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Biomedical subjects

G P Theodossiadis

Publications and source records attributed to G P Theodossiadis.

At least 19 recordsLinked to original sources
PubMed2003

A preliminary assessment of macular function by MF-ERG in myopic eyes with CNV with complete response to photodynamic therapy.

PURPOSE: To evaluate by multifocal electroretinogram (MF-ERG) macular function before and after photodynamic therapy (PDT) in myopic eyes with choroidal neovascularization (CNV). PATIENTS AND METHODS: Ten eyes with classic subfoveal CNV due to pathologic myopia were studied with MF-ERG before and after PDT in order to evaluate the results of PDT with verteporfin. The post-treatment follow-up was 6 months. Visual acuity testing, ophthalmic examinations, fluorescein and indocyanine green angiograms, and MF-ERG recordings were used to evaluate the results of PDT with verteporfin. The post-treatment period was 6 months. RESULTS: Before treatment, the electrical response densities in the foveal and perifoveal areas were apparently decreased in all patients. Six months after treatment, the mean retinal response densities in the same areas were found to be higher than before treatment. CONCLUSIONS: MF-ERG evaluates objectively the macular function in myopic eyes with CNV. After successful PDT, the electrical activity of the foveal and parafoveal areas is higher than before treatment. This finding postulates the efficacy of PDT in the treatment of CNV.

Adult↗
PubMed2002

Retinal hemorrhage after photodynamic therapy in patients with subfoveal choroidal neovascularization caused by age-related macular degeneration.

PURPOSE: To report the frequency and the evolution of the extensive retinal hemorrhages that can appear within 48 h after the application of photodynamic therapy. METHODS: Two hundred and fifteen individual eyes of 194 consecutive patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration who underwent photodynamic treatment were included in the study. The visual acuity was measured before and after treatment. Color and red-free photographs were taken. Fluorescein angiography and optical coherence tomography (OCT) were also performed in order to describe the macular hemorrhages. RESULTS: Four out of 215 eyes developed macular hemorrhage within 48 h after the photodynamic therapy. Before treatment one of the four patients had classic CNV, one predominantly classic and two patients occult CNV without any classic component. In all four cases, the hemorrhage after photodynamic therapy (PDT) was extensive, it extended beyond the arcades and it was not absorbed during the follow-up period, which ranged from 11 to 21 months. The greatest linear dimension of the hemorrhage was extremely high (>12,000 microm). CONCLUSION: Extensive macular hemorrhage was observed in 1.86% of the studied cases. The hemorrhage was not related to the type of the CNV lesion before treatment. The size and the appearance of hemorrhage within 48 h after treatment support the view that the hemorrhage is a direct consequence of the photodynamic therapy and not related to the natural course of the disease.

Aged↗
PubMed2001

Optical coherence tomography in optic disk pit maculopathy treated by the macular buckling procedure.

PURPOSE: To report optical coherence tomography in optic disk pit maculopathy treated with macular scleral buckling procedure. METHODS: Twenty six eyes (26 patients) with optic disk pit maculopathy were treated with macular buckling procedure and evaluated with optical coherence tomography. In group 1, five eyes were evaluated with optical coherence tomography before and after macular buckling procedure. In group 2, 21 eyes were evaluated with optical coherence tomography after macular buckling procedure. With optical coherence tomography, cross-sectional, horizontal retinal images were obtained through the fovea and optic disk pit. RESULTS: In group 1, four of five eyes showed absorption of intraretinal fluid 7 to 9 months after macular buckling procedure. After absorption of fluid, retinal thickness in the foveal center ranged from 128 to 178 microm. In one eye the channel from optic disk to fovea reopened and fluid reappeared. In group 2, 20 of 21 eyes showed absorption of intraretinal schisis and subretinal fluid after macular buckling procedure. After absorption of fluid, retinal thickness in the foveal center ranged from 119 to 216 microm. CONCLUSIONS: In optic disk pit maculopathy, optical coherence tomography enabled morphologic assessment of the retina before and after macular buckling procedure. In the successfully treated cases the permanent closure of the connection between the optic disk pit and the intraretinal schisis was demonstrated. Eventual disappearance of schisis and subretinal fluid was depicted. It was also proved that the thickness of the macula returned to normal and visual acuity improved.

Adolescent↗
PubMed2001

Hemostatic effects of SF6 after diabetic vitrectomy for vitreous hemorrhage.

PURPOSE: To investigate the hemostatic effects of SF6 gas in preventing postoperative vitreous hemorrhage in diabetic vitrectomy. METHODS: A prospective, randomized study of 33 diabetic eyes with vitreous hemorrhage, treated by vitrectomy. In 17 of our cases SF6 20% was injected into the eye at the end of the operation, while in 16 cases BSS remained in the vitreous cavity. RESULTS: The incidence of vitreous hemorrhage recurrence was 17.6% for the SF6 group and 12.5% for the BSS group (statistically not significant). Progression of lens opacities was observed in 23.5% of the SF6 group, and in 18.8% of the BSS group (statistically not significant, with a higher incidence in the SF6 group). CONCLUSIONS: SF6 gas did not show hemostatic effects in the cases studied. Furthermore, it may have contributed to cataract progression. Therefore we suggest that the use of SF6 is not recommended as a treatment modality in preventing new vitreous hemorrhage after diabetic vitrectomy.

Adult↗
PubMed2000

Combined clear cornea phacoemulsification and trabecular aspiration in the treatment of pseudoexfoliative glaucoma associated with cataract.

BACKGROUND: In the present prospective randomized study the effectiveness and safety of trabecular aspiration combined with clear cornea phacoemulsification (phaco) was compared to clear cornea phaco alone in patients with pseudoexfoliation (PEX) glaucoma and visually disabling cataract. METHODS: Twenty-seven patients suffering from visually significant cataract (visual acuity < 5 Snellen lines) and PEX glaucoma were randomly assigned to either phaco combined with trabecular aspiration (14 eyes of 14 patients) or phaco alone (13 eyes of 13 patients). Inclusion criteria for glaucoma were IOP < or = 22 mmHg under treatment with up to two antiglaucomatous agents, excluding pilocarpine 4%, and no previous surgery or laser trabeculoplasty treatment. Clear cornea phaco with foldable acrylic intraocular lens (IOL) implantation was carried out in all patients uneventfully. Trabecular aspiration was performed using a special probe in the inferior 180 deg of the angle after IOL implantation. RESULTS: Follow-up duration ranged from 12 to 18 months. In the combined procedure group there was a statistically significant decrease in postoperative IOP during the whole follow-up period (P < 0.01), while in 9 of the 14 patients the IOP was controlled without medications at the last examination. In the phaco alone group a statistically significant decrease in postoperative IOP was recorded at 9 and 12 months after surgery (P < 0.05), while in 4 of the 13 patients the IOP was controlled without medications at the last examination. Comparing the two groups, a statistically significantly lower number of medications was being used in the combined procedure group at the last recorded examination (P < 0.05). CONCLUSIONS: It seems that the combined clear cornea phaco and trabecular aspiration procedure in cases of PEX glaucoma associated with cataract is a safe and effective method. This technique controls IOP more effectively and with fewer postoperative medications than clear cornea phaco alone.

Aged↗
PubMed2000

Optical coherence tomography in the study of the Goldmann-Favre syndrome.

PURPOSE: To report a case of Goldmann-Favre syndrome with special emphasis on the optical coherence tomography findings. METHODS: In a 23-year-old white man with an 8-year history of visual impairment in both eyes and night blindness, vertical and horizontal optical coherence tomography images were obtained through the macula and through the retinoschisis located at the temporal side of the macula. RESULTS: Optical coherence tomography showed in the left eye a clear loss of the inner retinal layer at the fovea and the formation of inner and outer retinal layer holes in the temporally located retinoschisis. The outer retinal layer hole had rolled edges. CONCLUSION: In Goldmann-Favre syndrome, optical coherence tomography demonstrated confluent macular cystoid changes and retinoschisis in both eyes. In the left eye, a lamellar macular hole and retinoschisis with inner retinal layer and outer retinal layer holes were observed. The outer retinal layer hole had rolled edges.

Adult↗
PubMed2000

The macular buckling technique in the treatment of optic disk pit maculopathy.

In 1988 we introduced the macular buckling procedure for the treatment of optic disk pit maculopathy and we have been applying it since then. The surgery consists of a scleral sponge fixation of 7.5 x 5.5 mm at the posterior pole of the globe corresponding to the macula along the vertical axis of the 12 to 6 o'clock meridian. No additional treatment of any kind (laser, diathermy, or cryotherapy) is used. The correct positioning of the sponge during the surgery is monitored by B-scan ultrasonography. Within the first week after surgery, indocyanine green angiography (ICG) is used to evaluate the choroidal circulation. During the same period, magnetic resonance imaging (MRI) of the orbit is performed to determine the sponge position in relation to the optic nerve. We analyze the results of 23 eyes with optic disk pit maculopathy that underwent surgery with the macular buckling technique between November 1988 and December 1998. In 20 of them the macula and the surrounding area of the retina became completely flat. No recurrence was noted in the successfully treated patients in the follow-up period, which ranged from 9 months to 10 years. Visual acuity was improved by 1 to 7 Snellen lines in 18 of the 23 patients. An improvement in visual field indices was also recorded. The sponge positioning between the temporal part of the optic disk and the macula acts mechanically and seems to provide a barrier that prevents the flow of the fluid from the pit toward the macula.

Adolescent↗
PubMed1999

Cystoid macular edema in a patient with acquired immunodeficiency syndrome and past ocular history of cytomegalovirus retinitis after initiation of protease inhibitors.

PURPOSE: To describe a patient with acquired immunodeficiency syndrome (AIDS) who presented with cystoid macular edema (CME) which was not associated with active cytomegalovirus (CMV) retinitis or AIDS-related microvasculopathy. METHOD: A 32-year-old man with AIDS and a past ocular history of inactive CMV retinitis was placed on protease inhibitors when his CD4+ T lymphocyte counts dropped to 8 cells/mm3. Three months later, after his CD4+ T lymphocyte counts had increased to 196 cells/mm3 he complained of micropsia and metamorphopsia in his right eye of 1 week duration. The patient had a complete ocular examination including fluorescein angiography (FA). RESULTS: Visual acuity (VA) was 7/10 OD. Fundus examination revealed CME and inactive CMV retinitis, and FA demonstrated CME and a hot disc. Two transseptal injections of corticosteroids were administered 2 weeks apart in the right eye as treatment of the CME. The patient reported gradual visual improvement and 6 weeks later, his VA was 10/10(-2). CME had resolved clinically and angiographically. CONCLUSIONS: CME in our case is associated with inactive CMV retinitis and gradually increasing number of CD4+ T lymphocytes after initiation of treatment with protease inhibitors. It may be amenable to regional administration of corticosteroids without reactivation of retinitis.

AIDS-Related Opportunistic Infections↗
PubMed1999

Cyst formation in optic disc pit maculopathy.

PURPOSE: To evaluate the presence and the evolution of cyst formation in optic disc pit maculopathy. METHODS: In this prospective study, 18 cases with optic disc pit maculopathy were studied. Five of them showed cyst formation in the fovea at the initial examination. The fundus findings were documented with slit-lamp biomicroscopy, indirect ophthalmoscopy, and stereoscopic photography of the posterior pole. All 5 patients were treated with a macular scleral buckle procedure. RESULTS: The presence of cysts in the elevated macula depends on the grade of the disease. Cyst formation can develop not only in the later stage of the disease but also quite early. In all 5 patients cyst formation gradually decreased and finally disappeared after the surgical procedure. CONCLUSIONS: Cyst formation is an entity which accompanies the macular detachment associated with optic disc pit. The development of the cysts has been noticed after the establishment of the schisis-like separation and before or in conjunction with the formation of a lamellar macular hole which usually accompanies the optic disc pit maculopathy.

Adolescent↗
PubMed1999

Fluorescein and indocyanine green angiographic findings in congenital optic disk pit associated with macular detachment.

PURPOSE: To investigate the pattern of congenital optic disk pits associated with maculopathy using indocyanine green angiography (ICG) and fluorescein angiography (FA). METHODS: Seventeen consecutive patients with unilateral congenital optic disk pit complicated by maculopathy were prospectively enrolled in the study. Complete ophthalmologic examination, color stereophotography, red-free photography, FA, and ICG angiography were performed on all patients during their first examination in our department. RESULTS: Absolute hypofluorescence of the optic disk pit was noted in all eyes on ICG angiography. On the contrary, all eyes showed early hypofluorescence and late staining of the optic pit on FA. All 17 eyes presented a delineated late hyperfluorescence corresponding to the area of macular elevation on both ICG angiography and FA. The intensity of the hyperfluorescence was milder in cases with long-standing maculopathy. CONCLUSION: Imaging of congenital optic disk pits associated or not with macular elevation using ICG angiography has not been reported in the literature. The increased hyperfluorescence in the late phases of the macular elevation in the studied eyes could be attributed to leakage of indocyanine or fluorescein dye into the schisis cavity and the subretinal fluid.

Adolescent↗
PubMed1999

Visual field improvement after treatment of optic disk pit maculopathy with the macular buckling procedure.

PURPOSE: To evaluate visual field changes in 18 of 21 patients with unilateral optic disk pit maculopathy who were successfully treated with the macular buckling procedure. METHODS: In this prospective study, visual field examination with the Humphrey analyzer (programs 30-2 and 10-2) was recorded before treatment, repeated 1 month after the operation, and repeated every 6 months thereafter. All 18 patients were treated with the macular buckling procedure. The operation consisted of fixation of a silastic sponge explant at the posterior pole corresponding to the macula. RESULTS: In 18 eyes included in the study and successfully treated, an improvement in visual field indices was recorded. The mean deviation improved from -7.75+/-3.15 (program 30-2) and -10.19+/-3.66 (program 10-2) decibels before surgery to -6.25+/-2.61 (P<0.0001) and -8.56+/-3.13 (P<0.0001) decibels at the last examination, respectively. No additional visual field defect was induced in any of the 18 eyes after treatment. Also, the majority of the eyes (16/18) gained from 1 to 7 Snellen lines of visual acuity (P<0.0001). CONCLUSION: Improvement of central and peripheral visual field (within 30 degrees of fixation) was recorded after the treatment of optic disk pit maculopathy with the macular buckling procedure. This technique seems to be effective for treatment of the disease with good anatomic and functional results.

Adolescent↗
PubMed1997

Topical 2.0% dorzolamide vs oral acetazolamide for prevention of intraocular pressure rise after neodymium:YAG laser posterior capsulotomy.

OBJECTIVE: To compare the efficacy and safety of topical 2.0% dorzolamide hydrochloride with oral acetazolamide in preventing intraocular pressure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior capsulotomy. DESIGN: A prospective, randomized, double-masked, placebo-controlled study. PATIENTS: Two hundred ten patients undergoing Nd:YAG laser posterior capsulotomy. INTERVENTION: Pretreatment with dorzolamide, acetazolamide, or placebo. Dorzolamide administration as a single drop (1 drop approximately 20 microL) 1 hour before capsulotomy. Acetazolamide administration as a single dose of 125 mg orally 1 hour before capsulotomy. RESULTS: At first and third hour postoperatively, IOPs and IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the same time, IOPs and IOP changes from baseline were similar (P>.50) in the dorzolamide and acetazolamide groups. No patient treated with dorzolamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced IOP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients. CONCLUSION: Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 hour before Nd:YAG laser posterior capsulotomy, have comparable high efficacy and safety in preventing IOP elevation following this procedure.

Acetazolamide↗
PubMed1997

Ophthalmic dirofilariasis.

PURPOSE: To report a rare case of ophthalmic dirofilariasis in a 68-year-old man with sudden, intense pain and itching in the left eye. The nematode was located in the eye and recognized as Dirofilaria repens. METHODS: Slit-lamp examination disclosed a moving nematelminth under the bulbar conjunctiva of the left eye. The nematode was surgically removed. RESULTS: The nematelminth surgically removed from the subconjunctival space was identified as D repens on the basis of transverse sections and its macroscopic characteristics. CONCLUSION: It is important to identify the nematode as D repens, based on both its microscopic and macroscopic characteristics, to avoid treatment with anthelminthic agents. The surgical removal of the worm is the sole recommended treatment.

Aged↗
PubMed1996

Treatment of maculopathy associated with optic disk pit by sponge explant.

PURPOSE: To evaluate the anatomic and functional outcome in nine patients with optic disk pit maculopathy after the use of the macular buckling procedure. METHODS: In this prospective study, nine consecutive patients (five women and four men with a mean age of 28 years [range, 14 to 49 years] who had unilateral maculopathy associated with optic disk pit) were treated with macular buckling surgery. A scleral sponge of 7.5 x 5.5 mm was fixed at the posterior pole of the globe corresponding to the macula along the vertical axis of the 12-to-6 o'clock meridian. No additional treatment of any kind (laser, diathermy, or cryotherapy) was used. The correct positioning of the sponge during the operation was monitored by B-scan ultrasonography. Within the first week after surgery, indocyanine green angiography was performed to evaluate the choroidal circulation. During the same period, magnetic resonance imaging of the orbit was performed to determine the sponge position in relation to the optic nerve. RESULTS: In all nine eyes, complete disappearance of subretinal and intraretinal fluid in the macula and in the surrounding area was noted. The absorption of the macular fluid started immediately after the operation and was completed after five to six months. No further change of the appearance of the fundus was noted during the follow-up period, which ranged from 18 to 66 months (mean follow-up, 42 months). Six eyes gained four or five lines of visual acuity, and two eyes improved by three lines. CONCLUSIONS: The macular scleral buckling procedure in optic disk pit maculopathy can yield favorable anatomic and functional results.

Adolescent↗
PubMed1995

Coloboma of the optic disk associated with retinal vascular abnormalities.

PURPOSE: We studied a case of congenital optic disk pit and coloboma with associated malformations of the retinal vessels. METHODS: Slit-lamp biomicroscopy and fluorescein angiography were performed. RESULTS: Multiple retinal venous anastomoses associated with a congenital coloboma and pit of the optic disk were observed. The retinal vascular anomalies extended from the optic disk to the temporal periphery. CONCLUSIONS: We consider the coexistence of retinal venous anastomoses with optic disk coloboma and pit to be an extremely rare congenital retinal anomaly.

Abnormalities, Multiple↗
PubMed1994

The persistence of buckle height in relation to orientation of buckle fixation. An ultrasonographic study.

Forty phakic myopic eyes of 40 patients with rhegmatogenous retinal detachment were included in a prospective clinical trial designed to evaluate the changes in buckle height after retinal detachment surgery. The age of the patients ranged between 50 and 75 years. The eyes were divided into two groups (A and B) according to the orientation of sponge fixation. In group A (20 eyes) the sponge fixation was circumferential, while in group B (20 eyes) radial. A-scan ultrasonography was used for the measurements of buckle height 1, 3, 6, 12, and 18 months postoperatively. At all times of measurement, the buckle height presented a statistically significant difference between the patients of group A and B. More specifically, radial fixation produced a significantly lower scleral indentation compared with that produced by circumferential fixation. After a lapse of 18 months, the buckle height in group B retained 41% of its original value compared with that of group A which retained 66%.

Aged↗