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Charalampos Livir-Rallatos

Publications and source records attributed to Charalampos Livir-Rallatos.

14 recordsLinked to original sources
PubMed2006

Mooren ulcer: an immunopathologic study.

PURPOSE: To determine the pattern and distribution of mononuclear cells, adhesion, and co-stimulatory molecules in the conjunctiva of patients with Mooren ulcer. METHODS: Conjunctival biopsy specimens were obtained from 6 patients with Mooren ulcer and 6 healthy individuals. Immunohistochemistry was performed on frozen sections of the cryopreserved human conjunctivas using monoclonal antibodies directed against CD1alpha, CD3, CD4, CD8, CD20, CD25, CD57, and CD68 cells; the adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), very late activation-4 (VLA-4), ICAM-1, and LFA-1; and the co-stimulatory molecules CD28, B7-1, B7-2, and CTLA-4. RESULTS: Differences in expression on the conjunctival epithelium from patients with Mooren ulcer and normal subjects were noted only for VCAM-1, VLA-4, ICAM-1, and LFA-1. The ratio of CD4+/CD8+ cells in Mooren ulcer specimens was significantly higher (3.5-fold). However, in the substantia propria, Mooren ulcer specimens revealed significantly increased numbers of CD1alpha+, CD3+, CD4+, CD20+, CD28+, B7-1+, B7-2+, and CD68+ cells. The ratios of CD4+/CD8+ cells and B7-2+/antigen-presenting cells in Mooren ulcer specimens were significantly higher (5-fold). All tested adhesion molecules showed significant up-regulation in the patients' conjunctivas. Mooren ulcer vascular endothelial cells prominently expressed E-selectin, VCAM-1, VLA-4, and ICAM-1 compared with normal conjunctiva. CONCLUSION: The simultaneous presence of multiple types of inflammatory cells, adhesion, and co-stimulatory molecules in Mooren ulcer conjunctiva suggests that their interaction may contribute to a sustained immune activation as at least part of the pathogenic mechanism of this disorder.

Antibodies, Monoclonal↗
PubMed2003

Small-size pediatric vitrectomy wide-angle contact lens.

PURPOSE: We describe a new wide-field vitrectomy contact lens specifically designed to facilitate pediatric vitreoretinal surgery. DESIGN: Experimental study, instrument description. METHODS: A wide-field contact two-piece glass vitrectomy lens was designed with the largest diameter of 13.6 mm and a contact diameter of 7.00 mm, sacrificing only the more tilt-sensitive parts of the optics in order to reduce its physical size. RESULTS: Laboratory measurements in a model eye demonstrated a 61-degree binocular field of view, a 94-degree static field of view, and a maximum 129-degree field of view. Image magnification was 0.50 x. No complications were linked to the use of this instrument, and the need to exchange for another lens was never encountered in 10 cases. The two-piece glass construction enabled this lens to be sterilized in an autoclave or sterilized by any other instrument sterilization technique. CONCLUSION: The instrument successfully fulfilled the purpose of its design, providing at the same time an excellent wide field of view and ample space for the surgeon, performing well in 10 pediatric vitreoretinal cases (8 cases of retinopathy of prematurity; 2 cases of traumatic eye injury). Its loose two-piece design rendered it suitable for all sterilization techniques.

Child, Preschool↗
PubMed2003

Ocular photodynamic therapy for serous macular detachment in the diffuse retinal pigment epitheliopathy variant of idiopathic central serous chorioretinopathy.

PURPOSE: To describe the anatomical and functional outcome of verteporfin ocular photodynamic therapy (PDT) in serous retinal detachment caused by the diffuse retinal pigment epitheliopathy form of chronic idiopathic central serous chorioretinopathy. DESIGN: Interventional case report. METHOD: A 48-year-old Caucasian man with unilateral exudative retinal detachment from diffuse retinal pigment epitheliopathy and visual acuity of 20/40 was managed with verteporfin PDT applied sequentially in three separate spots targeting all retinal pigment epithelium leaks identified with intravenous fluorescein angiography (IVFA). Outcome measures included visual acuity, biomicroscopic appearance, and leakage on IVFA.Clinical practice. Subretinal fluid resolved within 2 weeks; visual acuity returned to 20/20 with no recurrence at 6 months of follow-up. There was no leakage on IVFA posttreatment and no obvious toxicity. To our knowledge, this is the first report of PDT causing resolution of macular detachment in diffuse retinal pigment epitheliopathy. Its long-term results with regard to the prognosis of the disease and the recurrence rate remain to be evaluated.

Choroid Diseases↗
PubMed2003

Intravitreal triamcinolone acetonide for refractory chronic pseudophakic cystoid macular edema.

PURPOSE: To determine the safety and efficacy of intravitreal triamcinolone acetonide (TAAC) injections in patients with refractory cystoid macular edema (CME) after cataract extraction. SETTING: LSU Eye Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. METHODS: In this nonrandomized retrospective case review, 8 eyes of 8 patients with a history of pseudophakic CME recalcitrant to current standard treatment modalities were enrolled. The mean duration of the CME was 20 months. The patients received intravitreal injections of 1 mg of TAAC and were followed for a mean of 8 months. The main outcome measures included visual acuity, the presence of CME on biomicroscopic examination, angiographic evidence of perifoveal leakage, intraocular pressure (IOP), and complications related to treatment. RESULTS: The visual acuity increased in all patients. The magnitude of improvement was mainly restricted by underlying macular pathology and correlated well with the level of visual acuity at entry into the study. Angiographic improvement occurred in all patients. Temporary increases in IOP were easily controlled with topical medications. No other adverse effects could be attributed to this technique. Repeated injections were required. CONCLUSIONS: Intravitreal administration of TAAC was safe and effective in recalcitrant cases of pseudophakic CME with a beneficial effect on the macular edema and visual acuity. A prospective randomized study is needed to determine with accuracy the efficacy, safety, and exact timing of this technique and possibly to recognize subtypes with a more favorable response. Repeated injections were required in all eyes. The development of a sustained-release intravitreal drug-delivery system would be beneficial.

Adrenal Cortex Hormones↗
PubMed2003

Human mast cell subtypes in conjunctiva of patients with atopic keratoconjunctivitis, ocular cicatricial pemphigoid and Stevens-Johnson syndrome.

PURPOSE: Investigate mast cell (MC(S)) subtypes in atopic keratoconjunctivitis (AKC), ocular cicatrical pemphigoid (OCP), and Stevens-Johnson Syndrome (SJS). METHODS: MC(S) subtypes were determined by immunohistochemistry of conjunctiva (obtained from 34 patients--9 AKC, 9 OCP, 9 SJS and 7 normal) using monoclonal antibodies directed against chymase (MC(C)) and tryptase (MC(T)). Double staining was used to distinguish MC(S) as positive for both chymase and tryptase (MC(TC)). RESULTS: The number of MC(S) was significantly increased in AKC, OCP and SJS patients, compared to normal subjects. MC( C) were especially high in AKC, and moderately high in OCP. MC(T ) and MC(TC) were similar in each disease group. CONCLUSIONS: While the AKC findings were not surprising, the result in OCP and SJS suggests that MC(S) play an underappreciated role in the inflammatory process of these disorders. Disparate proportions of MC(S) subtypes in these diseases may imply differential functions of MC(S) in these disorders.

Adult↗
PubMed2003

The role of scleral buckle in experimental posterior penetrating eye injury.

PURPOSE: Although episcleral buckles are frequently placed as an additional procedure to vitreoretinal surgery, little is known about their independent effect after ocular trauma. The authors created a posterior penetrating ocular injury model to evaluate the isolated role of primary episcleral buckle placement. METHODS: Twenty eyes underwent surgery. The penetrating injury consisted of two 5-mm circumferential incisions placed five clock hours apart and 8 mm behind the limbus. A segmental episcleral buckle was placed over a randomly chosen injury site after wound closure. The degrees of fibrous proliferation, traction, and the presence of retinal detachment were evaluated on follow-up examinations. After enucleation and initial fixation, tissue sectioning was performed, and the greatest dimension of the fibrous proliferation at both wound sites was measured with a caliper. RESULTS: Two eyes were excluded from the study. Three eyes developed a retinal detachment; the remaining 15 eyes showed varying degrees of proliferation and traction on the retina. The greatest dimension of the fibrous proliferation at the buckle site (1.22 +/- 1 mm) was significantly different from that at the nonbuckle site (2 +/- 1.45 mm, P = 0.01). CONCLUSIONS: Primary episcleral buckle placement at the time of surgical repair reduces vitreous traction from the buckle site and decreases the degree of fibrovascular proliferation.

Animals↗
PubMed2002

A new high-speed pneumatic vitrectomy cutter.

PURPOSE: To describe a new high-speed pneumatic vitrectomy instrument capable of 2000 cuts/minute. DESIGN: Observational report. METHODS: A high-speed guillotine vitrector, developed to perform vitrectomy, with the ability to adjust from 1 to 2000 cuts/minute, was used in 80 consecutive vitreoretinal cases with a variety of diagnoses in a hospital setting. RESULTS: The performance was almost vibration-free. The instrument performed efficiently up to 1500 cuts/minute during vitrectomy, maintaining a constant flow rate. Higher cutting rates were used successfully for special indications. No complications were linked to the use of the instrument. CONCLUSION: The instrument was used successfully in 80 consecutive vitrectomies for a variety of diagnoses, performing efficiently up to 1500 cuts/minute, with a constant flow rate without complications. Higher cutting rates (2000 cuts/minute) were used successfully for special indications.

Equipment Design↗
PubMed2002

The effect of internal limiting membrane peeling on chronic recalcitrant pseudophakic cystoid macular edema: a report of two cases.

PURPOSE: To describe the effect of internal limiting membrane peeling in chronic recalcitrant pseudophakic cystoid macular edema. DESIGN: Two interventional case reports. METHODS: Two consecutive patients with chronic pseudophakic cystoid macular edema of 11-22 months duration, after uncomplicated cataract surgery, unresponsive to previous treatment, were enrolled. The surgical technique consisted of pars plana vitrectomy and internal limiting membrane peeling. Main outcome measures included best-corrected visual acuity, biomicroscopic appearance, and perifoveal leakage on fluorescein angiography. Optical coherence tomography scans were performed postoperatively. RESULTS: Pars plana vitrectomy with internal limiting membrane peeling resulted in anatomical, angiographic, and functional improvement in both patients, for total follow-up periods of 8 and 11 months, respectively. CONCLUSION: To our knowledge, this is the first report of chronic pseudophakic cystoid macular edema that favorably responded to pars plana vitrectomy with internal limiting membrane peeling, as concluded after a MEDLINE search.

Aged↗
PubMed2002

An adjustable-tip brush for the induction of posterior hyaloid separation and epiretinal membrane peeling.

PURPOSE: To report a new adjustable-tip brush for induction of posterior hyaloid separation and epiretinal membrane peeling. DESIGN: Observational report. METHODS: The adjustable-tip brush made of 10-0 nylon was used during vitrectomy for a variety of vitreoretinal disorders to induce posterior vitreous detachment and to peel internal limiting membrane or epiretinal membranes. RESULTS: The instrument was especially effective in inducing posterior vitreous detachment in eyes with chronic pseudophakic macular edema and diabetic macular edema. It was used successfully to strip thin, immature epiretinal membranes and to unfold rolled edges of giant retinal tears. No complications were associated with the use of the adjustable-tip brush. CONCLUSION: The adjustable-tip brush was useful for posterior hyaloid separation and epiretinal membrane peeling during vitrectomy for a variety of vitreoretinal procedures.

Epiretinal Membrane↗
PubMed2002

Acute comitant esotropia after cataract surgery.

A 52-year-old woman developed comitant esotropia after cataract surgery. The ocular history was significant for accommodative esotropia; preoperatively, she manifested peripheral fusion with central suppression. Immediately postoperatively, the patient was diplopic with comitant esotropia and was treated with extraocular muscle surgery. The appearance of horizontal strabismus after cataract surgery in patients with a history of accommodative esotropia, especially those with subnormal binocularity, is a possible complication that should be discussed with the patient.

Accommodation, Ocular↗
PubMed2002

Relapsing polychondritis: a clinical review.

OBJECTIVE: This study comprehensively reviews the literature related to relapsing polychondritis (RP). METHODS: A detailed search via MEDLINE (PubMed) was performed using relapsing polychondritis as the key term. Relevant articles were analyzed with a focus on history, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of RP. RESULTS: RP is a rare episodic and progressive inflammatory disease of presumed autoimmune etiology first described in 1923. RP affects cartilage in multiple organs, such as the ear, nose, larynx, trachea, bronchi, and joints. In addition, it can affect proteoglycan-rich tissues, such as the eyes, aorta, heart, and skin. The diagnosis of RP is based on the presence of clinical criteria. A standardized therapeutic protocol for RP has not been established. Nonsteroidal anti-inflammatory drugs, dapsone and/or colchicine, may control disease activity in some patients. In other patients, immunosuppressive drugs and prednisone have been effective. RP is a potentially lethal disease; pulmonary infection, systemic vasculitis, airway collapse, and renal failure are the most common causes of death. Earlier studies indicate survival rates between 70% at 4 years and 55% at 10 years. In a recent study, a survival rate of 94% at 8 years may be due to improved medical and surgical management. CONCLUSIONS: RP is a rare, multisystemic, and potentially fatal disease. The pathogenesis and optimal therapeutic approach to patients with RP is poorly understood.

Cartilage↗
PubMedDate not supplied

Ocular photodynamic therapy in choroidal neovascularization complicating idiopathic central serous chorioretinopathy.

Two consecutive patients with idiopathic central serous chorioretinopathy and decreased vision subsequent to subfoveal choroidal neovascular membranes were treated with photodynamic therapy applied using the protocol of the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Study Group. Main outcome measures included best-corrected visual acuity, biomicroscopic appearance, and leakage on fluorescein and indocyanine green angiography. Photodynamic therapy offered anatomical, angiographic, and functional improvement. After an initial complete response, the patients required re-treatment at 3 and 4 months, respectively. Cessation of leakage with improvement in visual acuity occurred, but subretinal fibrosis posed a possible limitation for full functional recovery. Although choroidal neovascular membranes complicating idiopathic central serous chorioretinopathy portend a poor visual prognosis, the overall response to photodynamic therapy was favorable.

Adult↗