Publications by authors named "Georgios D Panos"

54 Publications

The diagnostic value of Optical Coherence Tomography Angiography in glaucoma.

Curr Med Imaging 2021 Apr 12. Epub 2021 Apr 12.

Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham. United Kingdom.

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http://dx.doi.org/10.2174/1573405617666210412141244DOI Listing
April 2021

The Effect of Antiglaucoma Procedures (Trabeculectomy vs. Ex-PRESS Glaucoma Drainage Implant) on the Corneal Biomechanical Properties.

J Clin Med 2021 Feb 17;10(4). Epub 2021 Feb 17.

Department of Ophthalmology, University Hospital of Alexandroupolis, 68131 Alexandroupolis, Greece.

The aim of this study is to investigate the effect of two antiglaucoma procedures, namely trabeculectomy and Ex-PRESS mini-shunt insertion on the biomechanical properties of the cornea. This is a prospective study. Thirty patients (30 eyes) were included in the study. Nineteen eyes had an Ex-PRESS shunt inserted (Group 1) and 11 had trabeculectomy (Group 2). The examination time points for both groups were one to three weeks preoperatively and at month 1, 6, and 12 postoperatively. Corneal biomechanical properties (corneal hysteresis (CH) corneal resistance factor (CRF)) were measured with the Ocular Response Analyzer (ORA). In group 1, CH was significantly increased at 6 and 12 months compared to baseline values. Corneal hysteresis was also higher at 1 month postoperatively, but this increase did not reach statistical significance. In group 2, the CH was significantly increased at all time points compared to the preoperative values. CRF decreased at all time points postoperatively compared to the preoperative values in both groups. The difference (preoperative values to postoperative values at all time points) of the CH and CRF between the two groups was also compared and no significant differences were detected between the two surgical techniques. Trabeculectomy and the EX-PRESS mini-shunt insertion significantly alter the corneal biomechanical properties as a result of the surgical trauma and the presence of the shunt in the corneal periphery. When compared between them, they affect the corneal biomechanical properties in a similar way.
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http://dx.doi.org/10.3390/jcm10040802DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922603PMC
February 2021

Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane.

Eur J Ophthalmol 2020 Dec 14:1120672120980951. Epub 2020 Dec 14.

Vitreoretinal and Uveitis Department, Ophthalmica Clinic, Thessaloniki, Greece.

Purpose: To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function.

Methods: A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed.

Results: Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision ( < 0.001).

Conclusion: MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.
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http://dx.doi.org/10.1177/1120672120980951DOI Listing
December 2020

First report of a new corneal pathogen: Phaeoacremonium parasiticum.

Eur J Clin Microbiol Infect Dis 2020 Dec 12;39(12):2477-2480. Epub 2020 Jul 12.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

Keratitis is a public health issue in developing countries and a potentially sight-threatening condition. Collagen fibrils in the corneal stroma are parallels to each other. Fundamental substance maintains the same space between collagen fibrils. That is how corneal transparency can be achieved. Any damage which can modify this structure will lead to corneal opacity and loss of vision. Fungal keratitis might appear in up to one-third of cases. Nevertheless, fungal keratitis remains poorly described and understood. Herein, we present the first ever reported case of corneal infection due to Phaeoacremonium parasiticum in a young patient. We describe the clinical and microbial characteristics, and we also discuss the use of confocal microscopy in early diagnosis of this infection.
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http://dx.doi.org/10.1007/s10096-020-03980-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669772PMC
December 2020

Ab interno trabecular bypass surgery with iStent and iStent inject for open angle glaucoma.

Ther Deliv 2020 06 11;11(6):357-362. Epub 2020 Jun 11.

Eye Treatment Centre, Whipps Cross Univeristy Hospital, Barts Health NHS Trust, London E11 1NR, UK.

Glaucoma is one of the leading causes of visual loss in industrialized world. Local lowering intra-ocular pressure drops are the first-line treatment for glaucoma. Penetrating and nonpenetrating surgery is considered when topical lowering intra-ocular pressure drops fail. Recently, the iStent device has been introduced in the management of glaucoma nonresponding sufficiently to local treatment. In this review, we present the results of the trials concerning the efficacy and safety of iStent for the treatment of open angle glaucoma.
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http://dx.doi.org/10.4155/tde-2020-0045DOI Listing
June 2020

The Risk of Posterior Capsule Rupture during Phacoemulsification Cataract Surgery in Eyes with Previous Intravitreal Anti Vascular Endothelial Growth Factor Injections.

J Cataract Refract Surg 2020 Jan 21. Epub 2020 Jan 21.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

Purpose: To investigate if previous intravitreal anti vascular endothelial growth factor (VEGF) injections are a predictor for posterior capsule rupture (PCR) during phacoemulsification cataract surgery.

Setting: National Health Service: Whipps Cross University Hospital Eye Treatment Centre. District General, London, United Kingdom DESIGN:: Single centre, retrospective, electronic medical record (EMR) database study with univariate analysis.

Methods: EMR (Medisoft) was used to extract data for eyes undergoing phacoemulsification surgery between 01.08.16 to 01.01.18. Patient demographics, indication for intravitreal therapy, treatment type, number of previous intravitreal injections (IVI), diabetic status, surgeon grade and operative complications were included as variables for analysis.

Results: Data was available for 4047 cataract operations. Of these, 108 had undergone previous anti-VEGF IVI treatment. Three eyes were noted to have pre-operative PC trauma and were excluded from the final analysis. The logistic regression analysis after exclusion of the eyes with pre-existing damage to the PC confirmed that prior anti-VEGF IVI treatment was associated with an increased risk of PCR when compared to the non IVI group (9.26% vs 1.88%, p<0.0001). There is a dose dependent relationship between the number of anti-VEGF injections and the likelihood of PCR.

Conclusions: Previous intravitreal anti-VEGF injections are significantly correlated with an increased risk of surgical PCR despite the absence of visible structural damage to the PC pre-operatively.
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http://dx.doi.org/10.1097/j.jcrs.0000000000000047DOI Listing
January 2020

Intraocular Pressure Elevation in Keratoconus with Coexisting Pseudoexfoliation Glaucoma: How Important is the Method of Measurement?

Klin Monbl Augenheilkd 2020 Apr 4;237(4):392-395. Epub 2020 Mar 4.

Department of Ophthalmology, University Hospital Basel, Basel, Switzerland.

Objective: In this report, we investigated the association between the intraocular pressure (IOP) values by two different measurement methods and the corneal biomechanical properties in a patient with keratoconus and secondary glaucoma due to pseudoexfoliation syndrome who developed a marked elevation of intraocular pressure in the right eye.

Methods: IOP was measured over a period of 3 days with Goldmann applanation tonometry (GAT) and dynamic contour tonometry (Pascal tonometry, DCT). Corneal hysteresis (CH) and corneal resistance factor (CRF) were estimated with the aid of an ocular response analyzer (ORA).

Results: CH and CRF were significantly reduced in the right eye compared to the left eye throughout the period of observation (paired t-test, p < 0.001). The difference between both methods of IOP measurement in the right eye was statistically significant for IOP < 30 mmHg by GAT (Wilcoxon test, p = 0.004). For IOP values > 30 mmHg by GAT, there was no statistically significant difference between DCT and GAT (Wilcoxon test, p = 0.0625).

Conclusions: This observation supports the clinical hypothesis that a significant decrease in CH translates to a decreased correlation of CH and IOP recordings by GAT and, furthermore, suggests that after a critical point of CH reduction, the impact of CH on GAT may be comparable to that on DCT.
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http://dx.doi.org/10.1055/a-1101-8918DOI Listing
April 2020

Risk of posterior capsular rupture during phacoemulsification cataract surgery in eyes with previous intravitreal antivascular endothelial growth factor injections.

J Cataract Refract Surg 2020 02;46(2):204-208

From the Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, (Nagar, Luis, Panos, Mckechnie, Patra), and University College London (Kainth), London, United Kingdom.

Purpose: To investigate whether previous intravitreal antivascular endothelial growth factor (VEGF) injections are a predictor for posterior capsular rupture (PCR) during phacoemulsification cataract surgery.

Setting: Whipps Cross University Hospital Eye Treatment Centre, London, United Kingdom.

Design: Single-center, retrospective, electronic medical record (EMR) database study with univariate analysis.

Methods: Data were extracted from an EMR system on eyes undergoing phacoemulsification surgery between August 1, 2016, and January 1, 2018. Patient demographics, indication for intravitreal therapy, treatment type, the number of previous intravitreal injections (IVIs), diabetic status, surgeon grade, and operative complications were included as variables for analysis.

Results: Data were available for 4047 cataract operations. Of these, 108 (2.7%) had undergone previous anti-VEGF IVI treatment. Three eyes were noted to have preoperative PC trauma and were excluded from the final analysis. The logistic regression analysis after exclusion of the eyes with pre-existing damage to the PC confirmed that previous anti-VEGF IVI treatment was associated with an increased risk of PCR when compared with the non-IVI group (6.67% vs 1.88%, P < .0001). There is a dose-dependent relationship between the number of anti-VEGF injections and the likelihood of PCR.

Conclusions: Previous intravitreal anti-VEGF injections are significantly correlated with an increased risk of surgical PCR, despite the absence of visible structural damage to the posterior capsule preoperatively.
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http://dx.doi.org/10.1016/j.jcrs.2019.09.004DOI Listing
February 2020

Stellate Nonhereditary Idiopathic Foveomacular Retinoschisis in a Female Patient: Case Report and Brief Literature Review.

Klin Monbl Augenheilkd 2020 Apr 22;237(4):474-476. Epub 2020 Jan 22.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland.

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http://dx.doi.org/10.1055/a-1067-4028DOI Listing
April 2020

Advances in intravitreal therapy and implants: where are we now?

Authors:
Georgios D Panos

Ther Deliv 2020 02 9;11(2):69-73. Epub 2020 Jan 9.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

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http://dx.doi.org/10.4155/tde-2019-0081DOI Listing
February 2020

The long-term efficacy and safety of fluocinolone acetonide intravitreal implant 190 μg (ILUVIEN) in diabetic macular oedema in a multi-ethnic inner-city population.

Eur J Ophthalmol 2021 Mar 6;31(2):620-629. Epub 2020 Jan 6.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

Purpose: The purpose of this study is to report the long-term efficacy and safety of 0.19 mg fluocinolone acetonide intravitreal implant (ILUVIEN) in pseudophakic eyes with diabetic macular oedema in a multi-ethnic patient cohort.

Methods: This is a single-centre retrospective analysis of patients with persistent diabetic macular oedema, despite previous anti-vascular endothelial growth factor and/or steroid treatment, treated with the ILUVIEN implant according to national guidelines. Patients with follow-up of less than 24 months were excluded. Best corrected visual acuity, central retinal thickness and intraocular pressure were evaluated at baseline and month 3, 12, 24 and 36 post-treatment. A sub-group analysis was performed on eyes with 36-month follow-up data.

Results: In total, 24 eyes (24 patients) completed at least 24 months of follow-up, of which 9 completed 36 months of follow-up. Three-fourths of the patients were black or South Asian (blacks, Asians and minority ethnic). Improvement in mean best corrected visual acuity was seen at year 1 and year 3 improving from 0.62 LogMAR at baseline to 0.55 LogMAR at year 1 and 0.47 LogMAR at year 3 (all p > 0.05). Mean central retinal thickness also showed a progressive reduction from 471 μm at baseline to 397 μm at year 1 and 339 μm at year 3 (all p < 0.05). Four eyes required intraocular pressure-lowering drops post-implant. Supplementary treatment for persistent or recurrent diabetic macular oedema was necessary in 13 eyes over the total study period of 3 years. Blacks, Asians and minority ethnic patients had a worse response compared with white patients.

Conclusion: The ILUVIEN implant was effective and safe in the treatment of multi-ethnic patients with diabetic macular oedema refractory to conventional therapies, improving the vision and macular anatomy, without significant adverse events up to 36 months post-treatment.
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http://dx.doi.org/10.1177/1120672119898414DOI Listing
March 2021

Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges.

Clin Ophthalmol 2019 10;13:1761-1777. Epub 2019 Sep 10.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

Macular edema (ME) is the most common sight-threatening complication in uveitis. The diagnostic and therapeutic management of the uveitic macular edema (UME) might be challenging due to the complex diagnostic workup and the difficulties physicians face to find the underlying cause, and due to its usually recurrent nature and the fact that it can be refractory to conventional treatment. Some of the mild cases can be treated with topical steroids, which can be combined with non-steroid anti-inflammatory drugs. However, immunomodulators such as methotrexate, tacrolimus, azathioprine, cyclosporine and mycophenolate mofetil together with anti-tumor necrosis factor-α (anti-TNF alpha) monoclonal antibodies such as adalimumab and infliximab, may be required to control the inflammation and the associated ME in refractory cases, or when an underlying disease is present. This review of the literature will focus mostly on the non-infectious UME.
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http://dx.doi.org/10.2147/OPTH.S180580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750710PMC
September 2019

Dexamethasone intravitreal implant (OZURDEX) for macular edema secondary to noninfectious uveitis: a review of the literature.

Ther Deliv 2019 06 11;10(6):343-351. Epub 2019 Jun 11.

Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, E11 1NR, UK.

Macular edema (ME) is the leading cause of visual loss in uveitis and may persist long after ocular inflammation has been resolved. Local steroids are the first line treatment for uveitis and uveitic ME. Dexamethasone intravitreal implant (OZURDEX; Allergan, Inc., CA, USA) has been used to treat diabetic ME and ME secondary to retinal vein occlusion. Recent studies have also demonstrated that Ozurdex may be effective treatment for patients with persistent uveitic ME. In this review, we present the results of the real word studies concerning the efficacy and safety of Ozurdex for the treatment of uveitic ME.
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http://dx.doi.org/10.4155/tde-2019-0024DOI Listing
June 2019

Effect of Aflibercept on Cystoid Macular Edema Associated with Central Retinal Vein Occlusion. Results from a District Hospital in the United Kingdom.

Klin Monbl Augenheilkd 2019 Apr 22;236(4):547-550. Epub 2019 Feb 22.

Department of Ophthalmology, The Ipswich Hospital NHS Trust (affiliated to the University of Cambridge), Ipswich, Suffolk, UK.

Purpose: The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO).

Methods: This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period.

Results: The median follow-up period was 6 months (range: 6 - 9). The median number of injections was 4 (range: 3 - 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 - 1.6) at baseline to 0.65 (range: 0.4 - 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 - 1235) at baseline to 243 µm (range: 207 - 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented.

Conclusion: Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.
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http://dx.doi.org/10.1055/a-0786-7872DOI Listing
April 2019

Intravitreal fluocinolone acetonide implant (ILUVIEN®) for diabetic macular oedema: a literature review.

J Int Med Res 2019 Jan 16;47(1):31-43. Epub 2018 Dec 16.

2 Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy and may lead to severe visual loss. In this review, we describe the pathophysiology of DMO and review current therapeutic options such as macular laser photocoagulation, anti-vascular endothelial growth factor agents, and steroid implants with a focus on the new fluocinolone acetonide implant, ILUVIEN®. The results of the Fluocinolone Acetonide in Diabetic Macular Edema (FAME) studies are also presented together with the results of real-world studies to support the clinical use of ILUVIEN® in achieving efficient resolution of DMO and improving vision and macular anatomy in this challenging group of patients.
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http://dx.doi.org/10.1177/0300060518816884DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384476PMC
January 2019

Re: Hoogewoud et al.: Prognostic factors in syphilitic uveitis (Ophthalmology. 2017;124:1808-1816).

Ophthalmology 2018 08;125(8):e57-e58

Department of Ophthalmology, University Hospital of Basel, Basel, Switzerland.

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http://dx.doi.org/10.1016/j.ophtha.2018.03.021DOI Listing
August 2018

Evolution of intravitreal therapy for retinal and macular disorders.

Authors:
Georgios D Panos

J Int Med Res 2020 Jan 4;48(1):300060518771411. Epub 2018 May 4.

Eye Treatment Centre, 156708Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.

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http://dx.doi.org/10.1177/0300060518771411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579327PMC
January 2020

Effect of Conus Eccentricity on Visual Outcomes After Intracorneal Ring Segments Implantation in Keratoconus.

J Refract Surg 2018 Mar;34(3):196-200

Purpose: To investigate the potential impact of cone eccentricity on visual outcomes after Keraring (Mediphacos, Belo Horizonte, Brazil) implantation for keratoconus.

Methods: Nineteen eyes from 19 patients with keratoconus who underwent femtosecond laser-assisted Keraring implantation for keratoconus were included in this retrospective study. Uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), keratometric readings, central corneal thickness, maximum keratometric distance from corneal apex (DKmax), corneal thinnest point from corneal apex (DTh), and coma were evaluated preoperatively and 6 months after the Keraring implantation. DKmax and DTh were used as metrics reflecting the eccentricity of the cone.

Results: UDVA, CDVA, keratometric readings, and coma improved at 6 months postoperatively. However, there was no correlation between DKmax or DTh and visual outcomes at 6 months postoperatively.

Conclusions: The data did not show any impact of the cone eccentricity on visual outcomes after Keraring implantation for keratoconus at 6 months postoperatively. [J Refract Surg. 2018;34(3):196-200.].
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http://dx.doi.org/10.3928/1081597X-20180115-02DOI Listing
March 2018

Author's Reply.

J Ophthalmic Vis Res 2018 Jan-Mar;13(1):89

Cornea and Cataract Service, Moorfields Eye Hospital, London, UK.

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http://dx.doi.org/10.4103/jovr.jovr_232_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782468PMC
February 2018

Collagen Cross- Linking for Paediatric Keratoconus.

Open Ophthalmol J 2017 31;11:211-216. Epub 2017 Jul 31.

ELZA Institute, Zurich, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Faculty of Medicine, University of South California, California, USA.

Background: Since the late 1990s corneal crosslinking (CXL) has been proposed as a new treatment option which can stop progression of keratoconus with promising results in adults.

Objective: Keratoconus presents a higher rate and faster progression in paediatric patients and for this reason prompt and effective treatment is essential. Due to its success in adult keratoconus patients, CXL has been recently applied to children in order to stop or slow progression of keratoconus in paediatric patients.

Conclusions: This article will present an update of the literature on the topic of CXL in this age group.
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http://dx.doi.org/10.2174/1874364101711010211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585458PMC
July 2017

Modified deep sclerectomy combined with Ex-PRESS filtration device versus trabeculectomy for primary open angle glaucoma.

Int J Ophthalmol 2017 18;10(5):728-732. Epub 2017 May 18.

Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, Democritus University of Thrace, Alexandroupolis, Eastern Macedonia and Thrace, GR-68100, Greece.

Aim: To compare the efficacy of modified deep sclerectomy combined with Ex-PRESS shunt versus trabeculectomy in primary open angle glaucoma.

Methods: This is a prospective cohort comparative single-center study. Forty-nine eyes of 49 patients were enrolled in the study. Patients were randomly divided into two groups. Group A (22 patients) underwent classic trabeculectomy and group B (27 patients) underwent modified deep sclerectomy combined with insertion of Ex-PRESS model P50 drainage device.

Results: Mean age was 69±7y in group A and 64±8y in group B (=0.03). The mean reduction was 11.1±5.7 mm Hg in group A compared to 15.8±5.7 mm Hg in group B at 6mo (=0.006), and 9.8±4.9 mm Hg and 15.4±4.7 mm Hg respectively at 1y (=0.0001). Regarding the postoperative glaucoma medication, significant difference was observed between the two groups (in favour of group B) only at 6mo (=0.017). At the end of the follow-up period complete success rate in group A was 68.2% compared to 92.6% in group B ( test, =0.07) and qualified success rate was 100% in both groups.

Conclusion: Modified deep sclerectomy combined with Ex-PRESS shunt may provide comparable IOP reduction with fewer complications in management of primary open angle glaucoma.
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http://dx.doi.org/10.18240/ijo.2017.05.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437459PMC
May 2017

Keratoconus: is it a Non-inflammatory Disease?

Med Hypothesis Discov Innov Ophthalmol 2017 ;6(1):1-2

Corneo-Plastic Unit, Queen Victoria Hospital, East Grinstead, United Kingdom.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392225PMC
January 2017

Unilateral Myelinated Retinal Nerve Fibers.

J Ophthalmic Vis Res 2017 Jan-Mar;12(1):122-123

Cornea and Cataract Service, Moorfields Eye Hospital, London, UK.

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http://dx.doi.org/10.4103/2008-322X.200170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340054PMC
March 2017

Impact of prostaglandin glaucoma drops on platelet-activating factor action: an in vitro study.

Drug Des Devel Ther 2016 7;10:3977-3981. Epub 2016 Dec 7.

Laboratory of Biochemistry, National and Kapodistrian University of Athens, Athens, Greece.

Aim: The aim of this study was to investigate the effect of different prostaglandin analogs on platelet-activating factor (PAF) levels.

Methods: Three prostaglandin analogs were selected: bimatoprost 0.3 mg/mL, latanoprost 50 μg/mL, and tafluprost 15 μg/mL. Each drug sample was tested for its ability to cause platelet aggregation, which was measured as PAF-induced aggregation, before and after the addition of various concentrations of the examined sample, creating a linear curve of percentage inhibition (ranging from 0% to 100%) versus different concentrations of the sample. The concentration of the sample that inhibited 50% PAF-induced aggregation was calculated based on this curve, and this value was defined as IC50. In addition, the effect of eye drops on PAF metabolism was examined, through an in vitro analysis on PAF basic metabolic enzymes (PAF-cholinephosphotransferase, PAF-acetyl-CoA:1-O-alkyl-sn-glycero-3-phosphocholine acetyltransferase, and PAF-acetylhydrolase).

Results: The IC50 values for Lumigan UD (bimatoprost 0.3 mg/mL), Monoprost (latanoprost 50 μg/mL), and Saflutan (tafluprost 15 μg/mL) were 8.7, 0.28, and 1.4 μg/mL, respectively.

Discussion: All three prostaglandin analogs suspended PAF, but bimatoprost induced the most potent inhibition, compared to tafluprost and to the weak effect of latanoprost.
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http://dx.doi.org/10.2147/DDDT.S117806DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153256PMC
March 2017

Comparison of dorzolamide/timolol vs brinzolamide/brimonidine fixed combination therapy in the management of primary open-angle glaucoma.

Eur J Ophthalmol 2017 Mar 16;27(2):160-163. Epub 2016 Jul 16.

 Department of Ophthalmology, University General Hospital of Evros, Alexandroupolis - Greece.

Purpose: To compare the efficiency of brinzolamide/brimonidine fixed combination vs the dorzolamide/timolol fixed combination.

Methods: Forty-four eyes of 44 patients were divided in 2 groups treated either with dorzolamide/timolol twice a day (group A) or with brinzolamide/brimonidine twice a day (group B). Complete ophthalmic examination including Goldmann applanation tonometry was performed before treatment administration and 1, 4, 8, and 12 weeks afterwards. The intraocular pressure (IOP) was measured twice a day (morning at 9 AM and afternoon at 4 PM).

Results: At the end of the follow-up period (12 weeks), mean morning IOP reduction was 7.0 ± 2.8 mm Hg in group A and 8.4 ± 1.9 mm Hg in group B. A significant difference was found (p = 0.0343). In contrast, mean afternoon IOP reduction was 8.6 ± 2.7 mm Hg in group A and 7.9 ± 1.6 mm Hg in group B and no significant difference was found (p = 0.3413). No significant adverse effects were observed in either group.

Conclusions: Brinzolamide/brimonidine seems to be an effective and safe alternative β-blocker free fixed combination, especially for patients with comorbidities, having its own antihypertensive profile.
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http://dx.doi.org/10.5301/ejo.5000826DOI Listing
March 2017

Trabeculectomy with or without Anterior Chamber Maintainer: A Study on Intraocular Pressure, Endothelial Cells, and Central Corneal Thickness.

Semin Ophthalmol 2017 29;32(6):748-750. Epub 2016 Jul 29.

b Department of Ophthalmology , Geneva University Hospitals , Geneva , Switzerland.

Purpose: To compare the impact of trabeculectomy and trabeculectomy with an anterior chamber (AC) maintainer on intraocular pressure (IOP), endothelial cell density (ECD), and central corneal thickness (CCT) in patients with primary open angle glaucoma (POAG).

Methods: The two groups consisted of 36 (trabeculectomy, Group A) and 42 (trabeculectomy with AC maintainer, Group B) patients with POAG. IOP, CCT, and ECD were measured one day prior to surgery, one month, six months, and 12 months postoperatively.

Results: No complications were observed. The mean decrease of mean IOP from baseline to 12 months was statistically significant for both groups (all p < 0.0001), but more significant in Group B (p = 0.01). ECD decrease was significant in both Groups (all p < 0.01), but more significant in Group A (p < 0.0001). CCT decrease was also greater in Group A (p < 0.0001). The surgical procedure's duration was significantly longer in Group B than in Group A (p < 0.0001).

Conclusions: Both techniques seem to be effective and safe options for patients with POAG. Using an AC maintainer might add some safety for the ECD and a bit greater IOP reduction; however, the classic technique, which is of less complexity and less time-consuming, has comparable results.
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http://dx.doi.org/10.1080/08820538.2016.1177096DOI Listing
December 2017

Transepithelial Corneal Cross-linking Using an Enhanced Riboflavin Solution.

J Refract Surg 2016 Jun;32(6):372-7

Purpose: To assess the efficacy of a modified high concentration riboflavin solution containing benzalkonium chloride 0.01% for transepithelial corneal cross-linking (CXL).

Methods: In this prospective, interventional multicenter cohort study, 26 eyes of 26 patients with documented progressive keratoconus who underwent transepithelial CXL were included. Follow-up at 6 and 12 months postoperatively included slit-lamp examination, uncorrected and corrected distance visual acuity (logMAR), maximum keratometry (Kmax), and corneal pachymetry (corneal thinnest point) as determined by Scheimpflug imaging. Statistical analysis was performed using repeated measures analysis of variance and the Friedman test for parametric and non-parametric data, respectively. P values less than .05 were considered significant.

Results: Kmax did not change significantly at postoperative months 6 and 12. Changes in corneal thinnest point did not change postoperatively over 12 months. Uncorrected and corrected distance visual acuity did not change postoperatively. Progression (defined by an increase in Kmax greater than 1.00 diopter occurred in 46% of eyes at 12 months. Corneal epithelial defects were observed in 46% of the patients and marked punctate corneal epitheliopathy/loose epithelium in 23% of the patients in the immediate postoperative period. No corneal infection, sterile infiltrates, or haze were observed.

Conclusions: Transepithelial CXL with an enhanced riboflavin solution did not effectively halt progression of keratoconus. Significant epithelium damage was evident in the immediate postoperative period. [J Refract Surg. 2016;32(6):372-377.].
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http://dx.doi.org/10.3928/1081597X-20160428-02DOI Listing
June 2016

"Association between platelet activating factor acetylhydrolase and diabetic retinopathy: Does inflammation affect the retinal status?".

Prostaglandins Other Lipid Mediat 2016 Jan 11;122:69-72. Epub 2016 Jan 11.

University Eye Clinic, General Hospital of Athens G. Gennimatas, Greece. Electronic address:

Aim: To assess the role of plasma platelet activating factor acetylhydrolase (PAF-AH) in pathogenesis and progression of diabetic retinopathy (DR).

Materials And Methods: Sixty eight diabetics and 23 age-frequency-matched non-diabetic patients underwent blood sampling and the plasma PAF-AH activity was calculated. The diabetic patients were further classified into two groups, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification, based on indirect fundoscopy and fluorescein angiography. Thirty seven patients with non-proliferative DR (NPDR) and 31 patients with proliferative DR (PDR) were finally included in the study.

Results: The plasma PAF-AH activity was increased in diabetic patients with PDR (0.206 μmol/min/ml) compared to control group (0.114 μmol/min/ml, post-hoc Bonferroni comparison test: p<0.0001) and to NPDR group (0.147 μmol/min/ml, post-hoc Bonferroni comparison test: p=0.012).

Conclusions: The activity of PAF-AH in the plasma increases in parallel with DR severity.
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http://dx.doi.org/10.1016/j.prostaglandins.2016.01.001DOI Listing
January 2016

Helicoid peripapillary chorioretinal degeneration complicated by choroidal neovascularization.

Eur J Ophthalmol 2016 Feb 15;26(2):e30-1. Epub 2016 Feb 15.

Department of Ophthalmology, University Hospital of Evros, Alexandroupolis - Greece.

Purpose: Helicoid peripapillary chorioretinal degeneration (HPCD) is a hereditary disease of the fundus that is characterized by atrophic chorioretinal areas that appear early in life and expand gradually from the optic disc towards the macula and the periphery.

Methods: We describe the case of an elderly man with a known diagnosis of HPCD who developed choroidal neovascular membrane (CNV) in both eyes during the course of the disease.

Results: The patient was treated with intravitreal injection of ranibizumab, to which he had excellent response. The CNV subsided with 2 injections in the right eye and 1 in the left. Two years after the initial diagnosis of CNV in the right eye, visual acuity was 5/10 OD and 9/10 OS.

Conclusions: Helicoid peripapillary chorioretinal degeneration is rarely complicated by CNV as the fundus lacks the trigger factors that would sustain this process. Although rare, HPCD complicated by CNV can be seen bilaterally, but responds well to few ranibizumab injections.
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http://dx.doi.org/10.5301/ejo.5000695DOI Listing
February 2016