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·        Transepithelial cross-linking in keratoconus patients: confocal analysis.

Academic Journal

(English) By: Filippello M; Stagni E; Buccoliero D; Bonfiglio V; Avitabile T, Optometry And Vision Science: Official Publication Of The American Academy Of Optometry [Optom Vis Sci], ISSN: 1538-9235, 2012 Oct; Vol. 89 (10), pp. e1-7; Publisher: Lippincott Williams & Wilkins; PMID: 22940781; 
Purpose: To analyze the modifications of the corneal layers after transepithelial (TE) corneal cross-linking (CXL).
Methods: Twenty eyes of 20 patients with progressive keratoconus were treated with TE-CXL (without epithelium debridement), and their corneas analyzed at different times, up to 18 months, by confocal microscopy using a Nidek Confoscan 4.
Results: The epithelial layer, after an initial disorganization due to the TE technique, returned to a normal state after 2 weeks. Keratocytes and nerve fibers in the stroma decreased in number (approximately 25%), to return to a normal density at about 6 months after the procedure. A demarcation dense line indicative of effective cross-linking could be observed after 6 months at a depth of around 60 μm below the Bowman membrane. The endothelium remained unaffected at all examination times.
Conclusions: The TE-CXL procedure appears to be safe and effective at least up to 18 months. The absence of epithelium debridement (necessary in the classical technique) makes the procedure more comfortable for the patient, and allows the treatment of thinner corneas (between 360 and 400 μm) and problematic patients.

Subjects: Corneal Stroma surgery; Cross-Linking Reagents therapeutic use; Debridement methods; Epithelium, Corneal surgery; Keratoconus diagnosis; Microscopy, Confocal methods; Adolescent: 13-18 years; Adult: 19-44 years; Young Adult: 19-24 years; All Child: 0-18 years; All Adult: 19+ years; Female; Male

  • 2.

Transepithelial corneal collagen crosslinking: bilateral study.

Academic Journal

(English) By: Filippello M; Stagni E; O'Brart D, Journal Of Cataract And Refractive Surgery [J Cataract Refract Surg], ISSN: 1873-4502, 2012 Feb; Vol. 38 (2), pp. 283-91; Publisher: Elsevier Science; PMID: 22104644; 
Purpose: To evaluate the efficacy of transepithelial collagen crosslinking (CXL) in patients with bilateral progressive keratoconus.
Setting: Outpatient ophthalmic clinic.
Design: Cohort study.
Methods: Patients with a history of bilateral progressive keratoconus were recruited. The worst eye was treated with transepithelial CXL, while the fellow eye was left untreated as a control. Transepithelial CXL was performed by applying an enhanced riboflavin solution (riboflavin 0.1%, dextrane T500 with trometamol [Tris-hydroxymethyl aminomethane] and EDTA [ethylenediaminetetraacetic] sodium salt) on the intact corneal epithelium for 30 minutes before irradiation with ultraviolet A (370 nm at 3 mW/cm(2)) for 30 minutes. Follow-up was 18 months in all eyes.
Results: The study enrolled 20 patients. Transient hyperemia and mild foreign-body sensation occurred in 8 eyes (40%) after treatment; both resolved after 24 hours. In treated eyes, there were statistically significant improvements in uncorrected and corrected visual acuity and topography-derived keratometry, cone apex power, and higher-order aberrations (P<.05). In untreated control eyes, there was a general trend toward worsening of these parameters. No complications were reported.
Conclusions: Transepithelial CXL treatment appeared to halt keratoconus progression, with a statistically significant improvement in visual and topographic parameters. The treatment was safe and well tolerated. Its noninvasive nature makes it potentially useful in cases in which epithelial debridement is ideally avoided, such as pediatric cases, uncooperative patients, and thin corneas with thicknesses nearing 380 μm.
Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Subjects: Collagen metabolism; Cross-Linking Reagents; Epithelium, Corneal drug effects; Keratoconus drug therapy; Adolescent: 13-18 years; Adult: 19-44 years; Child: 6-12 years; Young Adult: 19-24 years; All Child: 0-18 years; All Adult: 19+ years; Female; Male

  • 3.

Oral Echinacea purpurea extract in low-grade, steroid-dependent, autoimmune idiopathic uveitis: a pilot study.

Academic Journal

(English) By: Neri PG; Stagni E; Filippello M; Camillieri G; Giovannini A; Leggio GM; Drago F, Journal Of Ocular Pharmacology And Therapeutics: The Official Journal Of The Association For Ocular Pharmacology And Therapeutics [J Ocul Pharmacol Ther], ISSN: 1080-7683, 2006 Dec; Vol. 22 (6), pp. 431-6; Publisher: Association For Ocular Pharmacology And Therapeutics; PMID: 17238809; 
Aim: The aim of to test efficacy and safety of Echinacea purpurea (echinacea) extract in the control of low-grade uveitis.
Methods: Fifty-one (51) patients with low-grade, steroid dependent, autoimmune uveitis were recruited; posterior uveitis was excluded. The start therapy was represented by topical desamethazone for anterior uveitis and oral prednisone, rapidly tapered, for anterior uveitis with inflammatory scores equal to +2 and in all cases of intermediate uveitis. Best-corrected visual acuity (BCVA) decrease or improvement was defined as a reduction or increase of 2 or more letters seen from the initial BCVA; ETDRS chart was used. Thirty-two (32) patients (21 with anterior uveitis and 11 with intermediate uveitis) received Echinacea (150 mg twice/day) as add-on therapy, whereas 20 patients (10 with anterior uveitis and 9 with intermediate uveitis) were treated with the conventional steroid therapy alone.
Results: Thirty-one (31) patients showed anterior uveitis and 20 intermediate uveitis. The follow-up duration was 9 months. At the last follow-up, 19/21 patients with anterior uveitis and 9/11 with intermediate uveitis treated with echinacea presented uveitis settled, with a steroid-off time of 209 and 146 days, respectively. BCVA was stable or improved in 19/21 of anterior uveitis and 9/11 of intermediate uveitis. No adverse reactions supposed to be resulting from commercial-grade echinacea were recorded. Patients who did not receive echinacea required a longer treatment period with steroids with a steroid-off time of 121 and 87 days.
Conclusions: Systemic echinacea appears safe and effective in the control of low-grade autoimmune idiopathic uveitis.

Subjects: Autoimmune Diseases drug therapy; Echinacea chemistry; Steroids therapeutic use; Uveitis drug therapy; Middle Aged: 45-64 years; All Adult: 19+ years; Female; Male

  • 4.

[Leukocyanidines and collagenases: in vitro enzyme inhibition activity].

Academic Journal

(Italian) By: Barracchini A; Franceschini N; Filippello M; Pantaleoni P; Di Giulio A; Amicosante G; Pantaleoni G, La Clinica Terapeutica [Clin Ter], ISSN: 0009-9074, 1999 Jul-Aug; Vol. 150 (4), pp. 275-8; Publisher: Societa Editrice Universo; PMID: 10605164; 
Objective: The matrix metalloproteinases (MMPs) play a key role in the extracellular matrix turnover. This protein family has been involved in some ocular pathologies such as glaucoma, diabetic retinopathy, macular degeneration, vitreous degeneration and corneal stroma ulceration cleaving all the matrix components. In the present study we evaluated the action of leucocyanidin from Vitis vinifera seeds as non toxic inhibitor of these proteinases.
Materials and Methods: To this purpose we used a fluorimetric method to evaluate the effect of this substance on the collagenase activity. We evaluated "in vitro" the inhibitory potency of the tested drug on type III collagenase activity, and the recover of the metalloprotease activity upon removal by dialysis of the inhibitor.
Results: The leucocyanidines extract (minimum procyanidines value of 95.0) resulted to be a good collagenase activity inhibitor showing an inhibition constant value, Ki, of 82 microM, evident index of affinity between the extract and the enzyme. Furthermore, the dialysis experiments demonstrated that the inhibitory effect persisted 24 h later, probably because the extract forms a stable complex with the enzyme.
Conclusions: These results should be related to the pharmacokinetic profile of leucoanthocyanins, a family of natural polyphenols belonging to the class of bioflavonoids of grape seds extract (Vitis vinifera L.).

Subjects: Enzyme Inhibitors; Leukocidins pharmacology; Matrix Metalloproteinases metabolism

  • 5.

Impression cytology in Down's syndrome.

Academic Journal

(English) By: Filippello M; Cascone G; Zagami A; Scimone G, The British Journal Of Ophthalmology [Br J Ophthalmol], ISSN: 0007-1161, 1997 Aug; Vol. 81 (8), pp. 683-5; Publisher: BMJ Pub. Group; PMID: 9349158; 
Aim: To evaluate both the number and the average distribution of goblet cells, which are responsible for the production of the mucin layer of the tear film, in the bulbar conjunctiva of patients with Down's syndrome. Previous research had used the ferning test to indicate an alteration in Down's syndrome, but had not determined which film layer was involved.
Methods: The presence of goblet cells in the bulbar conjunctiva of 30 subjects (15 with Down's syndrome, and 15 normal control subjects) was evaluated using impression cytology.
Results: A marked reduction of goblet cells was found in the Down's syndrome group (81.4 per mm2) when compared with the control group, where (209.8 per mm2) was found.
Conclusion: The deficit observed appears to be the cause of the tear film alterations observed in Down's syndrome. In turn, this may often lead to the formation of dry spots, and to consequent frequent infections of the anterior segment of the eye. While it is further hypothesised that the alteration of the conjunctival epithelium in Down's syndrome may be due to an altered metabolism of some element or elements, such as vitamin A, further research will be necessary to corroborate this.

Subjects: Conjunctiva pathology; Down Syndrome pathology; Tears secretion; Female; Male

  • 6.

B-scan echographic measurement of endobulbar foreign bodies.

Academic Journal

(English) By: Cascone G; Filippello M; Ferri R; Scimone G; Zagami A, Ophthalmologica. Journal International D'ophtalmologie. International Journal Of Ophthalmology. Zeitschrift Für Augenheilkunde [Ophthalmologica], ISSN: 0030-3755, 1994; Vol. 208 (4), pp. 192-4; Publisher: Karger; PMID: 7970544; 
Echography plays an important role in symptomatology investigations of ocular traumatology. Trauma causes the opacification of eye fluids, and so echography is particularly suitable for studying the endobulbar situation. We wished to enrich ocular investigations with another methodology: ultrasonic evaluation of the dimensions of intraocular foreign bodies, and report here the results obtained with experimental studies introducing foreign bodies into enucleated bovine eyes.

Subjects: Eye Foreign Bodies ultrasonography

  • 7.

[Study of stereopsis using the Lang and Titmus stereo-tests to assess the presence of changes in binocular vision of children with mental retardation].

Academic Journal

(Italian) By: Filippello M; Scimone G; Morello P; Cuccia G; Ventimiglia G; Romano C, Minerva Pediatrica [Minerva Pediatr], ISSN: 0026-4946, 1988 Aug; Vol. 40 (8), pp. 473-6; Publisher: Minerva medica; PMID: 3221816

Subjects: Depth Perception; Intellectual Disability complications; Vision Tests methods; Adolescent: 13-18 years; Child: 6-12 years; Child, Preschool: 2-5 years; All Child: 0-18 years

  • 8.

[Visual evoked potentials in Down's syndrome].

Academic Journal

(French) By: Tomarchio S; De Pietro M; Filippello M; Profeta GM, Ophtalmologie: Organe De La Société Française D'ophtalmologie [Ophtalmologie], ISSN: 0989-3105, 1987 Jul-Sep; Vol. 1 (3), pp. 405-7; Publisher: Masson for Socete francaise d'ophtalmologie; PMID: 2978978

Subjects: Down Syndrome physiopathology; Evoked Potentials, Visual; Child: 6-12 years; All Child: 0-18 years; Female; Male

  • 9.

Penetration of 14C-methisoprinol into rabbit eyes with experimentally induced herpetic keratitis.

Academic Journal

(English) By: Alberghina M; Tognon M; Cassai E; Gorgone G; Cavallaro N; Filippello M; Scaletta S, Ophthalmologica. Journal International D'ophtalmologie. International Journal Of Ophthalmology. Zeitschrift Für Augenheilkunde [Ophthalmologica], ISSN: 0030-3755, 1986; Vol. 192 (1), pp. 46-8; Publisher: Karger; PMID: 2422617; 
The authors studied the penetration of 14C-labelled methisoprinol into ocular tissues (cornea, aqueous humour and iris) in rabbits, in which herpetic keratitis had been experimentally induced. It has been demonstrated that the methisoprinol crosses the corneal barrier. The maximum concentration of the drug in the tissues examined was measured 30 min after the instillation of the drug into the conjunctival sac, and persisted for 60 min, although at a slightly lower level.

Subjects: Eye metabolism; Inosine analogs & derivatives; Inosine Pranobex metabolism; Keratitis, Dendritic metabolism; Female