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Biomedical subjects

G Theodossiadis

Publications and source records attributed to G Theodossiadis.

At least 19 recordsLinked to original sources
PubMed2004

Assessment of macular function by multifocal electroretinogram in age-related macular degeneration before and after photodynamic therapy.

PURPOSE: To evaluate macular function, before and after photodynamic therapy (PDT) using multifocal electroretinogram (MF-ERG), in eyes suffering from classic subfoveal choroidal neovascularization (CNV) resulting from age-related macular degeneration (ARMD). METHODS: Twenty eyes of 20 patients (10 male, 10 female) with classic subfoveal CNV resulting from ARMD were studied. All received PDT with verteporfin. Fluorescein angiography and mF-ERG were performed in each patient 1 day before and 1 week, 3 months and 6 months after photodynamic therapy. RESULTS: Before treatment, visual acuity (VA) and electrical retinal response densities (RRD) in the foveal and parafoveal areas were low in all patients. The mean VA (ETDRS chart) before PDT was 24.35 (SD, 15). The mean RRD before PDT in area 1 was 4.39 nV/deg(2) (SD, 2.59) and in area 2 it was 2.11 (SD, 1.86). Six months after treatment, the mean VA was stable in 70% of the patients. However, the mean RRD after PDT was 2.24 nV/deg(2) in area 1 (SD, 2.59) and 1.07 nV/deg(2) in area 2 (SD, 1.59). CONCLUSION: Multifocal ERG objectively evaluates the macular function in eyes with CNV attributable to ARMD. In this study, the stability of VA coincided with a clear impairment of electrical activity of the foveal and parafoveal areas. This finding suggests that MF-ERG should be adopted to assess the efficacy of PDT objectively in the treatment of ARMD.

Adult↗
PubMed2001

Topical versus sub-Tenon's anesthesia without sedation in cataract surgery.

PURPOSE: To compare pain control using topical anesthesia with that using sub-Tenon's anesthesia for clear corneal phacoemulsification cataract surgery and foldable intraocular lens (IOL) implantation. SETTING: Departments of Ophthalmology, General Hospital Asklepeion Voulas and General Hospital of Athens, University of Athens, Athens, Greece. METHODS: One hundred consecutive patients scheduled for bilateral cataract surgery 1 to 2 months apart were prospectively randomized to receive topical anesthesia (100 eyes) or sub-Tenon's anesthesia (100 eyes). The randomization was stratified so that one half of first-eye surgeries and one half of second-eye surgeries were assigned to each anesthesia group, with each patient receiving each type of anesthesia once. All patients had clear corneal phacoemulsification with foldable IOL implantation. Patients were asked to rate their pain level on a 10-point scale for 4 periods: during the administration of the anesthetic agent, during surgery, immediately after surgery, and 24 hours postoperatively. The surgeon recorded his subjective assessment of ease of surgery and surgical complications using a standardized template. RESULTS: Eighty-one percent of patients who received topical anesthesia and 8% of patients who received sub-Tenon's anesthesia reported no pain during delivery of the anesthetic agent. The mean pain score was 0.19 +/- 0.39 (SD) in the topical group and 1.35 +/- 0.63 in the sub-Tenon's group. The difference between groups was statistically significant (P <.001). Seventy-two percent of patients in the topical anesthesia group and 86% in the sub-Tenon's anesthesia group reported no pain or slight discomfort during surgery (mean score 1.13 +/- 1.57 and 0.57 +/- 1.28, respectively) (P <.001). Ninety percent of topical anesthesia patients and 100% of sub-Tenon's anesthesia patients reported no pain or slight discomfort 30 minutes postoperatively (mean score 0.80 +/- 0.93 and 0.12 +/- 036, respectively) (P <.001). All patients in the topical anesthesia group and 77% in the sub-Tenon's group reported no pain 24 hours postoperatively (mean pain 0.00 +/- 0.00 and 0.23 +/- 0.40, respectively) (P <.001). Complications including prolonged akinesia of the globe, chemosis, and conjunctival hemorrhage occurred significantly more frequently in the sub-Tenon's than in the topical group (P <.001). CONCLUSIONS: Patients having cataract surgery under topical anesthesia had more intraoperative and postoperative discomfort than patients receiving sub-Tenon's anesthesia. However, patients having topical anesthesia reported less pain during its administration and had fewer complications. Both anesthesia methods provided high levels of pain control without additional sedation.

Aged↗
PubMed2001

Multifocal ERG changes before and after macular hole surgery.

To evaluate the visual function of 15 eyes suffering from macular hole the multifocal ERG was used pre and postoperatively. In all the cases a successful vitrectomy has been done with macular hole closure in all the eyes. The Multifocal ERG shows an improvement of retinal response density in regions 1 and 2, even in the 2 eyes with unchanged visual acuity postoperatively. Although a relationship exist between the postoperative retinal response density and the visual acuity, the retinal response density varies between eyes with the same visual acuity.

Aged↗
PubMed2001

Assessment of macular function by multifocal electroretinogram before and after epimacular membrane surgery.

PURPOSE: To evaluate macular function before and after successful surgical peeling of idiopathic epimacular membranes by means of multifocal electroretinogram (ERG) and measuring the first order Kernel. METHODS: Multifocal ERG of 10 patients (10 eyes) with idiopathic epimacular membrane were recorded before and after successful macular peeling. The retinal response densities of areas 1 and 2 were compared pre- and postoperatively and the functional state of the retina beneath the epimacular membrane was evaluated. The postoperative period was 3-6 months. RESULTS: Preoperatively, the electrical retinal response densities in the foveal and the perifoveal area were apparently decreased. After a mean postoperative period of 3 months the electrical response densities of the above areas improved. This improvement continued 6 months after the operation. CONCLUSION: In idiopathic epimacular membranes, the decrease in retinal electrophysiologic response was not limited to the fovea but also involved the perifoveal area. The electrical retinal response density of these areas gradually improved after peeling of the epimacular membrane.

Aged↗
PubMed2001

[Ahmed valve in high-risk glaucoma surgery].

We used the Ahmed valve for the treatment of 142 eyes with high-risk glaucoma. The glaucoma was neovascular in 74 cases, aphakic or pseudophakic in 19 eyes and occurred after previous faliure of filtering surgery in 49 eyes. Preoperative mean IOP was 31.6+/-10.4 mmHg under topical and/or systemic treatment. The success rate (IOP<22 mmHg with only topical treatment) was 56.3% with a mean follow-up of 32.4 months. Complications were fewer and milder compared with those reported for other types of drainage implants and for other types of antiglaucoma procedures.

Aphakia↗
PubMed2000

Optic nerve coloboma with retinal degeneration associated with cystic microphthalmia of the other eye.

In a seventy-five-year old man an optic nerve coloboma with generalised retinal degeneration associated with a cystic microphthalmia of the other eye is described. The MR imaging revealed the existence of a left microphthalmic eye with a lower lid cyst. From the other eye an optic nerve coloboma with a cystic ectasia of the coloboma area freely open to the vitreous cavity was apparent. The ERG recorded from this eye was extinguished.

Aged↗
PubMed2000

Arcuate relaxing incisions with a 5.00-mm optical zone for the correction of high postcataract astigmatism.

The purpose of this study was to investigate the efficacy and safety of arcuate cuts with a 5-mm optical zone to correct high postoperative astigmatism after extracapsular cataract extraction. We performed 5-mm optical zone arcuate cuts on 23 eyes of 23 patients with high postoperative astigmatism. Ophthalmic examination included uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA) and the amount of the refractive and keratometric cylinder before and 9 months after operation. Surgically induced refractive change was calculated in all cases. A significant reduction in astigmatism was achieved in all cases with minimal axis deviation. No case developed clinically significant irregular astigmatism. The mean magnitude of astigmatism of the surgically induced refractive change calculated from standard keratometry and refractive data was 3.73+/-0.72 and 3.70+/-0.77 dptr, respectively. The mean axis deviation calculated from the keratometric and refractive data was 1.18+/-2.33 and 1.32+/-3.62 degrees, respectively. At the last examination, 78.2% of the eyes had UCVA of 20/40 or better. No eye lost more than two lines of vision, 6 eyes lost one line, 2 eyes gained one and 1 eye gained two lines of BSCVA. The above data show that the 5-mm optical zone arcuate astigmatic keratotomy is an effective and safe method of correcting high postoperative astigmatism.

Adult↗
PubMed1999

The a- and b-wave latencies as a prognostic indicator of neovascularisation in central retinal vein occlusion.

To evaluate the prognostic value of ERG in cases of central retinal vein occlusion (CRVO) regarding the development of neovascularisation (NV), we studied 20 patients with unilateral CRVO. Half of them were allocated in the perfused group and the other 10 finally developed NV and were allocated in the non-perfused group. Flash ERG was recorded from all patients. Our findings suggest that b-wave latency is the most reliable parameter in predicting NV, followed by the a-wave latency. The b/a wave amplitude of ERG ratio does not seem to be suitable for clinical use.

Aged↗
PubMed1995

Retinal vascular involvement in acute toxoplasmic retinochoroiditis.

The present study deals with the retinal vascular involvement in 64 patients with toxoplasmic retinochoroiditis during the acute phase of the disease and its evolution. Vascular involvement was noted in all 64 eyes during the acute phase of the disease. In 59 (92%) out of 64 cases the vascular involvement was located in the same retinal quadrant as the active toxoplasmic lesion. In the remaining 5 eyes (8%) the vascular participation was found in all four retinal quadrants. In 3 (5%) out of 64 cases, the vascular infiltration was extremely severe and resulted in retinal vascular obstruction. In all three cases the vessel traversed the active toxoplasmic lesion. In 35 (55%) out of 64 patients the initial vascular picture changed in the course of the acute phase of the disease. In these patients, the lesions had extended to the adjacent vessels or to other parts of the involved vessel. In the further course of the evolution of the active toxoplasmic lesion, the vascular involvement did not persist indiscriminately. It was noted that in 14 (22%) out of 64 cases the vascular lesions gradually regressed and eventually disappeared together with the active toxoplasmic lesion and the formation of the retinochoroidal scar. In the remaining 50 (78%) out of 64 cases the vascular involvement either disappeared after the establishment of the retinochoroidal scar in 3-12 months (29 cases) or remained permanently (21 cases).

Acute Disease↗
PubMed1995

Extracapsular cataract extraction in diabetic eyes. The role of YAG laser capsulotomy.

Cataract surgery may exacerbate preexisting diabetic retinopathy. Especially diabetics with active retinal neovascularisation are at high risk of rubeosis iridis after intracapsular cataract extraction. Thirty-five eyes previously treated with panretinal photocoagulation underwent extracapsular cataract extraction with posterior chamber lens implantation. Twenty-eight eyes with retinal neovascularisation required further Argon laser PRP after surgery. Fourteen eyes required YAG-laser capsulotomy. From the group of eyes without YAG-laser capsulotomy none developed neovascular glaucoma. From the YAG laser capsulotomy group six eyes developed rubeosis iridis and neovascular glaucoma. Our results indicate that eyes in which PRP has been performed, have an excellent prognosis after ECCE with posterior chamber lens implantation only if YAG Laser posterior capsulotomy is not performed.

Cataract↗
PubMed1993

[Complications of secondary implantation in patients with aphakia].

We analyzed retrospectively the complications and visual results of 154 cases of secondary intraocular lens implantation. The follow-up ranged from 1 to 4 years (mean 2.8 years). Best corrected final post-operative visual acuity was better or the same as the best corrected preoperative vision in 95.5% of the eyes. Vision deteriorated in 7 eyes (4.5%): in 3 eyes because of cystoid macular edema, in 2 eyes because of retinal detachment, in 1 eye because of corneal decompensation and in 1 eye because of macular hole. The incidence of complications was 15.4%. We believe that, in carefully selected patients, secondary intraocular lens implantation is highly successful.

Aged↗
PubMed1991

[Lacrimal duct intubation as an alternative to dacryocystorhinostomy].

A series of 52 patients, aged 60-85 and suffering from chronic obstruction of the nasolacrimal duct with no other complication of the lacrimal mechanism or of the eyelids (e.g. ectropium), were treated by means of silicon tube intubation instead of dacryocystorhinotomy. The tubes remained in place for 10-12 months and the patients were observed a 3-year postoperative period. In 37 cases (71%) the nasolacrimal duct remained patient after 3 years. In 7 cases, although the drainage was not opened, the patients ceased to show evidence of secretion of mucus or pus. We consider that intubation of the nasolacrimal duct is an alternative to dacryocystorhinotomy, but only if the patient knows that the tubes are to remain in place for a lengthy period of time. This does not disturb a cooperative patient since the tubes are essential and do not create any irritation. Furthermore, tears are partially eliminated around them and, thus, improvement of the symptoms is apparent from the first day onward.

Aged↗
PubMed1990

[Peripheral neovascularization of the retina in diabetic retinopathy: fluorescein angiography classification and results of panretinal laser treatment].

The prospective study reported here was based on 105 diabetic eyes with "new vessels elsewhere" (NVE), treated exclusively by panretinal laser application and followed up for 2.5 to 4 years. Fundus angiography was performed before treatment. The eyes were then classified in four categories according to the extent and location of capillary nonperfusion responsible for the NVE, namely 1) generalized ischemia (Type A); 2) extensive midperipheral ischemia (Type B); 3) moderate midperipheral ischemia (Type C); and 4) peripheral ischemia (Type D). Analysis of the neovascularization distribution pattern showed that NVE alone existed only in Type D, whereas in the other three types the neovascularization was present either only in the retina or in both the retina and the optic disk. This mixed vascularization was 100% in Type A, 71% in Type B, 31% in Type C, and nonexistent in Type D. Statistical analysis revealed a significant correlation between the type of ischemia and the location of the new vessels. The therapeutic results 3-4 months, 1 year, and 2.5-4 years after intervention showed a significant trend toward an increase in the number of eyes with recurrences when moving from Type D to Type A. This means that the prognosis of NVE after panretinal laser coagulation depends mainly on the type of retinal ischemia. The poorest prognosis is that for generalized ischemia (Type A), followed in descending order by Types B, C, and D. The critical period for increased recurrence in cases which initially responded positively to treatment is primarily in the first 3-4 months following the intervention.

Adult↗
PubMed1989

[Optic disk and choroidal coloboma].

Most of the optic nerve head abnormalities are clinically innocuous, but sometimes they can cause significant symptoms and lead to visual disturbance, or even to visual loss; optic pists can cause defects in the visual fields, not necessarily explicable by the serous maculopathy, that is the most important complication associated with optic pits. Our purpose is to present a case of an optic pit with sensory macular detachment associated with a choroidal coloboma located at a distance of two optic disc diameters from the optic nervehead. This finding to our knowledge has not been previously reported.

Adolescent↗
PubMed1987

Giant cell astrocytoma of the retina. Clinicopathologic report of a case not associated with Bourneville's disease.

A 56-year-old man presented with a disc-based intraocular mass at the posterior pole with massive subretinal exudation. Fluorescein angiography, ultrasonography, and CAT scans did not aid final diagnosis. Four months later, the patient presented again, with massive tumor progression, total retinal detachment due to proliferative vitreoretinopathy, and rubeosis iridis. Pathologic evaluation of the enucleated globe revealed a giant cell astrocytoma of the retina.

Astrocytoma↗
PubMed1985

[Choroid effusion in an antiglaucoma operation in a child with Sturge-Weber syndrome].

The authors describe a case of expulsive choroidal effusion which occurred in the course of a fistulating operation in a child with Sturge-Weber syndrome. This is the youngest patient with this complication so far reported in the literature. The persistent postoperative choroidal and retinal detachments in this case led to a considerable diminution of visual acuity.

Angiomatosis↗
PubMed1984

[Thalassemia and macular subretinal neovascularization].

A 12 year old boy who suffered from homozygous beta-thalassemia came to our clinic complaining of progressive deterioration of the visual acuity of the left eye. His visual acuity at this eye was finger counting at a distance of 50 cm. Fundus examination revealed a tortuous course of the fundus vessels, angioid streaks radiating from the region of the disk and a greyish elevated circular lesion measuring about half a disk diameter in the macular area. Fluorescein angiography showed the existence of a subretinal new vascular membrane. The possibility of the development of severe fundus complications in patients with thalassemia syndromes is discussed.

Angioid Streaks↗