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Vasiliki Xirou,1 Tina Xirou,1 Charalambos Siganos,2 Panagiota Ntonti,3 Constantinos Georgakopoulos,4 Panagiotis Stavrakas,4 Olga E Makri,4 Menelaos Kanakis,4 Foteini Tsapardoni,4 Ioannis Fragkoulis,4 Christina Garnavou-Xirou,1 Vassilios Kozobolis3– 5 1Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece; 2Ophthalmology Department, University Hospital of Heraklion, Heraklion, Greece; 3Ophthalmology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece; 4Ophthalmology Department, University Hospital of Patras, Patras, Greece; 5Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, GreeceCorrespondence: Vasiliki Xirou, Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece, Email vxirou@yahoo.itPurpose: The aim of this study was to evaluate and compare the changes in Intraocular Pressure (IOP) and other ocular parameters: the Anterior Chamber Angle (ACA), Anterior Chamber Volume (ACV), and Anterior Chamber Depth (ACD) during phacoemulsification surgery in Greek patients with normotensive eyes and those with well-controlled Open-Angle Glaucoma (OAG). Additionally, parameters such as the Corneal Thickness (CCT), Axial Length (AL), Central Macular Thickness (CMT), and Retinal Nerve Fibre Layer (RNFL) were also examined.Patients and Methods: This was a prospective observational case–control study that included 50 phakic eyes, 25 normotensive (Group 1), and 25 with OAG: 15 Primary Open-Angle Glaucoma (POAG) and 10 Exfoliation Glaucoma (EXG) (Group 2). Ophthalmic assessment included IOP measurements, ocular biometry, and anterior and posterior segment optical coherence tomography evaluation of the aforementioned ocular parameters, prior and 6 months after phacoemulsification surgery.Results: At the 6 months post-operative review, a greater IOP reduction was recorded in eyes with OAG, in comparison to normotensive ones (5.3mmHg and 1.6 mmHg respectively). In addition, a significant but similar increase was recorded in the values of the ACA, ACV, and ACD of both groups between the pre- and the post-op period. Furthermore, the CCT and AL values remained unaltered. Finally, there was a non-statistically significant change in the mean CMT and the mean average RNFL of both groups.Conclusion: Eyes with OAG tend to undergo a greater reduction in IOP post-phacoemulsification surgery, in comparison to normotensive eyes. This reduction may not be solely attributed to ocular anatomical changes after phacoemulsification surgery but may also be due to the remodeling of the trabecular meshwork and the ciliary body. This may be especially true in the case of OAG eyes, which already start off with a compromised trabecular endothelium prior to surgery.Keywords: cataract surgery, open angle glaucoma, biometry, axial length, intraocular pressure, corneal pachymetry

Stamatina A Kabanarou,1 Tina Xirou,1 George Mangouritsas,1 Christina Garnavou-Xirou,2 Eirini Boutouri,1 Ilias Gkizis,1 Irini Chatziralli3 1Retina Department, Korgialeneio Benakeio, Hellenic Red Cross Hospital, Athens, Greece; 2Retina Department, King’s College Hospital, London, UK; 32nd Department of Ophthalmology, University of Athens, Athens, Greece Purpose: Macular hole (MH) is part of a group of age-related degenerative diseases characterized by pathology of vitreomacular interface. Similarly, neovascular age-related macular degeneration (nAMD) affects older patients and is a leading cause of irreversible visual loss. The purpose of this case series is to describe the development of full-thickness MH in patients with nAMD, following antivascular endothelial growth factor (anti-VEGF) treatment.Methods: Participants in this case series were four patients with nAMD, who received anti-VEGF injections with variable therapeutic response to treatment. Patients were examined at baseline (when AMD was diagnosed) and monthly thereafter. The examination included visual acuity measurement, slit-lamp biomicroscopy, and optical coherence tomography.Results: All patients were found to develop full-thickness MH within 1–4 months after the last anti-VEGF injection, even in the absence of pre-existing vitreomacular interface abnormalities in some cases. The median number of injections before the MH formation was 3.Conclusion: MH formation may represent an adverse effect of anti-VEGF treatment in patients with nAMD and could be also coexisting pathology with nAMD in older individuals. Keywords: macular hole, age-related macular degeneration, anti-VEGF

Tina Xirou,1 Panagiotis G Theodossiadis,2 Michael Apostolopoulos,3 A Stamatina Kabanarou,1 Elias Feretis,1 Ioannis D Ladas,3 Chrysanthi Koutsandrea31Vitreoretinal Unit, Red Cross Hospital, 2B Department of Ophthalmology, University of Athens, Greece; 3A Department of Ophthalmology, University of Athens, GreecePurpose: To report on the outcomes of vitrectomy and sulfur hexafluoride (SF6) gas tamponade for idiopathic macular holes with 2 days of face-down positioning.Patients and methods: This was a prospective, nonrandomized, observational sequential case-series study on 23 consecutive patients receiving macular hole surgery using 20% SF6 and advised to stay in a face-down position for 2 days postoperatively (SF6 group). These patients were compared to 23 consecutive patients who had previously undergone macular hole surgery, had received 14% C3F8, and were advised to maintain a face-down position for 2 days (C3F8 group). Patients in both groups underwent vitrectomy, internal limiting membrane peeling, and fluid gas exchange using either SF6 or C3F8. Preoperative and postoperative data included best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography.Results: At a 6-month follow-up, macular hole closure was noted in 23/23 eyes (100%) and in 22/23 eyes (96%) in the SF6 and C3F8 groups, respectively. The improvement in visual acuity (measured through Snellen acuity lines both preoperatively until 6 months postoperatively) was 4.08 ± 2.31 (95% confidence interval [CI]: 3.08–5.08) for the SF6 group and 2.87 ± 2.30 (95% CI: 1.87–3.86) for the C3F8 group; this difference was not statistically significant (P = 0.06).Conclusion: Vitrectomy with internal limiting membrane peeling and a short-acting gas tamponade using SF6 with posture limitation for 2 days may give a high success rate in macular hole surgery.Keywords: idiopathic macular holes, SF6 gas tamponade, C3F8 gas tamponade

Tina Xirou, Andrej Kidess, Christina Kourentis, Vasiliki Xirou, Elias Feretis, Stamatina A KabanarouRetina Department, Hellenic Red Cross General Hospital, Athens, GreeceBackground: The purpose of this study was to investigate lamellar macular hole formation in six patients after rhegmatogenous retinal detachment repair.Methods: A retrospective review of medical records of patients who underwent primary pars plana vitrectomy for rhegmatogenous retinal detachment repair was performed. Optical coherence tomography characteristics and best-corrected visual acuity were evaluated. Patients who developed lamellar macular hole after pars plana vitrectomy for rhegmatogenous retinal detachment repair were identified.Results: A total of 1185 eyes underwent pars plana vitrectomy for retinal detachment between 2004 and 2009. Optical coherence tomography evaluation was available in 450 cases. Six of these cases demonstrated lamellar macular hole formation, which was diagnosed by OCT-3. The mean time from retinal detachment surgery to lamellar hole diagnosis was 4.1 months. The presence of an epiretinal membrane on the surface of the juxtafoveal retina was a common finding in all six patients. Visual acuity was improved after successful retinal reattachment and remained unchanged after lamellar hole formation.Conclusion: Lamellar macular holes developing after pars plana vitrectomy is a rare complication. Stability of optical coherence tomography findings and best-corrected visual acuity after lamellar macular hole formation may be observed for at least two years.Keywords: lamellar macular hole, rhegmatogenous retinal detachment

Purpose To report a case with bilateral macular coloboma and RP (retinitis pigmentosa) like changes. Methods A 46‐year‐old female presented with macular coloboma in both eyes. There was a history of strabismic amblyopia in her right eye but no other contributory medical or family history.Best corrected Snellen visual acuity (BCVA) was measured and full ophthalmic examination was performed. Visual field testing, optical coherence tomography (OCT) and international‐standard electrophysiological (ISCEV) evaluation, including pattern and full‐field electroretinography (PERG and FFERG), were also performed. Results BCVA was hand movements in the right eye and 0.5 in her left eye. Fundoscopy revealed an oval sharply‐ demarcated defect at the macula with bare sclera at its base and pigment clumping, mainly in the right eye, resembling macular coloboma. There were also severe retinal vessel attenuation and scattered retinal pigmentary changes, occasionally resembling bone spicule RPE changes, in the retinal periphery in both eyes. Optic discs were pale bilaterally. Visual field testing demonstrated bilateral scotomas. OCT revealed a crater‐like depression at the macula with atrophic neurosensory retina and absence of retinal pigment epithelium (RPE) and choroid, more extensive in her right eye, where scleral excavation was also documented. Pattern ERG as an indication of macular function was extinguished in the right eye and severely affected in her left eye. Full field ERG was extinguished bilaterally for both scotopic and photopic responses. Conclusion Bilateral macular coloboma associated with RP like changes, an abnormal electroretinography and no relevant family history, may be indicative of a developmental retinal abnormality. [ABSTRACT FROM AUTHOR]

Purpose To report a case of unilateral peripheral exudative haemorrhagic chorioretinopathy (PEHCR) complicated with acute onset of visual loss. Methods A 64‐year‐old female presented with a one week history of sudden onset of visual loss in her left eye. There was no other relevant medical or family history. Best corrected Snellen visual acuity (BCVA) was documented and full ophthalmic examination was performed. Results BCVA was 1.0 in her right eye and hand movements in the left eye. Complete ophthalmic examination of her right eye was normal. Anterior segment examination of her left eye was unremarkable. There was no view of her left fundus. B‐scan ultrasonography revealed vitreous haemorrhage with no evidence of retinal detachment. Pars plana vitrectomy was performed few weeks later. At follow up examination fundoscopy revealed extensive subretinal and sub‐RPE haemorrhage in the retinal periphery temporal to the macula. Fundus fluorescein angiography (FFA) revealed patchy blockage of the background choroidal fluorescence corresponding to the suretinal/sub‐RPE haemorrhage. Indocyanine green angiography revealed no further pathology. Visual acuity was finally improved to 1.0 and disciform retinal degeneration was documented at the temporal periphery. Seventeen months later the patient remained stable. Conclusion PEHCR is a haemorrhagic retinal degenerative process, which can be complicated with vitreous haemorrhage and sudden visual loss. Differential diagnosis from choroidal melanoma or other vascular lesion is of major importance. [ABSTRACT FROM AUTHOR]