Objectives: The aim of the study was to evaluate the sleep architecture and its possible alterations in chronic tinnitus patients, and investigate any possible correlation between sleep architecture modifications and tinnitus perception, adaptation, and the degree of discomfort in these patients. Design: In a prospective, case-control, nonrandomized study, 18 patients affected by chronic tinnitus were compared with a homogeneous control group consisting of 15 healthy subjects. The experimental group was enrolled at the Tinnitus ambulatory at Policlinico Umberto I Department of Sensory Organs, and the control group was composed of voluntary subjects. A full overnight polysomnography was performed on both groups. Tinnitus patients answered two questionnaires: the tinnitus handicap inventory (THI) and a questionnaire concerning their subjective sleep quality, tinnitus intensity before bedtime, tinnitus intensity at remembered nocturnal wake-up periods, and tinnitus intensity at morning wake-up. Controls completed only the sleep quality questionnaire. Results: All tinnitus patients had a statistically significant alteration in sleep stages. Average percentage of stage 1 + stage 2 was 85.4% ± 6.3, whereas, in the control group, the average percentage of stage 1 + stage 2 was 54.9 ± 11.2 (p < 0.001). Stages 3 and 4 and rapid eye movement (REM) sleep was lacking in all tinnitus patients with an average percentage of 6.4 ± 4.9 of REM sleep, and 6.4 ± 4.9 of stages 3 + 4. The control group showed an average percentage of 21.5 ± 3.6 of REM sleep and 21.5 ± 3.6 of stages 3 + 4 (p < 0.001). No correlation was found between the decrease of REM and the increase of the THI score in the tinnitus group (r = 0.04). However, a mild correlation was found between the increase of light sleep (stage 1 + stage 2) and the THI score reported by the tinnitus group. Therefore, patients with light sleep report a higher THI score (r = 0.4). Conclusions: The significant alteration of sleep parameters assessed in tinnitus patients underlines the necessity to consider an adequate therapy that could improve patients’ sleep quality and also opens avenues for further investigations.

Ocular fibrosis leads to severe visual impairment and blindness worldwide, being a major area of unmet need in ophthalmology and medicine. To date, the only available treatments are antimetabolite drugs that have significant potentially blinding side effects, such as tissue damage and infection. There is thus an urgent need to identify novel targets to prevent/treat scarring and postsurgical fibrosis in the eye. In this review, the latest progress in biological mechanisms underlying ocular fibrosis are discussed. We also summarize the current knowledge on preclinical studies based on viral and non-viral gene therapy, as well as chemical inhibitors, for targeting TGFβ or downstream effectors in fibrotic disorders of the eye. Moreover, the role of angiogenetic and biomechanical factors in ocular fibrosis is discussed, focusing on related preclinical treatment approaches. Moreover, we describe available evidence on clinical studies investigating the use of therapies targeting TGFβ-dependent pathways, angiogenetic factors, and biomechanical factors, alone or in combination with other strategies, in ocular tissue fibrosis. Finally, the recent progress in cell-based therapies for treating fibrotic eye disorders is discussed. The increasing knowledge of these disorders in the eye and the promising results from testing of novel targeted therapies could offer viable perspectives for translation into clinical use.

Conclusion: The excellent tolerability of intratympanic (IT) steroid offers the possibility to use a high dose, which would appear to be more effective than intravenous (IV) steroid treatment, when both are associated with hyperbaric oxygen (HBO) therapy. Objective: The purpose of the study was to assess for the first time the efficacy of the association of IT steroid and HBO therapy in patients presenting idiopathic sudden sensorineural hearing loss (ISSNHL), comparing this protocol with another consisting of IV steroid administration and HBO therapy. Methods: A total of 48 patients presenting ISSNHL were recruited. Patients were divided into two categories: the severe ISSNHL group with a pure-tone average (PTA) between 70 and 90 dB, and the profound ISSNHL group with a PTA >90 dB. The first protocol consisted of 10 days of HBO therapy together with IV methylprednisolone 1 mg/kg body weight for 7 days; the second protocol consisted of HBO therapy for 10 days, associated with an IT injection of prednisolone at a dose of 62.5 mg/ml, once a day for 3 consecutive days, performed 2 h before the HBO therapy. Results: The overall success rate was superior in the group submitted to IT steroid and HBO therapy. Nevertheless, these clinical results were not statistically significant.