Publications by authors named "Sacconi R"
Focal capillary ectasia in the macular region can manifest in distinct clinical scenarios, which can be categorized into 2 main entities: perifoveal vascular anomalous complex (PVAC) and telangiectatic capillaries (TelCaps). PVAC represents a primary, idiopathic condition, whereas TelCaps occur secondary to underlying vascular disorders, including diabetic macular edema and retinal vein occlusion. We provide a comprehensive analysis of these 2 entities, encompassing their clinical presentations, multimodal imaging findings, histological evidence, and differential diagnosis from other retinal microvascular abnormalities, such as Type 1 macular telangiectasia, adult-onset Coats disease, Type 3 macular neovascularization in age-related macular degeneration, and retinal arterial macroaneurysms.
View Article and Find Full Text PDFIntravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) medications are the primary treatment for neovascular age-related macular degeneration (nAMD). However, frequent administrations pose significant burdens on patients, healthcare providers, and systems. The treat-and-extend (T&E) regimen, which adjusts treatment intervals based on patient response, aims to reduce injection frequency while maintaining disease control.
View Article and Find Full Text PDFPurpose: To identify baseline OCT predictors of the 3-year macular atrophy (MA) development for type 3 (T3) macular neovascularization (MNV) secondary to neovascular age-related macular degeneration (nAMD) treated by anti-VEGF therapy.
Design: Multicenter, retrospective, longitudinal study.
Participants: We included patients with treatment-naive T3 MNV secondary to nAMD at baseline, treated with anti-VEGF during a 3-year follow-up.
Purpose: To evaluate photobiomodulation (PBM) safety and efficacy in patient with atrophic AMD and to explore tissue effects using Spectrally Resolved Autofluorescence (SrAF) to identify a potential biomarker indicative of mitochondrial activity, the primary PBM target.
Methods: This retrospective, non-comparative case series involved six eyes of five patients with atrophic AMD, conducted at the Medical Retina and Imaging Unit, IRCCS San Raffaele Hospital in Milan, Italy. At baseline and follow-ups (after one and three months) a complete ophthalmological assessment and multimodal imaging, including spectrally resolved autofluorescence (SrAF), were performed.
Purpose: To describe and clarify a possible pathogenetic origin for choroidal caverns in young healthy individuals through a topographical analysis using swept-source optical coherence tomography angiography (SS-OCTA).
Methods: A cross-sectional evaluation of 44 healthy volunteers (44 eyes), aged 20-32 years with no systemic or ocular comorbidities. The topographical analysis of choroidal caverns was performed through a 15 × 15 mm volumetric scan cube using SS-OCTA (PLEX Elite 9000).
Purpose: To analyse the longitudinal changes in imaging parameters in eyes with acute or chronic central serous chorioretinopathy (CSCR).
Methods: This was a multicentric, retrospective, longitudinal, observational study in patients with a diagnosis of CSCR and having at least 4 years of follow-up. Trend in choroidal thickness (CT), area of double layer sign (DLS), area of retinal pigment epithelium (RPE) alterations, and area of hyper-autofluorescence were analysed.
Article Synopsis
- The study compares structural optical coherence tomography (OCT) and infrared reflectance (IR) imaging to analyze differences in non-exudative macular neovascularizations (NE MNVs) caused by age-related macular degeneration (AMD) and those linked to the pachychoroid spectrum.
- It assessed patients with documented NE-MNVs, focusing on treatment-naïve cases that remained non-exudative for at least a year and had high-quality imaging available.
- Results indicated that NE-MNVs in pachychoroid eyes exhibited sharper, more inhomogeneous pigment epithelium detachments and were more likely to show a hyporeflective halo than those in AMD eyes.
Purpose: To explore changes in reticular pseudodrusen (RPD) number and location after the development of macular neovascularization (MNV) in eyes with prior intermediate age-related macular degeneration, focusing on different retinal regions differently affected by MNV.
Methods: This retrospective longitudinal study included intermediate age-related macular degeneration eyes with RPD that developed MNV. Reticular pseudodrusen were assessed at baseline when MNV was diagnosed (MNV stage) and after anti-vascular endothelial growth factor treatment.
Purpose: To assess differences in choriocapillaris (CC) and macular neovascularization (MNV) optical coherence tomography angiography quantitative parameters between long-term persistently nonexudative MNVs (NE-MNVs) and long-term activated NE-MNVs in age-related macular degeneration.
Methods: Age-related macular degeneration patients with treatment-naïve NE-MNVs with >2 years of follow-up and no evidence of exudation within the first 6 months from diagnosis were retrospectively recruited. Two groups were considered according to the occurrence (EX group) or not (NE group) of exudation within the first 2 years of follow-up.
Article Synopsis
- The study investigated the effects of flavanol-rich dark chocolate on the anatomy and functionality of retinal vessels, using advanced imaging techniques on healthy participants.
- Twenty healthy individuals (mean age 24.4 years), consumed either dark chocolate or milk chocolate, with evaluations conducted before and two hours after consumption.
- Results showed that dark chocolate significantly improved arterial dilation in retinal vessels, suggesting potential short-term benefits, while no significant effects were observed from milk chocolate; further research is needed to explore long-term impacts on retinal health.
Impact of cumulative dose of hydroxychloroquine on retinal structures.
Graefes Arch Clin Exp Ophthalmol
August 2024
What is known • Hydroxychloroquine (HCQ) is widely used for autoimmune disorders but is associated with the risk of retinal toxicity. • Early detection of retinal structural changes due to HCQ toxicity remains challenging, and cumulative HCQ dose as a risk factor has conflicting clinical relevance. What Is New • Higher cumulative HCQ doses are significantly associated with thinner outer retinal layers (foveal, parafoveal, and perifoveal regions).
View Article and Find Full Text PDFGeographic Atrophy-associated Intraretinal Neovascularization (GAIN): A novel clinical entity.
Graefes Arch Clin Exp Ophthalmol
August 2024
KEY MESSAGES : WHAT IS KNOWN : Geographic atrophy could be associated with MNV or other vascular alterations. Intraretinal fluid could be present in GA also without neovascularization. WHAT IS NEW : GAIN is a novel clinical entity characterized by GA and an intraretinal neovascular network.
View Article and Find Full Text PDFArticle Synopsis
- Non-exudative choroidal and macular neovascularizations (NV) are increasingly found in various retinal disorders, with new non-invasive imaging methods like OCT and OCTA making detection and monitoring easier.
- These NV lesions differ significantly in their causes, structures, and potential outcomes, highlighting the need for better understanding and classification.
- The review emphasizes the importance of careful monitoring and timely treatment of non-exudative NVs due to their complexity and variability in retinal diseases.
Purpose: To assess the sensitivity and specificity of the "triple layer sign" (TLS) (retinal pigment epithelium (RPE), neovascular tissue, and Bruch's membrane) on structural optical coherence tomography (OCT) images for the diagnosis of treatment-naïve non-exudative type-1 macular neovascularization (NE-MNV) in age-related macular degeneration (AMD).
Design: Cross-sectional study.
Methods: Two masked retinal experts evaluated the presence of the TLS in eyes with NE-MNV and controls with an RPE elevation without exudation due to other causes than NE-MNV in AMD [e.
Article Synopsis
- This study focused on characterizing a specific condition called LeptoVitelliform Maculopathy (LVM), which is associated with diffuse choroidal thinning and reticular pseudodrusen, comparing it to other acquired vitelliform lesions (AVL).
- The research involved 56 patients, analyzing differences in lesion size, visual impairment, and structural features like the external limiting membrane and choroidal vascular index.
- Results showed that LVM patients were older, had smaller lesions, and displayed significant structural changes, suggesting that LVM represents a unique phenotype that requires further investigation for prognostic implications.
Objective: To characterize clinical and prognostic implications of leptovitelliform maculopathy (LVM), a distinctive phenotype of vitelliform lesion characterized by the coexistence of subretinal drusenoid deposits (SDDs) and leptochoroid.
Design: Retrospective, cohort study.
Subjects: The study compared patients affected by LVM with cohorts displaying a similar phenotypic spectrum.
In the last decade, optical coherence tomography angiography (OCTA) has become part of the clinical management of retinal vein occlusion (RVO), proving in itself a useful technique for both the prediction of visual acuity (VA) outcomes and the risk of complications. In fact, OCTA has been proven a valid imaging technique in detailed assessment of foveal and parafoveal microvascular status in both acute and chronic RVO. Quantitative OCTA data have shown a significant correlation not only with final VA but also with the extension of peripheral ischemia, which represents a major risk factor for macular edema recurrence and neovascularization onset.
View Article and Find Full Text PDFPurpose: To characterize the features of a peculiar association between reticular pseudodrusen (RPD) and pachychoroid (pachy-RPD) and to compare them with eyes affected by RPD and normal/leptochoroid.
Design: Observational, retrospective, case-control study.
Participants: Among a cohort of patients with intermediate age-related macular degeneration (AMD), we selected eyes with RPD and pachychoroid (i.
Age-related macular degeneration (AMD) is a leading cause of vision loss in the elderly, with dry AMD (d-AMD) leading to geographic atrophy (GA) and significant visual impairment. Multimodal imaging plays a crucial role in d-AMD diagnosis and management, allowing for detailed classification of patient phenotypes and aiding in treatment planning and prognosis determination. Treatment approaches for d-AMD have recently witnessed profound change with the development of specific drugs targeting the complement cascade, with the first anticomplement agents recently approved for GA treatment.
View Article and Find Full Text PDFPurpose: To analyze the progression of structural and functional retinal impairment in type 1 diabetes mellitus (T1DM) patients with no clinical signs of diabetic retinopathy (DR) during a 3-year follow-up.
Methods: This was an observational longitudinal study. Post-pediatric T1DM patients without clinical signs of DR, and sex- and age-matched healthy subjects were recruited at San Raffaele Hospital (Milan, Italy).
Age related macular degeneration (AMD) represents a leading cause of vision loss and it is expected to affect 288 million people by 2040. During the last decade, machine learning technologies have shown great potential to revolutionize clinical management of AMD and support research for a better understanding of the disease. The aim of this review is to provide a panoramic description of all the applications of AI to AMD management and screening that have been analyzed in recent past literature.
View Article and Find Full Text PDFBackground: Around 30% of nonexudative macular neovascularizations exudate within 2 years from diagnosis in patients with age-related macular degeneration. The aim of this study is to develop a deep learning classifier based on optical coherence tomography (OCT) and OCT angiography (OCTA) to identify nonexudative macular neovascularizations at risk of exudation.
Methods: Patients with age-related macular degeneration showing OCTA and fluorescein angiography-documented nonexudative macular neovascularization with a 2-year minimum imaging follow-up were retrospectively selected.
Purpose: To evaluate the impact of optical coherence tomography phenotypes preceding atrophy related to age-related macular degeneration on the progression of atrophic lesions.
Methods: In this observational retrospective cohort study, a total of 70 eyes of 60 consecutive patients with intermediate age-related macular degeneration with a minimum follow-up of 24 months were included. The atrophy was quantified using fundus autofluorescence, also considering the directionality of atrophy as centrifugal and centripetal progression rates.
Article Synopsis
- The study aimed to evaluate the treatment response of macular neovascularization (MNV) linked to age-related macular degeneration (AMD) with subclinical angioid streaks (AS) over a 2-year period.
- Researchers conducted a retrospective study comparing patients with subclinical AS to a control group without AS, analyzing factors such as the number of anti-VEGF injections and visual acuity outcomes.
- Results showed that patients with subclinical AS required more injections, experienced a decrease in visual acuity, and had higher rates of retinal pigment epithelium atrophy compared to those without AS, indicating poorer treatment outcomes.