Publications by authors named "Andrea Giani"
Article Synopsis
- - The study aimed to assess the safety and effectiveness of the drug BI 1467335 in patients with non-proliferative diabetic retinopathy (NPDR) using a randomized, placebo-controlled approach over 24 weeks.
- - Results showed that a higher percentage of patients taking BI 1467335 experienced ocular adverse events (35% vs. 23% in the placebo group), but both groups had similar rates of treatment-related adverse events (around 7.5%).
- - Although BI 1467335 was generally well tolerated, only a small number of patients (5.7%) showed improvement in diabetic retinopathy severity, indicating limited efficacy of the treatment.
: This one-year prospective observational study, conducted at two centers, aimed to report the natural history of retinal sensitivity (RS) loss in diabetic macular ischemia (DMI). : Patients with stable-treated proliferative diabetic retinopathy (PDR) were recruited if there was evidence of DMI on optical coherence tomography angiography, defined as a foveal avascular zone ≥ 0.5 mm or parafoveal capillary dropout ≥ 1 quadrant.
View Article and Find Full Text PDFPurpose: To describe the prevalence of subretinal transient hyporeflectivity (STHR) in exudative neovascular age-related macular degeneration (nAMD) and its response to a loading phase of aflibercept.
Methods: Optical coherence tomography (OCT) scans of treatment-naïve nAMD patients captured at baseline and after a loading phase of aflibercept were graded for presence of STHR, defined as a small, well-defined, round, subretinal, hyporeflective area, delimited between the ellipsoid zone (EZ) and the retinal pigmented epithelium/Bruch membrane complex. OCT parameters recorded were macular neovascularisation (MNV) subtypes, location of retinal fluids (subretinal fluid, SRF and intraretinal fluid, IRF), central retinal and choroidal thickness.
Article Synopsis
- - The study aimed to compare baseline characteristics of patients with and without early residual fluid (ERF) following treatment for neovascular age-related macular degeneration (nAMD) using aflibercept.
- - Out of 2128 patients, 50% experienced ERF after the loading phase, with specific characteristics like increased central subfield thickness (CST) and certain forms of fluid observed to correlate with the presence of ERF.
- - The findings suggest that patients with CST greater than or equal to 418 microns and certain fluid types may need additional monthly treatments before changing their treatment schedule.
Introduction: The aim of this study was to describe the design and the participants' baseline characteristics of a prospective natural history study of geographic atrophy (GA) secondary to age-related macular degeneration.
Methods: The optical coherence tomography (OCT) and microperimetry biomarker evaluation in patients with GA (OMEGA) study was conducted at a tertiary referral center (ClinicalTrials.gov identifier: NCT05963646).
Purpose: To study associations of optical coherence tomography (OCT) features with presenting visual acuity (VA) in treatment naive neovascular age-related macular degeneration (nAMD).
Methods: Patients with nAMD initiated on aflibercept therapy were recruited from December 2019 to August 2021. Demographic and OCT (Spectralis, Heidelberg Engineering) features associated with good VA (VA ≥ 68 ETDRS letters, Snellen ≥ 6/12) and poor VA (VA < 54 letters, Snellen < 6/18) were analysed using Generalised Estimating Equations to account for inter-eye correlation.
Purpose: This study aimed to determine the threshold for defining abnormal retinal sensitivity (RS) that correlates with structural changes in diabetic macular ischemia (DMI) patients with stable treated proliferative diabetic retinopathy (PDR).
Design: Prospective cross-sectional study.
Methods: In a single center, we recruited 85 eyes (67 patients) with stable treated PDR with best-corrected visual acuity (BCVA) ≥54 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Snellen equivalent 20/80) and optical coherence tomography angiography evidence of DMI.
Patients diagnosed with exudative neovascular age-related macular degeneration are commonly treated with anti-vascular endothelial growth factor (anti-VEGF) agents. However, response to treatment is heterogeneous, without a clinical explanation. Predicting suboptimal response at baseline will enable more efficient clinical trial designs for novel, future interventions and facilitate individualised therapies.
View Article and Find Full Text PDFPurpose: Fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD) are at risk of developing macular neovascularisation (MNV). These eyes may first develop subclinical non-exudative MNV (neMNV) before they leak to form exudative MNV (eMNV). The EYE NEON study is a 2-year study aimed at estimating the prevalence and incidence of neMNV and evaluating its role as a predictor for conversion to neovascular AMD.
View Article and Find Full Text PDFArticle Synopsis
- * Drug size and charge significantly affect how anti-VEGF agents are processed in the eye, impacting their effectiveness and how often they need to be administered.
- * Research is ongoing into methods for enhancing drug action duration, such as using larger molecules or alternative delivery systems, aiming to provide more effective treatments that require less frequent dosing for wAMD.
Background: Diabetic macular ischaemia (DMI) is a complication of diabetic retinopathy that leads to irreversible vision loss. DMI is characterised by reduced retinal vessel density and enlargement of the foveal avascular zone (FAZ). Despite its clinical burden, there is no formal consensus on the definition of DMI, and no approved treatment.
View Article and Find Full Text PDFObjective: To investigate the relative effect of disorganization of the retinal inner layers (DRIL) and ellipsoid zone (EZ) loss on visual function in diabetic macular ischemia (DMI).
Design: Prospective cross-sectional observational study.
Participants: Patients with stable treated proliferative diabetic retinopathy (PDR) without center-involved diabetic macular edema were recruited at the Moorfields Eye Hospital from December 2019 to November 2021.
Objective: To describe optical coherence tomography (SD-OCT) features, age, gender, and systemic variables that may be used in machine/deep learning studies to identify high-risk patient subpopulations with high risk of progression to geographic atrophy (GA) and visual acuity (VA) loss in the short term.
Design: prospective, longitudinal study.
Subjects: We analyzed imaging data from patients with iAMD (N= 316) enrolled in Age-Related Eye Disease Study 2 (AREDS2) Ancillary SD-OCT with adequate SD-OCT imaging for repeated measures.
The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (<70 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, Snellen equivalent 20/40) in DMI. The study was completed at the Moorfields Eye Hospital from December 2019 to August 2021.
View Article and Find Full Text PDFGeographic atrophy (GA) secondary to age-related macular degeneration accounts for close to one-quarter of cases of legal blindness in the USA and the UK. Despite this notable disease burden, the pathophysiology of GA is complex and not fully understood, and there is currently no approved treatment to prevent or slow its progression. GA is heterogeneous in its appearance and extent, and underlying associated traits such as drusen and complement factor polymorphisms vary between patients and by ethnicity, posing a challenge for treatment development.
View Article and Find Full Text PDFPurpose: To compare the difference in the rate of survival of unaffected fellow eyes between choroidal neovascularization (CNV) in the first eyes and retinal angiomatous proliferation (RAP) in the first eyes.
Design: Cohort retrospective study.
Participants: A total of 329 consecutive patients enrolled in our Eye Clinic between February 2006 and November 2014 were involved in the study.
Purpose: To compare indocyanine green angiography and four different optical coherence tomography angiography (OCTA) devices and to test their reproducibility in the evaluation of choroidal neovascularization (CNV).
Methods: This study was an observational case series of Type 1 and Type 2 CNV presenting at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, imaged with indocyanine green angiography and four different OCTA devices: prototype PlexElite (Carl Zeiss Meditec), prototype Spectralis OCTA (Spectralis; Heidelberg Engineering, Heidelberg, Germany), Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA), and AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec, Inc, Dublin, CA). Optical coherence tomography angiography examinations were performed using a 3 × 3-mm or 6 × 6-mm volume scan pattern to capture the full lesion.
Purpose: To report a case of acute idiopathic maculopathy complicated by choroidal neovascularization (CNV) in which multimodal imaging was used to confirm the presence of CNV and follow the response to anti-vascular endothelial growth factor treatment.
Methods: A 39-year-old man was referred to our clinic for the evaluation of maculopathy in the right eye. Multimodal imaging was performed including fundus photography, fundus autofluorescence, infrared fundus reflectance (IR), optical coherence tomography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography angiography.
Purpose: To determine interobserver and intraobserver agreement in classifying the subtypes of choroidal neovascularization (CNV) and the decision of retreatment in patients affected by exudative age-related macular degeneration. Different imaging techniques were evaluated individually and compared with multiimaging.
Methods: Fifty-two patients with naive CNV in age-related macular degeneration were evaluated after 3 monthly intravitreal injections of ranibizumab.
Purpose: To evaluate the reproducibility of parafoveal microvascular anatomy of 7 different optical coherence tomography angiography (OCT-A) devices by comparing vessel density (VD), fractal dimension (FD), and foveal avascular zone (FAZ) of superficial and deep capillary plexus in healthy volunteers.
Design: Reliability analysis.
Methods: Consecutive healthy volunteers presenting at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan in the same clinic visit were imaged by 7 different OCT-A devices: Optovue RTVue XR Avanti (Optovue, Inc, Fremont, California, USA), prototype Spectralis OCT-A (Spectralis; Heidelberg Engineering, Heidelberg, Germany), AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec, Inc, Dublin, California, USA), prototype PlexElite (Carl Zeiss Meditec), RS-3000 Advance (Nidek, Gamagori, Japan), OCT-HS100 (Canon, Tokyo, Japan), and Revo NX (Optopol Technology SA, Zawiercie, Poland).
Purpose: To evaluate baseline features and morphologic changes of vitreoretinal adhesion and outer retinal layers outside the macula after intravitreal ocriplasmin injection. To study the relation between vitreous detachment and attenuation of retinal outer segments signal.
Methods: Retrospective cases series of 15 eyes.
Long-term follow-up of fellow eye in patients with lamellar macular hole.
Graefes Arch Clin Exp Ophthalmol
August 2017
Background: To evaluate macular changes in fellow eyes of patients diagnosed with lamellar macular hole (LMH) using spectral-domain optical coherence tomography (SD-OCT) and blue fundus autofluorescence (B-FAF).
Methods: Fellow eyes of patients diagnosed with a LMH were retrospectively evaluated on OCT. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were recorded.
Purpose: To identify signs occurring more frequently in retinal angiomatous proliferation (RAP) lesions compared with other types of choroidal neovascularization (CNV) in age-related macular degeneration.
Methods: In this cross-sectional retrospective study, 30 patients were evaluated. These signs were correlated with the type of CNV: shunting of blood flow to the lesion by fluorescein angiography, late leakage by indocyanine green angiography, intraretinal cysts and retinal pigmented epithelium interruption along the retinal pigmented epithelium detachment with a hyperreflective oval area by spectral domain optical coherence tomography, and presence of reticular pseudodrusen by infrared light.
Purpose: To assess the status of choriocapillaris in eyes with macular atrophy secondary to age-related macular degeneration (AMD) (geographic atrophy [GA]) and Stargardt disease (STGD) using optical coherence tomography angiography (OCTA).
Design: Prospective, observational case series.
Participants: A total of 14 patients (20 eyes) affected by GA and 10 patients (20 eyes) affected by STGD.