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Karmiris E, Tsiogka A, Tsiripidis K, Papakonstantinou E, Georgalas I, Chalkiadaki E. Correlations of Corneal Endothelial Morphology and Corneal Thickness With Anterior Segment Parameters in Healthy Individuals. Cornea 2024; 43:764-770. [PMID: 38478761 DOI: 10.1097/ico.0000000000003515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/19/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE The purpose of this study was to investigate the associations between central corneal endothelial cell density (ECD), endothelial morphology, and corneal thickness (central corneal thickness) with the anterior chamber depth, corneal volume (CV), white-to-white (WTW) distance, mean anterior chamber angle (CAmean), and gender in healthy individuals. METHODS This observational study included 136 healthy volunteers. The ECD, coefficient of variation of cell area, and hexagonal cell appearance ratio (%Hex) were measured by means of specular microscopy. The central corneal thickness, anterior chamber depth, CV, WTW distance, and the angle width of 12 points were taken by the Pentacam HR Scheimpflug anterior segment imaging. The arithmetical mean of the 12 points was considered as the CAmean. We used mixed effect linear regression model for the statistical analysis of the data. RESULTS ECD was positively correlated with CV ( P = 0.028), while after adjusting for age, it was negatively correlated with age ( P < 0.001). Coefficient of variation of cell area was positively correlated with CAmean ( P = 0.036), while after adjusting for age, it was positively correlated with age ( P < 0.001) and CAmean ( P = 0.005). Hex was negatively correlated with WTW ( P = 0.023) and CAmean ( P = 0.025), and after adjusting for age, this correlation remained the same ( P = 0.029 when correlated with WTW and P = 0.035 with CAmean). CONCLUSIONS There were significant changes in the morphology of the corneal endothelial cells in eyes with wider anterior chamber angle. Greater pleomorphism and polymegethism of the corneal endothelium was observed in healthy patients with wider CAmean. Deepening of the anterior chamber as myopia progresses could render the corneal endothelium more fragile and susceptible to mechanical stress, which is an area worthy of further study.
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Affiliation(s)
- Efthymios Karmiris
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Athens, Greece
| | - Anastasia Tsiogka
- Department of Ophthalmology, 401 General Military Hospital of Athens, Greece; and
| | | | - Evangelia Papakonstantinou
- Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Ilias Georgalas
- Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
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Tsiogka A, Moster ML, Chatzistefanou KI, Karmiris E, Samoli E, Giachos I, Droutsas K, Papaconstantinou D, Spaeth GL. The TsiogkaSpaeth grid for detection of neurological visual field defects: a validation study. Neurol Sci 2024; 45:2869-2875. [PMID: 38191765 PMCID: PMC11082013 DOI: 10.1007/s10072-024-07305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND The TsiogkaSpaeth (TS) grid is a new, low-cost, and easy to access portable test for visual field (VF) screening which could be used by clinicians in everyday clinical practice. Our study aimed to determine the validity of an innovative screening grid test for identifying neurological disease-associated VF defects. METHODS We enrolled two groups of participants: We assessed the one eye of ten consecutive adult patients with different types of neurological disease associated VF defects and ten eyes of controls in each group. The TS grid test was performed in each group. Sensitivity, specificity, and positive and negative predictive values of the TS grid scotoma area were assessed using the 24-2 VF Humphrey field analyzer (HFA) as the reference standard. RESULTS Sensitivity and specificity of the TS grid test were 100% and 90.91%, respectively. The area under curve was 0.9545 with 95% CI 0.87-1.00. There was a significant correlation between the number of missed locations on the TS grid test and the visual field index of the HFA 24-2 (r = 0.9436, P < .0001). CONCLUSION The sensitivity and specificity of the TS grid test were high in detecting VF defects in neurological disease. The TS grid test appears to be a reliable, low-cost, and easily accessed alternative to traditional VF tests in diagnosing typical neurological patterns of visual field defects. It would be useful in screening subjects for neurologically derived ocular morbidity in everyday clinical practice and in remote areas deprived of specialized health care services.
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Affiliation(s)
- Anastasia Tsiogka
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece.
| | - Mark L Moster
- Department of Neurology and Ophthalmology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, USA
| | - Klio I Chatzistefanou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece
| | - Efthymios Karmiris
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece
- Ophthalmology Department, Hellenic Air Force General Hospital, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Giachos
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece
| | - Konstantinos Droutsas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece
| | - Dimitrios Papaconstantinou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, General Hospital of Athens "G. Gennimatas'', Athens, Greece
| | - George L Spaeth
- Glaucoma Service, Wills Eye Hospital, Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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Giachos I, Doumazos S, Tsiogka A, Manoli K, Tagaris G, Rotsos T, Kozobolis V, Iliopoulos I, Moschos M. Retinal capillary plexus in Parkinson's disease using optical coherence tomography angiography. Int J Ophthalmol 2024; 17:131-136. [PMID: 38239944 PMCID: PMC10754672 DOI: 10.18240/ijo.2024.01.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 11/07/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson's disease (PD) using optical coherence tomography angiography (OCT-A). METHODS A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens, "Georgios Gennimatas" from March 2021 to March 2022 was conducted. Totally 44 patients with PD were included and 18 healthy controls were examined, hence a total of 124 eyes were enrolled in the study. The foveal and parafoveal superficial and deep capillary plexus vascular density (fSCP-VD, fDCP-VD, pSCP-VD, pDCP-CD) and foveal avascular zone (FAZ) were quantified with OCTA. Optical coherence tomography (OCT) was used to measure macular thickness. Our statistical analysis was conducted by using a mixed effect linear regression model. RESULTS After adjustment for age and gender, the mean parafoveal superficial capillary plexus vascular density (pSCP-VD) and mean parafoveal deep capillary plexus vascular density (pDCP-VD) were significantly decreased in individuals with PD (P<0.001 in both) by -2.35 (95%CI -3.3, -1.45) and -7.5 (95%CI -10.4, -4.6) respectively. fSCP-VD and fDCP-VD didn't approach statistical significance. The FAZ area and perimeter were significantly decreased (P<0.001 in both) by -0.1 mm2 (95%CI -0.13, -0.07) and -0.49 mm2 (95%CI -0.66, -0.32) respectively. Circularity didn't approach statistical significance. Central retinal thickness (CRT) was significantly decreased in individuals with PD (P<0.001) by -23.1 µm (95%CI -30.2, -16) and temporal retinal thickness (TRT) was decreased (P=0.025) by -11 µm (95%CI -22, -1.5) while nasal retinal thickness (NRT) only approached statistical significance (P=0.066). CONCLUSION The mean pSCP-VD, pDCP-VD, CRT and TRT are significantly decreased and FAZ is altered in individuals with PD. These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.
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Affiliation(s)
- Ioannis Giachos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Spyridon Doumazos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Anastasia Tsiogka
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Konstantina Manoli
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - George Tagaris
- Department of Neurology, General Hospital of Athens, “Georgios Gennimatas”, Athens 11527, Greece
| | - Tryfon Rotsos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras 26504, Greece
| | - Ioannis Iliopoulos
- Neurology Department, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Marilita Moschos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
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Toumasis P, Tsantes AG, Tsiogka A, Samonis G, Vrioni G. From Clinical Suspicion to Diagnosis: A Review of Diagnostic Approaches and Challenges in Fungal Keratitis. J Clin Med 2024; 13:286. [PMID: 38202293 PMCID: PMC10779560 DOI: 10.3390/jcm13010286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Fungal keratitis is a relatively rare yet severe ocular infection that can lead to profound vision impairment and even permanent vision loss. Rapid and accurate diagnosis plays a crucial role in the effective management of the disease. A patient's history establishes the initial clinical suspicion since it can provide valuable clues to potential predisposing factors and sources of fungal exposure. Regarding the evaluation of the observed symptoms, they are not exclusive to fungal keratitis, but their timeline can aid in distinguishing fungal keratitis from other conditions. Thorough clinical examination of the affected eye with a slit-lamp microscope guides diagnosis because some clinical features are valuable predictors of fungal keratitis. Definitive diagnosis is established through appropriate microbiological investigations. Direct microscopic examination of corneal scrapings or biopsy specimens can assist in the presumptive diagnosis of fungal keratitis, but culture remains the gold standard for diagnosing fungal keratitis. Advanced molecular techniques such as PCR and MALDI-ToF MS are explored for their rapid and sensitive diagnostic capabilities. Non-invasive techniques like in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT) are useful for real-time imaging. Every diagnostic technique has both advantages and drawbacks. Also, the selection of a diagnostic approach can depend on various factors, including the specific clinical context, the availability of resources, and the proficiency of healthcare personnel.
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Affiliation(s)
- Panagiotis Toumasis
- Department of Ophthalmology, 212 Military Hospital of Xanthi, 67100 Xanthi, Greece
| | - Andreas G. Tsantes
- Department of Microbiology, Saint Savvas Oncology Hospital, 11522 Athens, Greece
- Laboratory of Haematology and Blood Bank Unit, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Anastasia Tsiogka
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital, 11527 Athens, Greece
| | - George Samonis
- Department of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Triantafyllopoulos GI, Karabatsas CH, Pateras E, Chandrinos A, Kapralos D, Georgiou I, Tsiogka A, Kourkoutas D. The Effect of Yellow Filter Use on Standard Automated Perimetry and Contrast Sensitivity in Healthy Individuals. Cureus 2024; 16:e51912. [PMID: 38333490 PMCID: PMC10850819 DOI: 10.7759/cureus.51912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Purpose The purpose of this study is to investigate the effect of two yellow filters (category 1: visible light transmission {VLT} from 80% to 43%) of Essilor (Kiros® and Lumior®) on standard automated perimetry (SAP) indices and Pelli-Robson (PR) contrast sensitivity (CS) testing in healthy individuals. Materials and methods This study is a prospective comparative study of 31 eyes of 31 healthy individuals aged 32.14 (8.13) years (14 males and 17 females). All participants underwent a series of three visual field (VF) examinations (24-2, Swedish Interactive Thresholding Algorithm {SITA} standard) with the Humphrey field analyzer (HFA II 740, Carl Zeiss Meditec, Jena, Germany) and three CS examinations with the PR chart (Precision Vision, Inc., Woodstock, IL). VF and CS examinations were carried out as follows: (a) no filter (NF), (b) with the yellow filter Kiros® (KIROS), and (c) with the yellow-orange filter Lumior® (LUMIOR). The effect of the two yellow filters on global VF indices (glaucoma hemifield test {GHT}, mean deviation {MD}, pattern standard deviation {PSD}, and visual field index {VFI}) and on CS score was evaluated and compared. Results When comparing the three pairs NF-KIROS, NF-LUMIOR, and KIROS-LUMIOR, no difference was presented on the global VF indices. However, a statistically significant difference was detected in the CS scores for all three pairs, favoring KIROS. It is important to note that while this difference was statistically significant, it did not reach clinical significance. Conclusions The use of yellow filters (category 1: VLT of 75% and 65%) does not affect the global VF indices and the CS of healthy individuals but significantly improves their CS score. Further studies are required to explore the clinical significance of these findings.
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Affiliation(s)
- George I Triantafyllopoulos
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Costas H Karabatsas
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Evangelos Pateras
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Aristeidis Chandrinos
- Department of Biomedical Sciences, Faculty of Health Sciences, University of West Attica, Athens, GRC
| | - Dimitrios Kapralos
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Iordanis Georgiou
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Anastasia Tsiogka
- Department of Ophthalmology, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | - Dimitrios Kourkoutas
- Department of Ophthalmology, 401 General Military Hospital of Athens, Athens, GRC
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Dimtsas GS, Tsiogka A, Moschos MM. VEGF levels in the aqueous humor of patients with primary open angle glaucoma: A systematic review and a meta-analysis. Eur J Ophthalmol 2023; 33:2228-2235. [PMID: 37038334 DOI: 10.1177/11206721231168146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
PURPOSE To compare the VEGF levels in the aqueous humor of patients with Primary Open Angle Glaucoma (POAG) and non-glaucomatous eyes and reveal any potential statistically significant correlations. METHODS We searched PubMed, from inception to December 31, 2021. Key search terms included VEGF and Glaucoma. All relevant studies that evaluated the VEGF levels in patients with POAG and in the control group were included in this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines were followed. Data were extracted independently by 2 authors. Heterogeneity was statistically quantified by Q, H, and I2 statistics, and a meta-analysis was performed using the random-effects model. RESULTS Seven cross-sectional studies were included in the meta-analysis. 144 eyes were enrolled in the POAG group and 162 eyes in the control group. The random effect model showed no statistically significant difference between the two groups (SMD =0.284, 95% CI = -0.173 to 0.741; P = 0.223), but we noticed a trend towards elevated VEGF levels in the aqueous humor of POAG patients. Significant heterogeneity was detected (I2 = 74.1%, P = 0.001). CONCLUSIONS This systematic review and meta-analysis indicates a trend towards elevated VEGF-A levels in the aqueous humor of patients with POAG and suggests a potential neuroprotective role of VEGF in patients with POAG. Future studies are required to evaluate the exact role of VEGF in POAG.
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Affiliation(s)
- Georgios S Dimtsas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Anastasia Tsiogka
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
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Dimtsas GS, Tsiogka A, Moschos MM. Latanoprost PF vs. Bimatoprost PF: Which Treats the Ocular Surface Better? J Clin Med 2023; 12:6732. [PMID: 37959198 PMCID: PMC10648670 DOI: 10.3390/jcm12216732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: The current study aimed to compare two of the most frequently prescribed preservative-free (PF) antiglaucoma drops, (Latanoprost PF vs. Bimatoprost PF) in promoting OSD in patients with POAG. (2) Methods: In this prospective study, 44 eyes from 44 participants were included. In the control group we enrolled 24 eyes, 11 eyes treated only with Latanoprost PF were enrolled in the Latanoprost PF group, and 9 eyes treated only with Bimatoprost PF in the Bimatoprost PF group. In all eyes, we evaluated the ocular levels of MMP-9 using the InflammaDry kit. We also performed Schirmer's test and the TBUT test. (3) Results: We found elevated ocular levels of MMP-9 (>40 ng/mL) in the Bimatoprost PF group (88.89% of the participants) compared to the control (8.33%) and the Latanoprost PF group (27.27%), and the difference was statistically significant (p < 0.001). The Schirmer's test values were statistically significantly lower in the Bimatoprost PF group compared to the other two groups. Additionally, the TBUT values were lower in the Bimatoprost PF group compared to the control group, and the difference was statistically significant. (4) Conclusions: Latanoprost PF eye drops treat the ocular surface better and they do not induce overexpression of MMP-9, a molecule that is related to OSD.
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Affiliation(s)
- Georgios S. Dimtsas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital, 11527 Athens, Greece
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Kavroulaki D, Konstantinidou E, Tsiogka A, Rallis K, Mavrikakis E. Quantum Molecular Resonance Electrical Stimulation as a Beneficial and Safe Treatment for Multifactorial Dry Eye Disease. Cureus 2023; 15:e39695. [PMID: 37398748 PMCID: PMC10308800 DOI: 10.7759/cureus.39695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION To assess the clinical benefits obtained with transcutaneous low-power, high-frequency quantum molecular resonance (QMR) electrotherapy in a group of multifactorial dry eye patients. METHODS Fifty-one patients (total of 102 eyes) with dry eye symptoms were enrolled in the study. Included clinical conditions were meibomian gland dysfunction, glaucoma, cataract surgery within the past six months, and autoimmune disease-related superficial punctuate keratitis. The QMR treatment was administered using the Rexon-Eye device (Resono Ophthalmic, Sandrigo, Italy) for four consecutive weeks, with one 20-minute treatment session per week. The measured ocular parameters included non-invasive tear break-up time (NIBUT), corneal interferometry, lower eyelid meibography, and tear meniscus height, all measured at baseline, at the end of treatment, and two months after the end of treatment. The Ocular Surface Disease Index (OSDI) questionnaire was gathered at the same time. The study has received approval from our institution's ethics committee. RESULTS At the end of treatment, interferometry, tear meniscus height, and OSDI score improved at a statistically significant level. No statistically significant change was observed in NIBUT or meibography. At two months after the end of treatment, all parameters showed a statistically significant improvement, namely NIBUT, meibography, interferometry, tear meniscus, and OSDI score. No adverse events or side effects were reported. CONCLUSIONS The QMR electrotherapy by the Rexon-Eye device shows statistically significant improvement of dry eye clinical signs and symptoms with a duration of at least two months.
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Tsiogka A, Petrou P, Droutsas K, Nikolopoulou A, Papaconstantinou D, Chatzistefanou KI. Hertel Exophthalmometry Values in a Greek Adult Outpatient Clinic-Based Population: Association With Demographic Factors and Systemic Disease. Cureus 2023; 15:e35027. [PMID: 36938254 PMCID: PMC10023137 DOI: 10.7759/cureus.35027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To investigate correlations of exophthalmometry values (EVs) with age, gender, and the presence of diabetes mellitus, arterial hypertension, and dyslipidemia. METHODS In a cross-sectional, clinic-based study, consecutive adult Greek patients presenting for evaluation at the outpatient general clinic on a scheduled appointment basis at a tertiary care referral center were submitted to Hertel exophthalmometry in both eyes by the same observer. Subjects with signs of history or orbital pathology, including thyroid-associated ophthalmopathy, were excluded. Demographics, as well as a detailed systemic history report, were recorded. Mixed effect linear regression analysis was performed to account for the correlation between the eyes of the same participant. RESULTS A total of 800 eyes (400 subjects) were included, 194 males and 206 females, with a mean age of 67.82 ± 12 years (range: 18-92 years). The mean exophthalmometry value was 15.7 ± 2.6 mm (range: 11-21 mm). Every one year of increase in age is associated with a decrease in EVs by 0.03 mm (95% CI -0.04, -0.02/p-value<0.001). Female gender was associated with lower EVs by 0.33mm (95% CI-0.56, -0.1/p-value=0.005). Patients with diabetes mellitus had higher EVs by 0.47 mm (95% CI 0.25, 0.70/p-value<0.001) compared to patients without diabetes, and patients with arterial hypertension had lower EVs by 0.26 mm (95% CI -0.5, -0.02/p-value=0.034) compared to patients without hypertension. No association was found between dyslipidemia and systemic history of thyroid dysfunction. Conclusions: A negative correlation of EVs was noted with increasing age, female gender, as well as history of arterial hypertension and a positive correlation with diabetes mellitus.
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Affiliation(s)
| | - Petros Petrou
- Ophthalmology, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | | | - Anthi Nikolopoulou
- Strabismus Service, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | | | - Klio I Chatzistefanou
- Ophthalmology, Strabismus Service, General Hospital of Athens "G. Gennimatas", Athens, GRC
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Tsiogka A, Karamaounas A, Sideri A, Georgiou I, Kourkoutas D, Petrou P. Blind spot enlargement: A differential diagnosis challenge. Saudi J Ophthalmol 2023; 37:66-68. [PMID: 36968769 PMCID: PMC10032287 DOI: 10.4103/sjopt.sjopt_132_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 05/28/2022] [Accepted: 02/02/2023] [Indexed: 03/11/2023] Open
Abstract
A 39-year-old woman, without any systemic or ocular history, presented with a paracentral scotoma in her right eye with normal visual acuity. Humphrey's visual fields showed a reversible enlargement of the right blind spot. The final diagnosis was acute idiopathic blind spot enlargement which was successfully treated with intravenous steroids. Although differential diagnosis of blind spot enlargement can be challenging, multimodal imaging with combination of visual field's assessment can help us make the right diagnosis.
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Dimtsas G, Tsiogka A, Moschos M. VEGF
levels in the aqueous humour of patients with primary open angle glaucoma: A systematic review and a meta‐analysis. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Georgios Dimtsas
- 1st Department of Ophthalmology “G. Gennimatas” General Hospital National and Kapodistrian University of Athens Athens Greece
- 1st Department of Ophthalmology Athens Greece
| | - Anastasia Tsiogka
- 1st Department of Ophthalmology “G. Gennimatas” General Hospital National and Kapodistrian University of Athens Athens Greece
- 1st Department of Ophthalmology Athens Greece
| | - Marilita Moschos
- 1st Department of Ophthalmology “G. Gennimatas” General Hospital National and Kapodistrian University of Athens Athens Greece
- 1st Department of Ophthalmology Athens Greece
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Fydanaki O, Chalkiadaki E, Tsiogka A, Gartaganis PS, Karmiris E. Preoperative dry eyes disease in cataract patients with deficient tear break up time: evaluation of OSDI questionnaire, its subcategories and Keratograph 5M device results. Int Ophthalmol 2022; 42:3017-3025. [PMID: 35394587 DOI: 10.1007/s10792-022-02287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/12/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate preoperatively dry eye disease (DED) in patients with pathological Tear Break Up Time (TBUT), utilising subjective Ocular Surface Disease Index (OSDI) with its subcategories and objective Keratograph 5M characteristics. METHODS Fifty-four cataract patients were included in this prospective study having a screening slit lamp TBUT of less than 10 s and more or equal to 5 s. Subjective evaluation of DED was performed with OSDI questionnaire and objective evaluation with Keratograph 5M. Tear Meniscus Height (TMH), bulbar and limbal redness and meibography grade were evaluated. Further analysis of OSDI subcategories, Visual Function Related (VFR), Ocular Symptoms related (OS) and Environmental Triggered (ET), was performed with linear and logistic multivariate regression models. Age, gender and logMAR visual acuity (VA) were also included in our models. RESULTS Following the initial TBUT screening we identified 27(50%) normal and 27(50%) dry eye patients, using OSDI questionnaire. There was no statistical difference in TMH (p = 0.64), bulbar redness (p = 0.54), limbal redness (p = 0.72) and meibography grade (p = 0.25), between normal and dry eye OSDI group. In our regression analysis, average logMAR VA was highly associated with a higher total OSDI score (p < 0.001) and with a higher OSDI-VFR score (p < 0.001). Female gender was associated with a higher OSDI-ET score (p = 0.03). Multivariate logistic regression models were performed by sorting patients into 2 categories of normal and dry eye group according to their total OSDI,OSDI-VRF,OSDI-OS and OSDI-ET score. An increase in logMAR VA increased the odds of having abnormal total OSDI score (p = 0.007) and OSDI-VFR score (p = 0.006). Females had increased odds of having abnormal OSDI-ET score (p = 0.044). CONCLUSIONS Clinicians should be aware of OSDI limitations when screening cataract patients for dry eyes, as there is high correlation with VA. Female patients were more susceptible to environmental factors. Keratograph results should be interpreted with caution when they are evaluated in conjunction with OSDI during preoperative assessment of DED in cataract patients.
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Affiliation(s)
- Ourania Fydanaki
- Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK
| | - Evangelia Chalkiadaki
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Hpeirou 36, Agia Paraskeyi, 15341, Athens, Greece.
| | - Anastasia Tsiogka
- First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Panos S Gartaganis
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Hpeirou 36, Agia Paraskeyi, 15341, Athens, Greece
| | - Efthymios Karmiris
- Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Hpeirou 36, Agia Paraskeyi, 15341, Athens, Greece
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Tsiogka A, Georgiou I. An Unexpected Outcome of Good Vision After a Penetrating Corneal Trauma by a Bayonet. Cureus 2022; 14:e22415. [PMID: 35371769 PMCID: PMC8941328 DOI: 10.7759/cureus.22415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/29/2022] Open
Abstract
Ocular trauma is a major cause of visual impairment. Corneal injuries can range from minor and insignificant to major and vision-threatening. This report describes the case of a healthy 21-year-old soldier who presented to the emergency department with a major ocular trauma to his left eye caused by a bayonet. The bayonet had penetrated the cornea and reached the anterior chamber. Under general anesthesia, we washed the anterior chamber, filled it with viscoelastic, and sutured the trauma. Visual acuity was 10/10 in his left eye after the surgery. We report this case because there is a limited number of patients with penetrating corneal bayonet injuries reported in the literature and to emphasize the importance of immediate and correct treatment for a good visual outcome.
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14
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Tsiogka A, Karmiris E, Samoli E, Spaeth GL. Comparison of Central and Peripheral Contrast Sensitivity Between Healthy and Refractive Surgery Patients Using the Spaeth/Richman Contrast Sensitivity (SPARCS) Test. J Refract Surg 2022; 38:128-133. [DOI: 10.3928/1081597x-20211123-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Karmiris E, Soulantzou K, Machairoudia G, Ntravalias T, Tsiogka A, Chalkiadaki E. Corneal Densitometry Assessed With Scheimpflug Camera in Healthy Corneas and Correlation With Specular Microscopy Values and Age. Cornea 2022; 41:60-68. [PMID: 33797466 DOI: 10.1097/ico.0000000000002722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate correlations between specular microscopy endothelial parameters and age with corneal densitometry values, as they are presented from a Scheimpflug device, in different levels of the cornea. METHODS Two hundred eighty-four eyes of 142 healthy subjects were included in this observational, prospective study. Corneal densitometry was evaluated with Scheimpflug imaging system in the central 0- to 2-mm annular zone of the cornea, whereas the endothelial cell properties were assessed with the use of a noncontact specular microscope. RESULTS Corneal densitometry values of all corneal layers were statistically significant and positively correlated with age. In univariate linear regression analysis among corneal densitometry values and the endothelial parameters, only endothelial cell density (CD) was statistically significant and inversely correlated with densitometry values in all corneal layers. In stepwise multivariate linear regression analysis, after adjustment for age, hexagonality was statistically significant and inversely correlated with posterior densitometry values, whereas coefficient of variation was positively and significantly correlated with the anterior densitometry values. When repeating stepwise multivariate linear regression analysis without adjusting for age, CD was negatively and significantly correlated with corneal densitometry values of all layers, whereas coefficient of variation was positively and significantly correlated with anterior and total corneal densitometry values. CONCLUSIONS Corneal densitometry increases with age. It is also inversely correlated with CD, and this might be used as an indirect way to assess the status of the corneal endothelium.
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Affiliation(s)
- Efthymios Karmiris
- Ophthalmology Department, Hellenic Air Force General Hospital, Athens, Greece
| | | | - Genovefa Machairoudia
- Ophthalmology Department, Hellenic Air Force General Hospital and Attikon University Hospital, Athens, Greece ; and
| | - Thomas Ntravalias
- Ophthalmology Department, Hellenic Air Force General Hospital, Athens, Greece
| | - Anastasia Tsiogka
- Ophthalmology Department, Hellenic Army General Hospital, Athens, Greece
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16
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Stavrakas P, Christou EE, Ananikas K, Tsiogka A, Tranos P, Theodossiadis P, Stefaniotou M, Chatziralli I. Sensitivity of spectral domain optical coherence tomography in the diagnosis of posterior vitreous detachment in vitreomacular interface disorders: A prospective cohort study. Eur J Ophthalmol 2021; 32:11206721211020644. [PMID: 34058907 DOI: 10.1177/11206721211020644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the sensitivity of Spectral Domain Optical Coherence Tomography (SD-OCT) regarding the diagnosis of posterior vitreous detachment (PVD) in vitreomacular interface disorders (VID). METHODS A total of 48 eyes of 48 patients were included in this prospective cohort study. PVD in eyes with VID was investigated. We determined the status of posterior vitreous cortex using slit lamp (SL) biomicroscopy and SD-OCT preoperatively, during vitrectomy and on the intraoperative video recording. Sensitivity and specificity of the examining methods were analysed. Four masked independent examiners participated in this study. RESULTS PVD was diagnosed in 16 eyes (33.3%) on SD-OCT, 20 eyes (41.7%) on SL examination and 28 eyes (58.3%) during vitrectomy. Sensitivity and specificity for diagnosis of PVD was 37.5% and 31.3% using SD-OCT, 90% and 64.3% on the SL examination, 92.9% and 90% on the video recording respectively, compared to the intraoperative PVD diagnosis. CONCLUSION SD-OCT shows a relatively low detection sensitivity of PVD in VID. Thorough OCT investigation is necessary to establish an appropriate diagnosis of PVD and treatment in VID.
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Affiliation(s)
| | | | - Konstantinos Ananikas
- Second Department of Ophthalmology, University of Athens Medical School, Athens, Greece
| | | | | | | | | | - Irini Chatziralli
- Second Department of Ophthalmology, University of Athens Medical School, Athens, Greece
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17
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Avramidis G, Kokkineli S, Trellopoulos A, Tsiogka A, Natsika M, Brilakis E, Antonogiannakis E. Excellent Clinical and Radiological Midterm Outcomes for the Management of Recurrent Anterior Shoulder Instability by All-Arthroscopic Modified Eden-Hybinette Procedure Using Iliac Crest Autograft and Double-Pair Button Fixation System: 3-Year Clinical Case Series With No Loss to Follow-Up. Arthroscopy 2021; 37:795-803. [PMID: 33127552 DOI: 10.1016/j.arthro.2020.10.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the clinical, functional, and radiological midterm outcomes of the all-arthroscopic modified Eden-Hybinette procedure in patients with recurrent anterior shoulder instability. METHODS A retrospective, single-center case series with prospectively collected data was conducted. The inclusion criterion was traumatic recurrent anterior shoulder instability with significant glenoid bone loss; patients with atraumatic or multidirectional instability were excluded. An all-arthroscopic modified Eden-Hybinette procedure using iliac crest autograft and double-pair button fixation was carried out. All patients were postoperatively assessed for recurrence and apprehension. Shoulder range of motion values and functional scores, including American Shoulder and Elbow Surgeons Score, Oxford instability, Rowe instability, and Walch-Dupplay, were recorded. Graft positions, healing, and absorption were evaluated with computed tomography. Comparisons of values were performed with paired t tests for normally distributed differences and with nonparametric Wilcoxon's signed rank test otherwise. RESULTS The final study cohort included 28 patients, mean age 36 ± 10 years, and mean follow-up period 43 ± 6 months (range 36 to 53). Median glenoid bone loss was 12.4% (range 8% to 33%). No recurrence occurred, no subjective shoulder instability was reported, and no major complications were documented through the last follow-up. Postoperative shoulder range of motion had no significant differences compared with the healthy side. All final postoperative functional scores significantly increased to show excellent results compared with preoperative values. All grafts were positioned and healed optimally, and none was completely reabsorbed. CONCLUSIONS The all-arthroscopic modified Eden-Hybinette procedure is safe, leading to excellent clinical and radiological midterm outcomes in patients with recurrent anterior shoulder instability. This technique restores glenoid bone defects and preserves the normal shoulder anatomy. LEVEL OF EVIDENCE IV, therapeutic, retrospective case series.
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18
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Tsiogka A, Karamaounas A, Papakonstantinou E, Petrou P. Tractional Retinal Detachment in a Patient With Waldenström's Macroglobulinemia. Cureus 2021; 13:e12430. [PMID: 33542877 PMCID: PMC7849914 DOI: 10.7759/cureus.12430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An 86-year-old man with Waldenström’s macroglobulinemia and a history of acute retinal necrosis (four years ago) presented with reduced visual acuity in his right eye of three days' duration. He developed epiretinal membrane and tractional retinal detachment, which were treated successfully. Epiretinal membrane and tractional retinal detachment usually occur one to two months after the onset of retinitis. In our case, this happened four years after the diagnosis of acute retinal necrosis syndrome, prophylactic vitrectomy, and successful treatment of acute retinal necrosis syndrome in a patient with Waldenström’s macroglobulinemia.
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Affiliation(s)
| | | | | | - Petros Petrou
- Ophthalmology, "G. Gennimatas" General Hospital of Athens, Athens, GRC
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19
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Gregoriou S, Tsiogka A, Tsimpidakis A, Nicolaidou E, Kontochristopoulos G, Rigopoulos D. Treatment of nail psoriasis with brodalumab: an open-label unblinded study. J Eur Acad Dermatol Venereol 2020; 35:e299-e301. [PMID: 33269501 DOI: 10.1111/jdv.17055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Gregoriou
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Tsiogka
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Tsimpidakis
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Nicolaidou
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - G Kontochristopoulos
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - D Rigopoulos
- Faculty of Medicine, 1stDepartment of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Fiste O, Tsiogka A, Arvanitou E, Karampeazis A, Christofyllakis C. Malignant Transformation of Schneiderian Papilloma Presenting With Progressive Binocular Diplopia and Blepharoptosis. Cureus 2020; 12:e10514. [PMID: 33094055 PMCID: PMC7571778 DOI: 10.7759/cureus.10514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sinonasal tumors arising from Schneiderian papillomas, most frequently associated with squamous cell carcinoma (SCC), are rare and often present with non-specific symptoms, even in an advanced stage. Herein, we report the case of a 61-year-old male who presented with a four-month history of progressive binocular diplopia, blepharoptosis, and amblyopia, and upon the essential diagnostic work-up he was subsequently diagnosed with SCC arising from an SP. Surgical management was not warranted due to the extent of the disease, so induction chemotherapy with cisplatin and 5-fluorouracil (5-FU) was commenced, followed by definitive concurrent chemoradiotherapy (CRT). The patient was still alive at 25 months after his first presentation, receiving supportive care. Our case highlights the importance of early recognition of neuro-ophthalmological disorders related to sinonasal carcinomas, as diagnostic delay may lead to both functional complications and higher morbidity.
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Affiliation(s)
- Oraianthi Fiste
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Anastasia Tsiogka
- Department of Opthalmology, 401 General Military Hospital of Athens, Athens, GRC
| | - Eleni Arvanitou
- Department of Oncology, 401 General Military Hospital of Athens, Athens, GRC
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Tsiogka A, Tsiogka E, Koller J. Piroxicam-induced fixed drug eruption in a patient with cystic acne. Hippokratia 2017; 21:61. [PMID: 29904264 PMCID: PMC5997024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- A Tsiogka
- Clinic of Dermatology, University Hospital of Paracelsus Medical University, Salzburg, Austria
| | - E Tsiogka
- Department of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - J Koller
- Clinic of Dermatology, University Hospital of Paracelsus Medical University, Salzburg, Austria
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