the watersheds of seismic areas can be useful in order to acquire a new knowledge of the mechanisms by which earthquakes can produce hydrological anomalies. Italy has the availability of many long historical series both of hydrological parameters and of seismological data, and is an ideal laboratory to verify the validity of theoretical models proposed by various authors. In this work we analyse the hydrological anomalies associated with some of the big earthquakes that occurred in the last century in the southern Apennines: 1930, 1980 and 1984. For these earthquakes we analysed hydrometric and pluviometric data looking for significant anomalies in springs, water wells and mountain streams. The influence of rainfalls on the normal flows of rivers, springs and wells has been ascertained. Also, the earthquake of 1805, for which a lot of hydrological perturbations have been reported, is considered in order to point out effects imputable to this earthquake that can be similar to the effects of the other big earthquakes. The considered seismic events exhibit different modes of energy release, different focal mechanisms and different propagation of effects on the invested areas. Furthermore, even if their epicentres were not localised in contiguous seismogenetic areas, it seems that the hydrological effects imputable to them took place in the same areas. Such phenomena have been compared with macroseismic fields and transformed in parameters, in order to derive empirical relationships between the dimensions of the event and the characteristics of the hydrological variations. The results of this work point to a close dependence among hydrological anomalies, regional structures and fault mechanisms, and indicate that many clear anomalies have been forerunners of earthquakes. In 1993, the Naples Bureau of the Hydrographic National Service started the continuous monitoring of hydrologic parameters by a network of automatic stations and transmission in real time; presently 7 acquifers are under control in which also pH, <i>T</i> , salinity, electrical conductivity, dissolved oxygen are measured. We envisage to increase the number of monitoring sites and controlled parameters

Cataract and optic disk drusen in a patient with glycogenosis and di George syndrome: clinical and molecular report

Background We report the ophthalmic findings of a patient with type Ia glycogen storage disease (GSD Ia), DiGeorge syndrome (DGS), cataract and optic nerve head drusen (ONHD). Case presentation A 26-year-old white woman, born at term by natural delivery presented with a post-natal diagnosis of GSD Ia. Genetic testing by array-comparative genomic hybridization (CGH) for DGS was required because of her low levels of serum calcium. The patient has been followed from birth, attending the day-hospital every six months at the San Paolo Hospital, Milan, outpatient clinic for metabolic diseases and previously at another eye center. During the last day-hospital visit, a complete eye examination showed ONHD and cataract in both eyes. Next Generation Sequencing (NGS) was subsequently done to check for any association between the eye problems and metabolic aspects. Conclusions This is the first description of ocular changes in a patient with GSD Ia and DGS. Mutations explaining GSD Ia and DGS were found but no specific causative mutation for cataract and ONHD. The metabolic etiology of her lens changes is known, whereas the pathogenesis of ONHD is not clear. Although the presence of cataract and ONHD could be a coincidence; the case reported could suggest that hypocalcemia due to DGS could be the common biochemical pathway

Liposomal amphotericin B for visceral leishmaniasis in human immunodeficiency virus-coinfected patients: 2-year treatment outcomes in Bihar, India

Reports on treatment outcomes of visceral leishmaniasis (VL)-human immunodeficiency virus (HIV) coinfection in India are lacking. To our knowledge, none have studied the efficacy of liposomal amphotericin B in VL-HIV coinfection. We report the 2-year treatment outcomes of VL-HIV-coinfected patients treated with liposomal amphotericin B followed by combination antiretroviral treatment (cART) in Bihar, India

Radon in active volcanic areas of southern Italy

The radiogenic gas radon is considered a valid precursor of events like eruptions and earthquakes. We are monitoring the variations in time of this gas in soils and in waters of many active volcanic areas of Southern Italy. The greatest differences in Rn content of the investigated volcanic areas are: Ischia and Campi Flegrei have more Rn than Vesuvio and Vulcano, both in soils and in waters. The thermalized waters of Ischia are enriched in Rn 15 times with respect to soils, while in the other areas soils and underground waters have comparable Rn contents