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Biomedical subjects

I D Ladas

Publications and source records attributed to I D Ladas.

At least 19 recordsLinked to original sources
PubMed2004

Polypoidal choroidal vasculopathy and exudative age-related macular degeneration in Greek population.

PURPOSE: To study the prevalence, the clinical features, and the visual prognosis without treatment of polypoidal choroidal vasculopathy (PCV) in a large series of Greek patients presenting with exudative maculopathy. METHODS: The medical records, photographs,as well as fluorescein and indocyanine green(ICG) angiograms of a series of 268 consecutive elderly white Greek patients, who were originally diagnosed as having exudative age-related macular degeneration (AMD) were reviewed retrospectively. RESULTS: In all, 22 of the 268 (8.2%) patients initially suspected of having AMD were ultimately diagnosed with PCV. In 15 of the 22(68.2%) patients with PCV, the polypoidal lesions were located in the peripapillary area. Large soft drusen were present in only two fellow eyes of the 10 (20%) patients with unilateral PCV compared with 120 fellow eyes of the 148 (81.1%) patients with unilateral AMD. At the last examination, 11 of the 22(50%) patients with PCV and 120 of the 246(48.8%) patients with AMD presented a visual acuity of less than 6/60 in at least one eye due to scar formation in the macula. CONCLUSIONS: PCV is not an infrequent disease in Greece. A measurable number of Greek patients with findings suggestive of exudative AMD will instead have PCV. ICG angiography is important in differentiating between these two clinical entities. In Greeks, polypoidal lesions are predominantly peripapillary and are not usually associated with macular drusen in the fellow eye. PCV and exudative AMD do not differ significantly in terms of their natural course and visual prognosis in Greek patients.

Aged↗
PubMed2003

Lacquer crack formation after photodynamic therapy.

PURPOSE: To report the occurrence of a lacquer crack after photodynamic therapy (PDT) of choroidal neovascularization (CNV) in a patient with pathologic myopia. METHODS: PDT was performed with verteporfin, which was activated by a diode laser light at 690 nm. RESULTS: The left eye of a 42-year-old woman was treated with PDT because of juxtafoveal CNV caused by pathologic myopia. No lacquer crack was present in the macula on either fluorescein or indocyanine green angiography before treatment. The CNV subsided after treatment. However, a large lacquer crack underlying a subretinal hemorrhage was formatted in the macula of the treated eye soon after PDT. CONCLUSIONS: Although the chorioretinal damage produced by PDT is minimal, it is enough to create, directly or indirectly, the basis for the formation of a lacquer crack in an eye with pathologic myopia.

Adult↗
PubMed1999

Cyst formation in optic disc pit maculopathy.

PURPOSE: To evaluate the presence and the evolution of cyst formation in optic disc pit maculopathy. METHODS: In this prospective study, 18 cases with optic disc pit maculopathy were studied. Five of them showed cyst formation in the fovea at the initial examination. The fundus findings were documented with slit-lamp biomicroscopy, indirect ophthalmoscopy, and stereoscopic photography of the posterior pole. All 5 patients were treated with a macular scleral buckle procedure. RESULTS: The presence of cysts in the elevated macula depends on the grade of the disease. Cyst formation can develop not only in the later stage of the disease but also quite early. In all 5 patients cyst formation gradually decreased and finally disappeared after the surgical procedure. CONCLUSIONS: Cyst formation is an entity which accompanies the macular detachment associated with optic disc pit. The development of the cysts has been noticed after the establishment of the schisis-like separation and before or in conjunction with the formation of a lamellar macular hole which usually accompanies the optic disc pit maculopathy.

Adolescent↗
PubMed1999

Fluorescein and indocyanine green angiographic findings in congenital optic disk pit associated with macular detachment.

PURPOSE: To investigate the pattern of congenital optic disk pits associated with maculopathy using indocyanine green angiography (ICG) and fluorescein angiography (FA). METHODS: Seventeen consecutive patients with unilateral congenital optic disk pit complicated by maculopathy were prospectively enrolled in the study. Complete ophthalmologic examination, color stereophotography, red-free photography, FA, and ICG angiography were performed on all patients during their first examination in our department. RESULTS: Absolute hypofluorescence of the optic disk pit was noted in all eyes on ICG angiography. On the contrary, all eyes showed early hypofluorescence and late staining of the optic pit on FA. All 17 eyes presented a delineated late hyperfluorescence corresponding to the area of macular elevation on both ICG angiography and FA. The intensity of the hyperfluorescence was milder in cases with long-standing maculopathy. CONCLUSION: Imaging of congenital optic disk pits associated or not with macular elevation using ICG angiography has not been reported in the literature. The increased hyperfluorescence in the late phases of the macular elevation in the studied eyes could be attributed to leakage of indocyanine or fluorescein dye into the schisis cavity and the subretinal fluid.

Adolescent↗
PubMed1999

Presumed congenital ocular toxoplasmosis in two successive siblings.

We present the cases of 2 consecutive siblings with bilateral macular lesions, for which there is strong clinical and laboratory evidence supporting the diagnosis of congenital ocular toxoplasmosis. These cases raise the possibility of maternal parasitemia during Toxoplasma gondii reinfection, leading to transmission to the fetus and congenital ocular toxoplasmosis despite prior immunity and lack of an immune disturbance in the mother.

Adolescent↗
PubMed1997

Topical 2.0% dorzolamide vs oral acetazolamide for prevention of intraocular pressure rise after neodymium:YAG laser posterior capsulotomy.

OBJECTIVE: To compare the efficacy and safety of topical 2.0% dorzolamide hydrochloride with oral acetazolamide in preventing intraocular pressure (IOP) rise following neodymium:YAG (Nd:YAG) laser posterior capsulotomy. DESIGN: A prospective, randomized, double-masked, placebo-controlled study. PATIENTS: Two hundred ten patients undergoing Nd:YAG laser posterior capsulotomy. INTERVENTION: Pretreatment with dorzolamide, acetazolamide, or placebo. Dorzolamide administration as a single drop (1 drop approximately 20 microL) 1 hour before capsulotomy. Acetazolamide administration as a single dose of 125 mg orally 1 hour before capsulotomy. RESULTS: At first and third hour postoperatively, IOPs and IOP changes from baseline were significantly (P<.001) higher in the placebo group than in the dorzolamide or acetazolamide group. At the same time, IOPs and IOP changes from baseline were similar (P>.50) in the dorzolamide and acetazolamide groups. No patient treated with dorzolamide or acetazolamide experienced an IOP higher than 30 mm Hg after capsulotomy, but 15.7% of patients receiving placebo had an IOP above this level (P<.001). Of patients receiving placebo, 5.7% experienced IOP higher than 35 mm Hg. No serious side effects were recorded in any of the studied patients. CONCLUSION: Topical 2.0% dorzolamide and oral acetazolamide, given prophylactically as a single administration 1 hour before Nd:YAG laser posterior capsulotomy, have comparable high efficacy and safety in preventing IOP elevation following this procedure.

Acetazolamide↗
PubMed1995

Choroidal neovascularization in second eyes of patients with unilateral exudative age-related macular degeneration.

PURPOSE: To evaluate patients with unilateral occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) for the nature of the neovascularization which develops in the fellow eyes. METHODS: Patients with newly diagnosed unilateral occult CNV were followed prospectively for the development of CNV in the fellow eye. Patients were classified based on the type of occult CNV in the first eye: (1) those with associated serous pigment epithelial detachment (serous PED) and (2) those without. Demographic and clinical data, including the type of CNV in the second eyes, were compared. RESULTS: Choroidal neovascularization developed in 115 patients in the second eye. Fifty-six patients had occult CNV with a serous PED (also termed vascularized PED) in the first eye, and 59 patients had occult CNV without serous PED. The two groups did not differ significantly in the demographic and the clinical features evaluated. Well-delineated (or classic) CNV developed in the fellow eye of one patient in each group. Of the remaining 55 patients with vascularized PED in the first eye, the same type of occult CNV developed in 48 (87%) patients in the second eye. Of 58 (84%) patients in the second group, the same type of occult CNV developed in the second eye of 49 patients. This symmetric distribution of type of CNV between eyes is highly significant (P < 0.001). CONCLUSIONS: Eyes with occult CNV secondary to AMD can be classified by the presence or absence of an associated serous PED. Patients with unilateral occult CNV have a significant risk of occult CNV developing in the second eye, and the type of occult disease in the first eye is highly predictive of the type of neovascularized disease in the second eye. These findings are important with respect to natural history, and possibly to the treatment response and visual prognosis of patients with neovascularized AMD.

Aged↗
PubMed1994

The persistence of buckle height in relation to orientation of buckle fixation. An ultrasonographic study.

Forty phakic myopic eyes of 40 patients with rhegmatogenous retinal detachment were included in a prospective clinical trial designed to evaluate the changes in buckle height after retinal detachment surgery. The age of the patients ranged between 50 and 75 years. The eyes were divided into two groups (A and B) according to the orientation of sponge fixation. In group A (20 eyes) the sponge fixation was circumferential, while in group B (20 eyes) radial. A-scan ultrasonography was used for the measurements of buckle height 1, 3, 6, 12, and 18 months postoperatively. At all times of measurement, the buckle height presented a statistically significant difference between the patients of group A and B. More specifically, radial fixation produced a significantly lower scleral indentation compared with that produced by circumferential fixation. After a lapse of 18 months, the buckle height in group B retained 41% of its original value compared with that of group A which retained 66%.

Aged↗
PubMed1994

8 mm bimedial rectus recession in infantile esotropia of 80-90 prism dioptres.

Sixteen patients with large angle infantile esotropia with deviations of 80-90 prism dioptres were operated at the age of about 2 years. All patients underwent 8 mm bilateral medial rectus recessions. At the last follow up examination, 6 to 48 months postoperatively (average 16.3 months), successful horizontal alignment was achieved in 12 patients (75%). Four patients (25%) were undercorrected. Clinically significant limitation of adduction or convergence was not observed postoperatively in any of the patients. Consecutive exotropia was not encountered in this series but a longer follow up is probably needed in order to assess its delayed appearance. These results suggest that 8 mm recession of the medial recti is an effective procedure for the correction of large angle infantile esotropia of 80-90 prism dioptres and can be considered as an acceptable alternative to operations on three or four muscles.

Child, Preschool↗
PubMed1993

Long-term effectiveness of modified grid laser photocoagulation for diffuse diabetic macular edema.

Fifty eyes of 42 patients with background diabetic retinopathy and diffuse macular edema were included in a prospective, randomized, clinical study to determine the long-term visual results of modified grid laser photocoagulation compared with the natural course of the disease. At the end of the three annual follow-up visits there were more eyes with improved visual acuity in the treatment group and more eyes with worse visual acuity in the control group. However, statistical analysis of the data showed that only at the end of the first and the second year was there a significant statistical difference between the two groups. At the end of the third year no statistically significant difference was found. These results suggest that modified grid laser photocoagulation is not an effective procedure for the long-term management of diffuse diabetic macular edema compared with the natural course of the disease.

Adult↗
PubMed1993

Prophylactic use of acetazolamide to prevent intraocular pressure elevation following Nd-YAG laser posterior capsulotomy.

Fifty four eyes of 54 patients undergoing Nd-YAG laser posterior capsulotomy were randomly assigned to pretreatment with either 125 mg of oral acetazolamide (group A) or placebo (group B). During the first 3 hours following capsulotomy, an intraocular pressure (IOP) rise of at least 10 mm Hg was recorded in eight of the 26 eyes of group B (30.8%) and in none of the 28 eyes of group A (p < 0.01). A rise of at least 5 mm Hg was recorded in 16/26 (61.5%) and 4/28 (14.3%) eyes respectively (p < 0.001). Three eyes of group B developed an IOP greater than 35 mm Hg. We found that pretreatment with a low dose of acetazolamide is highly effective in preventing IOP elevation following Nd-YAG laser posterior capsulotomy.

Acetazolamide↗
PubMed1993

Use of argon laser photocoagulation in the treatment of recurrent trichiasis: long-term results.

We describe our technique and analyze the long-term results of the use of argon laser photocoagulation in the treatment of 92 eyes with recurrent trichiasis. In spite of an incidence of recurrences of 64.1% which had to undergo a new laser photocoagulation session, the final success rate of the method was impressive (91.3%). The number of misdirected cilia per lid seems to constitute an important factor which affects both the rate of recurrences and the success rate of the procedure.

Aged↗
PubMed1983

Unusual ocular findings in an infant with cri-du-chat syndrome.

A newborn male with cri-du-chat syndrome, congenital nuclear cataracts, microspherophakia, and probably ectopic lenses is reported. Microspherophakia in cri-du-chat syndrome has not been previously described. The congenital cataracts were inherited from his mother who had a balanced 5;13 translocation; the two events are considered to be coincidental and a possible 'position effect' was excluded, since the other members of her family with congenital cataracts, were chromosomally normal. This is the fourth case reported where familial cri-du-chat syndrome involves chromosomes 5p and 13q.

Cataract↗
PubMedDate not supplied

Histocompatibility (HLA) antigens and eye diseases other than uveitis.

In recent years, numerous studies on the possible associations of histocompatibility (HLA) antigens with various eye diseases other than uveitis have been carried out. This paper presents, discusses and evaluates the results of these studies. Undoubtedly, apart from acute anterior uveitis, HLA-typing has very limited usefulness in the practice of clinical ophthalmology. Many reported HLA associations with other eye diseases have not been confirmed by subsequent studies. However, a sizable residuum of highly significant and reproducible associations between HLA antigens and several eye diseases remains, suggesting that HLA-typing in patients with these diseases may contribute to the understanding of pathogenesis and etiology and may prove a valuable prognostic indicator for some diseases.

Adolescent↗
PubMedDate not supplied

Recurrent vitreous hemorrhages due to combined pigment epithelial and retinal hamartoma: natural course and indocyanine green angiographic findings.

We report the clinical and angiographic features as well as the natural course of an optic disk and juxtapapillary combined pigment epithelial and retinal hamartoma in a 23-year-old white girl. The patient presented 3 episodes of recurrent vitreous hemorrhages in the first 4 years of follow-up, which were spontaneously and totally absorbed. During the last 6 years, she was absolutely free of any ocular symptom. The tumor did not show any growth during the 10 years of follow-up. The digital indocyanine green angiography, which was normal in the early frames, revealed a mild, patchy hyperfluorescence corresponding to the tumor location in the late phase.

Adult↗
PubMedDate not supplied

Diffuse retinal pigment epitheliopathy: treatment with laser photocoagulation.

PURPOSE: To evaluate the effectiveness of laser treatment in eyes with diffuse retinal pigment epitheliopathy (DRPE). METHODS: The authors retrospectively reviewed the medical records of 56 consecutive patients (78 eyes) with DRPE. All eyes were treated with digital fluorescein angiography guided argon green laser photocoagulation, direct on the focal retinal pigment epithelium (RPE) leaks and in a grid pattern to the RPE decompensation areas. A processed digital red-free fundus image including all the important traces on it was used as a guide to the laser treatment. The follow-up period ranged from 6 months to 7 years. RESULTS: At the end of the follow-up time, 70 (89.7%) eyes showed anatomic improvement with complete or partial resolution of the macular exudative lesions. Visual acuity of less than 20/40 was noted in 60 eyes (76.9%) preoperatively compared with 46 eyes (59.0%) finally (p=0.0252). The visual acuity was improved in 19 eyes (24.4%), stabilized in 51 (65.4%), and reduced in only 8 eyes (10.2%). CONCLUSIONS: In this series of patients with DRPE, the results of laser treatment were uniformly satisfactory producing a gradual resolution of the macular exudative lesions and an improvement or stabilization of the visual acuity.

Adult↗