Giacomo Abbruzzese

Bio: Giacomo Abbruzzese is an academic researcher from University of Florence. The author has contributed to research in topics: Visual acuity & Retinal detachment. The author has an hindex of 6, co-authored 12 publications receiving 130 citations.

3D SURGICAL VIEWING SYSTEM IN OPHTHALMOLOGY: Perceptions of the Surgical Team.

Abstract: Technology is continuously evolving in the ophthalmology world in many spheres. There is a huge innovation in ways to perform ocular surgery with the introduction of three-dimensional (3D) visualization systems (3D describes an image that provides the perception of depth), technology that makes images and movies appear more lifelike in print, on the computer, in the cinema, or on TV. Known as “stereoscopic imaging” and “3D stereo,” people sense a greater depth than with 2D and feel that they could reach out and touch the objects. However, the effects are not just for entertainment; the more realistic a 3D training session, the greater the test of a person’s reactions. The creation of 3D prints, images, and movies is accomplished by capturing the scene at two different angles corresponding to the distance between a person’s left and right eyes (roughly 64 mm). When the left image is directed to the left eye and the right image to the right eye, the brain perceives the illusion of greater depth. The stereo (left and right) frames are separated by colors, by polarization, or by rapidly alternating the left and right images. A corresponding pair of 3D glasses directs the images to the appropriate eye. In fact, 3D surgical microscopes are the frontiers that many pharmaceutical companies are looking at; in particular, a lot of research has been performed in the endoscopic surgery sphere.1–3 From an ophthalmologic point of view, this way of operating is called “heads-up” surgery, when the surgeon no longer looks through the microscope oculars as in a conventional microsurgical procedure. In fact, although wearing lightweight 3D glasses and watching the surgical field on a large flat screen that displays a high-definition 3D image from a camera mounted on the microscope, the surgeon is capable of performing surgery. Alcon recently launched the NGENUITY system, which consists of a 3D stereoscopic, high-definition digital video camera and workstation, which operates as an adjunct to the surgical microscope during surgery. The system displays images real time or from recordings on a flat-panel, high-definition, digital 3D display. There is no additional light (or energy) delivered by the system for visualization or image capture. In this study, we wanted to investigate surgical team satisfaction when using this system. In a survey conducted at the end of each surgery, the primary surgeon, assistant surgeon, anesthetists, and theater nurse were asked about their own experience and comfort during the 3D surgery.

Computer assisted evaluation of retinal vessels tortuosity in Fabry disease.

Abstract: . Purpose: Fabry Disease (FD) is a rare X-linked metabolic disorder characterized by diffuse deposition of sphingolipids in many tissues. Retinal vessel tortuosity is a common ocular manifestation in FD and may represent a useful marker for the disease. Unfortunately its clinical evaluation is poorly reproducibile and alternative means of evaluation may be of interest. We tested a new semi-automatic software measuring retinal vessel tortuosity from eye fundus digital images in a group of FD patients. Methods: Observational case-control study evaluating four mathematical parameters describing tortuosity (relative length, sum of angle metric [SOAM], product of angle distance [PAD], triangular index) obtained from fundus pictures of 35 FD patients and 35 age-matched controls. Only the right eye was considered in order to reduce bias. Mann–Whitney test was used to compare the FD group versus the control group, males versus females and patients with versus without clinically identified retinal vessels tortuosity in the FD group. Linear regression analysis was performed on a subgroup of patients to evaluate the possible association of retinal vessels tortuosity parameters with age and with markers of systemic disease’s progression. Results: Three parameters (SOAM, PAD and triangular index) were significantly higher in FD patients in comparison with the controls (p < 0.0001, p = 0.001, p = 0.002 respectively). In the FD group the same three parameters showed higher values in hemizygous males than in heterozygous females ((p < 0.0001, p = 0.002, p < 0.0001 respectively). Conclusion: A computer assisted analysis of retinal vasculature demonstrated an increased vessels tortuosity in FD patients. The technique might be useful to establish disease severity and monitor its progression.

Long-term results of photodynamic therapy for subfoveal choroidal neovascularization with pathologic myopia.

Abstract: Purpose The purpose of our study was to determine the long-term visual and anatomic outcomes of photodynamic therapy in patients affected with choroidal neovascularization secondary to pathologic myopia. Methods We retrospectively evaluated 43 eyes of 43 patients. Patients with pathologic myopia were included if they had received photodynamic therapy for choroidal neovascularization involving the center of the avascular foveal zone and if they had a follow-up of at least 5 years. We included only the cases for which both of the examiners of the FAs were in agreement concerning the subfoveal localization of choroidal neovascularization. Patients treated with other therapies such as anti-vascular endothelial growth factor or steroids in the study eye were excluded. Visual acuity was measured using Early Treatment Diabetic Retinopathy Study charts. Anatomic outcome measures were the lesion size expressed as the greatest linear diameter and the chorioretinal atrophy that developed around the regressed choroidal neovascularization. Results Average visual acuity was stable during the first year, tended to be worse at 2 years, whereas it was significantly worse at 3 years and afterward, reaching a loss of nearly 3 lines at 7 years. We found that neither the number of photodynamic therapy treatments nor baseline photodynamic therapy spot size influenced change of visual acuity during follow-up. Chorioretinal atrophy around choroidal neovascularization was detected in 83% of patients at the 5-year follow-up visit. Conclusion The results showed that visual acuity decreased significantly after a long follow-up period mainly because of the development of chorioretinal atrophy.

Dietary profile of patients with Stargardt's disease and Retinitis Pigmentosa: is there a role for a nutritional approach?

Abstract: Stargardt’s disease (STGD) and Retinitis Pigmentosa (RP) are inherited retinal degenerations that may be affected, in opposite way, by diet. Dietary profile was assessed in 24 patients with STGD and in 56 patients with RP. We documented in only 6 out of 24 (25 %) STGD patients a daily intake of vitamin A within the recommended range while 14/24 (58.3 %) reported a high daily intake and 4/24 (16.7 %) showed a low daily intake. With regard to RP, 4/56 (7.1 %) reported to be within the recommended range, 37/56 (66.1 %) reported high daily intake and 15/56 (26.8 %) showed low daily intake of vitamin A. Interestingly, STGD patients with low vitamin A intake (<600 µg RAE/day) showed significantly better visual acuity with respect to those introducing higher intake of vitamin A. The present study suggests insuitable nutrient intakes among patients with STGD and RP, especially for daily intake of vitamin A. The results may be used to provide tailored nutritional interventions in these patients.

Evaluation of Macular Thickness after Uncomplicated Cataract Surgery using Optical Coherence Tomography

Abstract: PurposeTo evaluate central macular thickness (CMT) after cataract surgery in selected groups of patients.MethodsThe study comprised 4 groups—patients with epiretinal membrane, patients with high my...

The Myopias: Basic Science and Clinical Management

Abstract: The author has set for himself what would appear to be an unattainable goal—a truly comprehensive treatise. In The Myopias , Curtin has succeeded in producing a work of landmark merit. Within the bounds of current knowledge, there is no aspect of myopia that has not been discussed. Even the disproven cultlike treatments are dealt with objectively. This prodigious work has 2822 references and is divided into four principal parts: (1) basic science of myopia, (2) the clinical myopias, (3) pathologic myopia, and (4) special forms of myopia. The four parts are subdivided into 20 sec "[T]his work should serve as an incentive... [to] assure that the myopic patient be examined for more than spectacles or contact lenses." tions, which are further divided into over 100 subdivisions. The socioeconomic implications, etiology, and psychological aspects, as well as the optics, are discussed. Oculometry and visual fields are also included, and the section

Myopic choroidal neovascularisation: current concepts and update on clinical management

Abstract: Choroidal neovascularisation (CNV) is a common vision-threatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm.

Recent Advancements in Retinal Vessel Segmentation

Abstract: Retinal vessel segmentation is a key step towards the accurate visualization, diagnosis, early treatment and surgery planning of ocular diseases. For the last two decades, a tremendous amount of research has been dedicated in developing automated methods for segmentation of blood vessels from retinal fundus images. Despite the fact, segmentation of retinal vessels still remains a challenging task due to the presence of abnormalities, varying size and shape of the vessels, non-uniform illumination and anatomical variability between subjects. In this paper, we carry out a systematic review of the most recent advancements in retinal vessel segmentation methods published in last five years. The objectives of this study are as follows: first, we discuss the most crucial preprocessing steps that are involved in accurate segmentation of vessels. Second, we review most recent state-of-the-art retinal vessel segmentation techniques which are classified into different categories based on their main principle. Third, we quantitatively analyse these methods in terms of its sensitivity, specificity, accuracy, area under the curve and discuss newly introduced performance metrics in current literature. Fourth, we discuss the advantages and limitations of the existing segmentation techniques. Finally, we provide an insight into active problems and possible future directions towards building successful computer-aided diagnostic system.

Quantification of Microvascular Tortuosity during Tumor Evolution Using Acoustic Angiography

Abstract: The recent design of ultra-broadband, multifrequency ultrasound transducers has enabled high-sensitivity, high-resolution contrast imaging, with very efficient suppression of tissue background using a technique called acoustic angiography. Here we perform the first application of acoustic angiography to evolving tumors in mice predisposed to develop mammary carcinoma, with the intent of visualizing and quantifying angiogenesis progression associated with tumor growth. Metrics compared include vascular density and two measures of vessel tortuosity quantified from segmentations of vessels traversing and surrounding 24 tumors and abdominal vessels from control mice. Quantitative morphologic analysis of tumor vessels revealed significantly increased vascular tortuosity abnormalities associated with tumor growth, with the distance metric elevated approximately 14% and the sum of angles metric increased 60% in tumor vessels versus controls. Future applications of this imaging approach may provide clinicians with a new tool in tumor detection, differentiation or evaluation, though with limited depth of penetration using the current configuration.