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Arnould L, Varsanyi B, Dervan E, Posarelli C, Filipe HP, Bourcier T, Wedrich A, Ivekovic R, Petrovski G, Porro GL, Laganovska G, Balciuniene VJ, Mrukwa-Kominek E, Paust K, Roemer S, Haefliger IO, Atilla H, Ursell P, Cvenkel B, Kiilgaard J, Grupcheva C, Furdova A, Claeys M, Maresova K, Mercieca F, Sepp T, Parikakis E, Burcea M, Aclimandos W, Khawaja AP. Variation in eye care professional distribution across Europe, a survey. Eye (Lond) 2024:10.1038/s41433-024-03010-7. [PMID: 38472379 DOI: 10.1038/s41433-024-03010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Affiliation(s)
- Louis Arnould
- Department of Ophthalmology, Dijon University Hospital, Dijon, France.
| | - Balazs Varsanyi
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Edward Dervan
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Chiara Posarelli
- Department of Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Helena Prior Filipe
- West Lisbon Hospitals Center, Hospital of Egas Moniz (CHLO), Lisbon, Portugal
- Egas Moniz Center of Interdisciplinary Research (CiiEM), Lisbon, Portugal
| | - Tristan Bourcier
- Department of Ophthalmology, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
- Gepromed Education Department, Strasbourg, France
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Goran Petrovski
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, and Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, Split, Croatia
| | - Giorgio L Porro
- Department of Ophthalmology, Utrecht University Hospital, Utrecht and Amphia Hospital, Breda, The Netherlands
| | - Guna Laganovska
- Department of Ophthalmology, Riga Stradins University, Riga, Latvia
- Department of Ophthalmlogy, P. Stradins Clinical University Hospital, Riga, Latvia
| | | | - Ewa Mrukwa-Kominek
- Department of Ophthalmolgy, Silesian University of Medicine, Katowice, Poland
| | | | | | | | - Huban Atilla
- Department of Ophthalmology, Ankara Uinversity Hospital, Ankara, Turkey
| | - Paul Ursell
- Department of Ophthalmology, Ashtead Hospital, Surrey, UK
| | - Barba Cvenkel
- Deparment of Ophthalmology, Eye Hospital Ljubljana, Ljubljana, Slovenia
| | | | | | - Alena Furdova
- Department of Ophthalmology, Comenius University, Bratislava, Slovakia
| | | | - Klara Maresova
- Department of Ophthalmology, Palacky University Olomouc, Olomouc, Czech Republic
| | - Franco Mercieca
- Department of Ophthalmology, Mater Dei Hospital, Msida, Malta
| | | | | | - Marian Burcea
- Carol Davila University of Medecine, Bucharest, Romania
| | | | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
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2
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Christodoulou E, Batsos G, Christou EE, Gorgoli K, Parikakis E, Karagiannis D, Kontomichos L, Stefaniotou M. Long-Term Outcomes following Intravitreal Ranibizumab for Choroidal Neovascularization Related to Nd:YAG Laser Macular Injury: A Case Report. Case Rep Ophthalmol 2023; 14:68-74. [PMID: 36820308 PMCID: PMC9938398 DOI: 10.1159/000529297] [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] [Received: 10/27/2022] [Accepted: 01/15/2023] [Indexed: 02/24/2023] Open
Abstract
Choroidal neovascularization (CNV) secondary to Nd:YAG laser macular injury consists of a rare condition without standardized treatment. Herein, we present the long-term outcomes of a case with a spontaneous closure of a laser-associated macular hole that was followed by late-onset CNV and was successfully treated with intravitreal ranibizumab. A 32-year-old man suffered a macula injury in his right eye after accidental exposure to an 800-nm wave length Nd:YAG laser pulse. Ophthalmological examination demonstrated deterioration in visual acuity along with parafoveal and post-hyaloid hemorrhage. After 1 month, fundoscopy indicated the formation of a full-thickness macular hole. A close observation revealed spontaneous closure of the hole and visual improvement within the next month. One and a half year later, the patient presented with sudden visual distortion, while optical coherence tomography and fluorescein angiography disclosed the development of CNV. The patient was successfully treated with a single intravitreal injection of ranibizumab. The patient's condition has remained stable during an 8-year follow-up period. In conclusion, laser-induced macular injury consists of an increasingly remarkable condition that may have a profound impact on visual outcomes. Our case provides insight into the potential mechanisms of Nd:YAG laser injury and its complications, indicating that CNV may occur even in the long term, while anti-vascular endothelial growth factor may help maintain stable anatomic and functional outcomes.
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Affiliation(s)
- Eleni Christodoulou
- Department of Ophthalmology, Tzaneio General Hospital of Piraeus, Athens, Greece
| | - Georgios Batsos
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Evita Evangelia Christou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Efstratios Parikakis
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Dimitrios Karagiannis
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Loukas Kontomichos
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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3
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Parikakis E, Diafa A, Kontomichos L, Batsos G, Gianni T, Mpouratzis N, Spanos E, Karagiannis D. Optic disc pit macular serous detachment recurrence. A surgical approach using
ILM
autograph. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0443] [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]
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4
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Parikakis E, Kontomichos L, Batsos G, Peponis V, Mpouratzis N, Mpisoukis A, Karagiannis D. Surgical removal of dexamethasone implant (Ozurdex) accidentally injected inside crystalline lens. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0011] [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: 02/11/2023]
Affiliation(s)
| | - Loukas Kontomichos
- 2nd Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens Greece
| | - Georgios Batsos
- 2nd Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens Greece
| | - Vasileios Peponis
- 1st Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens Greece
| | - Nikolaos Mpouratzis
- 2nd Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens Greece
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5
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Karagiannis D, Kontomichos L, Tzimis V, Parikakis E, Batsos G, Karampelas M. Progressive External Ophthalmoplegia Diagnosed in the Glaucoma Clinic: The Importance of a Complete Clinical Examination. Clin Optom (Auckl) 2021; 13:335-339. [PMID: 34992483 PMCID: PMC8714969 DOI: 10.2147/opto.s342972] [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] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To present a case of chronic progressive external ophthalmoplegia (CPEO) diagnosis in the setting of a busy glaucoma clinic. MATERIALS AND METHODS Case report. RESULTS A 70-year-old-female presented to our glaucoma clinic concerned on her glaucoma status. She was previously followed-up elsewhere. Her past ophthalmic history included a diagnosis of normal tension glaucoma 10 years earlier for which she was on topical anti-glaucoma medication. On inspection, symmetrical ptosis was noted and when she was asked about her family history, she reported that 4 members of her family had "problems with moving their eyes" as she also had from a young age. Her best corrected visual acuity was 20/100 in her right eye (RE) and 20/80 in her left eye (LE). Optic discs had normal margins with peripapillary atrophy and cup/disc ratio was 0.7 RE and 0.8 LE. Intraocular pressure was 10mmHg bilaterally. Ocular motility examination revealed severe restriction in all directions of gaze. She had mild alternating exotropia but she did not report any diplopia. Based on her family history, bilateral ptosis, ophthalmoplegia and reported symptoms, the diagnosis of CPEO was made. CONCLUSION In the setting of a busy subspecialty clinic, it is common for clinicians to focus on a specific pathology and overlook additional signs and symptoms that represent a second often unrelated condition. Our case highlights the importance of a thorough assessment including history taking (general, ophthalmic and family), good documentation of symptoms and an adequate clinical examination.
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Affiliation(s)
- Dimitrios Karagiannis
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Loukas Kontomichos
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Vasileios Tzimis
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Efstratios Parikakis
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Georgios Batsos
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
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6
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Christodoulou E, Batsos G, Parikakis E, Papadopoulos V, Karagiannis D, Koumoutsos PP, Tsilis A, Drazinos S. Combined Post-Traumatic Total Aniridia and Glaucoma Management. Case Rep Ophthalmol 2021; 12:204-207. [PMID: 33976683 PMCID: PMC8077530 DOI: 10.1159/000511099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 06/16/2020] [Accepted: 08/20/2020] [Indexed: 12/03/2022] Open
Abstract
We report a novel approach for managing traumatic total aniridia associated with secondary glaucoma. A 65-year-old male with symptoms of blurred vision, glare, and photophobia was managed in a district general hospital for post-traumatic aniridia associated with secondary glaucoma affecting the right eye. The patient previously suffered blunt ocular injury associated with rhegmatogenous retinal detachment, which was treated with pars plana vitrectomy and silicone oil (SO) tamponade and subsequent removal of SO (ROSO). Combined trabeculectomy and implantation of a foldable prosthetic iris (Reper NN Ltd) successfully addressed the dual pathology of aniridia and secondary glaucoma. In summary, the utilization of the trabeculectomy fistula can serve as the implant insertion site, which minimizes the requirement for additional incisions.
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Affiliation(s)
| | - Georgios Batsos
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Efstratios Parikakis
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | | | - Dimitrios Karagiannis
- 2nd Ophthalmology Department, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
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7
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Chatziralli I, Theodossiadis G, Chatzirallis A, Dimitriou E, Parikakis E, Theodossiadis P. Evolution of macular microvasculature and retinal layers alterations in patients with macula off retinal detachment after vitrectomy. Eur J Ophthalmol 2021; 32:520-526. [PMID: 33550843 DOI: 10.1177/1120672121992984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/16/2022]
Abstract
PURPOSE To examine the changes in retinal microvasculature in association with retinal layers' condition in patients with rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 89 patients with macula off RRD, who were successfully treated with PPV and gas tamponade without internal limiting membrane peeling, in two centers. All participants underwent best corrected visual acuity (BCVA) measurement, slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) at week 5, month 3 and month 6 postoperatively. The fellow untreated eyes were also examined and served as control data. RESULTS A statistically significant enlargement in foveal avascular zone (FAZ) in both superficial capillary plexus (SCP) and deep capillary plexus (DCP), accompanied with a statistically significant thinning of inner retinal layers, was noticed 5 weeks postoperatively. These changes, namely FAZ enlargement and thinning of inner retinal layers, in the operated eyes compared to the fellow eyes, remained unchanged till month 6 postoperatively. BCVA improved significantly from week 5 to months 3 and 6 postoperatively. The improvement in BCVA was associated with the gradual ellipsoid zone (EZ) recovery from the first (week 5) till the last examination (month 6). CONCLUSIONS The FAZ enlargement in the operated eyes was accompanied with a statistically significant thinning in the inner retinal layers. Inter-correlation of BCVA and EZ integrity was noticed.
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Affiliation(s)
| | | | | | - Eleni Dimitriou
- Department of Ophthalmology, University of Athens, Athens, Greece
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8
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Chatziralli I, Chatzirallis A, Kazantzis D, Dimitriou E, Machairoudia G, Theodossiadis G, Parikakis E, Theodossiadis P. Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy. Ophthalmologica 2021; 244:213-217. [PMID: 33465770 DOI: 10.1159/000514538] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time points (6 weeks and 6, 12, and 24 months). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors affecting the long-term postoperative visual outcome 24 months after PPV for RRD. RESULTS Increasing age, duration of RD of more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption, and external limiting membrane disruption were significantly associated with a worse BVCA. BCVA was not associated with gender, lens status, the location of breaks, the gas tamponade agent used in PPV, the presence of subretinal fluid, and intraretinal fluid. CONCLUSIONS It is important to determine predictive factors for visual outcomes in order to inform patients about their prognosis and help in the decision-making process for patient management.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
| | | | | | - Eleni Dimitriou
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
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9
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Kontomichos L, Parikakis E, Batsos G, Chatzirallis A, Peponis V, Karagiannis D. Idiopathic sclerochoroidal calcification. Acta Ophthalmol 2021. [DOI: 10.1111/aos.0160] [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: 11/26/2022]
Affiliation(s)
- Loukas Kontomichos
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Efstratios Parikakis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Georgios Batsos
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | | | - Vasileios Peponis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Dimitrios Karagiannis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
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10
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Parikakis E, Kontomichos L, Batsos G, Christodoulou E, Chatzirallis A, Peponis V, Karagiannis D. Μicrovascular foveal changes determined by optical coherence angiography following vitrectomy for idiopathic epiretinal membrane. Acta Ophthalmol 2021. [DOI: 10.1111/j.1755-3768.2020.0194] [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: 11/30/2022]
Affiliation(s)
- Efstratios Parikakis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Loukas Kontomichos
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Georgios Batsos
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | | | | | - Vasileios Peponis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
| | - Dimitrios Karagiannis
- 2nd Department of Ophthalmology Ophthalmiatreio Eye Hospital of Athens Athens Greece
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11
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Parikakis E, Batsos G, Kontomichos L, Peponis V, Christodoulou E, Karagiannis D. Traumatic Aniridia and Aphakia Management with Iris Reconstruction Lens Using Gore-Tex Sutures, an Ab-Externo Approach. Am J Case Rep 2020; 21:e924706. [PMID: 32958739 PMCID: PMC7521177 DOI: 10.12659/ajcr.924706] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Male, 55-year-old Final Diagnosis: Aphakia Symptoms: Decreased visual acuity • photophobia Medication:— Clinical Procedure: Lens implantation • vitrectomy Specialty: Ophthalmology
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Affiliation(s)
- Efstratios Parikakis
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Georgios Batsos
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Loukas Kontomichos
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | - Vasileios Peponis
- First Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
| | | | - Dimitrios Karagiannis
- Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece
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12
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Chatziralli I, Theodossiadis G, Parikakis E, Chatzirallis A, Dimitriou E, Theodossiadis P. Inner retinal layers' alterations and microvasculature changes after vitrectomy for rhegmatogenous retinal detachment. Int Ophthalmol 2020; 40:3349-3356. [PMID: 32729060 DOI: 10.1007/s10792-020-01521-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 03/02/2020] [Accepted: 07/17/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the retinal layers' changes and alterations in retinal microvasculature in patients with rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 103 patients with RRD, 85 macula off and 18 macula on, who were treated with PPV and gas tamponade without internal limiting membrane peeling, in two centers. All participants underwent best corrected visual acuity measurement, slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography and optical coherence tomography angiography at week 5 and at month 6 postoperatively. The fellow untreated eyes were also examined and served as control data. RESULTS A statistically significant enlargement in foveal avascular zone (FAZ) in both superficial capillary plexus (SCP) and deep capillary plexus (DCP) was noticed 5 weeks postoperatively in patients with RRD treated with PPV compared to the fellow eyes and remained 6 months after surgery. The FAZ enlargement in the operated eyes was accompanied with a statistically significant thinning of the inner retinal layer. In addition, there was a significant decrease in foveal and parafoveal vessel density (VD) in both SCP and DCP in the operated eyes compared to control eyes at week 5 postoperatively, which also remained at postoperative month 6. CONCLUSIONS The study demonstrated that patients with RRD treated with PPV presented changes in the retinal microvasculature in both SCP and DCP, including enlargement of FAZ and decrease in VD. These changes seemed to be associated with inner retinal layer thinning.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, 28, Papanastasiou Street, Alimos, 17342, Athens, Greece.
| | - George Theodossiadis
- 2nd Department of Ophthalmology, University of Athens, 28, Papanastasiou Street, Alimos, 17342, Athens, Greece
| | | | | | - Eleni Dimitriou
- 2nd Department of Ophthalmology, University of Athens, 28, Papanastasiou Street, Alimos, 17342, Athens, Greece
| | - Panagiotis Theodossiadis
- 2nd Department of Ophthalmology, University of Athens, 28, Papanastasiou Street, Alimos, 17342, Athens, Greece
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13
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Karagiannis D, Kontomichos L, Georgalas I, Peponis V, Antoniou E, Parikakis E. Glioma-associated radiation retinopathy treated successfully with aflibercept. Ther Clin Risk Manag 2019; 15:937-941. [PMID: 31440056 PMCID: PMC6669310 DOI: 10.2147/tcrm.s204841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Received: 02/11/2019] [Accepted: 07/08/2019] [Indexed: 11/24/2022] Open
Abstract
Radiation retinopathy is a chronic, progressive retinal microangiopathy which can occur with variable latency after retina exposure to ionizing radiation used for cancer treatment. It can occur secondary to treatment of nasopharyngeal tumors, as well as intraocular tumors, such as uveal melanoma and retinoblastoma. Several treatment modalities have been reported including intravitreal corticosteroids, intravitreal anti-VEGFs and argon laser photocoagulation. Our purpose is to present a case report of bilateral radiation retinopathy with macular edema in one eye that was revealed 6 years after glioma therapy and treated successfully by using monotherapy of aflibercept. A 59-year-old male patient presented with gradually deteriorating visual acuity in his left eye for the past 12 months. Best corrected visual acuity in his right eye was 20/25 and in his left eye 20/100. Fundoscopy and fluorescein angiography revealed severe non-proliferative retinopathy in his right eye and proliferative retinopathy in his left eye with macular edema. Following complete work-up and due to his past medical history, he was diagnosed with radiation retinopathy. The patient received 6 intravitreal injections of aflibercept in a period of 9 months in order to treat macular edema and radiation retinopathy. According to the literature, there is minimal experience using aflibercept monotherapy to successfully treat macular edema due to radiation retinopathy. In addition, radiotherapy for glioma is a rather rare cause of radiation retinopathy compared to other more common causes, such as nasopharyngeal tumors, meningiomas, and uveal melanomas.
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Affiliation(s)
- D Karagiannis
- Second Department of Ophthalmology, Opthalmiatreion Eye Hospital of Athens, Athens, Greece
| | - L Kontomichos
- Second Department of Ophthalmology, Opthalmiatreion Eye Hospital of Athens, Athens, Greece
| | - I Georgalas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - V Peponis
- Second Department of Ophthalmology, Opthalmiatreion Eye Hospital of Athens, Athens, Greece
| | | | - E Parikakis
- Second Department of Ophthalmology, Opthalmiatreion Eye Hospital of Athens, Athens, Greece
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14
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Karagiannis D, Parikakis E, Kontomichos L, Batsos G, Chatziralli I. The Effect of Eplerenone in Chronic Central Serous Chorioretinopathy Refractory to Photodynamic Therapy. Semin Ophthalmol 2019; 34:436-441. [DOI: 10.1080/08820538.2019.1642920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Loukas Kontomichos
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - Georgios Batsos
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
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15
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Chatziralli I, Theodossiadis P, Parikakis E, Dimitriou E, Xirou T, Theodossiadis G, Kabanarou SΑ. Dexamethasone Intravitreal Implant in Diabetic Macular Edema: Real-Life Data from a Prospective Study and Predictive Factors for Visual Outcome. Diabetes Ther 2017; 8:1393-1404. [PMID: 29110201 PMCID: PMC5688995 DOI: 10.1007/s13300-017-0332-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION The purpose of the study was to evaluate the long-term anatomical and functional outcomes in patients with diabetic macular edema (DME) treated with intravitreal dexamethasone implant and to determine the predictive factors for the final visual outcome. METHODS The study included 54 patients with DME refractory to previous antivascular endothelial growth factor (anti-VEGF) who were treated with intravitreal dexamethasone implant. Predictive factors for visual outcome were assessed. In addition, the change in best-corrected visual acuity (BCVA) and the percentage of patients with edema resolution were evaluated. RESULTS At the end of the 12-month follow-up, patients with DME gained + 5.2 letters (about 1 Snellen line), while 57.4% of patients presented total resolution of macular edema. Negative predictive factors for the final visual outcome were found to be increasing age, increasing macular thickness, phakic status, the presence of intraretinal fluid, hyperreflective foci, hard exudates, as well as external limiting membrane and ellipsoid zone disruption. The mean number of injections was 2.1. CONCLUSIONS The various predictive factors that determine the visual outcome and possibly define patient prognosis after dexamethasone intravitreal implant in DME cases have been studied. The long follow-up showed that dexamethasone intravitreal implant seems to be a safe and effective treatment for this disease, requiring a limited number of injections.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Panagiotis Theodossiadis
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Eleni Dimitriou
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Tina Xirou
- Retina Department, Red Cross "Korgialeneio-Benakeio" Hospital, Athens, Greece
| | - George Theodossiadis
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Karagiannis D, Chatziralli I, Kaprinis K, Georgalas I, Parikakis E, Mitropoulos P. Location of submacular hemorrhage as a predictor of visual outcome after intravitreal ranibizumab for age-related macular degeneration. Clin Interv Aging 2017; 12:1829-1833. [PMID: 29138543 PMCID: PMC5679569 DOI: 10.2147/cia.s145893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/23/2022] Open
Abstract
Purpose To evaluate the anatomical and functional outcomes in patients with submacular hemorrhage (SMH) due to age-related macular degeneration (AMD) treated with ranibizumab, and to evaluate the potential role of the SMH location in the final outcome after treatment. Methods Participants in this study were 12 treatment-naïve patients with SMH due to neovascular AMD who were treated with intravitreal ranibizumab and had at least 12 months’ follow-up. All patients underwent best-corrected visual acuity measurement and optical coherence tomography at baseline and at every visit posttreatment, while fluorescein angiography was done at baseline and at the discretion of the physician thereafter. Results Of the patients, 83.4% showed improvement or stabilization in best-corrected visual acuity after treatment at the 12-month follow-up, with a mean number of 7.3±2.9 injections. Patients with SMH surrounding the foveal area in 360° presented worse anatomical and functional outcomes compared to those with SMH adjacent to the fovea. Conclusion Intravitreal ranibizumab seems to be safe and effective, either improving or stabilizing visual acuity, in patients with SMH due to wet AMD. The location of the SMH may predict the final outcome after treatment.
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Affiliation(s)
| | - Irini Chatziralli
- Second Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | | | - Ilias Georgalas
- First Department of Ophthalmology, University of Athens, Athens, Greece
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Batsos G, Parikakis E, Christodoulou E, Karagiannis D, Stefaniotou M. Long-term outcome following ranibizumab treatment for CNV related to ND: YAG-Laser macular injury. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f026] [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: 11/27/2022]
Affiliation(s)
- G. Batsos
- Second Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - E. Parikakis
- Second Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - E. Christodoulou
- Department of Ophthalmology; University Hospital of Ioannina; Ioannina Greece
| | - D. Karagiannis
- Second Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - M. Stefaniotou
- Department of Ophthalmology; University Hospital of Ioannina; Ioannina Greece
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Kontadakis G, Parikakis E, Peponis V, Batsos G, Georgalas I, Tsilimbaris M, Karagiannis D. Is the age a prognostic factor for the outcome after treatment of myopic CNV? Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f024] [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: 11/29/2022]
Affiliation(s)
- G. Kontadakis
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - E. Parikakis
- 2nd Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - V. Peponis
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - G. Batsos
- 2nd Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - I. Georgalas
- 1st Department of Ophthalmology; University of Athens; Athens Greece
| | - M. Tsilimbaris
- Department of Ophthalmology; University of Crete; Heraklion Greece
| | - D. Karagiannis
- 2nd Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
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Kontadakis G, Parikakis E, Kaprinis K, Stoupaki M, Nikas S, Konstantinidou V, Peponis V. Femtosecond assisted intracorneal segments implantation for mild to moderate keratoconus: long term results. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.00032] [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: 11/29/2022]
Affiliation(s)
- G. Kontadakis
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - E. Parikakis
- 2nd Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - K. Kaprinis
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - M. Stoupaki
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - S. Nikas
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - V. Konstantinidou
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
| | - V. Peponis
- 1st Department of Ophthalmology; Ophthalmiatreio Eye Hospital of Athens; Athens Greece
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Chatziralli I, Theodossiadis G, Parikakis E, Mitropoulos PG, Theodossiadis P. Long-Term Anatomical and Functional Outcomes in Patients with Ischemic Central Retinal Vein Occlusion Treated with Anti-Vascular Endothelial Growth Factor Agents. Ophthalmic Res 2017; 58:203-208. [DOI: 10.1159/000462976] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 02/12/2017] [Indexed: 11/19/2022]
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Chatziralli I, Kabanarou SA, Parikakis E, Chatzirallis A, Xirou T, Mitropoulos P. Risk Factors for Central Serous Chorioretinopathy: Multivariate Approach in a Case-Control Study. Curr Eye Res 2017; 42:1069-1073. [PMID: 28306346 DOI: 10.1080/02713683.2016.1276196] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [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: 12/18/2022]
Abstract
PURPOSE The purpose of this prospective study was to investigate the potential risk factors associated independently with central serous retinopathy (CSR) in a Greek population, using multivariate approach. MATERIALS AND METHODS Participants in the study were 183 consecutive patients diagnosed with CSR and 183 controls, matched for age. All participants underwent complete ophthalmological examination and information regarding their sociodemographic, clinical, medical and ophthalmological history were recorded, so as to assess potential risk factors for CSR. Univariate and multivariate analysis was performed. RESULTS Univariate analysis showed that male sex, high educational status, high income, alcohol consumption, smoking, hypertension, coronary heart disease, obstructive sleep apnea, autoimmune disorders, H. pylori infection, type A personality and stress, steroid use, pregnancy and hyperopia were associated with CSR, while myopia was found to protect from CSR. In multivariate analysis, alcohol consumption, hypertension, coronary heart disease and autoimmune disorders lost their significance, while the remaining factors were all independently associated with CSR. CONCLUSIONS It is important to take into account the various risk factors for CSR, so as to define vulnerable groups and to shed light into the pathogenesis of the disease.
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Affiliation(s)
- Irini Chatziralli
- a 2nd Department of Ophthalmology , Ophthalmiatrion Athinon , Athens , Greece
| | - Stamatina A Kabanarou
- b Medical Retina Department , Korgialeneio Benakeio, Red Cross Hospital , Athens , Greece
| | | | | | - Tina Xirou
- b Medical Retina Department , Korgialeneio Benakeio, Red Cross Hospital , Athens , Greece
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Abstract
PURPOSE The purpose of this study was to evaluate the quality of life in patients with age-related macular degeneration (AMD) and compare it with that of healthy controls. Additionally, our study aims to investigate the possible risk factors for poor quality of life in AMD patients. METHODS Participants in the study were 114 patients with AMD, 63 male and 51 female, mean-aged 76.5 ± 6.1 years. Demographic data, lifestyle factors, and medical history were recorded. All patients underwent a routine examination for AMD, including best-corrected visual acuity measurement, dilated fundoscopy and optical coherence tomography, and completed three questionnaires assessing quality of life (SF-36, EQ-5D, NEI VFQ-25). In addition, 100 controls, adjusted for gender and age, were included in the study. Risk factors for quality of life in AMD patients were investigated. Univariate analysis was performed using SPSS 22.0. RESULTS Patients with AMD scored lower in vision- and health-related quality-of-life questionnaires compared to controls. Risk factors associated with quality of life in patients with AMD were found to be the female gender, alcohol consumption, the presence of hypertension, diabetes mellitus, cardiovascular diseases, myosceletal problems, migraine, anxiety/depression, subretinal or intraretinal fluid, pigment epithelium detachment, previous treatment for AMD, visual acuity, the stage of the disease, and the integrity of the ellipsoid zone. CONCLUSION Patients with AMD presented lower quality of life in comparison with controls. Potential risk factors should be taken into account and clinicians should thus focus on the most vulnerable subgroups.
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Affiliation(s)
- Irini Chatziralli
- a Second Department of Ophthalmology , Ophthalmiatrion Athinon , Athens , Greece
- b Hellenic Open University , Faculty of Social Sciences , Patra , Greece
| | | | - Efstratios Parikakis
- a Second Department of Ophthalmology , Ophthalmiatrion Athinon , Athens , Greece
| | - Dimitrios Niakas
- b Hellenic Open University , Faculty of Social Sciences , Patra , Greece
| | - Georgios Labiris
- b Hellenic Open University , Faculty of Social Sciences , Patra , Greece
- c Department of Ophthalmology , University Hospital of Alexandroupolis , Alexandroupolis , Greece
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Chatziralli I, Theodossiadis G, Datseris I, Parikakis E, Theodossiadis P. Anatomical and Functional Changes in the Coexistence of Vitreomacular Traction and Epiretinal Membrane: A Spectral-Domain Optical Coherence Tomography Study. Ophthalmic Res 2016; 57:54-59. [PMID: 27424310 DOI: 10.1159/000446658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/07/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the anatomical and functional findings in patients with vitreomacular traction (VMT) combined with epiretinal membrane (ERM) in the same eye. METHODS In this retrospective, cross-sectional study, we studied 65 patients with VMT and ERM. In 36 of them, ERM/VMT had a 'unified' appearance (group Ι) but in 29, VMT and ERM coexisted without an interrelationship (group ΙΙ). All patients were examined with spectral-domain optical coherence tomography (SD-OCT). We recorded the macular thickness, the presence, type and location of macular edema, the horizontal diameter of VMT, ellipsoid zone/external limiting membrane (EZ/ELM) status, the vitreofoveal angle of VMT nasally and temporally and the best corrected visual acuity (BCVA). RESULTS Group Ι presented with increased macular thickness, a broader adhesion diameter, extensive EZ/ELM defect and decreased BCVA compared to those where VMT and ERM were not intercorrelated. In group I ('unified' VMT and ERM), cystoid macular edema was found at a greater percentage (41.7%), while in patients where the 2 entities were not intercorrelated, diffuse macular edema was more evident (69%). There was no statistically significant difference between the 2 groups in the vitreofoveal angle temporally and nasally. CONCLUSIONS Macular thickness, type of macular edema, adhesion diameter, the extent of the EZ/ELM defect and BCVA appeared different in cases where VMT and ERM were unified compared to cases where ERM and VMT coexisted but were not intercorrelated.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Attikon Hospital, Athens, Greece
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Chatziralli IP, Peponis V, Parikakis E, Maniatea A, Patsea E, Mitropoulos P. Risk factors for intraoperative floppy iris syndrome: a prospective study. Eye (Lond) 2016; 30:1039-44. [PMID: 27367744 DOI: 10.1038/eye.2016.122] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/15/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo evaluate risk factors for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification.MethodsParticipants in the study were 1274 consecutive patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors: ophthalmological conditions, axial length of the eye, sociodemographic features, clinical data (hypertension and diabetes mellitus), medications being taken at the time of surgery, and duration of their intake. Cases were characterized intraoperatively as IFIS and non-IFIS. Univariate and multivariate logistic regression analysis were performed.ResultsIFIS was observed in 63/1274 eyes (4.9%, 95% CI: 3.9-6.7%). Current use of tamsulosin, alfuzosin, terazosin, benzodiazepines, quetiapine, and finasteride, as well as hypertension, were all independently associated with IFIS. Significant associations were noted for male sex, rivastigmine, and short axial length, which did not reach significance at the multivariate analysis. Duration of α-blockers intake was not found to be associated with IFIS.ConclusionApart from the well-established associations with α-blockers, this prospective study points to benzodiazepines, quetiapine, finasteride, and hypertension as potential risk factors for IFIS. Short axial length and rivastigmine were significantly associated with IFIS only at the univariate analysis.
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Affiliation(s)
- I P Chatziralli
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - V Peponis
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - E Parikakis
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - A Maniatea
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - E Patsea
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
| | - P Mitropoulos
- 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece
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Chatziralli IP, Theodossiadis GP, Parikakis E, Datseris I, Theodossiadis P. Complications of intravitreal ocriplasmin for vitreomacular traction and macular hole: a prospective spectral-domain optical coherence tomography study. Cutan Ocul Toxicol 2015; 35:263-9. [PMID: 26555379 DOI: 10.3109/15569527.2015.1096941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the safety of intravitreal ocriplasmin prospectively, reporting potential complications in patients with vitreomacular traction (VMT) alone or associated with macular hole (MH). MATERIALS AND METHODS Participants in this prospective, multicenter study, were 24 patients with VMT (17 with VMT alone and seven with MH combined with VMT). All patients were treated with a single ocriplasmin injection and followed-up prospectively at baseline, day 7, 28 and the last examination of the follow-up for each patient (mean ± SD: 64.2 ± 24.4 d, range: 40-145 d). Best-corrected visual acuity (BCVA) was assessed, and spectral-domain optical coherence tomography was performed at each visit while the percentage of resolution of VMT and the association with various potential adverse events were recorded and analyzed. RESULTS 66.7% of patients presented VMT release at the end of the follow-up, while 28.6% exhibited MH closure. Severe adverse events, such as enlargement of preexisting MH and formation of lamellar MH, were observed in one and four cases, respectively and remained till the end of the follow-up. Moderate adverse events, such as ellipsoid zone disruption and subretinal fluid development, became evident seven days after injection, in four cases. Formation of cystoid macular edema (CME), not evident at baseline, was noticed in three cases at day 28 after injection. Mild adverse events, like vitreous floaters, photopsias, eye pain and foreign body sensation, were noticed at day 7 and resolved till the end of the follow-up. CONCLUSIONS Mild and moderate adverse events occurred mainly during the first week of the follow-up, while severe adverse events, such as the lamellar MH formation and CME at day 28 post injection were seen.
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Affiliation(s)
- Irini P Chatziralli
- a 2nd Department of Ophthalmology, Ophthalmiatrion Athinon , Athens , Greece
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Karampelas M, Soumplis V, Karagiannis D, Parikakis E, Webster AR. An atypical case of choroidal neovascularization associated with pseudoxanthoma elasticum treated with intravitreal bevacizumab: a case report. BMC Res Notes 2013; 6:530. [PMID: 24325973 PMCID: PMC3866942 DOI: 10.1186/1756-0500-6-530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 12/09/2013] [Indexed: 01/31/2023] Open
Abstract
Background Pseudoxanthoma elasticum is an inherited disorder that is associated with accumulation of pathologic elastic fibers in the skin, vascular walls and Bruch’s membrane in the eye. Choroidal neovascularization is one of the most common causes of acute vision loss in these patients. We report an atypical case of suspected choroidal neovascularization associated with pseudoxanthoma elasticum. Case presentation A 47-year-old Caucasian woman with pseudoxanthoma elasticum and angioid streaks was referred because of decreased and distorted vision in her right eye of one week’s duration. Visual acuity was 6/12 in the right eye and 6/6 in the left eye. Fundus examination revealed angioid streaks and white intraretinal macular deposits bilaterally. Fluorescein angiography did not reveal any obvious leakage in the right eye while optical coherence tomography revealed subretinal fluid associated with an adjacent intraretinal hyperreflective structure. Autofluoresence imaging showed focal areas of increased autofluorescence corresponding to the deposits in both eyes. Over the following year the patient underwent five intravitreal injections of bevacizumab (Genentech/Roche,US) in the right eye, which resulted in visual acuity improving to 6/9 with regression of the hyperreflective structrure and complete resolution of subretinal fluid. Conclusions Traditionally, fluorescein angiography is effective in the detection of choroidal neovascularization in patients with pseudoxanthoma elasticum. In our case, optical coherence tomography revealed subretinal fluid and an adjacent hyperreflective structure while fluorescein angiography did not reveal any obvious leakage. The sole presence of subretinal fluid does not necessarily imply the presence of choroidal neovascularization and certainly retinal pigment epithelium dysfunction could also explain subretinal fluid in these patients. However, the complete absorption of the fluid and the disappearance of the previously evident hyperreflective structure following treatment, led us to suspect choroidal neovascularization as the primary cause of the above findings. The poor natural course of choroidal neovascularization in these patients increases the importance of early detection and should result in the adaptation of a low-threshold strategy concerning the initiation of treatment.
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Karagiannis DA, Ladas ID, Parikakis E, Georgalas I, Kotsolis A, Amariotakis G, Soumplis V, Mitropoulos P. Changing from bevacizumab to ranibizumab in age-related macular degeneration. Is it safe? Clin Interv Aging 2009; 4:457-61. [PMID: 20054410 PMCID: PMC2801585 DOI: 10.2147/cia.s8367] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [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] [Received: 11/25/2009] [Indexed: 11/30/2022] Open
Abstract
Objective: To report our experiences in changing from intravitreal bevacizumab to ranibizumab in age-related macular degeneration (AMD). Design: Retrospective case series. Participants and methods: We retrospectively reviewed the records of 34 patients (36 eyes) who were treated with monthly injections of intravitreal bevacizumab for six months and then switched to monthly injections of ranibizumab for 12 months. Best-corrected visual acuity measurements (BCVA), contact lens biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography were performed at the baseline examination and then monthly. Chi-square test was used for statistical analysis. Results: Following bevacizumab treatment, retinal thickness decreased (P = 0.033) while BCVA improved (P = 0.040). Changing from bevacizumab to ranibizumab resulted in a transient decrease in BCVA (P = 0.045) and an increase in retinal thickness (P = 0.042). In addition, three eyes presented with a large subretinal hemorrhage. However, final retinal thickness was better than the initial thickness and the value following the bevacizumab course. No major ocular or systemic side effects were noted. Conclusions: Ranibizumab was clinically effective in the long term but the change of treatment from bevacizumab to a half-size molecule with less half-life in the vitreous such as ranibizumab contributed to a transient “instability” in the eye which may have triggered the large subretinal hemorrhage. There is insufficient experience reported in the literature in switching from one agent to another. A prospective study with controls is necessary to determine whether it is safe to change from one medication to another.
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Schulenburg WE, Yang YF, Parikakis E, Bydder GM. Cryotherapy for retinopathy of prematurity: a MRI study of the surgical-anatomical relationship of the neonatal conjunctival fornices to the globe. Eye (Lond) 2001; 15:587-90. [PMID: 11702967 DOI: 10.1038/eye.2001.190] [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] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To demonstrate the surgical-anatomical relationship of the neonatal conjunctival fornices to the globe in order to ascertain whether adequate cryotherapy is possible in infants with stage 3 retinopathy of prematurity using a trans-scleral approach without opening the conjunctiva. METHODS Magnetic resonance (MR) scans of the orbit were performed on an adult and an infant of 38 weeks post-conceptual age with maximal posterior placement of a MR-compatible replica of the Schulenburg cryoprobe in the nasal and temporal aspects of the globe. RESULTS In the infant MR scan, the scleral indentation produced by the probe was anterior to the equator on the nasal side and at, or just anterior to, the equator on the temporal side. Nasally, the scleral indentation reached only the more anterior part and not the posterior part of zone 2 and none of zone 1. Temporally, the scleral indentation reached the central part of zone 2 but not the posterior part of zone 2 or zone 1. CONCLUSION The findings suggest that adequate cryotherapy with a trans-scleral approach without opening the conjunctiva is unlikely to be achieved in the more immature neonate with posteriorly located retinopathy of prematurity. To permit access of the cryoprobe to the more posterior part of the globe, one radial conjunctival incision from the corneal limbus in each quadrant may be required to achieve adequate ablation of the posterior non-vascularised retina in these high-risk infants.
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