Luca Cimino

Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Reggio nell'Emilia, Emilia-Romagna, Italy

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Publications (51)181.05 Total impact

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    ABSTRACT: Objective: To evaluate if there are histopathological features of negative TAB that allow to differentiate patients with GCA from those without. Methods: All consecutive patients with negative TAB seen between January 2009 and December 2012 were retrospectively selected. Demographic, clinical and laboratory data at presentation and at each follow-up visit were collected. A pathologist with expertise in vasculitis blinded to clinical data and final diagnosis reviewed all negative TABs. Histopathologic features evaluated were: the presence of a focal medio-intimal scar, medial attenuation, intimal hyperplasia, fragmentation of inner elastic lamina (IEL), calcification, adventitial fibrosis and neoangiogenesis. Results: After a median (Q1, Q3) follow-up period of respectively 19 (9.2, 31.2) and 26.3 (4.9, 36.7) months (p=0.041), 38/69 (55%) patients had a final diagnosis of TAB-negative GCA, while in the remaining 31/69 patients (45%), GCA was excluded. ACR classification criteria for GCA were satisfied by 31/38 (81.6%) and 2/31 (6.5%) patients, (p<0.0001). Compared to non-GCA patients, those with TAB-negative GCA had more frequent cranial manifestations and higher ESR and CRP levels. The frequency of patients receiving prednisone, mean dosage and duration of prednisone treatment at TAB were similar in the two groups. There were no significant differences between TAB-negative GCA and non-GCA patients in the frequencies of all the histological features evaluated. Conclusion: The histological features of negative TAB evaluated in this study do not allow to differentiate between GCA and non-GCA patients. In the absence of an inflammatory infiltrate, other histological changes of the TA wall are not specific for GCA. This article is protected by copyright. All rights reserved.
    09/2015; DOI:10.1002/acr.22736
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    ABSTRACT: There is increasing evidence that microRNAs (miRNAs) are deregulated in autoimmune and cardiovascular diseases. The present study aimed to identify if miRNAs are deregulated in giant cell arteritis (GCA), a vasculitis affecting large-sized and medium-sized arteries, and to determine if miRNA levels might allow to discriminate between patients with GCA and those without. 58 patients who had temporal artery biopsy (TAB) for suspected GCA were included in the study and divided into three groups: patients with TAB-positive GCA showing a transmural inflammation (n=27), patients with TAB-negative GCA (n=8) and TAB-negative non-GCA patients with a final diagnosis different from GCA (n=23). To identify candidate miRNAs deregulated in GCA, we profiled the expression of 1209 miRNAs in inflamed TABs and normal TABs. Selected miRNAs were then validated by real-time PCRs and in situ hybridisation (ISH). MiR-146b-5p, -146a, -155, -150, -21 and -299-5p were significantly more expressed in inflamed TABs from patients with GCA. miRNAs were mainly deregulated at the tissue level because peripheral blood mononuclear cells and polymorphonuclear cells from the three groups of patients and age-matched healthy controls had similar levels of miRNAs. ISH showed that miR-21 was mainly expressed by cells in the medial and intimal layers of inflamed TABs. Patients with TAB-negative GCA had a miRNA profile similar to TAB-negative non-GCA patients. MiR-146b-5p, -146a, -21, -150, -155, -299-5p are overexpressed in the presence of inflammation in TABs from patients with GCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Annals of the rheumatic diseases 09/2015; DOI:10.1136/annrheumdis-2015-207846 · 10.38 Impact Factor

  • Annals of the Rheumatic Diseases 06/2015; 74(Suppl 2):160.1-160. DOI:10.1136/annrheumdis-2015-eular.5449 · 10.38 Impact Factor
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    Alfonso Iovieno · Luca Cimino · Luigi Fontana ·

    Jama Ophthalmology 02/2015; 133(2):e143483. DOI:10.1001/jamaophthalmol.2014.3483 · 3.32 Impact Factor
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    ABSTRACT: Purpose: To assess the visualization of choroidal granulomas (CG) by enhanced depth imaging optical coherence tomography (EDI-OCT) and to describe their EDI-OCT characteristics. Methods: Combined indocyanine green (ICG) angiography and EDI-OCT images of 44 CG (sarcoid, tubercular, or Vogt-Koyanagi-Harada related) were reviewed. By ICG angiography, CG were classified as full thickness or partial thickness and as small or large. Two independent operators evaluated EDI-OCT scans over granulomas to record their characteristics (full thickness/partial thickness, shape, reflectivity, internal pattern, margins, and shadowing/increased transmission effect). The agreement between ICG angiography and EDI-OCT, the interobserver agreement, and the correlations between EDI-OCT features and lesion size or disease were studied. Results: Enhanced depth imaging optical coherence tomography could visualize 100% of CG detected on ICG. Lesions resulted full thickness in 90.9% and 77.3% of the cases on ICG angiography and EDI-OCT, respectively (K = 0.5). All CG were more homogeneous and showed increased transmission of the optical coherence tomography signal as compared with the surrounding choroid. Choroidal granulomas angiographic size influenced lesions characteristics on EDI-OCT. Large granulomas were more likely to be full thickness, round shaped, with defined margins, lower reflective than the surrounding structures, and with internal homogenous pattern. The type of disease significantly influenced CG shape and pattern. Most of tubercular-related lesions showed lobulated shape and nonhomogeneous internal pattern. Conclusion: Enhanced depth imaging optical coherence tomography is suitable to visualize CG and to describe their characteristics. Choroidal granulomas size and disease influence lesions appearance on EDI-OCT. Increased transmission effect could be helpful for CG identification.
    Retina (Philadelphia, Pa.) 08/2014; 35(3). DOI:10.1097/IAE.0000000000000312 · 3.24 Impact Factor
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    ABSTRACT: Objective: The aim of this study was to assess the usefulness of colour duplex sonography (CDS)-guided temporal artery biopsy (TAB) for the diagnosis of GCA in patients with suspected GCA. Methods: From September 2009 through December 2012, 112 consecutive patients with suspected GCA were randomized to undergo CDS-guided TAB or standard TAB. All patients underwent temporal artery physical examination and temporal artery CDS prior to TAB. CDS of the temporal artery was performed by the same ultrasonographer, who was unaware of the patient's clinical data, and all TABs were evaluated by the same pathologist. Seven patients in whom biopsy failed to sample temporal artery tissue were excluded from the analysis. Results: Fifty patients were randomized to undergo CDS-guided TAB and 55 patients to standard TAB. Except for a younger age in patients who underwent standard TAB (P = 0.026), no significant differences were observed between the two groups. There were no significant differences in the frequencies of positive TAB for classic transmural inflammation (28% vs 18.2%) or for periadventitial small vessel vasculitis and/or vasa vasorum vasculitis (6% vs 14.5%) between the two groups. No significant differences in the frequency of positive TAB in the two groups were observed when we excluded the patients treated with glucocorticoids and when we stratified the patients of the two groups for the presence or absence of the halo sign. Conclusion: Our study showed that CDS-guided TAB did not improve the sensitivity of TAB for diagnosing GCA.
    Rheumatology (Oxford, England) 06/2014; 54(3). DOI:10.1093/rheumatology/keu241 · 4.48 Impact Factor
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    ABSTRACT: Immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis, psoriatic arthritis, psoriasis, axial spondyloarthropathies, Crohn's disease, ulcerative colitis and juvenile idiopathic arthritis, comprise a group of chronic disorders characterized by an immune-mediated pathogenesis. Although at clinical presentation these diseases appear unrelated, they have been recognized to share similar pathogenic mechanisms. Data from epidemiological and genetic studies further support the concept that IMIDs are interrelated, as they can co-occur in the same patient and share a similar genetic susceptibility. The specific aetiologies of IMIDs remain unknown, but all are known to involve dysregulation of the immune system, including an over-expression of the pro-inflammatory cytokine tumour necrosis factor (TNF). The pivotal role played by TNF in the pathogenesis and pathophysiology of IMIDs has been documented by extensive preclinical and clinical investigations, and confirmed by the efficacy of anti-TNF biotechnological drugs, such as etanercept, infliximab and adalimumab, in the therapeutic management of these disorders. In this narrative review, we discuss the available data on the TNF-dependent pathogenesis of IMIDs and associations among the different disorders. Although much remains to be discovered about the pathogenesis and aetiology of IMIDs, their common inflammatory pathological features may explain why they can be successfully targeted by anti-TNF drugs. Among these, adalimumab, a fully human monoclonal antibody, has been approved for treatment of nine distinct IMID indications and it is likely to become a valuable therapeutic tool for this complex cluster of chronic inflammatory disorders.
    International journal of immunopathology and pharmacology 04/2014; 27(1 Suppl):1-10. · 1.62 Impact Factor
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    ABSTRACT: The complex pathogenesis of immune-mediated inflammatory diseases (IMIDs) has been extensively investigated and dysregulation of cytokines, such as tumour necrosis factor (TNF) has been shown to play a dominant role in the pathogenesis of various IMIDs, such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis and psoriatic arthritis. The subsequent development of biological agents capable of blocking TNF has led to important advances in the pharmacotherapy of such diseases and confirmed the concept of a common pathophysiology among IMIDs with TNF having a predominant role. Five TNF inhibitors have currently been approved for treatment of one or more IMIDs; these include infliximab, etanercept, adalimumab, golimumab and certolizumab pegol. Given the similarities in the pathogenic background of IMIDs, one could expect that anti-TNF agents be similarly effective and with comparable tolerability profiles; however, this may not be the case. Structural and pharmacological differences among the anti-TNF drugs are likely to result in differences in efficacy and tolerability among the agents in the different IMIDs, together with differences in potency, therapeutic dose ranges, dosing regimens, administration routes, and propensity for immunogenicity. Among the five TNF inhibitors approved for treatment of IMIDs, adalimumab has the widest range of indications. Data from controlled clinical trials of adalimumab, showing its excellent efficacy and tolerability in a wide range of indications, are supported by real-world long-term data from observational studies, which confirm the value of adalimumab as a suitable choice in the management of IMIDs.
    International journal of immunopathology and pharmacology 04/2014; 27(1 Suppl):11-32. · 1.62 Impact Factor
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    ABSTRACT: To assess the effectiveness of spectral domain optical coherence tomography (SD-OCT) in providing in vivo measurements of iris thickness in healthy and pathological subjects. 14 healthy volunteers and 14 patients with unilateral Fuchs' uveitis were enrolled in the study. The two groups were comparable for age, gender and race. Each subject underwent complete clinical examination and anterior segment SD-OCT imaging in both eyes. SD-OCT scans of the iris were performed following a cross-sectional pattern. Iris thickness values were obtained using a purposely developed software-based analysis of OCT images. Measurements were carried out twice by two trained independent operators to assess intraobserver and interobserver repeatability. Analysis of iris thickness was conducted in four main quadrants: superior, inferior, nasal and temporal. Iris thickness values from normal subjects were compared with the ones measured in the affected and fellow eyes of patients with Fuchs' uveitis. Iris thickness measurements showed good intraobserver and interobserver repeatability (intraclass correlation coefficient >0.971). Superior and temporal iris sectors showed respectively thickest and thinnest values in all groups. In healthy eyes, iris thickness ranged from 327.92±37.29 μm temporally to 405.25±48.49 μm superiorly. Iris thickness measurements in the affected eyes of Fuchs' uveitis patients ranged from 285.48±56.02 μm temporally to 376.12±60.97 μm superiorly. Multiple comparison analysis showed iris thickness values to be significantly lower in eyes affected by Fuchs' uveitis than both in fellow eyes (p<0.001) of the same patients and in healthy eyes (p=0.0074). SD-OCT is a suitable technique for iris thickness assessment. Thickness analysis must be carried out using a sectorial approach, taking into consideration anatomical variations existing between different iris regions. SD-OCT is a potentially useful tool for detecting iris thickness variations induced by pathological conditions such as Fuchs' uveitis.
    The British journal of ophthalmology 04/2014; 98(9). DOI:10.1136/bjophthalmol-2013-304481 · 2.98 Impact Factor
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    ABSTRACT: Background Temporal artery biopsy (TAB) is the gold standard to diagnose giant cell arteritis (GCA), but is negative in approximately 20% of patients Objectives The study aimed to establish whether Color-doppler-ultrasonography (CDU)-guided TAB might provide a greater yield compared to standard TAB technique in patients with GCA Methods We enrolled 100 consecutive patients suspected of having GCA from September 2009 through December 2011. The average age of patients was 74 years. At randomization mean values of ESR were 54 mm/1st hour, mean CRP were 6 mg/dl (n.v. <0.5). Two patients were excluded because biopsy showed no evidence of artery. 44 out of 98 patients were taking mean dose of 17.4 mg of prednisone daily for more than 2 weeks. Patients were randomized to undergoing US-guided TAB (group 1), or to undergoing TAB performed according to conventional technique (group 2). Patients randomized to group 1 were 47; those to group 2 were 51. All patients were evaluated by physical examination of the temporal arteries (PETA), CDU and TAB. CDU was carried out by a physician who was blinded to the clinical data of the patients. CDU was performed using an ESAOTE MyLab 70 device fitted with a LA435 probe set for examination of the temporal arteries. The common trunk and the main branches of the temporal arteries were screened in a longitudinal and transverse plane along the entire vessel course. In patients from group 1 the ultrasonographist marked the segment of the temporal artery which showed the largest halo if present. In patients from group 1 the TAB was performed in the segment marked by the ultrasonographist, while in patients from group 2 was carried in according to standard procedure. PETA was performed before CDU. PETA was considered positive in the presence of tenderness or decreased or absent pulse of the temporal arteries. Chi square test was used for statistical analysis. Results TAB was positive in 33/98 (33.7%) patients, including 17/47 (36.2%) in group 1 and 15/51 (29.4%) in group 2. The difference of TAB positivity between group 1 and 2 was not significant. In total, the halo was detected in 42 (42.9%) patients, 25 (53.2%) in group 1 and 15 (29.4%) in group 2.In the group 1, the frequency of positive biopsy in patients with US evidence of halo was 68% (17/25), while in the group 2 the biopsy was positive in 15 of the overall 51 patients (29.4%). The difference was statistically significant (p=0.0489; OR: 2.31; 95% CI: 0.1-5.3). Conclusions Halo-guided TAB was associated with a significantly greater probability of being positive. However, the frequency of TAB-positive patients was similar regardless of whether TAB was performed under CDU guidance or not. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):387-387. DOI:10.1136/annrheumdis-2012-eular.2673 · 10.38 Impact Factor
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    ABSTRACT: Tumour necrosis factor (TNF) plays an important role in the pathogenesis of immune-mediated inflammatory diseases (IMIDs). TNF inhibition results in down-regulation of abnormal and progressive inflammatory processes, resulting in rapid and sustained clinical remission, improved quality of life and prevention of target organ damage. Adalimumab is the first fully human monoclonal antibody directed against TNF. In this article, we review the role and cost effectiveness of adalimumab in the treatment of IMIDs in adults and children. The efficacy and tolerability of adalimumab has been demonstrated in patients with a wide range of inflammatory conditions, leading to regulatory approval in rheumatoid arthritis (RA), psoriatic arthritis (PsA), plaque psoriasis, inflammatory bowel diseases (Crohn's disease, ulcerative colitis, paediatric Crohn's disease, and intestinal Behçet's disease), ankylosing spondylitis (AS), axial spondyloarthritis (SpA) and juvenile idiopathic arthritis. The major tolerability issues with adalimumab are class effects, such as injection site reactions and increased risk of infection and lymphoma. As with all anti-TNF agents, adalimumab is immunogenic, although less than infliximab, and some patients receiving long-term adalimumab will develop anti-drug antibodies, causing a loss of response. Comparisons of its clinical utility and cost effectiveness have shown it to be a valid treatment choice in a wide range of patients. Recent data from Italian economic studies show the cost effectiveness of adalimumab to be below the threshold value for health care interventions for most indications. In addition, analysis of indirect costs shows that adalimumab significantly reduces social costs associated with RA, PsA, AS, Crohn's disease and psoriasis. The fact that adalimumab has the widest range of approved indications, many often presenting together in the same patient due to the common pathogenesis, may further improve the utility of adalimumab. Current clinical evidence shows adalimumab to be a valuable resource in the management of IMIDs. Further research, designed to identify patients who may benefit most from this drug, will better highlight the role and cost-effectiveness of this versatile TNF inhibitor.
    International journal of immunopathology and pharmacology 11/2013; 27(1 Suppl):33-48. · 1.62 Impact Factor
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    ABSTRACT: We report a 62-year-old man with mild fever, headache and acute visual loss in his right eye due to anterior ischaemic optic neuropathy (AION), followed a few days later by pain in the legs and left arm associated with numbness and weakness. Giant cell arteritis complicated by AION was suspected at the beginning and high-dose oral glucocorticoids were started. However, on the basis of the past medical history of nasal polyposis, asthma, and hypereosynophilia as well as of further investigations (biopsy of the nasal mucosa showing granulomatous inflammation with a rich eosinophilic infiltrate, electromyography demonstrating, mononeuritis multiplex and positive p-ANCA), eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, was diagnosed. Because visual acuity in the right eye deteriorated despite glucocorticoid therapy, pulse intravenous cyclophosphamide was started, subsequently replaced by oral azathioprine, while prednisone was slowly tapered. This treatment led to gradual improvement of the neurological symptoms, whereas the right visual impairment remained unchanged. EGPA-related AION is an uncommon lesion that is probably due to vasculitic involvement of posterior ciliary and/or chorioretinal arteries. The prognosis of established AION is poor for the affected eye, even when glucocorticoid treatment is started immediately. However, early recognition of AION and prompt aggressive treatment with high-dose glucocorticoids plus cyclophosphamide can prevent visual loss in the unaffected eye.
    Clinical and experimental rheumatology 10/2013; 32(3 Suppl 82). · 2.72 Impact Factor
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    ABSTRACT: Objective: To assess the findings of temporal artery colour duplex sonography (CDS) in GCA characterized by a histological pattern of periadventitial small vessel vasculitis (SVV) and/or vasa vasorum vasculitis (VVV) and compare it with those observed in classic GCA with transmural vasculitis. Methods: We studied 30 patients with SVV and/or VVV, 63 patients with classic GCA and 67 biopsy-negative patients identified over a 9-year period. CDS of the temporal arteries was performed in all patients by one ultrasonographer. Temporal artery biopsy was used as the reference standard. Sensitivities, specificities and likelihood ratios (LRs) were calculated. Results: The frequency of the halo sign on CDS was significantly lower in the patients with SVV and/or VVV compared with those with classic GCA (20% vs 82.5%, P = 0.0001). The halo sign had a sensitivity of only 20% (95% CI 8.4, 39.1%) and a specificity of 80.6% (95% CI 68.7, 88.9%) for the diagnosis of SVV and/or VVV. The negative LR was 0.992 (CI 0.824, 1.195), and the positive LR was 1.030 (CI 0.433, 2.451). The halo sign for the diagnosis of biopsy-proven classic GCA had a higher sensitivity of 82.5% (CI 70.5, 90.5%), the same specificity of 80.6% (CI 68.7, 88.9%) and a higher positive LR (4.253; CI 2.577, 7.021). Conclusion: The halo sign is infrequently found in GCA characterized by a histological pattern of SVV and/or VVV. This limits the sensitivity of CDS in correctly identifying patients with GCA.
    Rheumatology (Oxford, England) 09/2013; 52(12). DOI:10.1093/rheumatology/ket258 · 4.48 Impact Factor
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    ABSTRACT: Background: To characterise the polyspecific intraocular antibody synthesis in aqueous humor of patients with Fuchs uveitis and other types of non-infectious uveitis. Methods: Aqueous and serum samples collected from 24 patients with Fuchs uveitis, 21 patients with non-infectious uveitis, and 27 healthy subjects undergoing elective cataract surgery (control group) were analysed. In addition, vitreous samples, collected from seven uveitis patients (five Fuchs and two panuveitis) during retinal surgery, were examined. Specific immunoglobulin G antibodies against cytomegalovirus (CMV), rubella virus, herpes simplex virus (HSV), and varicella zoster virus (VZV) were investigated, and Goldmann-Witmer coefficients (GWCs) were calculated. Real-time PCR was performed to detect viral genome for HSV, VZV, and CMV, while nested PCR was conducted to detect rubella RNA. Results: None of the control samples tested positive for any of the viral antibodies investigated. Intraocular antibody production was found in eight samples of patients affected by Fuchs uveitis (6/8 positive for rubella virus and 2/8 positive for herpes virus). Among patients with non-infectious uveitis, three tested positive for intraocular antibody production (one RV, one HSV and one for VZV). PCR was positive for RV in two patients with Fuchs uveitis, in three patients with non-infectious uveitis (one for RV and two for HSV), and in three control subjects (one for CMV and one for HSV). Conclusions: Our series confirmed the presence of specific viral antibodies, especially against rubella virus, in the subgroup of patients affected by Fuchs uveitis, suggesting that this virus may be responsible for this chronic inflammatory condition. Rubella virus is probably the main causative agent of Fuchs uveitis, but other viruses may also be involved in the pathogenesis of this disease.
    Albrecht von Graæes Archiv für Ophthalmologie 03/2013; 251(6). DOI:10.1007/s00417-013-2287-6 · 1.91 Impact Factor
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    ABSTRACT: To evaluate the frequency and clinical characteristics of periadventitial small-vessel vasculitis (SVV) and isolated vasa vasorum vasculitis (VVV). We identified 455 temporal artery biopsies performed in residents of Reggio Emilia, Italy between 1986 and 2003. Slides of temporal artery biopsy specimens were reviewed by a pathologist who was blinded with regard to clinical data. SVV was defined as inflammation of the small vessels external to the temporal artery adventitia, and VVV was defined as isolated inflammation of temporal artery vasa vasorum. Medical records of patients with SVV and/or VVV were reviewed, and demographic, clinical, laboratory, and followup data were collected. For comparison purposes, we collected the same data from an equal number of randomly selected patients with evidence of classic giant cell arteritis (GCA). Sixteen patients had SVV, 18 had isolated VVV, and 5 had both SVV and VVV. Compared with patients with classic GCA, the frequencies of headache, scalp tenderness, abnormalities of temporal arteries, jaw claudication, anorexia, and weight loss, the levels of acute-phase reactant at diagnosis, and the initial and cumulative doses prednisone were significantly lower and the frequency of peripheral synovitis was higher in the patients with SVV, and the frequency of cranial ischemic events was similar in the 2 groups. In contrast, the clinical characteristics and erythrocyte sedimentation rate at diagnosis of patients with isolated VVV were similar to those of patients with classic GCA. Our findings indicate that isolated VVV and SVV should be considered part of the histopathologic spectrum of GCA.
    Arthritis & Rheumatology 02/2012; 64(2):549-56. DOI:10.1002/art.33362 · 7.76 Impact Factor
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    ABSTRACT: Non-penetrating procedures have recently gained attention within the scientific community. An at times fierce debate concerning their role as a successor to the gold standard, trabeculectomy, has revolved around its relative effectiveness in short-to medium-term intraocular pressure control. Several controlled clinical trials, comparing both surgical procedures in terms of long-term IOP control, safety, and visual outcomes are underway and some short-to medium-term results are already available [4, 14]. However, we must remember that the goal of any glaucoma surgery is: (a) to reach the “guess” timated target IOP in the individual patient, (b) without threatening the patient’s visual function, and (c) at a sustainable cost for the community. We will discuss what penetrating and non-penetrating surgery can offer.
    07/2011: pages 209-215;
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    ABSTRACT: Purpose To relate patterns of progression and role of tuberculosis (TB) infection in serpiginous choroiditis (SC) by reviewing a series of cases of SC seen at Centre for Ophthalmic Specialized Care (COS), Lausanne, Switzerland and at the Ophthalmology Department of Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.Methods Retrospective review of clinical data, visual field (VF), fluorescein angiographic (FA), indocyanine green angiographic (ICGA) and optical coherence tomography (OCT) features and TB infectious status in cases of SC.Results In the time span of 9 years 16 SC cases were seen in the two centres. Interferon gamma release assays (IGRA) revealed positivity for latent tubercular infection in 11 out of 16 patients. Patterns of evolution under immunosuppressive therapy differed between the TB positive and TB negative casesConclusion Even in non endemic areas TB infection, as a cause of SC has to be excluded. Typical behaviour of TB related SC is relentless progression despite immunosuppressive therapy.
    Acta ophthalmologica 09/2010; 88(s246). DOI:10.1111/j.1755-3768.2010.3451.x · 2.84 Impact Factor
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    ABSTRACT: To investigate potential associations of the ICAM-1 gene polymorphisms and Fuchs uveitis in a cohort of Italian patients. Seventy-one consecutive Italian patients affected by Fuchs uveitis were observed at the Ocular Immunology Unit, Arcispedale S. Maria Nuova (Reggio Emilia, Italy) from 2002 to 2008. Two hundred twenty-six healthy Italian blood donors from the same geographic area were selected as the control group. All Fuchs uveitis patients and control subjects were genotyped by polymerase chain reaction (PCR) and allele-specific oligonucleotide techniques for ICAM-1 polymorphisms at codon 241 (exon 4). The frequency of the ICAM-1 G/R 241 polymorphism was significantly higher in Fuchs uveitis than in the control subjects (16.9% vs. 5.8%; P=0.006, Pcorr=0.012; odds ratio, 3.3; 95% confidence interval, 1.4-7.7). No significant association between clinical features and ICAM-1 polymorphisms was found. This study demonstrates for the first time that the ICAM-1 G/R 241 polymorphism may represent a candidate gene for Fuchs uveitis susceptibility.
    Investigative ophthalmology & visual science 05/2010; 51(9):4447-50. DOI:10.1167/iovs.09-4669 · 3.40 Impact Factor
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    ABSTRACT: Uveitis is a complex intraocular inflammatory disease resulting from several aetiological entities that are linked to geographical, genetic and socioeconomic variables. The purpose of this study was to provide an overview of the distribution patterns of uveitis as seen in a nationwide referral centre at a community hospital in Reggio Emilia, northern Italy, and to compare our data with those reported in previously published international series. The records of 1064 patients of Italian origin with uveitis referred to the Immunology Ocular Unit of the Arcispedale S. Maria Nuova Hospital in Reggio Emilia from 2002 to 2008 were classified and analysed. Data regarding sex, race, residence, age at presentation and at onset of uveitis, ocular involvement, clinical characteristics, ocular condition, and systemic disease associations were collected. The mean age at onset of uveitis was 41 years (range: 1-94), and the male-to-female ratio was 1:1.2. Anterior uveitis was the most common location (51.2%), followed by posterior uveitis (23.4%), panuveitis (19.6%), and intermediate uveitis (5.8%). The most frequent entities included Fuchs uveitis (22.7%), herpetic anterior uveitis (9.9%), toxoplasmosis (6.9%), HLA-B27-associated anterior uveitis (5.3%), and Behçet's disease (5.3%). The distribution we observed of the most common disease entities conformed to previous international series. In our series, Fuchs uveitis represented the most common diagnosis (22.7%, 45% of anterior uveitis). The high percentage of specific diagnosis (74%) can be explained by the establishment of new disease categories over time as well as by a systematic multi-disciplinary diagnostic approach.
    International Ophthalmology 03/2010; 30(5):521-9. DOI:10.1007/s10792-010-9359-y · 0.55 Impact Factor
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    ABSTRACT: To investigate potential associations between toll-like receptor 4 (TLR4) gene polymorphisms and susceptibility to, and clinical features of giant cell arteritis (GCA). A total of 155 patients with biopsy-proven GCA who were residents of Reggio Emilia, Italy, and 210 population-based controls from the same geographical area were genotyped for two coding single nucleotide polymorphisms of TLR4 (Asp299Gly and Thr399Ile) by molecular methods. The patients were subgrouped according to the presence or absence of polymyalgia rheumatica and severe ischemic complications (visual loss and/or cerebrovascular accidents). The distribution of allele and genotype frequencies did not differ significantly between GCA patients and healthy controls. Carriers of the -299 G allele (G/A+ G/G) [odds ratio (OR) 1.78, 95% confidence intervals (CI) 0.90-3.50)] were more frequent among GCA patients than among the controls, but the difference was not statistically significant. No significant associations were found when GCA patients with and without PMR or with and without severe ischemic complications were compared. Our data suggest that the TLR4 gene polymorphisms are not associated with susceptibility to, and clinical expression of, GCA in Italian patients.
    Clinical and experimental rheumatology 01/2009; 27(1 Suppl 52):S40-4. · 2.72 Impact Factor

Publication Stats

792 Citations
181.05 Total Impact Points


  • 2005-2014
    • Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia
      Reggio nell'Emilia, Emilia-Romagna, Italy
  • 2013
    • Istituto di Cura e Cura a Carattere Scientifico Basilicata
      Rionero in Vulture, Basilicate, Italy
  • 1997-2011
    • Università degli studi di Parma
      • Department of Clinical and Experimental Medicine
      Parma, Emilia-Romagna, Italy
  • 2002
    • Università degli Studi di Milano-Bicocca
      Milano, Lombardy, Italy