Mk Tsilimbaris

Comparison of digital color fundus imaging and fluorescein angiographic findings for the early detection of diabetic retinopathy in young type 1 diabetic patients

PURPOSE To compare the findings from digital 7-field color fundus (CF) photography and fundus fluorescein angiography (FFA) in young patients with diabetes mellitus (DM) type 1 without known diabetic retinopathy. METHODS In this prospective, observational cohort study, 54 type 1 diabetic patients were recruited. Participants had been diagnosed with diabetes mellitus (DM) for at least 6 years, had Best Corrected Visual Acuity of 20/25 or better and did not have any known retinal pathology. One hundred and seven eyes were analyzed. All patients underwent a complete ophthalmic examination in the Retina Service of a University Eye Clinic including digital CF imaging and FFA. RESULTS The mean age of the patients was 18.6 years. Mean duration of DM was 11.3 years, and mean haemoglobin A1c (HbA1c) level was 8.6%. Of the 107 eyes, 8 eyes (7.5%) showed microvascular abnormalities on CF images, while FFA images revealed changes in 26 eyes (24.3%). Hence, 18 of the 26 eyes showing abnormalities on FFA did not show any abnormalities on CF images. Mean DM duration in the patient group with detectable microvascular changes was found to be significantly higher compared to patients without changes, while no difference in HbA1c levels, serum lipid levels or blood pressure was observed. CONCLUSIONS Comparison of digital CF and FFA findings for the detection of diabetic microvascular changes in type 1 diabetic patients showed that FFA reveals more information about retinal vascular pathology for early detection of diabetic retinopathy.

Reasons for reduced vision after anatomically successful retinal detachment surgery

Purpose To identify the cause of reduced visual acuity in patients with successful anatomical result after retinal detachment surgery.

Effect of anti-VEGF drugs and steroids on the inner blood-retinal barrier, after experimental BRVO in rats: preliminary results

Purpose To evaluate the effect of anti‐VEGF drugs and steroids on the inner blood‐retinal barrier (BRB) function after experimental branch retinal vein occlusion (BRVO) in rats. The integrity of the barrier is related to the expression of occludins by retinal endothelial cells.

Contact transcleral ciliary body photodynamic treatment with verteporfin in cases of refractory glaucoma

Purpose Previous animal studies showed that contact transcleral ciliary body photodynamic treatment with verteporfin is a safe procedure for temporarily reducing IOP. The purpose of this study is to investigate safety and efficacy in cases of refractory or absolute glaucoma. Methods 8 patients, 8 blind painful eyes of with absolute glaucoma (6 neovascular, 1 Sil Oil, 1 refractory), with mean IOP 37±12 mmHg, were treated. Verteporfin bolus infusion of 6 mg/m^2 body surface area over 1 minute was done prior to irradiation, realized with a triple optic fiber connected to a 689nm diode laser. Energy at each fiber’s tip was 80mW and irradiation time 3min per spot. 12 spots over 360 degrees (12min) were done. Eye drops with dexamethasone and tobramycin qd for 4 days were prescribed. Follow up consisted of daily slit lamp examination and IOP measurements with Goldman Tonometer during the first week, then weekly during the first month, then monthly. Photography was used to document clinical findings. Results Significant mean IOP reduction of 25% for 2 weeks was observed in all cases. IOP returned to pre-treatment values during the third week in 4 cases, during the 2nd month in 2 cases and 3rd month in 2 cases. Conjunctival oedema and anterior chamber reaction were mild and lasted 24-48 hours. No serious adverse events were observed and patient’s discomfort was limited. Conclusion Our findings suggest that contact transcleral ciliary body photodynamic treatment with verteporfin with the above mentioned settings is safe and efficient in short term in cases of refractory or absolute glaucoma.