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Purpose: To evaluate macular capillary plexus changes with OCT-angiography with regard to macular detachment duration in macula-off rhegmatogenous retinal detachment (RRD). Methods: 23 eyes of 23 patients were included in this retrospective case–control study and were divided into 2 groups. Group-A had a macular detachment duration of 0 to 10 days and group-B of 11 to 30 days. All eyes underwent a single successful pars plana vitrectomy (PPV) and gas tamponade. We analysed the OCT-A characteristics and visual outcomes at 12 weeks postoperatively in the 2 groups. The fellow eye was used as control. Results: Vessel density (VD) and flow density (FD) in the superficial capillary plexus (SCP) were significantly lower in group-B (p

Purpose: To review the role of antigen-presenting cells (APC) in the pathogenesis of ocular surface diseases (OSD). Methods: A thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items. Results: APCs have the ability to initiate and direct immune responses and are found in most lymphoid and non-lymphoid tissues. APCs continuously sample their environment, present antigens to T cells and co-ordinate immune tolerance and responses. Many different types of APCs have been described and there is growing evidence that these cells are involved in the pathogenesis of OSD. OSD is a complex term for a myriad of disorders that are often characterized by ocular surface inflammation, tear film instability and impairment of vision. Conclusions: This review summarizes the current knowledge concerning the immunotopographical distribution of APCs in the normal ocular surface. APCs appear to play a critical role in the pathology of a number of conditions associated with OSD including infectious keratitis, ocular allergy, dry eye disease and pterygium. © 2020, Springer Nature B.V.

Purpose: To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD). Methods: This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out. Results: This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications. Conclusion: CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection. © 2019, Springer Nature B.V.

Children comprise a unique population of patients in regard to the diagnostic and therapeutic approach of uveitic glaucoma. The management of glaucoma secondary to uveitis in children is extremely challenging and presents various difficulties, which are associated both with the underlying uveitis and the young age of the patients. The treatment of uveitic glaucoma calls for a thorough and individualized approach, involving both pharmacotherapeutic and surgical modalities. It appears that the efficient control of inflammatory activity plays a significant role in the final visual outcome of these patients. This study aims to review the current literature about the management of uveitic glaucoma in pediatric patients.

Pregnancy is a normal state of physiological stress that induces significant changes in the human body, some of which can potentially affect the visual system. The pregnant state may exacerbate pre-existing ocular disorders (i.e. diabetic retinopathy or central serous retinopathy). Moreover, other systemic conditions related to pregnancy can induce ophthalmic disorders affecting the retina and the choroid, some of which are of acute nature. Increasing awareness and improving collaboration between ophthalmologists, obstetricians and internists can play a pivotal role in the management of complex conditions during pregnancy. Special attention should be given while prescribing medications or deciding about other diagnostic or therapeutic techniques. The purpose of this review is to summarise the physiologic and pathologic effects of pregnancy in the eyes, highlighting the most acute clinical entities that may be threatening for the vision or even the life of the mother and her baby. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Primary vitreoretinal lymphoma (PVRL) is a rare ocular lymphoid malignancy, which consists a subset of primary central system lymphoma (PCNSL) and the most common type of intraocular lymphoma. The involvement of eyes is estimated to be approximately 20% of PCNSL, but the brain involvement may be up to 80% of PVRL. Typically, PVRL is a high grade B-cell malignancy of the retina and needs to be assorted from choroidal low-grade B-cell lymphomas. Very often PVRL masquerades and can be erroneously diagnosed as chronic uveitis, white dot syndromes or other neoplasms. Establishing an accurate diagnosis may involve cytology/pathology, immunohistochemistry, flow cytometry, molecular pathology and cytokine profile analysis. There is inadequate information about PVRL's true incidence, ethnic/geographical variation and pathogenetic mechanisms. The therapeutic approach of PVRL involves aggressive chemotherapy and radiation therapy. Although PVRL tends to have a good response to the initial treatment, the prognosis is poor and the survival restricted due to the high relapse rates and CNS involvement. © 2019 The Authors

OBJECTIVE: The study was designed to investigate the potential effect of fish consumption on macular structure and function of healthy individuals. PATIENTS AND METHODS: The participants were Greek, who used to consume less than one portion of fish per week since their childhood. All participants underwent body mass index (BMI) measurements and ophthalmological examination. At their first examination, they were asked to consume at least 2 portions of fish per week over a period of 8 weeks, after which all the measurements were repeated. RESULTS: Eighteen healthy individuals (36 eyes) participated in this study. The central macular thickness was reduced, while the amplitudes in the foveal and parafoveal area were increased after the fish consumption. However, all measurements remained within the normal range at both visits. CONCLUSIONS: Regular fish consumption could enhance the structural and functional status of the macula. © 2018 Verduci Editore s.r.l. All rights reserved.

Aim: To determine depression in patients with choroidal melanoma (CM) treated with proton beam radiotherapy. Patients and Methods: This was a cross-sectional study including 50 patients with CM (50% males, mean age=49.88±6.34 years) and 46 age- and sex-matched healthy controls (52% males, mean age=48.60±8.05 years). Participants completed the Patient Health Questionnaire-9 (PHQ-9) and the Zung Self-Rating Depression Scale (SDS) questionnaires. Results: There was a considerable difference in visual acuity as logarithm of the minimum angle of resolution (logMAR) between the patient and control groups (1.16±0.97 and 0.04±0.05 logMAR, respectively, p

OBJECTIVE: Diabetic retinopathy is the leading cause of irreversible blindness in the western world, among the working-age people. Its exact pathogenesis, however, remains obscure. Systemic inflammation is regarded to play a significant role in diabetes by contributing, among others, to the development of diabetic retinopathy. This review focuses on the possible involvement of the systemic inflammatory markers in the pathogenesis of diabetic retinopathy. MATERIALS AND METHODS: We performed a systematic search of the literature of published papers until August 2017 using the PubMed search engine. RESULTS: We demonstrated that many systemic inflammatory markers contribute to the pathogenesis and progression of retinopathy, while we highlighted in several occasions their usefulness as a key tool in the monitoring of the disease progression and the treatment efficacy. CONCLUSIONS: To the best of our knowledge this is the first review in the literature that elaborates the possible association of serum inflammatory markers and diabetic retinopathy, a disease that may cause irreversible loss of vision. © 2018 Verduci Editore.All right reserved.

Cogan's syndrome is a rare disorder characterized by ocular and audiovestibular manifestations in its typical form and caries a wide variety of atypical manifestations. It is considered as an autoimmune disease. We present the first case in the literature of a 67. year old woman with the development of low grade non-Hodgkin lymphoma (NHL) in the mastoid bone in a pre-existing history of atypical Cogan's syndrome. The anatomical development of NHL was to a "target" organ of Cogan's syndrome, which is the inner ear. © 2014. 6 3 523 527

Background: In this study, we conducted the genotyping of D326Y in COL4A3 and M1327V, as well as F1644F in COL4A4 polymorphisms, in a case-control sample panel of Greek origin population. Materials and methods: A case-control panel, with 45 keratoconus (KC) patients and 78 healthy controls, were surveyed. DNA from each individual was tested for the D326Y in COL4A3 and M1327V, as well as F1644F in COL4A4 polymorphisms by direct sequencing. Results: When analyzing the Hardy-Weinberg equilibrium, we observed no significant deviation from expected numbers in both KC patients and controls. The genotype frequencies in the polymorphisms tested were not found to be significantly associated with KC development risk. The M1327V AA and F1644F TT genotypes were significantly over-represented in healthy individuals. Conclusions: We could hypothesize that mutations in COL4A3 and COL4A4 genes are not involved in KC risk in Greek population. Nevertheless, the M1327V AA and F1644F TT genotypes were significantly over-represented in healthy individuals, suggesting a protective role of these genotypes in KC development risk in our population. © 2014 Informa Healthcare USA, Inc. All rights reserved.

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. © 2014 Moschos et al.

Purpose: To evaluate the retinal toxicity of intravitreal trastuzumab in a rabbit model. Methods: Fourteen New Zealand albino rabbits, weighing between 2.5 and 3 kg were used for this study. In the first group (n=6), 0.1 mL trastuzumab 10 mg/mL was injected into the vitreous. In the second group (n=6), the same volume of sterile balanced saline solution was injected intravitreally (sham injection). Additionally, 0.1 mL of 2 other concentrations of trastuzumab (7.5 and 5 mg/mL, respectively), was injected into the vitreous of 2 rabbits. Slit-lamp and funduscopic examinations were performed and the animals were observed for 2 weeks for signs of inflammation, infection, and toxicity. An electroretinogram (ERG) was performed at baseline and 14 days after the injection. The animals were killed on day 14 and a histological examination was performed in the enucleated eyes. Results: The clinical examination was unremarkable on either sham or intravitreal injection of trastuzumab. Conversely, the ERG was greatly affected and in 2 cases extinguished 14 days after trastuzumab injection. Consistent with electrophysiological abnormalities of the retina, signs of retinal edema in experimented eyes, suggesting morphologic retinal damage, were observed. In contrast, in the sham injected eyes, the ERG was normal without histopathologic retinal changes. Conclusions: Intravitreal trastuzumab seems to be toxic to the retina in albino rabbits even at a concentration of 5 mg/mL. Further studies are needed to evaluate the safety of intravitreal trastuzumab in models of choroidal neovascularization, as well as to obtain experience concerning the intravitreal toxicity of trastuzumab in primates too and not only in rabbits. © Mary Ann Liebert, Inc. 2013.

We describe 6 bilateral cases of progressive Mooren's ulcer treated by performing conjunctival excision (regional or 360 degrees peritomy). The histopathological study of the conjunctiva adjacent to the lesion showed an hyperaemic and edematous stroma infiltrated mainly by plasma cells and lymphocytes without signs of vasculitis. The peripheral portion of the ulcer was characterized by necrobiotic and hemorrhagic elements along with an absence of the overlying epithelium and Bowman's membrane. Inflammation of the corneal stroma was present in the peripheral but absent in the central edge of the ulcer, a characteristic sign of a rodent ulcer. Therefore, the histopathological study was very useful for the final diagnosis and the differential diagnosis of Mooren's ulcer from other cases of peripheral ulcerative keratitis. In all 6 cases conjunctival excision appeared to be an effective procedure in halting the progression of the disease: absence of recurrences during a follow-up period of 1-2 years provided an essential healing of the cornea. Int Ophthalmol

PURPOSE: To estimate the incidence of retinopathy of prematurity and other ocular problems in a population of preterm infants. METHODS: This retrospective study included all infants with gestational age (GA)

PURPOSE: To evaluate the use of F6H8 as a temporary endotamponade for complicated and special cases of retinal detachment instead of silicone oil. METHODS: We have used F6H8 with 14 patients since February 1999. Eight suffered from rhegmatogenous retinal detachment (RRD) with multiple tears located inferiorly. Three presented inferior traction retinal detachment (TRD) under silicone oil, two suffered from ocular trauma with inferior TRD, and one had idiopathic macular hole. The substance was introduced into the eye after pars plana vitrectomy and membrane peeling if needed, and we tried to introduce as much as possible. RESULTS: With F6H8 the retina was easily reattached in all cases, like with perfluorocarbon liquids. The postoperative view was very good. F6H8 was removed in all cases after 3-8 weeks. Anatomical success was achieved in 12 out of 14 eyes. Two eyes presented severe PVR. F6H8 entered the anterior chamber in 4 cases, but no corneal complications occurred. In one case there was a marked IOP rise due to an anterior block, treated with superior iridotomy. In two cases retinal detachment (RD) occurred in the upper part and was treated with additional surgery, F6H8 removal and silicone oil injection. CONCLUSIONS: F6H8 seems to be a promising tamponade agent for special cases of RD. Eur J Ophthalmol

There is a recognized association between the presence of anticardiolipin antibodies and vascular occlusive disease. The purpose of our study is to detect the presence of high titers of anticardiolipin antibodies (ACA) in the serum and to correlate the titers with the severity of the vascular disease in patients with occlusive ocular vascular disease. 82 patients were included in a prospective study; 25 patients with anterior ischaemic optic neuropathy, 36 with retinal vein occlusion and 21 with retinal artery occlusion. ACA (IgG and IgM isotypes) were measured by ELISA in the sera of all patients. The group of the patients (group A) was compared to an age-matched control group of 79 healthy individuals (group B). IgG isotype (but not IgM) titers of ACA were found significantly higher in group A (P < 0.001). In patients with titers of ACA (IgG isotype) > 100 units we noted a higher incidence of a more severe disease (recurrency, involvement of both eyes or extraocular manifestations) especially among those with anterior ischaemic optic neuropathy and secondarily in those with retinal artery occlusion. Our results suggest that the association between high titers of ACA and occlusive vascular disease of the eye concerns only the IgG isotype. In addition, the detection of high titers of IgG/AGA in patients could be a useful marker for disease severity and prognosis and this observation seems to be more explicit in cases with arterial occlusive disease than in cases with venous occlusive disease. Doc Ophthalmol

Copper (Cu) and zinc (Zn) are essential trace elements for the structure and function of the retina, particularly for the pigment epithelium and photoreceptors, where they participate as coenzymes in very important reactions. This study was to determine whether patients with Stargardt's disease and with typical retinitis pigmentosa show changes in serum levels for Cu and Zn, Serum analysis for Cu and Zn concentrations was performed by means of a Perkin Elmer 560 atomic absorption spectrophotometer, in 10 patients with retinitis pigmentosa (group RP), 10 patients with Stargardt's disease (group St) and 10 normal individuals (group N) of the same age range, all were inhabitants of the same region. Statistical analysis of the results was carried out using the Student's t test. The mean serum levels (+/- SD) of Zn (mu g/ml) in groups RP, St, aad N were 0.51 +/- 0.1, 0.79 +/- 0.1, and 0.98 +/- 0.15, respectively. The mean serum levels (+/- SD) of Cu (mu g/ml) in groups RP, St, and N were 1.04 +/- 0.2, 0.95 +/- 0.14, and 0.94 +/- 0.1, respectively, Zinc serum levels were found to be significantly lower (p < 0.001) in retinitis pigmentosa and Stargardt's disease (p = 0.003) compared to those of normal subjects. In addition, zinc serum levels were significantly lower (p < 0.001) in patients with retinitis pigmentosa compared to those with Stargardt's disease. Cu serum levels did not differ significantly between the groups. Our results suggest that these 2 retinal diseases are associated with disturbances mainly of zinc metabolism. Zn serum levels difference between Stargardt's disease and typical retinitis pigmentosa is probably related to the pathophysiology and type of lesions in these diseases. Trace Elements and Electrolytes

PURPOSE: Study of early hystological lesions after experimental branch venous occlusion (BVO) in miniature pigs. MATERIALS AND METHODS: The retina was taken 1, 2, 4, 6 and 8 hours after BVO with green argon laser for examination with conventional and electronic microscopy. RESULTS: 1 hour after occlusion an extracellular focal oedema is observable in the ganglion cells optic nerve fibers and cells of inner plexiform layer; 2 hours after occlusion there is also an extracellular oedema of the external plexiform layer as intracellular oedema of the inner nuclear layer, 4 hours after occlusion the extracellular oedema is more diffuse especially in the ganglion cells, inner nuclear and optic nerve fibers layers. Cytoplasmic vacuolisation, nuclear pycnosis and ruptured cell membrane layers are observed; 8 hours after occlusion both intra and extracellular oedema are observable throughout the inner retina. CONCLUSIONS: After BVO histological lesions are found within one hour only following the occlusion, apoptosis and cell necrosis are present as soon as 4 hours after experimental BVO. Klin Monbl Augenheilkd

PURPOSE: We present hereby some results indicating that there is a significant decrease in the release of NO by the retina immediately after branch-venous occlusion (BVO). METHODS: Using an NO microprobe we measured (NO) in the preretinal vitreous of miniature pigs before and two hours aRer bvo. Conventional and electronic microscopy were performed on the affected retina. RESULTS: At the retinal surface (NO) was reduced to 25% of the previous value two hours after BVO, at the same time significative oedema of the inner retina was observed. CONCLUSIONS: Immediately after BVO there is a significative decrease in the amount of NO released by the affected retina, parallel to the first evidences of an oedema of the inner retinal layers. Klin Monbl Augenheilkd

Several intraocular lens (IOL) power calculation formulas (either theoretical or empirical) are used to determine the emmetropic IOL power) The Sanders-Retzlaff-Kraff (SRK) linear regression formula is among the most widely recognized empirical ones. In the present study intraocular lens power calculation aiming at emmetropia was performed, using SRK formula, in 145 cataractous eyes undergoing lens implantation. The final refraction was evaluated at 8 to 12 months after surgery. The purpose of this study was the identification and quantitative evaluation of the factors which influence significantly the accuracy of SRK in the intraocular lens power calculation. The following factors were studied: (1) the error in preoperative biometry with regard to the difference between post and preoperative axial length measurements, (2) the position of the implantation of the intraocular lens (anterior versus posterior chamber), (3) the intraocular lens style, (4) the intraocular lens power level, (5) the preoperative corneal astigmatism, (6) the surgically induced corneal astigmatism, and (7) the postoperative astigmatism. Multiple regression and stepwise regression analysis showed a strong correlation (R2 = 0.65; p < 0.001) between postoperative refractive error (Rf) and error in preoperative biometry (delta AL), surgically induced corneal astigmatism (SIA) and postoperative astigmatism (Ap) only. This correlation is expressed by the following equation: Rf = 0.07 -2.55 delta AL -0.42 SIA + 0.34 Ap. This equation indicates the quantitative effect of each factor on the accuracy of the SRK formula, by defining the pattern of the fluctuations of the amount or state (myopic or hyperopic) of refractive error induced by changes of variables delta AL, SIA and Ap. Doc Ophthalmol

Tuberculous uveitis usually appears as chronic anterior uveitis or disseminated choroiditis. From 1982 to 1989, we conducted a retrospective study of 23 patients with presumed tuberculous uveitis. All patients had a positive tuberculin purified protein derivative skin test. The diagnosis was based on history, positive skin test, and physical examination. We excluded other conditions that could induce uveitis, based on the absence of signs, symptoms, or laboratory results suggesting any other diagnosis. Tuberculous uveitis was also considered in the differential diagnosis when progressive ocular inflammation was resistant to corticosteroid therapy. The patients received the following treatment: (1) isoniazid (300mg/day) and rifampin (600mg/day) for nine to 12 months, (2) ethambutol (1200mg/day) in some cases for two to three months, and (3) corticosteroids orally where indicated. In cases with anterior uveitis, we added local instillation of mydriatics and corticosteroids. There was no regression, nor were there any side effects of antituberculosis therapy in all 23 patients. We noted clinical improvement in 78% of cases. Five patients had other conditions (cataract or retinal detachment) that worsened their vision. Ann Ophthalmol

To investigate the possibility of limiting infarct size by decreasing afterload 32 normotensive patients with uncomplicated acute myocardial infarction (AMI) were put on prazosin and compared with 32 control patients. Blood pressure fell significantly lower in the prazosin group without increase of heart rate. The mean daily and peak levels of serum aspartate transaminase and lactic dehydrogenase and the calculated from the 12 lead ECG mean daily sum of ST segment elevation, number of leads with ST greater than or equal to 0.1 mV, mean ST elevation, number of new Q waves greater than or equal to 0.03 s and the loss of height of R waves were significantly less in the prazosin group. ST segment re-elevation occurring on 2nd-3rd day in the control group was absent or minimal in the prazosin group. The enzyme levels and the change of the ECG variables correlated fairly well with the change of blood pressure. These findings indicate that, at least in the selectively good risk cases of our material, reduction of afterload without increase of heart rate induced by prazosin may favorably influence the balance of myocardial oxygen supply and demand early in AMI and prevent death of jeopardized ischaemic tissue, thus limiting the final extent of the infarct. Acta Cardiol