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Panagiotis Kousiouris,1,&ast; Nikolaos Gouliopoulos,2,&ast; Anastasia Kourtesa,1,&ast; Georgios S Dimtsas,1 Klio Chatzistefanou,1 Nikolaos Bouratzis,2 Maria Kantzanou,3 Marilita M Moschos1 1 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece; 2 2nd Department of Ophthalmology, University of Athens Medical School, Attikon Hospital, Athens, Greece; 3Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece&ast;These authors contributed equally to this workCorrespondence: Marilita M Moschos, 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, 154 Leof. Mesogeion, Athens, 115 27, Greece, Tel +30 6944887319, Email moschosmarilita@yahoo.frPurpose: To present the demographic and social characteristics of patients with ocular foreign bodies (OFB), who visit the Ophthalmological Outpatient Department of a tertiary hospital in Athens, Greece.Patients and Methods: During the period January-March 2019, 5181 patients presented to the Ophthalmological Outpatient Department of our hospital, and 543 of them were diagnosed with an ocular foreign body. Moreover, 106 of them were interviewed about their demographic and social factors, regarding among others data about their occupation, level of education, nationality, family, and insurance status.Results: The patients with ocular foreign bodies were significantly younger compared to the rest of the examined patients (49.5± 13.9 vs 56.3± 17 years, p< 0.001). Moreover, the ocular foreign bodies were more frequent in men compared to women (15.5% vs 5.0%, p< 0.001) and in non-Greek patients (23.7% vs 9.2%, p< 0.001). Regarding the social characteristics of the patients with ocular foreign bodies, we found that the majority of them were married, employed, insured, while their educational status was middle and high school. Furthermore, the vast majority of the patients practiced manual professions (73.1% of them).Conclusion: We documented that the introduction of an ocular foreign body is frequently encountered in the Outpatient Department of our tertiary hospital in Athens, Greece. We also demonstrated that these patients are younger, while they are more frequently men, of non-Greek origin, with an educational status of middle and high school, and their occupation is associated with manual labour.Keywords: ocular foreign body, ocular trauma, demographic characteristics, social characteristics

Panagiotis Kousiouris,1,&ast; Olga Klavdianou,1,&ast; Konstantinos AA Douglas,1 Nikolaos Gouliopoulos,2 Klio Chatzistefanou,1 Maria Kantzanou,3 Georgios S Dimtsas,1 Marilita M Moschos1 1 1st Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital, Athens, Greece; 2 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, “Attikon” General Hospital, Athens, Greece; 3Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece&ast;These authors contributed equally to this workCorrespondence: Marilita M Moschos 1st Department of Ophthalmology, National and Kapodistrian University of Athens, “G. Gennimatas” General Hospital, Leof. Mesogeion 154, Athens, 115 27, GreeceTel +30 6944887319Email moschosmarilita@yahoo.frAbstract: Globe injury is a serious worldwide public health issue frequently leading to permanent vision impairment. The plethora of different types of globe injuries is classified into categories, including open and closed globe injuries. Globe injury occurs mainly in the workplace and at home, affecting predominantly middle-aged working men. Socioeconomic status (SES) is defined by income level, educational attainment, and employment status. Low socioeconomic status has been associated with a higher incidence of globe injury and can be utilized to identify at-risk populations. For managing open and closed globe injuries, different strategies are applied and the implementation of adequate globe injury prevention measures is needed for reducing the occurrence of globe injury. The following article aims to provide an overview of globe injury characteristics and their correlation with socioeconomic status and to highlight the significance of considering SES as a variable in globe injury prevention.Keywords: eye injuries, occupational injuries, social class, educational status

Brouzas Dimitrios, George Krassas, Maria Dettoraki, Anastasios Lavaris, Anna-Maria Sideri, Konstantinos Droutsas, Marilita M Moschos Department of Ophthalmology, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Brouzas DimitriosDepartment of Ophthalmology, School of Medicine, National and Kapodistrian University of Athens, 10 G. Papandreou Str, Byron-Athens 16231, GreeceEmail brouzas@yahoo.comPurpose: To assess the anatomic and functional outcomes of eyes undergoing vitrectomy and large retinectomy for the management of retinal detachment (RD) complicated by advanced proliferative vitreoretinopathy (PVR).Methods: A total of 66 eyes of 63 patients with RD complicated by PVR were treated with vitrectomy and 180° or more retinectomy and silicone oil (n=46) or perfluoropropane gas (n=20) were used as intraocular tamponades.Results: Retinal reattachment was achieved in 89.39% (59 eyes) of the cases. The mean follow-up was 33.7 months (range 12– 76 months). In gas-filled eyes, the final anatomic success rate was 85% (17 eyes) and in silicone oil-filled eyes was 91.3% (42 eyes) (p=0.46). After the initial retinectomy, the total anatomic success rate was 80.3% (53/66 eyes), 70% in gas-filled eyes (14/20 eyes) and 84.79% in silicone oil-filled eyes (39/46 eyes) (p=0.19). Visual acuity (VA) improved in 37 (56.06%) eyes, remained the same in 19 (28.78%) eyes and became worse in 10 (15.15%) cases. Best corrected VA was ≥ 20/200 in 22 eyes 33.33%. The final VA was associated with the preoperative VA (r=0.68), the preoperative status of the macula influence significantly the final visual acuity (p< 0.0001) and there is statistically significant difference in the final visual acuity between eyes with and without anatomic success (p< 0.05).Conclusion: The large circumferential retinectomies can be beneficial in eyes with RD complicated by advanced PVR. No significant difference was found in anatomic success rate, and rate of complications between eyes with silicone oil tamponade and long acting gas undergoing large retinectomy. Regarding the final BCVA, slight difference was found in favor of gas-filled eyes.Keywords: large retinectomies, proliferative vitreoretinopathy, silicone oil tamponade, perfluoropropane gas tamponade

Stylianos Tsapakis, Dimitrios Papaconstantinou, Andreas Diagourtas, Konstantinos Droutsas, Konstantinos Andreanos, Marilita M Moschos, Dimitrios Brouzas 1st Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece Purpose: To present a visual field examination method using virtual reality glasses and evaluate the reliability of the method by comparing the results with those of the Humphrey perimeter.Materials and methods: Virtual reality glasses, a smartphone with a 6 inch display, and software that implements a fast-threshold 3 dB step staircase algorithm for the central 24° of visual field (52 points) were used to test 20 eyes of 10 patients, who were tested in a random and consecutive order as they appeared in our glaucoma department. The results were compared with those obtained from the same patients using the Humphrey perimeter.Results: High correlation coefficient (r=0.808, P

Antonia Sarli,1 Iosif Skalidakis,2 Aliki Velissari,1 Chryssanthi Koutsandrea,2 Maria Stefaniotou,3 Michael B Petersen,4,5 Christos Kroupis,1,* George Kitsos,3,* Marilita M Moschos2,* 1Department of Clinical Biochemistry, Attikon University General Hospital, 21st Department of Ophthalmology, “G. Gennimatas” General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, 3Department of Ophthalmology, Ioannina University General Hospital, University of Ioannina, Ioannina, Greece; 4Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark; 5Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark *These authors contributed equally to this work Background: Age-related macular degeneration (AMD) is a multifactorial degenerative ocular disease that leads to loss of central vision. Functional gene polymorphisms have already been associated with the disease (for example, ARMS2 A69S, rs10490924).Aim: The goal of our study was to verify the correlation of the aforementioned ARMS2 variation with the disease, to examine, for the first time, the role of the CD14 C260T variation (rs2569190), and to investigate the association of two TLR4 polymorphisms (Asp299Gly or rs4986790 and Thr399Ile or rs4986791) in a Greek population with the wet form of AMD.Patients and methods: Genomic DNAs were isolated from blood samples of 103 healthy controls and 120 Greek patients with wet AMD who were age- and sex-matched, and all of whom were clinically evaluated. For the genotyping of all selected polymorphisms, polymerase chain reaction–restriction fragment length polymorphism analysis was performed.Results and conclusions: This study confirmed the association between the ARMS2 variation and AMD, detecting the T risk allele in a significantly higher frequency in the patient group, compared with the control subjects (45% vs 29.13%, P

Marilita M Moschos,1,2 Giannis A Moustafa,1 Vasiliki D Papakonstantinou,3 Michael Tsatsos,4 Konstantinos Laios,1 Smaragdi Antonopoulou3 11st Department of Ophthalmology, Medical School, University of Athens, Athens, Greece; 2Biomedical Research Foundation, Academy of Athens, Athens, Greece; 3Laboratory of Biology, Biochemistry, Physiology and Microbiology, Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; 4Royal Eye Infirmary, Dorset County Hospital NHS Foundation Trust, Dorchester, UK Purpose: Altered platelet aggregability has been implicated in the pathogenesis of glaucoma. This study aims to investigate the anti-platelet potential of intraocular pressure lowering drops, with the possibility of establishing it as an additional mechanism of anti-glaucomatous action.Materials and methods: The anti-aggregating effects of a series of anti-glaucomatous eye drops were determined on human platelets in the platelet aggregation model, using four known aggregating factors (platelet activating factor [PAF], adenosine diphosphate [ADP], thrombin receptor-activating peptide [TRAP], and arachidonic acid [AA]).Results: Almost all of the tested samples inhibited platelet aggregation induced by PAF, ADP, TRAP, and AA, except for Alphagan, which did not demonstrate inhibition of ADP- and TRAP-induced aggregation at a wide range of concentrations. Trusopt, Betoptic, and Azarga eye drops were the most potent inhibitors of all four aggregating factors, while Alphagan was the least potent (P

Klio I Chatzistefanou,1 Christianna Samara,2 Ioannis Asproudis,3 Dimitrios Brouzas,1 Marilita M Moschos,1 Elisabeth Tsianta,1 George Piaditis4 1First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece; 2Department of Radiology and Endocrinology, 3Department of Ophthalmology, University of Ioannina, Ioannina, Greece; 4Athens General Hospital “G. Gennimatas”, Athens, Greece Background: Thyroid associated orbitopathy (TAO) comprises a spectrum of well-recognized clinical signs including exophthalmos, eyelid retraction, soft tissue swelling, ocular misalignment, keratopathy as well as a number of less common manifestations. Subconjunctival fat prolapse is a rare clinical condition occurring typically spontaneously in elderly patients with a mean age of 65–72 years. We describe subconjunctival prolapse of orbital fat as an uncommon clinical association of TAO. Materials and methods: Observational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center. Results: A superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.03%). It was one of the presenting manifestations of TAO in four of ten eyes studied and incited the diagnostic work-up for TAO in two of six patients in this series. Magnetic resonance imaging of the orbit indicated fat density in continuity with intraorbital fat in the area of protrusion. A male to female preponderance of 4:2 and an advanced mean age at onset of TAO is noteworthy for these six patients compared to the pool of 192 patients (64.8 versus 51.8 years, respectively, P=0.003) not bearing this sign. Conclusion: Subconjunctival orbital fat prolapse, a clinically impressive age-related ocular lesion, may occasionally predominate amid other clinical manifestations of TAO. It is a nonspecific sign developing most commonly among patients with a relatively advanced age at presentation. Awareness of this association may alert to the diagnosis of thyroid orbitopathy and reassure the patient and physician as to the benign character of the lesion. Keywords: subconjunctival orbital fat prolapse, elderly, age-related, Graves ophthalmopathy, thyroid associated orbitopathy, autoimmune thyroidopathy

Konstantinos Andreanos, Chryssanthi Koutsandrea, Dimitris Papaconstantinou, Andreas Diagourtas, Andreas Kotoulas, Panagiotis Dimitrakas, Marilita M Moschos First Department of Ophthalmology, University of Athens, “G. Gennimatas” General Hospital of Athens, Athens, Greece Purpose: The aim of the study was to assess the influence of central corneal thickness (CCT) and corneal curvature in tonometry measurements taken by Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT).Methods: This was a prospective study of 185 eyes from 97 subjects, attending outpatient ophthalmology appointments, who underwent intraocular pressure measurements by GAT and Pascal DCT. CCT and corneal curvature were obtained using ultrasound pachymetry and Orbscan topography, respectively. All measurements were carried out among males and females during the period 2009–2012. Apart from the usual descriptive and exploratory data analysis, one-way analysis of variance and agreement analysis were performed, linear as well as intraclass correlation coefficients were estimated, and multiple scatter and Bland–Altman plots were produced.Results: Mean IOP measurements obtained were 17.21±4.10 mmHg by DCT and 13.23±4.07 mmHg by GAT. Mean difference between the GAT and DCT measurements was 3.88±2.8 mmHg. Mean CCT and corneal curvature were 522.78±52 µm and 43.83±2.9823 D, respectively.Conclusion: Intraocular pressure measured by GAT was consistently lower when compared with DCT, and this difference was greatest with thinner CCT. Flat corneas seem to influence GAT measurements compared to DCT. Keywords: glaucoma, Goldmann, Pascal, tonometry

Marilita M Moschos,1 Eirini Nitoda,1 Irini P Chatziralli,1 Georgios D Panos,2 Constantinos A Demopoulos3 11st Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2Department of Ophthalmology, Geneva University Hospitals (HUG), University of Geneva, Geneva, Switzerland; 3Laboratory 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. Keywords: glaucoma, platelet-activating factor, prostaglandin analogs, treatment, platelet aggregation

Marilita M Moschos, Eirini Nitoda 1st Department of Ophthalmology, Medical School, National & Kapodistrian University of Athens, Athens, Greece Aim: The aim of this review was to summarize the ocular action of the most common phosphodiesterase (PDE) inhibitors used for the treatment of erectile dysfunction and the subsequent visual disorders.Method: This is a literature review of several important articles focusing on the pathophysiology of visual disorders induced by PDE inhibitors.Results: PDE inhibitors have been associated with ocular side effects, including changes in color vision and light perception, blurred vision, transient alterations in electroretinogram (ERG), conjunctival hyperemia, ocular pain, and photophobia. Sildenafil and tadalafil may induce reversible increase in intraocular pressure and be involved in the development of nonarteritic ischemic optic neuropathy. Reversible idiopathic serous macular detachment, central serous chorioretinopathy, and ERG disturbances have been related to the significant impact of sildenafil and tadalafil on retinal perfusion.Discussion: So far, PDE inhibitors do not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors. However, physicians should write down any visual symptom observed during PDE treatment and refer the patients to ophthalmologists. Keywords: erectile dysfunction, pathophysiological mechanisms, phosphodiesterase inhibitors, PDE5, visual disorders

Marilita M Moschos,1 Irini P Chatziralli,2 Michael Tsatsos3 1First Department of Ophthalmology, University of Athens, 2Second Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece; 3Department of Ophthalmology, Cambridge University Hospital NHS, Cambridge, UK Purpose: The purpose of this study is to compare the efficacy and safety of one-site and two-site combined phacotrabeculectomy with foldable posterior chamber intraocular lens implantation.Methods: Thirty-four patients (41 eyes) with glaucoma and cataract were randomly assigned to undergo either a one-site (22 eyes) or a two-site (19 eyes) combined procedure. One-site approach consisted of a standard superior phacotrabeculectomy with a limbus-based conjunctival flap, while two-site approach consisted of a clear cornea phacoemulsification and a separate superior trabeculectomy with a limbus-based conjunctival flap.Results: Mean follow-up period was 54 months (standard deviation [SD] 2.3). Mean preoperative intraocular pressure (IOP) in the one-site group was 21.3 mmHg (SD 2.8) and in the two-site group was 21.8 mmHg (SD 3.0) (P>0.1). Mean postoperative IOP significantly decreased in both groups compared to the preoperative level and was 15.6 mmHg (SD 3.5) in the one-site group and 14.9 mmHg (SD 2.7) in the two-site group. Three months later, the difference between the two groups was not statistically significant (P=0.058). The one-site group required significantly more medications than the two-site group (P=0.03). Best-corrected visual acuity (BCVA) improved similarly in both groups, but there was less postoperative (induced) astigmatism in the two-site group in a marginal statistical level (P=0.058). Intra- and postoperative complications were comparable in the two groups.Conclusion: Both techniques yielded similar results concerning final BCVA and IOP reduction. However, the two-site group had less induced astigmatism and a better postoperative IOP control with less required postoperative antiglaucoma medications compared to the one-site group. Keywords: glaucoma, filtering surgery, intraocular pressure

Marilita M Moschos,1 Eirini Nitoda,1 Irini P Chatziralli,1 Zisis Gatzioufas,2 Chryssanthi Koutsandrea,1 George Kitsos3 1First Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2Swiss Eye Research Foundation, Orasis Eye Clinic, Reinach, Switzerland; 3Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece Objective: This study was conducted to evaluate the macular status of patients treated with hydroxychloroquine before and after cessation of treatment.Methods: Forty-two patients with systemic lupus erythematosus underwent ocular examination based on visual acuity evaluation, optical coherence tomography retinal thickness measurements, and multifocal electroretinography (mfERG) records at first visit. The tests were repeated 6 months after treatment withdrawal and compared to the findings at their first visit.Results: Mean visual acuity (measured in log minimum angle of resolution) of both eyes was statistically increased after hydroxychloroquine discontinuation (difference in means: 0.06 [P

Dimitrios Brouzas, Stylianos Tsapakis, Eirini Nitoda, Marilita M Moschos First Department of Ophthalmology, Medical School, University of Athens, Greece Purpose: To present a method of visual field examination using a video projector. Also, we compare our results with those of a Humphrey perimeter, which is accepted as standard in automated perimetry. Materials and methods: Software implementing a full-threshold 4-2-step staircase algorithm for the central 30-2 of the visual field (76 points) has been developed and tested in nine eyes of seven patients using an Epson TW 700 video projector. The results were compared to those obtained from the same patients using the Humphrey perimeter. Results: High correlation between the video projector visual fields and those of the Humphrey perimeter was found. The point-to-point correlation coefficient ranged from 0.75 to 0.90, with P

Marilita M Moschos,1 Nikolaos S Gouliopoulos,1 Christos Kalogeropoulos2 1Laboratory of Electrophysiology, First Department of Ophthalmology, University of Athens, Athens, Greece; 2Department of Ophthalmology, University of Ioannina, Ioannina, Greece Purpose: Uveitis is the inflammation of the uveal tract, which usually also affects the retina and vitreous humor. The electrophysiological examination is an objective ocular examination that includes the electroretinogram, visual evoked potentials, the electrooculogram, the multifocal electroretinogram, and multifocal visual evoked potentials. Our aim is to review the literature of the use of the electrophysiological examination in cases of uveitis. Methods: We performed a systematic search of the literature of published papers until October 2012 using the PubMed search engine. The key terms that were used were “uveitis,” “electrophysiological examination”, “electroretinogram”, “visual evoked potentials”, “electro-oculogram”, “multifocal electroretinogram”, and “multifocal visual evoked potentials” in multiple combinations. To the best of our knowledge, this is the first review concerning the assessment of electrophysiology in uveitis. Results: Our search of the literature demonstrated that the electrophysiological examination, mainly by means of electroretinogram, multifocal electroretinogram, and visual evoked potentials, is performed in several cases of uveitis for many purposes, including diagnosis and monitoring of disease progression and treatment efficacy. The electrophysiological examination is more useful in patients with multiple evanescent white dot syndrome, acute posterior multifocal placoid pigment epitheliopathy, birdshot chorioretinopathy, Vogt–Koyanagi–Harada disease, Adamantiades–Behçet disease, ocular syphilis, and Fuchs heterochromic cyclitis. Conclusion: This review summarizes the use of the electrophysiological examination in uveitic patients and underlines its value as a useful tool in the objective assessment and the monitoring of the disease. Keywords: uveitis, ERG, mfERG, VEP

Marilita M Moschos, Irini P Chatziralli, George Verriopoulos, Aristeides Triglianos, Dimitrios S Ladas, Dimitrios BrouzasLaboratory of Electrophysiology, First Department of Ophthalmology, University of Athens, Athens, GreeceIntroduction: Our purpose was to study the correlation between the macular morphology and function in eyes with retinitis pigmentosa (RP).Methods: Sixty-six eyes from 33 patients with RP and with different visual acuity (VA) were studied using optical coherence tomography (OCT) and multifocal electroretinogram (mfERG). Correlation analysis was performed between VA, macular thickness, mfERG amplitude, and latency.Results: Retinal thickness, retinal response density, and latency of the mfERG in the foveal area were independently and positively associated with VA (P = 0.002; P < 0.0001; P = 0.029; and P = 0.002, respectively), whereas there was no evidence for a correlation between VA and the amplitude of mfERG in the parafoveal area. Evidence of a correlation between the OCT and the mfERG evaluation was of borderline significance (P = 0.047). Also, there was evidence for an inverse association of VA with latency in ring 1 and ring 2 (b = -0.138; 95% confidence interval: -0.261, -0.015; P = 0.029). In accordance with the univariate findings, when foveal retinal thickness, mfERG amplitude, and latency in ring 1 were inserted simultaneously in the same model, all the three variables remained significantly associated with VA (P = 0.016; P < 0.0001; and P = 0.031, respectively). Nevertheless, some individual values deviated from the expected range. More specifically, 15 eyes showed a normal retinal thickness, whereas the respective VA was relatively low and the mfERG values were abnormal. Conversely, in seven eyes, despite the low retinal thickness, the respective VA was high.Conclusion: The combined use of OCT with mfERG appears to be more appropriate for the estimation of macular function.Keywords: retinitis pigmentosa, OCT, mfERG, VA

Ioannis Havvas,1,2 Dimitris Papaconstantinou,1 Marilita M Moschos,1 Panagiotis G Theodossiadis,1 Vasilios Andreanos,1 Pantelis Ekatomatis,1 Ioannis Vergados,1 Dimitrios Andreanos1 1Department of Ophthalmology, School of Medicine, University of Athens, General Hospital of Athens, Athens, 2Department of Ophthalmology, General Hospital of Patras, Patras, Greece Background: The purpose of this study was to compare the two perimetric modalities, SWAP (short wavelength automated perimetry) and SAP (standard automated perimetry), on the point of conversion to glaucoma. Methods: In this prospective, longitudinal, follow-up study, 282 patients with ocular hypertension were recruited consecutively and tested with both SAP and SWAP annually for 5 years or until the onset of conversion to glaucoma. SAP and SWAP perimetry was performed with the Humphrey Field Analyzer II using the 24-2 full-threshold test. Abnormality for both SAP and SWAP fields was determined on the pattern deviation plot and defined as either a) one point below the 0.5% probability level or b) a cluster of 2 or more points below 1% or c) a cluster of 3 or more points below 2% or d) a cluster of 4 or more points below 5%. Abnormal tests had to be confirmed on a subsequent test within one year to be classified as conversion. Results: Of the 282 patients initially recruited, 32 were excluded. Of the 250 remaining patients, a total of 38 converted during the follow-up period; 36.8% of conversions were detected earlier with SWAP, 29% simultaneously, and 34.2% were not detected with SWAP during the follow-up period; 2.4% of patients showed SWAP visual field loss that did not result in conversion during the follow-up period. Conclusion: The results in our study are inconclusive. There were patients with earlier, simultaneous, or no SWAP conversion, with SAP conversion as the golden standard criterion. One should consider both SAP and SWAP with confirmation when visual field loss is evident to maximize early detection of glaucoma, because it appears that each method identifies early glaucoma in a subset of patients and these subsets overlap only partially. Keywords: short wavelength automated perimetry, standard automated perimetry, blue on yellow, glaucoma conversion, ocular hypertension

Marilita M Moschos,1 Zisis Gatzioufas,2 Tryfon Rotsos,1 Chrysanthos Symeonidis,3 Xuefei Song,2 Berthold Seitz2 11st Department of Ophthalmology, University of Athens, Athens, Greece; 2Department of Ophthalmology, University of Saarland, Homburg/Saar, Germany; 32nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece Background: Macular edema (ME) is caused by abnormal retinal capillary permeability and has also been described as a postoperative complication of cataract surgery (Irvine-Gass syndrome). Objective: To present a patient with Irvine-Gass syndrome in the right eye complicated with a macular hole (MH) in the same eye and possible associations between these two entities. Case report: A 72-year-old male with a history of uneventful bilateral cataract surgery was followed-up with biomicroscopy and optical coherence tomography (OCT). Four weeks after cataract surgery oculus dexter (OD), there was progressive visual deterioration (best corrected visual acuity [BCVA]: 0.5). OCT disclosed cystoid ME. A parabulbar triamcinolone injection, dexamethasone 0.1% and ketorolac 0.4% eye drops, both 4 times per day OD were administered. Six weeks later (BCVA OD: 0.2), OCT revealed cystoid ME and full-thickness MH. Conclusion: ME secondary to diabetes or central retinal vein occlusion may lead to MH by inducing focal vitreomacular traction and by triggering inflammatory mechanisms which facilitate a marked thinning of the fovea. MH may occur even in cases of pseudophakic ME, representing a rare complication of Irvine-Gass syndrome. Keywords: Irvine-Gass syndrome, macular hole, macular edema