Ugo Menchini

Azienda Ospedaliero Universitaria Careggi, Firenzuola, Tuscany, Italy

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Publications (184)377.62 Total impact

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    ABSTRACT: Abstract Purpose: To report long-term results of photodynamic therapy (PDT) in young patients affected by Best vitelliform macular dystrophy (VMD) complicated by choroidal neovascularization (CNV). Methods: We evaluated a group of 30 VMD patients with confirmed mutations in the BEST1 gene. Five of these patients had been diagnosed with CNV when younger than 15 years of age and three of them were treated by PDT. After the treatment they were followed for an average period of 77 months (range 62-99). Results: In all the treated eyes visual acuity was stable during the first year of follow-up and then slowly improved even some years after the treatment. The improvement in visual acuity was associated with the development of fibrous tissue in the macula. Conclusions: PDT was a safe procedure in our series of pediatric patients with VMD complicated by CNV. It was followed by a CNV regression and a consequent improvement in visual acuity which continued to progress even several years after the treatment.
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    ABSTRACT: Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD) eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The ocular surface temperature (OST) of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA) test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272). OST in AMD patients was significantly lower than in controls (P > 0.05). Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.
    Journal of Ophthalmology 11/2014; DOI:10.1155/2014/281010 · 1.94 Impact Factor
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    ABSTRACT: PURPOSE: To evaluate the refractive outcomes and rotational stability of a 4-haptic toric intraocular lens (IOL) in myopic eyes and the correlations between IOL rotation and refractive sphere, axial length (AL), and white-to-white (WTW) diameter. SETTING: Eye Clinic, Careggi Hospital, Florence, Italy. DESIGN: Prospective case series. METHODS: Phacoemulsification cataract extraction and implantation of an AT Torbi 709M IOL were performed. Corneal astigmatism was 1.50 diopters (D) or greater and the AL between 25.0 mm and 27.0 mm in all eyes. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and IOL axis were evaluated preoperatively and postoperatively up to 6 months. RESULTS: The study enrolled 20 eyes (20 patients). The UDVA and CDVA improved significantly postoperatively (P<.001). The mean refractive spherical equivalent decreased significantly from -7.10 D +/- 1.78 (SD) preoperatively to -0.55 +/- 0.25 D 1 day postoperatively (P<.001) and remained stable thereafter. Vector analysis showed that 90% and 85% of the eyes were within +/-0.25 D for J0 and J45, respectively. At 3 months and 6 months, the mean IOL rotation was 2.66 +/- 1.53 degrees and 3.00 +/- 1.69 degrees, respectively (P<.001), with 95% of eyes and 90% of eyes, respectively, within +/-5 degrees. A positive correlation was found between IOL rotation and preoperative sphere; none was found with AL and WTW. CONCLUSIONS: Implantation of the 4-haptic toric IOL in myopic eyes was effective and safe. The IOL showed no significant rotation over the 6-month follow-up. (C) 2014 ASCRS and ESCRS
    Journal of Cataract and Refractive Surgery 09/2014; 40(9):1479-87. DOI:10.1016/j.jcrs.2013.12.024 · 2.55 Impact Factor
  • Ophthalmology 05/2014; 121(5):1045-1053. · 6.17 Impact Factor
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    ABSTRACT: To evaluate the efficacy of intravitreal ranibizumab with a "pro re nata" regimen in the treatment of nonsubfoveal neovascular membranes secondary to age-related macular degeneration. Retrospective noncomparative case series. Thirty-one eyes with naive nonsubfoveal neovascularization secondary to age-related macular degeneration were consecutively enrolled and treated with ranibizumab intravitreal injections according to a pro re nata regimen. The follow-up was performed monthly up to 6 months and quarterly up to 2 years (25 patients). Early treatment diabetic retinopathy study best-corrected visual acuity and lesion size analysis with fluorescein angiography were recorded. The mean baseline early treatment diabetic retinopathy study best-corrected visual acuity worsened from 20/40 (0.28 logMAR) at baseline to 20/50 (0.42 logMAR) at 1-year follow-up and 20/60 (0.53 logMAR) at 2-year follow-up. The mean lesions size nearly doubled from baseline at the 2-year follow up (1.19-2.47 mm). Twenty-two patients had one or more recurrences at 1-year follow-up. All 25 patients developed a recurrence at 2 years with 7 cases developing a recurrence by 12 months. Twelve cases progressed to subfoveal lesions by the 24-month visit. Other regimens described in the literature might result in a more the satisfactory outcome using more frequent follow-up and more frequent intravitreal injections.
    Retina (Philadelphia, Pa.) 05/2014; 34(5):860-7. DOI:10.1097/IAE.0000000000000007 · 3.18 Impact Factor
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    ABSTRACT: An impairment of ocular blood flow regulation is commonly considered one of the main pathogenetic mechanisms involved in the development of several eye diseases, like glaucoma. The aim of this study was to investigate whether an alteration of ocular blood supply induced by peripheral vasoconstriction might be detected by measuring the ocular surface temperature. The ocular surface temperature was evaluated in a group of 38 healthy young subjects (28 males and 10 females; mean age: 25.4 ± 4.1 years) by infrared thermography. For each subject, the experimental procedure consisted of two thermographic acquisitions both lasting 10 s, recorded before and during the immersion of both hands in a mixture of ice and water (1.6 °C ± 0.4 °C). Specifically, the second acquisition began 20 s after the hand immersion. Analysis of variance was used to compare the ocular surface temperature of the two profiles. The analysis of infrared images was carried out every 2 s: at the eye opening (t0) until 10 s (t5), for both profiles. Data showed that ocular surface temperature increased significantly (p-value < 0.05), especially near the sources of ocular blood supply, that is, temporal and nasal areas (mean increasing temperature at t0 for P1 = 0.12 °C ± 0.13 °C). Therefore, these results suggest a response of the ocular hemodynamic to the peripheral vasoconstriction. The ocular surface temperature may represent a cheap, non-invasive and non-time-consuming test to evaluate ocular vaso-regulation.
    02/2014; 228(3). DOI:10.1177/0954411914523755
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    ABSTRACT: Abstract Purpose: To investigate the safety of trypan blue, brilliant blue G (BBG), Evans blue (EB), patent blue, Chicago blue (CB), and bromophenol blue (BB), with and without halogen and xenon light exposure. Methods: All dyes were diluted in a balanced saline solution at a concentration of 0.5%. Cells of the human RPE line ARPE-19 and rat RGC5 were exposed to vital dyes for 5 min. Experiments with and without xenon or halogen illumination were performed. The viability of ARPE-19 and RGC5 cells was determined at 12, 24, or 120 h by a cell proliferation assay using WST-1 reagent. The apoptotic events as well as cell numbers were registered for 72 h and counted by time-lapse videomicroscopy. Results: There was no evidence of ARPE-19 or RGC5 toxicity, immediate (0 and 24 h) or delayed (120 h), following exclusive exposure to each single dye. After halogen light exposure, ARPE-19 cell lines did not show any significant toxicity, except for when they were exposed to EB. After xenon illumination, ARPE-19 cells showed a marked decrease in cell viability when exposed to EB or CB and a moderate decrease when exposed to BBG and BB. After xenon illumination, RGC5 cells showed the highest decrease in cell viability when exposed to EB and CB; BB caused the same decrease in cell viability as in ARPE-19 cells. Conclusion: Interaction of light from endo-illumination source and blue vital dyes may increase the risk of retinal toxicity.
    Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics 02/2014; DOI:10.1089/jop.2013.0213 · 1.42 Impact Factor
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    ABSTRACT: To analyze the spectrum of sequence variants in the MYO7A and USH2A genes in a group of Italian patients affected by Usher syndrome (USH). Thirty-six Italian patients with a diagnosis of USH were recruited. They received a standard ophthalmologic examination, visual field testing, optical coherence tomography (OCT) scan, and electrophysiological tests. Fluorescein angiography and fundus autofluorescence imaging were performed in selected cases. All the patients underwent an audiologic examination for the 0.25-8,000 Hz frequencies. Vestibular function was evaluated with specific tests. DNA samples were analyzed for sequence variants of the MYO7A gene (for USH1) and the USH2A gene (for USH2) with direct sequencing techniques. A few patients were analyzed for both genes. In the MYO7A gene, ten missense variants were found; three patients were compound heterozygous, and two were homozygous. Thirty-four USH2A gene variants were detected, including eight missense variants, nine nonsense variants, six splicing variants, and 11 duplications/deletions; 19 patients were compound heterozygous, and three were homozygous. Four MYO7A and 17 USH2A variants have already been described in the literature. Among the novel mutations there are four USH2A large deletions, detected with multiplex ligation dependent probe amplification (MLPA) technology. Two potentially pathogenic variants were found in 27 patients (75%). Affected patients showed variable clinical pictures without a clear genotype-phenotype correlation. Ten variants in the MYO7A gene and 34 variants in the USH2A gene were detected in Italian patients with USH at a high detection rate. A selective analysis of these genes may be valuable for molecular analysis, combining diagnostic efficiency with little time wastage and less resource consumption.
    Molecular vision 01/2014; 20:1717-31. · 2.25 Impact Factor
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    ABSTRACT: Purpose: To assess the efficacy of intravitreal anti-vascular endothelial growth factor (VEGF) treatment of vascularized pigment epithelial detachment (PED) due to age-related macular degeneration (AMD). Methods: A total of 26 patients with vascularized PED secondary to AMD were retrospectively analyzed and treated with anti-VEGF intravitreal injections according to a PRN regimen after 3 initial injections. Best-corrected visual acuity (BCVA), optical coherence tomography, and fluorescein angiography were performed at baseline and quarterly. Results: Mean follow-up ranged from 9 to 26 months (mean 13.5). There was a deterioration in mean BCVA from 0.46 at baseline to 0.79 logMAR at 12 months (p<0.001). The mean PED greatest linear diameter (GLD) increased from 4499 at baseline to 5206 μm at 1-year follow-up (p<0.001). The mean PED maximum height decreased from 669 μm at baseline to 305 μm at 1-year follow-up (p = 0.001). The mean central retinal thickness (CRT) was unchanged (from 277 to 209 μm at 1 year follow-up) (p = 0.099). No effect was seen on the change of VA according to groups of baseline predictors as defined by the medial value: baseline VA, PED height, and CRT (p>0.10).There was a borderline trend (p = 0.064) that GLD affected response to treatment. The mean number of injections was 5.5 (3 to 9). Seven out of 26 (27%) patients developed a retinal pigment epithelium (RPE) tear. Conclusions: Intravitreal anti-VEGF therapy, with a PRN regimen, did not prevent visual acuity loss or RPE tear.
    European journal of ophthalmology 11/2013; 24(3). DOI:10.5301/ejo.5000388 · 1.06 Impact Factor
  • Jama Ophthalmology 10/2013; 131(10):1339-1347. · 3.83 Impact Factor
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    ABSTRACT: BACKGROUND: Endophthalmitis is a rare but severe complication of vitrectomy. CLINICAL RELEVANCE: Post-surgical endophthalmitis is suspected to be more frequent after microincisional (23- and 25-gauge) compared with standard (20-gauge) vitrectomy. METHODS: We conducted a systematic review of studies that compared microincisional and standard vitrectomy by searching MEDLINE and EMBASE up to November 2012. We used the Bayesian meta-analysis method to compute the odds ratio (OR) of endophthalmitis. We conducted subgroup analyses to compare the effect of different incision types and use of perioperative antibiotics. RESULTS: We identified 3 small randomized and 18 nonrandomized studies that reported 68 cases of endophthalmitis in 148 643 participants. The overall OR of endophthalmitis for microincisional versus standard vitrectomy was 2.3 (95% credible interval [CrI], 0.8-5.8). We found an increased risk of endophthalmitis using a microincisional straight approach compared with standard vitrectomy (OR, 15.1; 95% CrI, 2.01-179), but not for a beveled approach (OR, 0.82; 95% CrI, 0.23-2.28). The OR of studies that reported on mixed microincision was between these 2 values (OR, 4.4; 95% CrI, 1.32-14.3). We estimated that the overall rate of endophthalmitis with 20-gauge vitrectomy was 3 cases in 10 000 procedures, and the probability that a beveled microincision increases the rate of endophthalmitis to more than 6 or 9 events was small (no more than 5% or 1%, respectively). CONCLUSIONS: We did not find an increased risk of endophthalmitis for microincisional vitrectomy compared with standard vitrectomy. The beveled approach seems to be safer than a straight approach, supporting the current recommendation of its adoption in microincisional vitrectomy. However, these findings must be interpreted cautiously because of the small number of endophthalmitis events reported from included studies. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
    Ophthalmology 06/2013; DOI:10.1016/j.ophtha.2013.04.010 · 6.17 Impact Factor
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    ABSTRACT: PURPOSE: To investigate the simultaneous association of several psychophysical measures with reading ability in patients with mild and moderate low vision attending rehabilitation services. METHODS: Standard measurement of reading ability (MNREAD charts), visual acuity (ETDRS charts), contrast sensitivity (Pelli-Robson charts), reading contrast threshold (REX charts), retinal sensitivity and fixation stability and localization (MP1 fundus perimetry) were obtained in 160 low-vision patients with better-eye visual acuity from 0.3 to 1.0 logMAR and affected by either age-related macular degeneration or diabetic retinopathy. RESULTS: All variables were moderately associated with reading performance measures (MNREAD reading speed and acuity, REX contrast threshold), as well as among each other. In a SEM model, REX reading contrast threshold was highly associated to reading speed (standardized coefficient 0.63) and moderately associated to reading acuity (-0.30). The REX test also mediated the effect of Pelli-Robson contrast sensitivity (0.44), MP1 fixation eccentricity (-0.19) and mean retinal sensitivity (0.23) on reading performance. MP1 fixation stability was associated with both reading acuity (-0.24) and speed (0.23), while ETDRS visual acuity only affected reading acuity (0.44). CONCLUSIONS: Fixation instability and contrast sensitivity loss are key factors limiting reading performance of patients with mild or moderate low vision. REX charts directly assess the impact of text contrast on letter recognition and text navigation and may be a useful aid in reading rehabilitation.
    Investigative ophthalmology & visual science 05/2013; 54(6). DOI:10.1167/iovs.12-10734 · 3.66 Impact Factor
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    ABSTRACT: P urpose : To evaluate the natural history of a case of retinoschisis with giant outer layer break and retinal detachment. M ethods : A 42-year-old patient with a sudden paracentral scotoma in the visual field of the right eye underwent the following examinations: best-corrected visual acuity, slit-lamp biomicroscopy, optical coherence tomography, ocular echography, and fundus photography . R esults : The eye examination revealed inferotemporal retinoschisis-detachment with a giant outer retinal layer break and absence of foveal involvement. No breaks in the internal retinal layer were noted. No treatment was advised in the right eye. During the 3-year follow-up, a progressive reabsorption of subretinal fluid was detected and visual acuity remained unchanged. C onclusions : Deliberate nontreatment of a case of nonprogressive retinoschisis-detachment carries less risk of serious complications or loss of vision than does either surgical or prophylactic treatment.
    European journal of ophthalmology 05/2013; 23(5). DOI:10.5301/ejo.5000310 · 1.06 Impact Factor
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    ABSTRACT: Purpose: To evaluate the efficacy of biofeedback (BF) microperimetric rehabilitation in patients with Stargardt disease (STGD). Methods: Eighteen patients with STGD with unstable fixation located in the superior retina and best-corrected visual acuity (BCVA) between 20/100 and 20/320 in the better eye were recruited. All the patients underwent Nidek MP-1 microperimetry and fixation analysis. Twelve patients underwent 8 consecutive BF training sessions of 10 minutes each, performed once a week in the better eye. Six patients did not receive any training and were used as controls. In both groups, BCVA, reading speed, contrast sensitivity, bivariate contour ellipse area (BCEA), and retinal sensitivity were evaluated in the better eye at baseline and after 10 weeks. Paired and unpaired t tests were used as appropriate. Results: In the control group, after the follow-up period, fixation pattern did not show any modification and the other parameters worsened or remained unchanged. On the contrary, the BF group showed significantly improved stabilization of fixation (mean BCEA 68.2% from 5.63°2 to 1.58°2), improved mean BCVA (from 34.00 to 37.67 letters), higher mean reading speed (from 66.67 to 84.00 words/min), higher contrast sensitivity (from 16.33 to 18.75 letters), and improved retinal sensitivity (from 10.68 to 12.29 dB). The comparison of the results obtained in the 2 groups was statistically significant for all the considered parameters except for retinal sensitivity.
    European journal of ophthalmology 04/2013; 23(5). DOI:10.5301/ejo.5000291 · 1.06 Impact Factor
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    ABSTRACT: Purpose: To evaluate central macular thickness (CMT) after cataract surgery in selected groups of patients. Methods: The study comprised 4 groups-patients with epiretinal membrane, patients with high myopia, patients with diabetes without retinopathy, and healthy subjects-who underwent phacoemulsification and intraocular lens implantation. Central macular thickness was measured with spectral domain optical coherence tomography (OCT) using the 3D macular cube scan. The OCT evaluation was performed preoperatively and 1, 6, 15, 30, 60, 90, and 360 days after surgery. Visual acuity was measured preoperatively and after 6 and 360 days after surgery. Results: The study included 258 patients, 164 women and 94 men, with a mean age of 74 (SD 7.6) years. A statistically significant increase in CMT was observed from day 30 in patients with epiretinal membrane (p = 0.010) and diabetic patients (p = 0.026), reaching its maximum thickness at day 60 (p = 0.001 and p = 0.001), while it was observed only on day 360 in healthy subjects (p = 0.018) and those with high myopia (p = 0.003). The correlation between CMT and visual acuity was statistically significant only in the diabetic group (r = 0.61, p<0.01). Conclusions: Following cataract surgery, CMT changes according to characteristic patterns in the different groups studied. These changes did not prevent an optimal recovery of visual function.
    European journal of ophthalmology 03/2013; 23(5). DOI:10.5301/ejo.5000280 · 1.06 Impact Factor
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    ABSTRACT: BACKGROUND/AIM: To evaluate wavefront aberrations and subjective quality of life after toric intraocular lens (TIOL) implantation. METHODS: Three groups of subjects who underwent unilateral cataract surgery with intraocular lens (IOL) implantation were compared: (1) toric group (n=40): corneal astigmatism >1.50 D, implanted with Acrysof toric SN60TT IOL (Alcon Inc, Fort Worth, Texas, USA); (2) astigmatic SN60AT group (n=40): corneal astigmatism >1.50 D, implanted with Acrysof SN60AT IOL; and (3) control group (n=40): corneal astigmatism <1.00 D, implanted with Acrysof SN60AT IOL. Uncorrected distance visual acuity (UDVA), refraction, lower order astigmatism (Z22, Z-22), Strehl ratio and the modulation transfer function area ratio were evaluated over a 3 month follow-up period. A standardised quality of life test (National Eye Institute Refractive Error Quality of Life Instrument-42) was distributed to both astigmatic groups 3 months postoperatively. RESULTS: Postoperative UDVA and aberrometric values were significantly better (p<0.001) and mean postoperative spherical equivalent was significantly lower (p<0.05) in the toric and control groups compared with the astigmatic SN60AT group. The toric group had significantly better postoperative quality of life compared with the astigmatic SN60AT group (p<0.05). CONCLUSIONS: Acrysof TIOL implantation resulted in better visual, refractive and aberrometric results than SN60AT spherical IOL implantation in astigmatic patients, similar to the control group. The better objective optical and retinal image quality resulted in better subjective quality of life after TIOL implantation.
    The British journal of ophthalmology 03/2013; 97(5). DOI:10.1136/bjophthalmol-2013-303094 · 2.81 Impact Factor
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    ABSTRACT: Purpose: To describe the in-vivo confocal microscopy corneal findings in a patient with bilateral corneal deposits caused by an underlying monoclonal gammopathy. Methods: A 68-year-old man came to our center for an ophthalmologic examination. Besides visual acuity, the examination included slit-lamp biomicroscopy, intraocular pressure, and fundoscopy. Confocal microscopy was performed using Confoscan 4 (Nidek Technologies Padova, Italy) with a 40× lens because of the presence of bilateral crystalline corneal deposits. Serological tests were also performed. Results: Every layer of the cornea is interested by deposits with high reflectivity,especially the epithelium and anterior stroma. The emathological tests evidenced a monoclonal gammopathy of undetermined significance with high levels of Immunoglobulin M. Conclusion: Crystalline corneal deposits in monoclonal gammopathycan be usefully evaluated by confocal microscopy. These manifestations may be evaluated long before systemic signs of the pathology appear, so the early diagnosis is mandatory.
    Seminars in ophthalmology 01/2013; 28(1):37-40. DOI:10.3109/08820538.2012.730102 · 1.20 Impact Factor
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    ABSTRACT: In vivo confocal microscopy is becoming a mandatory examination to study corneal abnormalities such as drug deposits in systemic disease. A female diagnosed with fibromyalgia on systemic chloroquine for 9 months presented for an ophthalmic examination. Confocal microscopy was performed using the Confoscan 4 (Nidek Co. Ltd., Gamagori, Japan) and multiple highly reflective deposits in the epithelial basal cells were found, that were consistent with choloquine. Deposits were also present in the wing cell layer. In the anterior stroma these deposits were rare. Atypically shaped and branched nerves were also present in the anterior stroma. Corneal deposits of chloroquine can be evaluated by confocal microscopy. Confocal microscopy provides information on corneal metabolism and physiology. Chloroquine keratopathy can affect the anterior stroma in addition to the epithelium.
    Middle East African journal of ophthalmology 01/2013; 20(1):77-9. DOI:10.4103/0974-9233.106397
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    ABSTRACT: To compare the cytotoxic effects of preservative-free azithromycin on corneal epithelial cells in vivo with those of preservative-free netilmicin and levofloxacin, and the preservative benzalkonium chloride (BAK). Rabbit corneal epithelial cells in vitro were incubated for 15 minutes or 6 hours with commercially available ophthalmic preservative-free netilmicin 0.3%, levofloxacin 0.3%, or azithromycin 1.5% preparations or different concentrations of unpreserved azithromycin and different concentrations of BAK. Qualitative analysis was undertaken using phase-contrast optics to examine the morphological aspects of cell cultures and quantitative analysis was undertaken by measuring the release of the cytoplasmic enzyme lactate dehydrogenase into the medium immediately and 24 hours after exposure to drugs. Finally, we observed the wound-healing rate of mechanically injured corneal epithelial cells exposed to each antibiotic ophthalmic preparation for 48 hours. Our results show that both the commercially available unpreserved mono-dose preparation of azithromycin and ophthalmic preparations of azithromycin up to a concentration of 1.5% were virtually devoid of harmful effects under our experimental conditions. This was not significantly different from the results obtained for the other antibiotic preparations (P > 0.05) tested, but was unlike the results obtained for BAK. Azithromycin 1.5% also showed good recovery properties after a mechanical wound test. Under our experimental conditions, unpreserved azithromycin 1.5% showed a much lower toxicity than BAK and did not interfere with the wound-healing process.
    Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:965-71. DOI:10.2147/OPTH.S43934

Publication Stats

2k Citations
377.62 Total Impact Points

Institutions

  • 2007–2014
    • Azienda Ospedaliero Universitaria Careggi
      • • Department of Ophthalmology
      • • Department of Heart and Vessels
      Firenzuola, Tuscany, Italy
  • 2003–2014
    • University of Florence
      • Dipartimento di Chirurgia e Medicina Traslazionale (DCMT)
      Florens, Tuscany, Italy
  • 2013
    • Complexo Hospitalario Universitario de Ourense
      Ourense, Galicia, Spain
  • 2010
    • Azienda ULSS numero 10 Veneto Orientale
      San Donà di Piave, Veneto, Italy
  • 2005
    • Hospital Melegnano
      Milano, Lombardy, Italy
  • 2004
    • INO - Istituto Nazionale di Ottica
      Florens, Tuscany, Italy
  • 1992–2002
    • University of Udine
      • Department of Medical and Biological Sciences
      Udine, Friuli Venezia Giulia, Italy
  • 1985–1998
    • San Raffaele Scientific Institute
      Milano, Lombardy, Italy
  • 1988–1991
    • University of Milan
      • • Unitá Oculistica
      • • Department of Internal Medicine
      Milano, Lombardy, Italy