Laser treatment of feeder vessels in subfoveal choroidal neovascular membranes: a revisitation using dynamic indocyanine green angiography.

OBJECTIVE: This study aimed to determine whether the indocyanine green angiography (ICGA)-guided laser treatment of feeder vessels (FVs) may be useful in the management of the subfoveal choroidal neovascular membranes (CNVM) in patients with age-related macular degeneration (ARMD). DESIGN: Noncomparative case series. PARTICIPANTS: The authors considered a series of 15 patients with subfoveal CNVM in whom feeder vessels could be clearly detected by means of dynamic ICGA but not necessarily with fluorescein angiography (FA). On the basis of the indications of the pilot study, the authors also studied a second series of 16 patients with FVs smaller than 85 microm. INTERVENTION: Treatment of FV using argon green laser was performed. The ICGA was performed immediately after treatment, after 2, 7, 30 days, and then every 3 months, to assess FV closure. If an FV appeared to be still patent, it was immediately retreated and the follow-up was started again. The follow-up time ranged from 23 to 34 months for the pilot study and from 4 to 12 months for the second series. MAIN OUTCOME MEASURES: The obliteration of the membrane and change in visual acuity from baseline were measured. The effect on the treatment of the number and width of the FVs, and the size and location of the membrane, also was evaluated. RESULTS: In the pilot study, the CNVM was obliterated after the first treatment in only one patient, five patients needed more than one treatment, and obliteration failed in nine patients (40% success rate). The rate of success was affected by the width and number of the FVs. The success rate in the second series of 16 patients was higher (75%). CONCLUSIONS: The success of the laser treatment of FVs depends on their width, length, and number. Dynamic ICGA, which detects smaller FVs and makes it possible to control the laser effect and initiate immediate retreatment in the case of incomplete FV closure, should be considered mandatory for this type of treatment; a comparable success rate would have been unlikely using the other currently available methods of treating subfoveal CNVMs.

[Eosinophilic gastroenteritis. A report of a clinical case]. / Gastroenterite da eosinofili. Descrizione di un caso clinico.

Eosinophilic gastroenteritis is an inflammatory pathology with an unknown etiology characterised by the presence of an eosinophil infiltrate on the intestinal wall. The symptoms (bleeding, occlusion, fistulae, etc.) may lead to surgery even if the best treatment is medical. Endoscopic examination with specific multiple biopsies is indispensable for the diagnosis of the pathology. The authors report the case of a 2-month-old baby suffering from intermittent pyloric obstruction secondary to eosinophilic gastroenteritis which was wrongly interpreted as hypertrophic stenosis of the pylorus.

[Conservative treatment of post-traumatic hepatic hematoma. Case reports]. / Trattamento conservativo dell'ematoma epatico post-traumatico. Casistica clinica.

Post-traumatic hepatic haematomas may need surgical or conservative treatment. TC allows exact stadiation of hepatic lesions, detecting those mandatory for surgical approach. Haemodinamic unsteadiness and/or necessity of > 40 ml/kg blood transfusion suggest serious uncontrollable bleeding, that is surgical emergency. Three cases of post-traumatic heapatic haematomas recovered after conservative treatment (clinical, haematological and radiological survey) are described.

[Recto-cutaneous penile fistula. A description of a clinical case and review of the literature]. / Fistola retto-cutanea peniena. Descrizione di un caso clinico e revisione della letteratura.

This describes a newborn with an imperforate anus associated to a fistulous track extending along the scrotal raphe and opening at the penis top. This variant appears to be a low anomaly. The surgical treatment of this pathology is discussed.

[Congenital testicular torsion: a true emergency?]. / Testicolo torto congenito: una vera emergenza?

In the following article the description of four cases of congenital testicular testis, which attend to be under our observation, is reported. Moreover, the diagnostic process is discussed, with particular reference to echography. Afterwards, the method for early surgical exploration is evaluated. The survey concludes that echographic inquiry does not have to be judged indispensable.

[Amniotic band syndrome. Clinico-therapeutic considerations on 3 cases]. / Sindrome da briglie amniotiche. Considerazioni clinico-terapeutiche su tre casi.

In three patients with "Congenital Annular Constricting Bands Syndrome" the monstrous leg and foot lymphedemas were aesthetically and functionally cured using the two-stage Ombredanne's crown-like operation. Plaster splints were useful in curing and consolidating the tibia and fibula pseudoarthrosis present in one case and in curing the clubfeet present in the other two cases. Some consideration is made to the different etiopathogenetic theories, proposed in the past and recently, to explain this syndrome.

[Apple-peel syndrome. A clinical case report and therapeutic considerations]. / Apple-peel syndrome. Osservazione su un caso clinico e considerazioni terapeutiche.

A recently observed case of proximal jejunal atresia with apple-peel syndrome and associated multiple ileal atresia is reported. Some clinical and anatomopathological features are pointed out. Surgical techniques and medical care are analysed.