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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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Stavrakas P, Tsapardoni F, Karmiris E, Iatropoulos I, Kounas K, Lygeros S, Kozobolis V, Vavvas DG. Early recurrence of macular schisis in X-linked retinoschisis treated with vitrectomy for rhegmatogenous retinal detachment under silicone oil: case report and brief literature review. Ther Adv Ophthalmol 2024; 16:25158414241232261. [PMID: 38406626 PMCID: PMC10894533 DOI: 10.1177/25158414241232261] [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: 07/21/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
X-linked retinoschisis (XLRS) is an inherited retinal degeneration affecting males, characterized by splitting of the retinal layers. We herein present the outcomes of surgical treatment in a case of XLRS complicated by rhegmatogenous retinal detachment (RRD). A 22-year-old male presented to the emergency department due to decreased visual acuity and visual field defect in his left eye Oculus Sinister (OS) of 1 week duration. The patient reported an early onset retinal degeneration and decreased visual acuity in both eyes since childhood in his past ocular history. Upon presentation, best corrected visual acuity (BCVA) was 6/30 on the right eye Oculus Dexter (OD) and 6/120 OS. Fundus examination revealed areas of peripheral retinal schisis, and the characteristic spoke wheel pattern on the macula of both eyes. In OS, a temporal RRD involving the macula was identified. The patient underwent surgical treatment with pars plana vitrectomy with internal limiting membrane (ILM) peeling, endolaser, and silicone oil (SO) tamponade. BCVA in OS improved to 6/60 and schistic cavities resolution was observed in the immediate postoperative period. The patient's BCVA further improved to 6/19 at 1 month, as foveal anatomy showed relative improvement. However, there was a rapid reappearance of schisis spaces in the macular area at this point, which was also followed by progressive deterioration of foveal schisis by 3 months post-operatively. The resorption and recurrence of lamellar macular schisis changes after ILM peel and presence of SO, highlights that although XLRS findings can temporarily improve upon surgical intervention, the pathogenetic mechanisms contributing to disease phenotype remain to be elucidated.
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Affiliation(s)
- Panagiotis Stavrakas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece
| | - Foteini Tsapardoni
- Department of Ophthalmology, University Hospital of Patras, Rio, Patras GR-26504, Greece
| | - Efthymios Karmiris
- Department of Ophthalmology, Hellenic Air Force General Hospital, Athens, Greece
| | - Ioannis Iatropoulos
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece
| | - Konstantinos Kounas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece
| | - Spyridon Lygeros
- Department of Otorhinolaryngology, School of Medicine, University of Patras, Patras, Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece
| | - Demetrios G. Vavvas
- Ines and Fredrick Yeatts Retinal Research Laboratory, Retina Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Totou S, Karmiris E, Kanakis M, Gartaganis P, Petrou P, Kalogeropoulos C, Kozobolis V, Stavrakas P. Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function. Med Hypothesis Discov Innov Ophthalmol 2023; 12:127-141. [PMID: 38476577 PMCID: PMC10926315 DOI: 10.51329/mehdiophthal1478] [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: 11/04/2023] [Accepted: 12/27/2023] [Indexed: 03/14/2024]
Abstract
Background Exposure to high-altitude conditions during flight or similar activities affects many aspects of visual function, which is critical not only for flight safety but for any altitude-related activity. We aimed to summarize the available literature pertaining to ocular changes during flight or equivalent short-term high-altitude exposure (e.g., hypobaric chamber, effortless ascent lasting ≤ 24 h) and to highlight future research priorities. Methods Using the PubMed/MEDLINE and Web of Science/ISI Web of Knowledge databases with structured search syntax, we conducted a systematic review of the literature spanning a 40-year period (January 1, 1983, to October 10, 2023). Articles pertaining to ocular changes during flight or flight-equivalent exposure to altitude were retrieved. The reference lists of retrieved studies were also searched, and citations of these references were included in the results. Results Of 875 relevant PubMed and ISI publications, 122 qualified for inclusion and 20 more were retrieved from the reference lists of initially selected records, for a total of 142 articles. Reported anterior segment changes included deterioration in tear film stability and increased dry eye incidence, increased corneal thickness, discomfort and bubble formation in contact lens users, refraction changes in individuals with prior refractive surgery, decreased intraocular pressure, and alterations in pupillary reaction, contrast sensitivity, and visual fields. Photoreceptor-visual pathway changes included alterations in both photoreceptors and neuro-transduction, as evidenced in dark adaptation, macular recovery time, reduction in visual field sensitivity, and optic neuritis (likely an element of decompression sickness). Retinochoroidal changes included increases in retinal vessel caliber, retinal blood flow, and choroidal thickness; central serous chorioretinopathy; and retinal vascular events (non-arteritic ischemic optic neuropathy, high-altitude retinopathy, and retinal vein occlusion). Conclusions The effect of short-term high-altitude exposure on the eye is, in itself, a difficult area to study. Although serious impairment of visual acuity appears to be rare, ocular changes, including tear film stability, contact lens wear, central corneal thickness, intraocular pressure, contrast sensitivity, stability of refractive surgeries, retinal vessels, visual fields, and macula recovery time, should be considered in civilian aviators. Our report provides guidance to climbers and lowlanders traveling to altitude if they have pre-existing ocular conditions or if they experience visual symptoms while at altitude. However, key outcomes have been contradictory and comprehensive studies are scarce, especially those pertaining to the choroid and retina. Such studies could not only deepen our understanding of high-altitude ocular pathophysiology, but could also offer valuable information and treatment possibilities for a constellation of other vision-threatening diseases.
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Affiliation(s)
- Styliani Totou
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
- Hellenic Air Force General Hospital, Athens, Attika, Greece
| | | | - Menelaos Kanakis
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
| | | | - Petros Petrou
- Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Vassilios Kozobolis
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
| | - Panagiotis Stavrakas
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
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Kontou EP, Karakosta C, Kounas K, Iatropoulos I, Tsinopoulos I, Kozobolis V, Stavrakas P. Macular Edema Following Silicone Oil Tamponade for Retinal Detachment: A Literature Review. Cureus 2023; 15:e51233. [PMID: 38283484 PMCID: PMC10821764 DOI: 10.7759/cureus.51233] [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: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Macular edema (ME) is a major cause of reduced vision following intraocular surgery. Although the pathophysiology of ME is not completely understood, inflammatory mediators play a key role. The incidence of ME following pars plana vitrectomy with silicone oil tamponade varies between 13% and 27%. ME usually resolves spontaneously following silicone oil removal, but treatment may be required for resistant cases. In this review, the mechanisms of ME formation after pars plana vitrectomy, its incidence, and its possible therapeutic approaches are discussed.
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Affiliation(s)
- Evgenia P Kontou
- Department of Ophthalmology, General Hospital of Athens "Korgialeneio-Benakio" Hellenic Red Cross, Athens, GRC
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Christina Karakosta
- Department of Ophthalmology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Konstantinos Kounas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Ioannis Iatropoulos
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Ioannis Tsinopoulos
- Second Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Vassilios Kozobolis
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Panagiotis Stavrakas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
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Diafas A, Dastiridou A, Samouilidou M, Tzamalis A, Mataftsi A, Tsinopoulos I, Kozobolis V, Ziakas N. The effect of acetazolamide on the retinal and choroidal vasculature of the macula and the optic disc using OCT angiography. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:125-131. [PMID: 36738925 DOI: 10.1016/j.oftale.2023.02.003] [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] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES To investigate the effect of acetazolamide (AZ) on the retinal and choroidal ocular microvasculature in the macula and radial peripapillary capillaries (RPC) of the optic disc with OCT Angiography (OCTA). MATERIALS AND METHODS Nine-month observational cross-sectional study. Forty-five eyes from 45 healthy participants who underwent cataract surgery were recruited. Macular retina and choriocapillaris vessel density (VD) and RPC VD in the optic disc area were compared before and 60min after 250mg acetazolamide per os. Intraocular pressure (IOP) and systemic blood pressure (BP) were also measured before each scan. RESULTS Mean age was 73.1±6.9 years. VDs in the superficial (SCP) and deep (DCP) capillary plexus of the retina and the choriocapillaris (CC) in the macular area showed no significant change (P>.5, for all parameters). VD in the RPC showed no significant change with AZ (P>.5, for all parameters). Foveal and parafoveal thickness increased from 248.98 (±23.89) to 250.33 (±23.74) and from 311.62 (±16.53) to 311.98 (±16.38) (P<.001 and P=.046), respectively. IOP decreased from 13.2 (±3.0) mmHg to 11.8 (±3.2) mmHg (P<.001), while systolic and diastolic BP decreased from 144.8 (±21.8) to 137.7 (±19.0) and from 80.0 (±12.7) to 76.2 (±11.7) (P=.021 and P=.030), respectively. CONCLUSIONS OCTA imaging did not reveal any significant changes in the VD of the optic disc or the retinal and choroidal VD in the macula with oral AZ one hour after its administration in otherwise healthy participants who underwent cataract surgery.
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Affiliation(s)
- A Diafas
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece; St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
| | - A Dastiridou
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - M Samouilidou
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - A Tzamalis
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - A Mataftsi
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - I Tsinopoulos
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - V Kozobolis
- Instituto Oftalmológico de Tracia, Universidad Demócrito de Tracia, Alexandroupoli, Greece
| | - N Ziakas
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
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Christou EE, Katsanos A, Georgalas I, Kozobolis V, Kalogeropoulos C, Stefaniotou M. The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy. Acta Medica (Hradec Kralove) 2023; 65:89-98. [PMID: 36735886 DOI: 10.14712/18059694.2022.24] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To characterize choroidal structure and vasculature after half-dose verteporfin photodynamic therapy (hd-vPDT) in eyes with chronic central serous chorioretinopathy using Enhanced Depth Imaging Optical Coherence Tomography (EDI OCT) and Optical Coherence Tomography Angiography (OCT-A). METHODS This prospective case-control study included 10 eyes. Choroid was examined before and at 1 month following hd-vPDT. We measured choroidal thickness (CT) at subfoveal area and at 750 μm nasal and temporal of fovea and thickness of Haller and choriocapillaris/Sattler layers. Whole (WA), luminal (LA) and interstitial area (IA) at EDI-OCT, and perfusion density at OCT-A were analyzed. The unaffected fellow eyes were used for comparisons. RESULTS Mean CT at subfoveal area and at 750 μm nasal and temporal of fovea, values of Haller and choriocapillaris/Sattler layers and those of WA, LA and IA were reduced, while PD increased at 1 month after hd-vPDT (all p < 0.001). There was a significant (p < 0.05) negative correlation (ρ = -0.658) between PD and post-treatment logMARVA. None of analyzed parameters reached values of unaffected fellow eye. CONCLUSION Following hd-vPDT, choroidal thickness with both luminal and interstitial components markedly decreased, while perfusion of choriocapillaris improved.
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Affiliation(s)
- Evita Evangelia Christou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
| | - Andreas Katsanos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Christos Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Xirou V, Xirou T, Siganos C, Ntonti P, Georgakopoulos C, Stavrakas P, Makri OE, Kanakis M, Tsapardoni F, Fragkoulis I, Garnavou-Xirou C, Kozobolis V. Impact of Cataract Surgery on IOP and Ocular Structures in Normotensive Patients and Primary and Exfoliation Open-Angle Glaucoma Patients. Clin Ophthalmol 2023; 17:1047-1055. [PMID: 37041963 PMCID: PMC10083030 DOI: 10.2147/opth.s402550] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
Purpose The aim of this study was to evaluate and compare the changes in Intraocular Pressure (IOP) and other ocular parameters: the Anterior Chamber Angle (ACA), Anterior Chamber Volume (ACV), and Anterior Chamber Depth (ACD) during phacoemulsification surgery in Greek patients with normotensive eyes and those with well-controlled Open-Angle Glaucoma (OAG). Additionally, parameters such as the Corneal Thickness (CCT), Axial Length (AL), Central Macular Thickness (CMT), and Retinal Nerve Fibre Layer (RNFL) were also examined. Patients and Methods This was a prospective observational case-control study that included 50 phakic eyes, 25 normotensive (Group 1), and 25 with OAG: 15 Primary Open-Angle Glaucoma (POAG) and 10 Exfoliation Glaucoma (EXG) (Group 2). Ophthalmic assessment included IOP measurements, ocular biometry, and anterior and posterior segment optical coherence tomography evaluation of the aforementioned ocular parameters, prior and 6 months after phacoemulsification surgery. Results At the 6 months post-operative review, a greater IOP reduction was recorded in eyes with OAG, in comparison to normotensive ones (5.3mmHg and 1.6 mmHg respectively). In addition, a significant but similar increase was recorded in the values of the ACA, ACV, and ACD of both groups between the pre- and the post-op period. Furthermore, the CCT and AL values remained unaltered. Finally, there was a non-statistically significant change in the mean CMT and the mean average RNFL of both groups. Conclusion Eyes with OAG tend to undergo a greater reduction in IOP post-phacoemulsification surgery, in comparison to normotensive eyes. This reduction may not be solely attributed to ocular anatomical changes after phacoemulsification surgery but may also be due to the remodeling of the trabecular meshwork and the ciliary body. This may be especially true in the case of OAG eyes, which already start off with a compromised trabecular endothelium prior to surgery.
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Affiliation(s)
- Vasiliki Xirou
- Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece
- Correspondence: Vasiliki Xirou, Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece, Email
| | - Tina Xirou
- Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece
| | - Charalambos Siganos
- Ophthalmology Department, University Hospital of Heraklion, Heraklion, Greece
| | - Panagiota Ntonti
- Ophthalmology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | - Olga E Makri
- Ophthalmology Department, University Hospital of Patras, Patras, Greece
| | - Menelaos Kanakis
- Ophthalmology Department, University Hospital of Patras, Patras, Greece
| | | | | | | | - Vassilios Kozobolis
- Ophthalmology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece
- Ophthalmology Department, University Hospital of Patras, Patras, Greece
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
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Kanakis M, Georgalas I, Kozobolis V, Lekkou A, Karmiris E, Stavrakas P. Late PAMM-Like Lesions in a Patient with HIV Retinopathy. Case Rep Ophthalmol 2023; 14:23-28. [PMID: 36644617 PMCID: PMC9837467 DOI: 10.1159/000528408] [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: 08/03/2022] [Accepted: 11/13/2022] [Indexed: 01/15/2023] Open
Abstract
This report describes a case of a newly diagnosed 49-year-old HIV patient, who presented with decreased visual acuity and retinal lesions characterized by ischemia at the level of the deep retinal capillary plexus, documented with optical coherence tomography (OCT), OCT angiography, fluorescein angiography, and visual fields testing. These lesions closely resembled the morphologic and clinical characteristics of late paracentral acute middle maculopathy. The presence of these lesions suggests that HIV microangiopathy can potentially affect both superficial and deep retinal capillary plexuses.
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Affiliation(s)
- Menelaos Kanakis
- University Eye Clinic, University of Patras School of Medicine, Rion University Hospital, Patras, Greece
| | - Ilias Georgalas
- 1st Athens University Eye Clinic, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Vassilios Kozobolis
- University Eye Clinic, University of Patras School of Medicine, Rion University Hospital, Patras, Greece
| | - Alexandra Lekkou
- Division of Internal Medicine, University of Patras School of Medicine, Rion University Hospital, Patras, Greece
| | - Efthymios Karmiris
- Ophthalmology Department, Hellenic Air Force General Hospital, Athens, Greece
| | - Panagiotis Stavrakas
- University Eye Clinic, University of Patras School of Medicine, Rion University Hospital, Patras, Greece
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Makri OE, Tsekouras IK, Leonidou L, Kagkelaris K, Kozobolis V, Georgakopoulos CD. Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis. Vision (Basel) 2022; 6:vision6020027. [PMID: 35645381 PMCID: PMC9149933 DOI: 10.3390/vision6020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/17/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
We report the case of a 52-year-old woman who presented to the emergency department with acute retinal necrosis in her left eye secondary to herpes simplex virus type 1 encephalitis for which she had been hospitalized four months before. Treatment with intravitreal foscarnet and intravenous acyclovir was promptly commenced followed by the addition of oral prednisolone. PCR analysis of aqueous humor detected HSV type 1 DNA. The condition responded to therapy with partial resolution of intraocular inflammation and improvement of visual acuity, but the presence of Kyrieleis plaques was observed two weeks after the initiation of treatment, when five intravitreal foscarnet injections had been administered. The patient was switched to oral therapy with valacyclovir, and 10 weeks after commencing treatment, the patient’s left eye was free of inflammation, having achieved a BCVA of 20/20. Oral steroid treatment was gradually tapered off, and the patient was instructed to remain on prophylactic antiviral therapy. Kyrieleis arteriolitis is an uncommon finding in the context of acute retinal necrosis. As far as we are aware, we report the first case of Kyrieleis arteriolitis in acute retinal necrosis secondary to viral encephalitis and the second one presenting Kyrieleis plaques in acute retinal necrosis caused by herpes simplex virus type 1. Prior reports of cases of Kyrieleis arteriolitis in acute retinal necrosis are also presented.
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Affiliation(s)
- Olga E. Makri
- Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece; (O.E.M.); (I.K.T.); (K.K.); (V.K.)
| | - Iasonas K. Tsekouras
- Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece; (O.E.M.); (I.K.T.); (K.K.); (V.K.)
| | - Leonidia Leonidou
- Internal Medicine, Department of Internal Medicine, Patras University Hospital, 265 04 Patras, Greece;
| | - Konstantinos Kagkelaris
- Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece; (O.E.M.); (I.K.T.); (K.K.); (V.K.)
| | - Vassilios Kozobolis
- Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece; (O.E.M.); (I.K.T.); (K.K.); (V.K.)
| | - Constantinos D. Georgakopoulos
- Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, Greece; (O.E.M.); (I.K.T.); (K.K.); (V.K.)
- Correspondence:
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Christou EE, Stavrakas P, Kozobolis V, Katsanos A, Georgalas I, Stefaniotou M. Evaluation of the choriocapillaris after photodynamic therapy for chronic central serous chorioretinopathy. A review of optical coherence tomography angiography (OCT-A) studies. Graefes Arch Clin Exp Ophthalmol 2022; 260:1823-1835. [PMID: 35044503 DOI: 10.1007/s00417-022-05563-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/10/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Emerging evidence suggests that choroidal microcirculation and microstructural changes after verteporfin photodynamic therapy (vPDT) for chronic central serous chorioretinopathy (CSC) can be shown in detail using OCT-Angiography (OCT-A). The use of OCT-A for the examination of choriocapillaris (CC) has attracted significant attention as the technique offers potential explanations for the effects of vPDT on choroidal tissue. METHODS A meticulous literature search was performed in the PubMed database without restriction on year of publication until June 2021. The reference list of all electronically retrieved articles was carefully reviewed for potentially relevant articles that had not been identified. RESULTS We identified and reviewed 11 studies reporting a comprehensive update on microvasculature and morphologic changes of the CC layer as seen on OCT-A in chronic CSC. The reviewed articles extensively analyze both the qualitative and quantitative characteristics of the CC flow pattern after applying vPDT safety-enhanced protocols. The changes in the CC plexus indicate the potential of beneficial or deleterious treatment effect on choroidal tissue remodeling. The reviewed series have revealed variability of flow pattern, vessel density, and perfusion of the CC over time. CONCLUSION The CC plexus alterations during the post-vPDT period in chronic CSC may imply the treatment effect on choroidal tissue, indicating the potential of anatomical or functional recovery over time. The reviewed literature may confirm the diagnostic value of OCT-A in the assessment of the pathophysiology of eyes with CSC.
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Affiliation(s)
- Evita Evangelia Christou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece.
| | - Panagiotis Stavrakas
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupoli, Greece.,Eye Institute of Thrace, Democritus University of Thrace, Komotini, Greece
| | - Andreas Katsanos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece
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11
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Bolivar G, Sanchez-Barahona C, Ketabi S, Kozobolis V, Teus MA. Corneal Factors Associated with the Amount of Visual Field Damage in Eyes with Newly Diagnosed, Untreated, Open-angle Glaucoma. Ophthalmol Ther 2021; 10:669-676. [PMID: 34279846 PMCID: PMC8319248 DOI: 10.1007/s40123-021-00375-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the correlation between several ocular parameters (intraocular pressure [IOP], corneal biomechanical properties) and the visual field (VF) mean deviation (VF MD) in eyes with open-angle glaucoma (OAG). METHODS We conducted a cross-sectional, observational study in which we measured the IOP with Goldmann applanation tonometry, the central corneal thickness (CCT), and the corneal parameters obtained from the Ocular Response Analyzer® (ORA®) and the Corvis® ST non-contact tonometer, in newly diagnosed and treatment-naïve eyes with OAG, to investigate whether there was any correlation between these ocular parameters and the VF MD. RESULTS A total of 51 eyes were analyzed. A statistically significant correlation was found only between the VF MD and corneal hysteresis (CH) (P = 0.003, r2 = 0.16) and CCT (P = 0.03, r2 = 0.08). CONCLUSIONS These results demonstrate that CH and CCT are associated with the amount of VF damage in treatment-naïve OAG eyes.
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Affiliation(s)
- Gema Bolivar
- Department of Ophthalmology, University Hospital Principe de Asturias, Carretera Alcalá-Meco S/N, Alcalá de Henares, 28805, Madrid, Spain.
- Department of Ophthalmology, University of Alcalá, Alcalá de Henares, Spain.
| | | | - Samira Ketabi
- Department of Ophthalmology, University of Alcalá, Alcalá de Henares, Spain
- Department of Ophthalmology, University Hospital of Mostoles, Madrid, Spain
| | - Vassilios Kozobolis
- Department of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Miguel A Teus
- Department of Ophthalmology, University Hospital Principe de Asturias, Carretera Alcalá-Meco S/N, Alcalá de Henares, 28805, Madrid, Spain
- Department of Ophthalmology, University of Alcalá, Alcalá de Henares, Spain
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12
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Dalianis G, Trivli A, Limnopoulou A, Stavrakis A, Terzidou C, Detorakis ET, Kozobolis V, Labiris G. Association of obstructive sleep apnea/hypopnea syndrome with glaucomatous optic neuropathy and ocular blood flow. Exp Ther Med 2021; 21:657. [PMID: 33968187 PMCID: PMC8097189 DOI: 10.3892/etm.2021.10089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/16/2020] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to investigate the prevalence of glaucomatous optic neuropathy in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). In total, 83 subjects (45 cases of severe OSAHS and 38 controls) underwent polysomnographic assessment and were evaluated for the severity of the disease using the Apnea-Hypopnea index. A detailed ophthalmologic exam was then performed, including measurement of the intraocular pressure (IOP) with a Goldmann applanation tonometer and Pascal dynamic contour tonometer (DCT), recording of the ocular pulse amplitude measured by the Pascal DCT, standard automated perimetry and retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness evaluation using optical coherence tomography. Ocular blood flow was assessed using color Doppler imaging (CDI) and ophthalmic artery indices were evaluated, including peak systolic blood velocity, end diastolic blood velocity and resistivity index (RI). There was a significant difference in the mean IOP between controls (11.03±3.85 mmHg) and cases of severe OSAHS (18.06±3.39 mmHg) when the IOP was measured by DCT (P<0.0001), but not with the Goldmann applanation tonometer (IOP, 13.97±2.85 mmHg for controls and 14.89±3.21 mmHg for cases of severe OSAHS; P=0.0877). Significant negative correlations were observed between RNFL thickness and RI (P=0.0011) in cases of severe OSAHS, as well as between GCC thickness and RI (P<0.008) in all subjects. Furthermore, a negative correlation between RI and RNFL thickness in severe cases of OSAHS suggested a hemodynamically induced vulnerability of RNFL in OSAHS. The correlation between RI and GCC thickness in all subjects suggested that impaired perfusion, more prominent in OSAHS, leads to structural changes. Therefore, cases of severe OSAHS should be monitored for changes in RNFL and GCC thickness, as well as CDI findings. Furthermore, patients with increased ophthalmic artery RIs should be monitored for changes in the GCC, regardless of the etiology of the RI increase.
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Affiliation(s)
- Georgios Dalianis
- Department of Ophthalmology, Konstantopouleio-Patission General Hospital, Athens 14233, Greece
| | - Alexandra Trivli
- Department of Ophthalmology, Konstantopouleio-Patission General Hospital, Athens 14233, Greece
| | - Aliki Limnopoulou
- Department of Ophthalmology, Public Health Center, Athens 10679, Greece
| | - Andreas Stavrakis
- Department of Sleep Apnea, Konstantopouleio-Patission General Hospital, Athens 14233, Greece
| | - Chryssa Terzidou
- Department of Ophthalmology, Konstantopouleio-Patission General Hospital, Athens 14233, Greece
| | | | - Vassilios Kozobolis
- Eye Institute Thrace, Alexandroupolis 68131, Greece.,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
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13
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Sideroudi H, Labiris G, Giarmoulakis A, Bougatsou N, Mikropoulos D, Kozobolis V. Repeatability, reliability and reproducibility of posterior curvature and wavefront aberrations in keratoconic and cross‐linked corneas. Clin Exp Optom 2021; 96:547-56. [DOI: 10.1111/cxo.12044] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 12/14/2012] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Georgios Labiris
- Eye Institute of Thrace, Alexandroupolis, Greece,
- Department of Opthalmology, Democritus University of Thrace, Alexandroupolis, Greece,
| | | | | | | | - Vassilios Kozobolis
- Eye Institute of Thrace, Alexandroupolis, Greece,
- Department of Opthalmology, Democritus University of Thrace, Alexandroupolis, Greece,
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14
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Akritidou F, Praidou A, Papamitsou T, Kozobolis V, Labiris G. Ocular manifestations in patients with transfusion-dependent β-thalassemia. Hippokratia 2021; 25:79-82. [PMID: 35937508 PMCID: PMC9347341] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Ocular involvement in patients with transfusion-dependent β-thalassemia is quite common, and its frequency differs among studies. This case series aimed to describe the ocular abnormalities occurring in β-thalassemia patients who need regular blood transfusions and receive iron chelation therapy. CASE SERIES This is a case series prospectively studied 32 β-thalassemia patients from Northern Greece receiving regular blood transfusions and iron-chelating therapy. Patients' average age was 35.5 years. Eighteen patients with major phenotypes and fourteen patients with intermedia type underwent comprehensive ophthalmic examination at the time of enrolment, including visual acuity evaluation, refraction and color vision tests, Amsler grid test, slit-lamp, and dilated-pupil fundus examination. Additionally, we performed visual field testing and optical coherence tomography in all patients and fluorescein angiography only in selected cases. After six months, patients' complete ophthalmic examination was repeated for any new ocular findings due to the disease process and iron chelation therapy. Ocular involvement was detected in 46.87 % of the patients. Lesions were most frequently seen in elderly patients with thalassemia major. Lens opacities were present in 21.8 %, and degeneration of the retinal pigment epithelium was described in 15.6 % of the patients, representing the commonest fundus alteration observed, followed by fundus atrophy. The most severe and vision-threatening condition described in this study was the presence of angioid streaks with choroidal neovascularisation. Six months follow-up of patients did not reveal any new ocular findings. CONCLUSION Early detection of severe ocular abnormalities is important in patients with thalassemia; thus, an ophthalmologic examination should be included at regular check-ups. An annual examination is currently indicated for asymptomatic patients, while in symptomatic and complicated cases, patients should be closely followed-up. HIPPOKRATIA 2021, 25 (2):79-82.
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Affiliation(s)
- F Akritidou
- Department of Ophthalmology, General Hospital of Serres, Greece
| | - A Praidou
- Department of Ophthalmology, General Hospital of Thessaloniki "G.Gennimatas-O Agios Dimitrios", Thessaloniki, Greece
| | - T Papamitsou
- Department of Histology-Embryology, Aristotle University of Thessaloniki, Greece
| | - V Kozobolis
- Department of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece
| | - G Labiris
- Department of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece
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15
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Ragkousis A, Kozobolis V, Kabanarou S, Bontzos G, Mangouritsas G, Heliopoulos I, Chatziralli I. Vessel Density around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: An Optical Coherence Tomography Angiography Study. Semin Ophthalmol 2020; 35:316-323. [PMID: 33258720 DOI: 10.1080/08820538.2020.1845386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose: The purpose of this study was to investigate the changes of optical coherence tomography angiography (OCTA) parameters in diabetic retinopathy (DR) using an updated software with 3D projection artifact removal. Methods: In this cross-sectional observational study, 192 eyes of 111 patients with diabetes mellitus (DM) and 55 eyes of 34 age-matched healthy subjects were included. Diabetic patients were divided into three subgroups: without DR, with mild non-proliferative DR, and with moderate-to-severe non-proliferative DR. All eyes underwent dilated fundoscopy along with 3x3mm and 6x6mm OCTA image acquisition. Vessel density (VD), retinal thickness and foveal avascular zone (FAZ) parameters were analyzed. Correlation analyses between OCTA parameters and DR severity were also performed. Results: There was a statistically significant difference in all OCTA parameters among groups, except for superficial foveal VD in 6x6mm scan and whole image retinal thickness in both 3x3mm and 6x6mm scans, while 3x3mm scan parameters were found to be diagnostically superior to the corresponding ones of 6x6mm scan. As the DR stage progressed, the mean VD values decreased. FD-300, which is the VD of a 300-μm width annulus surrounding FAZ, demonstrated the strongest inverse correlation with DR severity (r = -0.590/rs = -0.562, p < .001) and showed the highest area under the ROC curve (AUROC = 0.833 ± 0.030, p < .001) in scan 3 × 3. Conclusion: OCTA shows progressive decrease of VD parameters with increasing DR severity. Foveal VD, FAZ area, and perimeter are not very useful indexes due to the high interindividual variability of FAZ size. OCTA and specifically FD-300 may serve as a promising DR screening tool for detecting preclinical microvascular alterations.
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Affiliation(s)
- Antonios Ragkousis
- Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece.,2nd Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace , Alexandroupolis, Greece
| | - Stamatina Kabanarou
- Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece
| | - Georgios Bontzos
- Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece
| | - George Mangouritsas
- Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece
| | - Ioannis Heliopoulos
- Department of Neurology, Democritus University of Thrace , Alexandroupolis, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
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16
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Chatziralli I, Karamaounas A, Dimitriou E, Kazantzis D, Theodossiadis G, Kozobolis V, Theodossiadis P. Peripapillary Retinal Nerve Fiber Layer Changes in Patients with Diabetes Mellitus: A Case-control Study. Semin Ophthalmol 2020; 35:257-260. [PMID: 32835571 DOI: 10.1080/08820538.2020.1810289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate peripapillary retinal nerve fiber layer (RNFL) changes in patients with diabetes mellitus (DM) and compare them with those of normal population. In addition, this study aims to determine potential factors, affecting RNFL changes in patients with DM. METHODS Participants in this study were 107 patients (211 eyes) with DM and 100 healthy controls (200 eyes). Diabetic patients were further classified into four groups depending on severity of diabetic retinopathy (no retinopathy, mild, moderate, severe nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy, while presence of macular edema was also assessed. All participants underwent spectral-domain optical coherence tomography (SD-OCT) to measure RNFL thickness, while demographic and clinical characteristics of the participants were also recorded. RESULTS Patients with DM with or without DR presented significantly decreased peripapillary RNFL thickness in all quadrants. In the diabetic group, the multivariate analysis showed a significant association between decreased average RNFL thickness and increased HbA1c (p < 0.001), longer DM duration (p = 0.007), and more severe diabetic retinopathy status (p = 0.016), while presence of DME, age, gender, hypertension, and hyperlipidemia were not found to be associated with RNFL thickness decrease. CONCLUSION Diabetes mellitus seems to affect RNFL thickness, suggesting that early neurodegenerative changes may occur, potentially before microvascular alterations. Since duration of disease, DR severity, and HbA1c levels were associated with RNFL thinning, modifying glycemic control seems to be important to potentially prevent the development of DM complications.
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Affiliation(s)
- Irini Chatziralli
- 2 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - Aristotelis Karamaounas
- 1 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - Eleni Dimitriou
- 2 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - Dimitrios Kazantzis
- 2 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - George Theodossiadis
- 2 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece
| | - Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace , Alexandroupolis, Greece
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17
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Papadakou P, Chatziralli I, Papathanassiou M, Lambadiari V, Siganos CS, Theodossiadis P, Kozobolis V. The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study. Ophthalmic Res 2020; 63:550-554. [PMID: 32172250 DOI: 10.1159/000507197] [Citation(s) in RCA: 4] [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: 10/28/2019] [Accepted: 03/07/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. METHODS Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. RESULTS Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm2, respectively; p < 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (p < 0.001), longer DM duration (p = 0.003), and more severe diabetic retinopathy status (p = 0.008). CONCLUSION DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.
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Affiliation(s)
- Panagiota Papadakou
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece,
| | | | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
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18
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Bontzos G, Moysaki N, Tsatsos M, Kozobolis V, Detorakis ET. Preliminary results of a semi-automated platform for pixel-based quantification of choroidal naevus progression. Can J Ophthalmol 2019; 54:601-605. [PMID: 31564351 DOI: 10.1016/j.jcjo.2018.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate a novel method for choroidal naevus progression monitoring using semiautomated software for pixel-based quantification. METHODS Retrospective analysis of patients with choroidal melanotic lesions. In total, 87 eyes fulfilled our inclusion criteria. The progression of the choroidal lesions was evaluated by 2 masked and independent investigators. Total naevus area was measured on fundoscopic images using ImageJ semiautomated segmentation at baseline examination and 5 years later. The efficacy of our method was also tested on a separate patient group applying test-retest analysis. RESULTS Pixel-based analysis for objective quantification, displayed high repeatability, and reliability. We identified 4 cases of naevus size progression using the described semiautomated technique, while only 2 cases of progression were reported by simple observation. The novel method performance displayed 50% increased sensitivity over simple observation and 100% specificity. CONCLUSIONS The presented method of displayed higher sensitivity and specificity compared to conventional observation and photograph qualification. Our results imply that the proposed methodology may be applicable as an accurate, easily employed diagnostic tool for the early detection of size progression in melanotic choroidal lesions.
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Affiliation(s)
- Georgios Bontzos
- Eye Clinic of the University General Hospital of Heraklion, Crete, Greece.
| | - Nektaria Moysaki
- Eye Clinic of the University General Hospital of Heraklion, Crete, Greece; Eye Clinic of the University Hospital of Alexandroupolis, Dragana, Greece
| | - Michael Tsatsos
- Royal Eye Infirmary, Dorset County Hospital NHS Foundation Trust, Dorchester, U.K; Southampton University Hospitals NHS Foundation Trust, Southampton, U.K
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19
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Abstract
PURPOSE To evaluate the outcomes of a new antiglaucoma surgical method, a modification of the standard deep sclerectomy, the penetrating deep sclerectomy. PARTICIPANTS Patients with medically uncontrolled primary open-angle glaucoma or pseudoexfoliative glaucoma were prospectively, in a consecutive way, enrolled in this study. METHODS The study was conducted in Glaucoma Unit, Department of Ophthalmology, University of Hospital of Alexandroupolis, Greece, in 29 eyes of 29 patients. In a fornix-based surgical procedure, all eyes underwent the proposed penetrating deep sclerectomy (deep sclerectomy plus trabeculectomy) with the use of mitomycin C applied intraoperatively (0.2 mg/mL for 2 min). The follow-up period was 3 years. Ocular examination was conducted before the operation and at 1, 3, 6, 12, 18, 24, and 36 months postoperatively. RESULTS The average reduction in intraocular pressure at the end of follow-up was 11.24 (57.88%). The complete success rate (intraocular pressure ⩽21 mm Hg without medication) after 3 years was 58.6%. The qualified success rate (intraocular pressure ⩽21 mm Hg without or with medication) was 75.86%. Postoperatively, the mean number of medication dropped from 3.75 ± 0.89 to 0.89 ± 0.98. Low postoperative complications were recorded. CONCLUSION During the 3-year follow-up period, penetrating deep sclerectomy presented very positive outcome. The addition of a controlled perforation of the trabeculo-Descemet's membrane in deep sclerectomy, playing the role of an early goniopuncture, seems to ensure a satisfactory outcome and is not associated with additional complications.
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Affiliation(s)
- Vassilios Kozobolis
- Eye Clinic, University Hospital of Evros, Alexandroupolis, Greece.,Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | - Eleni Kalogianni
- Eye Clinic, University Hospital of Evros, Alexandroupolis, Greece.,Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | - Haris Sideroudi
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
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20
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Kozobolis V, Konstantinidis A, Sideroudi H, Teus M. Efficacy of the travoprost/timolol fixed combination versus the concomitant use of travoprost 0.004% and timolol 0.1% gel formulation. Clin Ophthalmol 2018; 12:2393-2398. [PMID: 30538422 PMCID: PMC6260185 DOI: 10.2147/opth.s172822] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the hypotensive effect of travoprost 0.004%/timolol 0.5% fixed combination (TTFC) to the concomitant use of travoprost and timolol 0.1% gel formulation (Trav + Geltim). Materials and methods Thirty-three patients (62 eyes) were enrolled and divided into two groups. Patients in group 1 (31 eyes) received the TTFC and patients in group 2 (31 eyes) received the concomitant treatment with Trav + Geltim. Patients on previous antiglaucoma treatment discontinued their drops for 2–4 weeks before starting their new treatment (TTFC or Trav + Geltim). The drops were instilled in the evening in group 1 and in group 2, the prostaglandin was installed in the evening, and timolol in the morning. IOP was measured at 1 and 3 months after the initiation of treatment at four time points during the day (09:00, 12:00, 15:00, and 18:00). Results Both groups showed significant IOP reduction from baseline at all time points at 1 and 3 months. When the two groups were compared, group 2 showed slightly better hypotensive effect that reached statistical significance only at the 18:00 time point at both 1 and 3 months. Conclusion Both the TTFC and the concomitant use of the travoprost/timolol gel showed similar hypotensive effect with the latter being slightly more potent in reducing the IOP.
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Affiliation(s)
- Vassilios Kozobolis
- Department of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece, .,Eye Institute of Thrace (EIT), Democritus University of Thrace, Alexandroupolis, Greece,
| | - Aristeidis Konstantinidis
- Department of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece, .,Eye Institute of Thrace (EIT), Democritus University of Thrace, Alexandroupolis, Greece,
| | - Haris Sideroudi
- Eye Institute of Thrace (EIT), Democritus University of Thrace, Alexandroupolis, Greece,
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21
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Sideroudi H, Labiris G, Georgantzoglou K, Ntonti P, Siganos C, Kozobolis V. Fourier analysis algorithm for the posterior corneal keratometric data: clinical usefulness in keratoconus. Ophthalmic Physiol Opt 2017; 37:460-466. [DOI: 10.1111/opo.12386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/01/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Haris Sideroudi
- Department of Ophthalmology; Medical School; Democritus University; Greece
- Eye Institute of Thrace; Alexandroupolis Greece
| | - Georgios Labiris
- Department of Ophthalmology; Medical School; Democritus University; Greece
- Eye Institute of Thrace; Alexandroupolis Greece
| | | | - Panagiota Ntonti
- Department of Ophthalmology; Medical School; Democritus University; Greece
| | - Charalambos Siganos
- Laboratory of Vision and Optics, School of Medicine; University of Crete; Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology; Medical School; Democritus University; Greece
- Eye Institute of Thrace; Alexandroupolis Greece
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Sideroudi H, Labiris G, Ditzel F, Tsaragli E, Georgatzoglou K, Siganos H, Kozobolis V. Validation of Fourier analysis of videokeratographic data. Int Ophthalmol 2017; 38:1433-1440. [PMID: 28620708 DOI: 10.1007/s10792-017-0602-7] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim was to assess the repeatability of Fourier transfom analysis of videokeratographic data using Pentacam in normal (CG), keratoconic (KC) and post-CXL (CXL) corneas. METHODS This was a prospective, clinic-based, observational study. One randomly selected eye from all study participants was included in the analysis: 62 normal eyes (CG group), 33 keratoconus eyes (KC group), while 34 eyes, which had already received CXL treatment, formed the CXL group. Fourier analysis of keratometric data were obtained using Pentacam, by two different operators within each of two sessions. Precision, repeatability and Intraclass Correlation Coefficient (ICC), were calculated for evaluating intrassesion and intersession repeatability for the following parameters: Spherical Component (SphRmin, SphEcc), Maximum Decentration (Max Dec), Regular Astigmatism, and Irregularitiy (Irr). Bland-Altman analysis was used for assessing interobserver repeatability. RESULTS All parameters were presented to be repeatable, reliable and reproductible in all groups. Best intrasession and intersession repeatability and reliability were detected for parameters SphRmin, SphEcc and Max Dec parameters for both operators using ICC (intrasession: ICC > 98%, intersession: ICC > 94.7%) and within subject standard deviation. Best precision and lowest range of agreement was found for the SphRmin parameter (CG: 0.05, KC: 0.16, and CXL: 0.2) in all groups, while the lowest repeatability, reliability and reproducibility was detected for the Irr parameter. CONCLUSIONS The Pentacam system provides accurate measurements of Fourier tranform keratometric data. A single Pentacam scan will be sufficient for most clinical applications.
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Affiliation(s)
- Haris Sideroudi
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece. .,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
| | - Georgios Labiris
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Fienke Ditzel
- Medical Center, Universtity of Groningen (RuG), Groningen, The Netherlands
| | - Efi Tsaragli
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | | | | | - Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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Kozobolis V, Gkika M, Sideroudi H, Tsaragli E, Lydataki S, Naoumidi I, Giatromanolaki A, Mikropoulos D, Teus M, Labiris G. Effect of Riboflavin/UVA Collagen Cross-linking on Central Cornea, Limbus and Intraocular Pressure. Experimental Study in Rabbit Eyes. Acta Medica (Hradec Kralove) 2017; 59:91-96. [PMID: 27770837 DOI: 10.14712/18059694.2016.96] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Purpose of present study was to investigate the effect of riboflavin/ultraviolet-A-induced collagen cross-linking (CXL) on central cornea, limbus and intraocular pressure (IOP). This was an animal experimental study. The right corneas of 10 rabbits were ultraviolet-A irradiated (3 mW/cm2 for 30 minutes) after de-epithelialization and instillation of 0.1% riboflavin / 20% Dextran drops. Left corneas served as controls. Samples were examined histologically one month postoperatively. Before and after treatment, IOP measurements were recorded bilaterally. At central cornea of eyes underwent CXL keratocyte repopulation, normal arrangement of collagen fibres and a statistically significant change in fibres diameter were detected, compared to controls. At limbus area, there were not any significant histological differences after CXL. There was no statistically significant difference between pre- and postoperative IOP in all eyes.
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Affiliation(s)
- Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Gkika
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | - Haris Sideroudi
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Efthymia Tsaragli
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stylliani Lydataki
- Institut Carnot de Bourgogne, University of Burgundy, Bourgogne, France.,Institute of Vision and Optics, University of Crete, Heraklion, Greece
| | - Irini Naoumidi
- Institute of Vision and Optics, University of Crete, Heraklion, Greece
| | | | - Dimitrios Mikropoulos
- 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Georgios Labiris
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
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Labiris G, Ntonti P, Sideroudi H, Kozobolis V. Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study. Eye Vis (Lond) 2017; 4:13. [PMID: 28497070 PMCID: PMC5424421 DOI: 10.1186/s40662-017-0079-5] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/01/2017] [Indexed: 11/25/2022]
Abstract
Background Universal postoperative guidelines for cataract extraction surgery are yet to be introduced. Artificial tears are gaining popularity as an additional integral component of the postoperative regime. The primary objective of this study was to explore the impact of two prevalent artificial tear preparations on postoperative discomfort following cataract extraction surgery. Methods A total of 180 patients that underwent cataract extraction surgery were randomly divided into three groups according to their postoperative regime: a) Study group 1 (SG1) received a fixed combination of tobramycin and dexamethasone (FCTD) quid for 3 weeks and, additionally polyethylene glycol 400/propylene glycol/hydroxypropyl-guar quid, for 6 weeks, b) Study group 2 (SG2) received FCTD quid for 3 weeks and, additionally 0.1% sodium hyaluronate provided in the COMOD® device quid, for 6 weeks, and, c) Control Group (CG) received only FCTD quid for 3 weeks. The following indexes were evaluated at three postoperative checkpoints: 1) Subjective discomfort index (SDI) derived from four direct 10-scale Likert-type questions that were addressed to the patient and pertained to: a) foreign body sensation (FBS), b) blinking discomfort (BD), c) stinging sensation (SS), d) tearing sensation (TS), 2) Tear break-up time (TBUT), 3) Central corneal thickness (CCT) and, 4) Central Corneal Sensitivity (CCS). Results Both groups showed increased CCT values at the first examination point and reduced CCS values at all examination points. Furthermore, both SGs had better TBUT times at all examination points compared to CG (CG: 8.86 ± 1.08, SG1: 9.59 ± 1.45, CG2: 9.45 ± 1.33, p < 0.05). BD was significantly better in both SGs only at the 1st week of examination, while SDI values were better until the 3rd week and only borderline better at 6th week. Lastly, no significant differences were detected between SGs, regarding all parameters, at all examination points. Conclusion Polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate provided in the COMOD® device seem to be equally efficient in alleviating OSD symptoms following cataract extraction surgery and any of them should be routinely added to the postoperative regime. Trial registration ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02558218NCT02558218 Electronic supplementary material The online version of this article (doi:10.1186/s40662-017-0079-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece.,Eye Institute of Thrace, Alexandroupolis, Greece
| | - Panagiota Ntonti
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece
| | | | - Vassilios Kozobolis
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece.,Eye Institute of Thrace, Alexandroupolis, Greece
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Sideroudi H, Labiris G, Georgatzoglou K, Ditzel F, Siganos C, Kozobolis V. Fourier analysis of videokeratography data: Clinical usefulness in grade I and subclinical keratoconus. J Cataract Refract Surg 2016; 42:731-7. [DOI: 10.1016/j.jcrs.2016.01.049] [Citation(s) in RCA: 9] [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: 12/08/2015] [Revised: 01/20/2016] [Accepted: 01/23/2016] [Indexed: 11/25/2022]
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Konstantinidis A, Panos GD, Triantafylla M, Labiris G, Tsaragli E, Gatzioufas Z, Kozobolis V. Imaging of filtering blebs after implantation of the Ex-PRESS shunt with the use of the Visante optical coherence tomography. Int J Ophthalmol 2015; 8:492-5. [PMID: 26085996 DOI: 10.3980/j.issn.2222-3959.2015.03.10] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/08/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To analyze the features of the filtering blebs following implantation of the Ex-PRESS glaucoma device (model P-50) with the aid of the Visante anterior segment optical coherence tomography (AS-OCT). METHODS Five patients with open angle glaucomas were included in the study. They all underwent implantation of the Ex-PRESS device under a scleral flap. The surgical procedure was augmented with the use of mitomycin C subconjunctivally. The filtering blebs were analyzed with the Visante AS-OCT with the scans taken along the axis of the implantation of the glaucoma device. RESULTS All filtering blebs were graded as diffuse functioning. The morphological characteristics of the blebs were similar to those of the trabeculectomy. However the use of the Ex-PRESS implant tend to form a characteristic episcleral lake at the site of the plate of the implant. CONCLUSION The use of the Ex-PRESS implant produces filtering blebs similar to those of the trabeculectomy with the formation of a characteristic episcleral lake at the site of the plate of the implant.
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Affiliation(s)
- Aristeidis Konstantinidis
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece
| | - Georgios D Panos
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece ; Department of Ophthtalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, CH 1211, Geneva 14, Switzerland
| | - Magdalini Triantafylla
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece
| | - Georgios Labiris
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece
| | - Efthimia Tsaragli
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece
| | - Zisis Gatzioufas
- Department of Ophthtalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, CH 1211, Geneva 14, Switzerland
| | - Vassilios Kozobolis
- Department of Ophthtalmology, University Hospital of Alexandroupolis & Eye Institute of Thrace, Dragana 68100, Alexandroupolis, Greece
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Triantafylla M, Massa HF, Dardabounis D, Gatzioufas Z, Kozobolis V, Ioannakis K, Perente I, Panos GD. Ranibizumab for the treatment of degenerative ocular conditions. Clin Ophthalmol 2014; 8:1187-98. [PMID: 25028531 PMCID: PMC4077856 DOI: 10.2147/opth.s40350] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF) drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions.
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Affiliation(s)
- Magdalini Triantafylla
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece
| | - Horace F Massa
- Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland
| | - Doukas Dardabounis
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece
| | - Zisis Gatzioufas
- Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland
| | - Vassilios Kozobolis
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Ioannakis
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece
| | - Irfan Perente
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece ; Beyoglou Eye Research and Teaching Hospital, Istanbul University, Istanbul, Turkey
| | - Georgios D Panos
- Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece ; Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland
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Sideroudi H, Labiris G, Soto-Beobide A, Voyiatzis G, Chrissanthopoulos A, Kozobolis V. The effect of collagen cross-linking procedure on the material of intracorneal ring segments. Curr Eye Res 2014; 40:592-7. [PMID: 25025990 DOI: 10.3109/02713683.2014.941071] [Citation(s) in RCA: 5] [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] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the potential impact of corneal crosslinking treatment (365 nm ultraviolet (UV)A irradiation with riboflavin) on the material properties of Intracorneal Rings Segments (ICRS). MATERIALS AND METHODS Material properties were studied using FT-IR spectroscopy and UV-Vis spectroscopy. Rings were examined: (1) after installation of riboflavin solution, (2) after irradiation with UV-A light and (3) after instillation of riboflavin solution followed by instillation and coeval irradiation. The experiments followed the standard corneal cross-linking (CXL) protocol of corneal crosslinking treatment. RESULTS After instillation of riboflavin solution, a permanent intense yellow staining of the samples was observed. UV-Vis spectroscopy confirmed that a certain amount of riboflavin solution was absorbed into the samples after CXL procedure. FT-IR spectroscopic analysis showed alterations in the spectra of ICRS mainly at the 2800-3200 cm(-1) spectral region [modification in band intensities of CH(2) (2925 cm(-1)) and CH(3) (2950 cm(-1))]. CONCLUSIONS Our results suggest crosslinking reaction in ICRS material. This should be taken into consideration prior to any CXL treatment of post ICRS-implanted cornea.
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Affiliation(s)
- Haris Sideroudi
- Eye Institute of Thrace, Democritus University , Alexandroupolis , Greece and
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Labiris G, Vamvakerou V, Tsolakaki O, Giarmoukakis A, Sideroudi H, Kozobolis V. Perceptions of Greek medical students regarding medical profession and the specialty selection process during the economic crisis years. Health Policy 2014; 117:203-9. [PMID: 24862377 DOI: 10.1016/j.healthpol.2014.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 04/03/2014] [Accepted: 04/14/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess the beliefs and preferences of 6th year Greek medical students, regarding medical profession and the specialty selection process, in the years of financial crisis. SETTING Democritus University of Thrace, Medical School, Alexandroupolis, Greece. MATERIAL AND METHODS A custom questionnaire based on former similar studies was developed and administered to senior medical students. Further to demographics, the questionnaire gathered information on perceptions and trends regarding medical profession, the specialty and residency selection processes. Total question scores were summed for comparisons among questions. Mean scores and standard deviations were calculated for comparisons between student groups. RESULTS 111 students responded successfully to the instrument. "Helping patients" and the "scientific basis of medicine" were the fundamental reasons for choosing the medical profession. Compared to women, male students placed greater importance on the "financial allowances" (men: 3.73±1.03, women: 3.05±1.30, p=0.01). Regarding the selection criteria for a certain specialty, "challenging specialty" and "bedside specialty", were the main influence factors. Men more strongly preferred a specialty that could "financially support their desired lifestyle" (men: 3.93±0.88, women: 3.41±1.30, p=0.02). Concerning selection criteria of a residency program, students chose a "well structured" program at a "recognized hospital/department". Regarding the country of preference for their residency, 86% planned to continue abroad, primarily in Germany and the United Kingdom. CONCLUSION Greek medical students perceive the medical profession and the specialty process in a similar way like their colleagues form Western countries. However, the vast majority identify that migration to another country is the most promising alternative choice for their medical career.
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Affiliation(s)
- Georgios Labiris
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
| | | | - Olympia Tsolakaki
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Haris Sideroudi
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Labiris G, Giarmoukakis A, Sideroudi H, Song X, Kozobolis V, Seitz B, Gatzioufas Z. Diagnostic capacity of biomechanical indices from a dynamic bidirectional applanation device in pellucid marginal degeneration. J Cataract Refract Surg 2014; 40:1006-12. [PMID: 24774010 DOI: 10.1016/j.jcrs.2014.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/06/2014] [Accepted: 03/07/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the diagnostic capacity of the keratoconus match index (KMI) and keratoconus match probability (KMP) classification from a dynamic bidirectional applanation device (Ocular Response Analyzer) in eyes with pellucid marginal degeneration (PMD). SETTING Department of Ophthalmology, University Clinics Saarland, Homburg, Germany. DESIGN Cross-sectional study. METHODS Pellucid marginal degeneration eligibility was confirmed by inferior peripheral thinning, corneal protrusion, and irregular astigmatism. The KMI and KMP parameters in PMD eyes (study group) were compared with those in normal eyes (control group). The KMI's overall predictive accuracy was assessed operating characteristic (ROC) curves. The relationship between KMI and corneal hysteresis (CH), the corneal resistance factor (CRF), and a series of Scheimpflug camera indices was evaluated with Spearman analysis (r). RESULTS The mean KMI in the study group (40 eyes) and control group (40 eyes) was 0.34 ± 0.43 (SD) and 0.95 ± 0.30, respectively (P<.001). The KMI correlated significantly with the CH, CRF, and most Scheimpflug camera indices. Regression analysis indicated that the index of height decentration (r = -0.877, P<.001) was the primary determinant of the KMI. Moreover, the KMP index identified 50.0%, 29.16%, and 20.83% of PMD eyes as ectatic, suspect for ectasia, and normal, respectively. The ROC curve analysis of the KMI parameter indicated a predictive accuracy of 94.8% (cutoff point 0.626; sensitivity 85.71%; specificity 90.1%). CONCLUSIONS The KMI seems to be a promising diagnostic index for PMD. In contrast, the KMP index identified a significant percentage of topographically defined PMD eyes as normal, limiting its diagnostic value in PMD. FINANCIAL DISCLOSURES No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Georgios Labiris
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece.
| | - Athanassios Giarmoukakis
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
| | - Haris Sideroudi
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
| | - Xuefei Song
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
| | - Vassilios Kozobolis
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
| | - Berthold Seitz
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
| | - Zisis Gatzioufas
- From the Department of Ophthalmology (Labiris, Song, Seitz, Gatzioufas), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis,), Alexandroupolis, Greece
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Labiris G, Giarmoukakis A, Gatzioufas Z, Sideroudi H, Kozobolis V, Seitz B. Diagnostic capacity of the keratoconus match index and keratoconus match probability in subclinical keratoconus. J Cataract Refract Surg 2014; 40:999-1005. [PMID: 24713585 DOI: 10.1016/j.jcrs.2013.08.064] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the diagnostic capacity of the Ocular Response Analyzer's keratoconus match index (KMI) and keratoconus match probability (KMP) classification in keratoconus-suspect eyes. SETTING Department of Ophthalmology, University Clinics Saarland, Homburg, Germany. DESIGN Comparative case series. METHODS The KMI and KMP parameters in keratoconus-suspect eyes and normal eyes (control group) were compared. The quantitative keratoconus percentage index was calculated for all suspect eyes. According to the thinnest corneal thickness (TCT), keratoconus-suspect eyes were divided into 2 subgroups: subgroup 1 (TCT <520 μm) and subgroup 2 (TCT >520 μm). The KMI's overall predictive accuracy was assessed using receiver operating characteristic (ROC) curves. The relationship between KMI and a series of Scheimpflug-derived keratoconus-related indices was evaluated using Spearman analysis. RESULTS The mean KMI was 0.41 ± 0.29 (SD) in the keratoconus-suspect group (50 eyes) and 0.94 ± 0.29 in the control group (50 eyes) (P<.001). Nonsignificant KMI differences were detected between the keratoconus-suspect subgroups (subgroup 1, 27 eyes; subgroup 2, 23 eyes) (P=.059). Nonsignificant correlations were found between Scheimpflug indices and the KMI. The KMP identified 27.65% of control eyes as keratoconus suspect and 10.71%, 28.57%, and 3.57% of keratoconus-suspect eyes as being normal, having mild keratoconus, or having moderate keratoconus, respectively. The ROC analysis for the KMI indicated a predictive accuracy of 94% (cutoff point 0.72). CONCLUSIONS The KMI seems to be a valuable index in the early diagnosis of keratoconus-suspect eyes. The KMP identified a significant percentage of topographically defined keratoconus-suspect eyes as normal or keratoconic. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Georgios Labiris
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece.
| | - Athanassios Giarmoukakis
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece
| | - Zisis Gatzioufas
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece
| | - Haris Sideroudi
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece
| | - Vassilios Kozobolis
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece
| | - Berthold Seitz
- From the Department of Ophthalmology (Labiris, Gatzioufas, Seitz), University Medical Center of Saarland UKS, Homburg/Saar, Germany; the Eye Institute of Thrace (Labiris, Giarmoukakis, Sideroudi, Kozobolis), Alexandroupolis, Greece
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Labiris G, Gatzioufas Z, Sideroudi H, Giarmoukakis A, Kozobolis V, Seitz B. Biomechanical diagnosis of keratoconus: evaluation of the keratoconus match index and the keratoconus match probability. Acta Ophthalmol 2013; 91:e258-62. [PMID: 23557430 DOI: 10.1111/aos.12056] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 11/28/2022]
Abstract
PURPOSE To evaluate the diagnostic capacity of the Ocular Response Analyser's keratoconus match index (KMI) and keratoconus match probability (KMP) classification in a sample of keratoconus (KC) patients. METHODS Keratoconus match index and KMP from 114 KC eyes, randomly selected from 114 patients with bilateral keratoconus (KCG), were compared with the corresponding ones from 109 normal eyes (CG). Keratoconus match index's predictive accuracy was assessed by receiver operating curves (ROC). Keratoconus match probability level of agreement was evaluated at the different KC stages of the Amsler-Krumeich classification. Correlations were estimated with topographic keratoconus classification (TKC), keratoconus index (KI), index of surface variance (ISV), vertical asymmetry (IVA), height asymmetry (IHA), height decentration (IHD), minimal radius (Rmin), central corneal thickness (CCT), thinnest corneal thickness (TCT) mean keratometry (Km) and intraocular pressure (IOPg). RESULTS Mean KMI in KCG and CG was 0.20 ± 0.38 and 0.98 ± 0.25, respectively (p < 0.01). Significant KMI differences (p < 0.01) were detected in different KC groups [range: 0.62 ± 0.38 (KC 1), -0.62 ± 0.04 (KC 4)]. Significant correlation was detected between KC staging and KMI (r = -0.56, p < 0.0001). Keratoconus match probability identified 22.03% of the CG eyes as suspect. Moreover, KMP identified 7.01% and 23.68% of the KCG eyes as normal and suspect, respectively. Receiver operating curves analysis for KMI parameter indicated a predictive accuracy of 97.7% (cut-off point: 0.512, sensitivity: 91.18%, specificity: 94.34%). CONCLUSIONS Keratoconus match index seems to be a reliable index in keratoconus diagnosis and staging. Keratoconus match probability identifies a significant percentage of topographically defined KC and CG eyes as suspect. Diagnostic capacity of these novel indexes needs to be further explored.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Medical Center of Saarland UKS, Homburg/Saar, Germany.
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Panos GD, Konstantinidis A, Mendrinos E, Kozobolis V, Perente I, Gatzioufas Z. Effect of Tafluprost 0.0015% on Central Corneal Thickness in Patients With Primary Open-angle Glaucoma. Curr Eye Res 2013; 38:977-82. [DOI: 10.3109/02713683.2013.801495] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Panos GD, Kozobolis V, Ioannakis K, Gatzioufas Z. Giant iris cyst in an 11-year-old child. BMJ Case Rep 2013; 2013:bcr-2013-008941. [PMID: 23531936 DOI: 10.1136/bcr-2013-008941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Georgios D Panos
- Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland.
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Labiris G, Gatzioufas Z, Giarmoukakis A, Sideroudi H, Kozobolis V. Evaluation of the efficacy of the Allegretto Wave and the Wavefront-optimized ablation profile in non-anterior astigmatisms. Acta Ophthalmol 2012; 90:e442-6. [PMID: 22690672 DOI: 10.1111/j.1755-3768.2012.02463.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 12/01/2022]
Abstract
PURPOSE To assess the efficacy of the Allegretto Wave and the wavefront-optimized ablation profile (WFO) in non-anterior astigmatism correction, in both LASIK and photorefractive keratectomy (PRK) treatments. METHODS Seventy-four refractive surgery candidates were recruited prospectively in a non-randomized trial. Only one eye from each candidate was randomly enrolled in the study. Of them, 40 eyes underwent LASIK treatment (LG group), while 34 eyes underwent PRK treatment (PG group). Preoperatively, the ocular residual astigmatism (ORA) was calculated for each eye, according to which each astigmatism fault was characterized as primarily anterior or non-anterior. Twenty LG eyes and 16 PG eyes presented primarily anterior astigmatism (LG-A and PG-A subgroups, respectively), while 20 LG eyes and 18 PG eyes demonstrated primarily non-anterior astigmatism (LG-NA and PG-NA subgroups, respectively). Postoperatively, vector analysis of astigmatism correction was conducted. The following indexes were calculated: (i) correction index (CI), (ii) difference vector (DV) and (iii) index of success (IOS). RESULTS Preoperatively, mean differences between manifest and topographic astigmatisms for the LG and the PG subgroups were significant (p:0.006 and p<0.001, respectively), while postoperatively, aforementioned differences were non-significant (p:0.18 and p:0.09, respectively). Regarding vector analysis in the LG group, mean CI, IOS and DV were 1.39±1.26, 0.37±1.06 and 0.30±0.51, respectively. Differences in CI, IOS and DV between LG-A and LG-NA subgroups were non-significant. Regarding vector analysis in the PG group, mean CI, IOS and DV were 1.22±0.33, 0.47±0.46 and 0.27±0.25, respectively. Differences in CI, IOS and DV between PG-A and PG-NA subgroups were non-significant. CONCLUSIONS Our results suggest that the Allegretto Wave and WFO profile seem to be equally effective in both anterior and non-anterior astigmatism correction, regardless of treatment type.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
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Gkika M, Labiris G, Giarmoukakis A, Koutsogianni A, Kozobolis V. Evaluation of corneal hysteresis and corneal resistance factor after corneal cross-linking for keratoconus. Graefes Arch Clin Exp Ophthalmol 2011; 250:565-73. [DOI: 10.1007/s00417-011-1897-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 11/29/2011] [Accepted: 12/02/2011] [Indexed: 11/29/2022] Open
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Gkika M, Labiris G, Kozobolis V. Corneal collagen cross-linking using riboflavin and ultraviolet-A irradiation: a review of clinical and experimental studies. Int Ophthalmol 2011; 31:309-19. [PMID: 21847678 DOI: 10.1007/s10792-011-9460-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 07/08/2011] [Indexed: 11/28/2022]
Abstract
Corneal collagen cross-linking (CXL) using riboflavin and ultraviolet-A irradiation is a common method of tissue stabilization and has been developed primarily to address the need of treating keratoconus. CXL's promising results on keratoconus indicated that it might be effective in other corneal diseases as well. This new treatment promises a slowing effect on the progression of these diseases and its initial results show that it is safe and reasonably curative. The purpose of this review is to critically evaluate this treatment, to explore its benefits, to highlight its limitations in terms of efficacy and long-term safety and finally to identify areas for future research in this topic with a significant potential to change the way we treat our patients. In addition, in this unbiased review we try to bring together all the scientific information from both laboratory and clinical trials that have been conducted during recent years and to review the most recent publications regarding the therapeutic indications of CXL.
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Affiliation(s)
- Maria Gkika
- Eye Institute of Thrace and Department of Ophthalmology, Medical School of Democritus University of Thrace, Dragana, 68100, Alexandroupolis, Greece.
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Holló G, Thelen U, Teus MA, Quaranta L, Ferkova S, Babić N, Misiuk-Hojlo M, Mikropoulos DG, Kaluzny BJ, Kozobolis V, Januleviciene I, Kóthy P, Camara C, Russo A, Krzyzanowska-Berkowska P, Cieślińska I, Stewart JA, Kristoffersen MS, Nelson LA, Stewart WC. Long-term outcomes of prostaglandin analog versus timolol maleate in ocular hypertensive or primary open-angle glaucoma patients in Europe. J Ocul Pharmacol Ther 2011; 27:493-8. [PMID: 21790326 DOI: 10.1089/jop.2011.0051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To determine the direct costs of therapy over 5 years of a European monotherapy cohort begun on a prostaglandin (PTG) versus timolol in patients with primary open-angle glaucoma or ocular hypertension. METHODS A retrospective, multicenter, active-controlled, observational study. Data were abstracted for European patients treated as initial monotherapy in 1996 or afterward, with 5 years of available records. RESULTS This study included 271 patients (166 on a PTG and 105 on timolol at baseline). The average cost/month/patient over 5 years was $45.47±12.61 for PTG and $31.50±15.47 for timolol (P<0.001, based on German prices). After 5 years, although there was no difference in number of glaucoma medicines prescribed between groups (1.0 PTGs and 1.1 timolol, P=0.41), the timolol group demonstrated a higher intraocular pressure (17.7±2.9 vs. 16.5±3.0 mm Hg, P<0.001), more medication changes (P=0.01), greater incidence of glaucomatous progression (P=0.04), and less patients persistent on original monotherapy (P<0.001) than the PTG cohort. CONCLUSIONS Patients originally on timolol monotherapy have a lower cost of care over 5 years than those started on a PTG. However, timolol patients during follow-up may demonstrate a higher intraocular pressure, more progression, more medication changes, and lower persistency of the original monotherapy.
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Kozobolis V, Labiris G, Gkika M, Sideroudi H. Additional applications of corneal cross linking. Open Ophthalmol J 2011; 5:17-8. [PMID: 21448300 PMCID: PMC3065117 DOI: 10.2174/1874364101105010017] [Citation(s) in RCA: 7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/15/2010] [Accepted: 11/03/2010] [Indexed: 11/26/2022] Open
Abstract
Corneal collagen cross-linking (CxL) is a prevalent surgical method for the management of keratoconus. However, literature suggests that, further to keratoconus, CxL has a beneficial impact on a series of corneal related diseases and states. This article attempts to provide a contemporary review for all additional applications of CxL. Specifically, it outlines the most recent studies that demonstrate the beneficial impact of CxL for iatrogenic ectasias, pellucid marginal degeneration, infectious keratitis, bullous keratitopathy, and for ulcerative keratitis. The outcome of this review indicates that CxL could serve as a primary or adjuvant therapeutic modality for all aforementioned corneal-related pathologic states.
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Affiliation(s)
- Vassilios Kozobolis
- Eye Institute of Thrace (EIT), Democritus University, Alexandroupolis, Greece
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Gatzioufas Z, Charalambous P, Loew U, Kozobolis V, Schirra F, Krause M, Seitz B. Evidence of oxidative stress in Schnyder corneal dystrophy. Br J Ophthalmol 2010; 94:1262-4. [PMID: 20530186 DOI: 10.1136/bjo.2009.160366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Labiris G, Gkika M, Katsanos A, Fanariotis M, Alvanos E, Kozobolis V. Anterior chamber volume measurements with Visante optical coherence tomography and Pentacam: repeatability and level of agreement. Clin Exp Ophthalmol 2009; 37:772-4. [DOI: 10.1111/j.1442-9071.2009.02132.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kozobolis V, Aristeidou A, Gkika M, Koukoula S, Seitz B, Gatzioufas Z, Löw U. Evaluierung der Flapdicke bei dem Mikrokeratom Carriazo Pendular Head-130. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213620] [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: 10/20/2022]
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Kozobolis V, Aristeidou A, Gkika M, Koukoula S, Seitz B, Gatzioufas Z, Löw U. Evaluierung der Nervenfaserschichtdicke nach PRK und LASIK mittels Scanning Laser-Polarimetrie (GDX VCC). Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213674] [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: 10/20/2022]
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Gatzioufas Z, Löw U, Mauer B, Kozobolis V, Gkika M, Seitz B. Architektur der Vorderkammer und Augeninnendruck nach perforierender Keratoplastik bei Patienten mit Keratokonus. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213613] [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: 10/20/2022]
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Löw U, Jonescu-Cuypers C, Gatzioufas Z, Schnaidt A, Kozobolis V, Gkika M, Seitz B. Densiometrie der Linsenvorderflächen bei Patienten mit Pseudo-Exfoliations-Syndrom. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1213606] [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: 10/20/2022]
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Topouzis F, Melamed S, Danesh-Meyer H, Wells AP, Kozobolis V, Wieland H, Andrew R, Wells D. A 1-year study to compare the efficacy and safety of once-daily travoprost 0.004%/timolol 0.5% to once-daily latanoprost 0.005%/timolol 0.5% in patients with open-angle glaucoma or ocular hypertension. Eur J Ophthalmol 2007; 17:183-90. [PMID: 17415690 DOI: 10.1177/112067210701700206] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [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: 11/16/2022]
Abstract
PURPOSE The objective of the study was to compare the intraocular pressure (IOP)-lowering efficacy and safety of travoprost 0.004%/timolol 0.5% ophthalmic solution (Trav/Tim) to latanoprost 0.005%/timolol 0.5% ophthalmic solution (Lat/Tim), dosed once daily in the morning, in patients with open-angle glaucoma (OAG) or ocular hypertension (OH). METHODS This was a randomized, double-masked, multicenter, parallel group, active-controlled study conducted at 41 sites. At the eligibility visit the patients were randomized (1:1) to the assigned masked medication if they met inclusion/exclusion criteria, and the mean IOP values in the eligible eyes were > or =24 mmHg at 9 AM and > or =21 mmHg at 11 AM and 4 PM. Patients were excluded if the mean IOP in either eye was >36 mmHg. Patients were instructed to administer the assigned medication each morning at 9 AM. During the treatment phase of the study, IOP was measured at 9 AM at week 2, week 6, month 3, and month 9. At the month 6 and month 12 visits, IOP was measured at 9 AM, 11 AM, and 4 PM. Statistical methods included a repeated measures analysis of variance (ANOVA); to test for noninferiority, a 95% confidence interval for the treatment group difference was constructed based on the ANOVA results for each time point at month 12. RESULTS Patients (n=408) with OAG or OH were enrolled at 41 sites. One patient withdrew prior to receiving medication so 207 in the Trav/Tim group and 200 in the Lat/Tim group were evaluable for safety. Baseline demographic characteristics as well as IOP values showed no statistical differences between the two groups. Trav/Tim provided lower mean IOP values than Lat/Tim that were statistically significant at the week 2 9 AM (p=0.0081), month 6 9 AM (p=0.0056), and month 6 11 AM (p=0.0128) time points and at 9 AM time point pooled across all visits (p=0.0235) when mean IOP was 0.6 mmHg lower in the Trav/Tim group. Treatment-related adverse events were mild in both groups. Although hyperemia was reported from a higher percentage of patients in Trav/Tim group, differences in average hyperemia scores between the two groups were not considered clinically relevant. CONCLUSIONS Travoprost 0.004%/timolol 0.5% ophthalmic solution produced mean IOP levels that are statistically noninferior to latanoprost 0.005%/timolol 0.5% ophthalmic solution. Furthermore, at 9:00 AM, 24 hours after dosing, IOP was statistically lower for travoprost 0.004%/timolol 0.5% pooled across all visits. Travoprost 0.004%/timolol 0.5% fixed combination ophthalmic solution is an effective treatment for reducing IOP and it is safe and well-tolerated in patients with OAG or OH.
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Affiliation(s)
- F Topouzis
- II Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Periferiaki Odos Thessalonikis, Thessaloniki 56403, Greece.
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Katsimpris J, Siganos D, Konstas A, Kozobolis V, Georgiadis N. Efficacy of brimonidine 0.2% in controlling acute postoperative intraocular pressure elevation after phacoemulsification. Am J Ophthalmol 2004. [DOI: 10.1016/j.ajo.2004.04.043] [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: 11/28/2022]
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Katsimpris JM, Siganos D, Konstas AGP, Kozobolis V, Georgiadis N. Efficacy of brimonidine 0.2% in controlling acute postoperative intraocular pressure elevation after phacoemulsification. J Cataract Refract Surg 2003; 29:2288-94. [PMID: 14709288 DOI: 10.1016/j.jcrs.2003.08.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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: 10/26/2022]
Abstract
PURPOSE To determine the efficacy of brimonidine tartrate 0.2% drops given 2 times a day in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery. SETTING Department of Ophthalmology, General Hospital of Patras Agios Andreas, Patras, Greece. METHODS In this prospective double-blind placebo-controlled study, 1 eye of 40 consecutive normotensive cataract patients having small-incision cataract surgery was randomized into 1 of 2 treatment arms. Twenty patients received a placebo (artificial tears) and 20 patients received brimonidine tartrate 0.2% drops 2 times a day the day before and the day of surgery. Diurnal IOP variation was the primary efficacy variable; IOP was measured at baseline, before surgery, and 4, 6, 12, and 24 hours postoperatively. RESULTS The placebo group had higher IOPs at every time point after surgery. Peak elevation of IOP occurred 6 hours after surgery. The mean IOP in the placebo group (27.71 mm Hg +/- 3.75 [SD]) was statistically significantly higher than in the brimonidine group (21.45 +/- 1.32 mm Hg) (P<.001). A major IOP rise (>/=20 mm Hg above baseline IOP) occurred in 1 patient (5%) in the placebo group who required emergency hypotensive therapy. Twenty-four hours after surgery, 11 eyes (55%) in the brimonidine group and 4 eyes (20%) in the placebo group had an IOP lower than baseline. CONCLUSION Prophylactic treatment with brimonidine tartrate 0.2% 2 times a day for 2 days was effective in reducing IOP peaks throughout the first 24 hours after phacoemulsification surgery.
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Affiliation(s)
- John M Katsimpris
- Department of Ophthalmology, General Hospital Agios Andreas, Alexandroupoli, Greece.
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