Konstantinos Laios

Aretaeus of Cappadocia and the first description of diabetes

The name Aretaeus of Cappadocia has been linked with diabetes more than that of any other physician of antiquity, his texts forming a sophisticated synthesis of the previous knowledge on this disease copiously supplemented by his own observations. Gifted with a unique faculty for observing pathologic phenomena, he was able to elaborate upon earlier texts enriching them with his own original findings and numerous thoughtful reflections. Among the many diseases he dealt with, Aretaeus has bequeathed to us an outstandingly vivid and accurate description of diabetes.

A unique representation of hypospadias in ancient Greek art

Hypospadias, a congenital defect in the development of the penis and urethra, was well-described in ancient Greek medical literature.

Apollinaire Bouchardat (1806-1886): founder of modern Diabetology.

Apollinaire Bouchardat is regarded as the founder of the field of Diabetology. His contributions to the field include the first known recommendations for specific diets for the management of Diabetes Mellitus and his emphasis on patient education and self-monitoring. He was moreover a great pharmacist as well as a distinguished physician and biochemist.

Anatomy and art

Leonardo da Vinci, Jean Falcon, Andreas Vesalius, Henry Gray, Henry Vandyke Carter and Frank Netter created some of the best atlases of anatomy. Their works constitute not only scientific medical projects but also masterpieces of art.

Glaucoma and the Origins of Its Name.

Purpose:To identify the origins of the name of the disease Glaucoma. Methods:Ancient Greek medical literature, Homeric poems, and ancient Greek religion and art were examined. Results:The roots of the name Glaucoma could be traced back to Homeric times. Ancient Greek physicians following the Hippocratic tradition preferred the use of the terms Hypochysis or Hypochyma for the same disease. This fact indicates that the older term Glaucoma did not fulfill strict medical criteria, but had a long history connected to superstition, which the rational ancient Greek physician tried to overcome using terms derived from their fundamental principal of humoral pathology. Conclusions:In ancient Greek medical literature, Glaucoma had a significant place among ocular diseases. The origin of its name could be traced back to Homeric times and could be connected to the ancient belief of a primitive folk about the apotropaic role of animals against diseases, which in this case is represented by the superstitious role of the owl.

Electrophysiological assessment for early detection of retinal dysfunction in β-thalassemia major patients

PurposeThe purpose of this study was to assess the role of various diagnostic tests in early detection of retinal changes in β-thalassemia major patients.MethodsThirty-eight visually asymptomatic β-thalassemia major patients receiving regular blood transfusions and iron-chelation therapy with deferoxamine (group A, n = 13), deferasirox (group B, n = 11) or deferoxamine with deferiprone (group C, n = 14) and fourteen age- and sex- matched healthy individuals were included in the study. All participants underwent ophthalmoscopy, full-field electroretinography (ERG), visual evoked potentials (VEP), multifocal electroretinography (mfERG), fundus autofluorescence (FAF) imaging and optical coherence tomography (OCT) scans.ResultsRetinal pigment epithelium changes were present in two cases. Scotopic ERG demonstrated decreased a-wave amplitude in groups A, B and C (p = 0.03, p = 0.002 and p = 0.002, respectively) and decreased b-wave amplitude in groups B and C (p = 0.002 and p = 0.01, respectively) compared to controls. Photopic ERG showed delayed b-wave latency in groups A and C (p = 0.03 and p = 0.03, respectively) ERG maximal combined response and VEP response did not differ between groups. MfERG showed reduced retinal response density in ring 1 in groups A, B, C (p < 0.001, p < 0.001, p = 0.001, respectively) and ring 2 in group B (p = 0.02) and delayed latency in ring 5 in groups A and B (p = 0.04 and p = 0.04, respectively). Abnormal FAF images appeared in three cases and OCT abnormalities in one case, whereas no changes were observed in controls (p = 0.55 and p = 1.00, respectively).ConclusionsFull-field ERG and mfERG are more sensitive tools for detecting early retinal changes in β-thalassemia patients compared with ophthalmoscopy, VEP, FAF imaging and OCT scans.

Response to: Comment on "The Impact of Chronic Tobacco Smoking on Retinal and Choroidal Thickness in Greek Population".

We would like to thank Uzun for his observations [1]. Indeed choroidal thickness is influenced by several factors such as age, axial length, corneal curvature, intraocular pressure, systolic blood pressure, ocular perfusion pressure, and time of measurement [2]. Margolis and Spaide reported a 15.6-micron decrease in choroidal thickness every decade [3]; similarly, a 14-micron decrease every decade was reported by Ikuno et al. [4]. Wei et al. noted a thinning in subfoveal choroidal thickness among people around 65 years, estimating this reduction around 4 μm per year of age. Regarding axial length Wei et al. reported that the subfoveal thickness decreases by 15 microns for every increase in myopic refractive error of 1 D or by 32 microns for every increase in axial length of 1 mm [5]. Fujiwara et al. reported that choroidal thickness decreases by 12.7 μm for each decade of life and by 8.7 μm for each diopter of increasing myopia [6]. Gupta et al. supported that peripapillary choroidal thickness on average is decreased by 13.02 μm and 36.72 μm for each millimeter increase in axial length and corneal curvature, respectively. They also noted that each increment of myopic diopter resulted in the reduction of mean peripapillary choroidal thickness by 5.39 μm. On the other hand, they estimated that choroidal thickness augmented by 1.40 μm and 0.74 μm, when the intraocular pressure was increased by a millimeter of mercury or the retinal nerve fibre layer was raised by a micrometer, respectively [7].

The Forgotten Asclepieion of Peparithos and the Islander Worshippers of the Snake God

The ancient Asclepieion of the island of Peparithos, modern Skopelos, had been build in an ideal position, one kilometer from the ancient city of Peparithos. The angry north Aegean Sea brought in the surface its north wall at the beginning of the 60s decade. The monument was identified as an Asclepieion from one partially saved ceramic inscription “ASCL…” (Greek: ΑΣΚΛ…). The sanctuary was surrounded by covered walkway (Greek: στοά) and it is dated at the early years of the fourth century BC. It is possible that god Apollo and goddess Artemis were worshiped in parallel. The monument reflects the culture of Peparitheans and the importance given toward the holistic treatment for the patients.

François Rousset (c. 1525–1598): an innovative and forgotten obstetrician, master of caesarean section

Francois Rousset (c. 1525–1598) was born in Sens, a small commune in Burgundy in north-central France. In 1545, he was enroled in the Medical School of Montpellier and 1 year later he received his master degree. Initially, Rousset was attached as physician to the Duke of Savoy, but later on he was named personal physician of the queen of France, Catherine de Medicis (1519–1589). Living in Paris, Rousset gained experience in surgery and decided to specialize in the practise of caesarean section [1, 2]. Rousset decided to engage himself on the path of obstetrics simply because as he said, ‘‘no one who was more qualified stepped forward to do so’’ [3, 4]. Soon, he became an expert in the field and he was appointed as the head physician in the Parisian hospital ‘‘Hopital de Châtillon’’. At the end of the year 1561, Rousset was treating a female patient that she had been once submitted to a caesarean section 7 years before their meet and both she and her newborn survived the operation. Although Rousset’s surgical skills cannot be verified, we may assume that they were accurate as they were mentioned in the personal memoires of the eminent Professor of Medicine, Jean Astruc (1684–1766) [5]. Rousset, an innovative obstetrician, performed six consecutive caesarean sections to a multiparous woman in which she died during the seventh C-section, unlucky in his hands [1]. During the 16th century, caesarian section was used only as a measure of last resort and was commonly fatal for the mother. Noticing that in other cases, operations of the abdominal and uterine wall were successfully performed, Rousset proposed the procedure of laparotomy, uterine incision and suture of the abdominal wall for the parturient which could not give birth vaginally [6]. His leading work ‘‘Hysterotomotokia’’ (Greek: hystera = womb, tomo = intersection) (Fig. 1) was published twice in 1581 and 1590 [1, 4, 7, 8]. French had became the official administrative

Refractive Nightmares Revisited: Calcification of a Multifocal Intraocular Lens

Background/Aim: Cataract is the leading cause of reversible blindness and visual impairment worldwide. Although cataract surgery using phacoemulsification and intraocular lens (IOL) implantation is one of the commonest surgical procedures, IOL opacification remains a potential complication that can affect the visual outcome of the operation. Case Report: A 50-year-old female patient presented to our clinic complaining of glare and blurry vision in her right eye over the previous 6 weeks. She had undergone bilateral refractive lens exchange elsewhere 9 months earlier. Her unaided distance visual acuity was 8/10 in the right eye and 10/10 in the left. On slit-lamp examination, we observed the presence of in-the-bag, multifocal, hydrophobic acrylic IOLs bilaterally. Specifically, calcified deposits within the substance of the IOL were observed. Conclusion: To our knowledge, this is the first case of spontaneous calcification of a hydrophobic multifocal IOL and all cataract/refractive surgeons should be aware of this rare complication.