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Miltiadis K Tsilimbaris

Publications and source records attributed to Miltiadis K Tsilimbaris.

9 recordsLinked to original sources
PubMed2006

Ocular rigidity in patients with age-related macular degeneration.

PURPOSE: To compare the ocular rigidity in vivo measurements of patients with age-related macular degeneration (AMD) and control subjects. DESIGN: Prospective comparative clinical study. METHODS: The pressure-volume relation and the ocular rigidity coefficient were compared among 32 patients with AMD (AMD group: 16 with neovascular and 16 with nonneovascular AMD) and 44 age-matched control patients (control group) who underwent operation for cataract. This was achieved by an injection of 200 microl of a balanced salt solution (in steps of 4.5 microl) through the limbus in the anterior chamber, while the intraocular pressure was monitored continually with a transducer, up to the limit of 30 mm Hg. RESULTS: The mean age (AMD group: 69.89 +/- 15.92 years vs control group: 65.28 +/- 12.34 years; P = .195), gender (AMD group: 13 female vs control group: 17 female; P = .513), eye's axial length (AMD group: 23.14 +/- 0.75 mm vs control group: 23.04 +/- 1.16 mm; P = .725) of patients with AMD and the healthy control subjects were comparable. No statistically significant difference in ocular rigidity measurements between patients with AMD and control subjects (AMD group: 0.0142 +/- 0.0077 microl(-1) vs control group: 0.0125 +/- 0.0049 microl(-1); P = .255) was found. When we examined separately the two subgroups of patients with AMD (neovascular and nonneovascular AMD), the average ocular rigidity measurements were higher in patients with neovascular AMD vs both control subjects and patients with nonneovascular AMD (neovascular AMD group: 0.0186 +/- 0.0078 microl(-1) vs control group: 0.0125 +/- 0.0048 microl(-1) [P = .014] vs nonneovascular AMD group: 0.0104 +/- 0.0053 microl(-1) [P = .004]). CONCLUSIONS: Despite the limitations placed by the small sample of the examined cases, patients with neovascular AMD who are treated (with photodynamic therapy) have increased ocular rigidity measurements compared with patients with nonneovascular AMD and control patients.

Aged↗
PubMed2005

Safety and efficacy of intravitreal injection of ranibizumab in combination with verteporfin PDT on experimental choroidal neovascularization in the monkey.

OBJECTIVE: To study the safety and efficacy of intravitreal injections of anti-vascular endothelial growth factor antibody fragment (ranibizumab [formerly known as rhuFabV2], Lucentis; Genentech, South San Francisco, Calif) in combination with intravenous verteporfin (Visudyne; Novartis, East Hanover, NJ) photodynamic therapy (PDT) on experimental choroidal neovascularization in the monkey eye. METHODS: Choroidal neovascularization was induced by laser injury in both eyes of cynomolgus monkeys and followed with weekly fundus photography and fluorescein angiography. Two weeks after induction, weekly treatments were initiated. These treatments included using either an intravitreal injection of ranibizumab (previously known as rhuFabV2) in combination with verteporfin PDT or a ranibizumab vehicle (placebo) in combination with verteporfin PDT (PDT only). Six animals (group 1) initially received intravitreal injections followed 1 week later by PDT. Four animals (group 2) initially received PDT followed 1 week later by intravitreal injection. Two animals (group 3) received injections and PDT on the same day at 2-week intervals. Photodynamic therapy was applied in all 3 groups every 2 weeks for 3 treatments with follow-up through 2 weeks after the last PDT treatment. Fluorescein angiograms were graded using a masked standardized protocol. The data were analyzed using the McNemar chi(2) test for matched pairs. RESULTS: No choroidal neovascularization leakage was observed in the eyes of animals treated with ranibizumab and PDT at day 21 or 42 after the start of the first treatment. Leakage persisted in eyes treated with PDT alone at 21 days (3 of 12 eyes) and 42 days (2 of 12 eyes). At all time points studied, the ranibizumab and PDT-treated eyes experienced better angiographic outcomes than the eyes receiving PDT alone. CONCLUSION: These preliminary data indicate that an intravitreal ranibizumab injection in combination with verteporfin PDT (ranibizumab and PDT) causes a greater reduction in angiographic leakage than PDT and intravitreal vehicle injection (PDT only) in experimental choroidal neovascularization. CLINICAL RELEVANCE: This combination therapy can potentially offer a new treatment modality for choroidal neovascularization in patients with macular degeneration and other diseases.

Animals↗
PubMed2005

Ocular rigidity in living human eyes.

PURPOSE: To measure the rigidity coefficient of a large number of subjects at clinically encountered intraocular pressures (IOPs) and to examine the possible correlation of ocular rigidity with other factors, such as the age of the patients, ocular parameters (axial length and corneal thickness), and pathologic conditions affecting the eye. METHODS: The pressure-volume relationship and the ocular rigidity coefficient (K) were determined in 79 eyes undergoing cataract surgery, by injecting 200 microL of saline solution (in steps of 4.5 microL) through the limbus into the anterior chamber, while continually monitoring the IOP with a transducer, up to the limit of 60 mm Hg. Data within an IOP range of 10 to 35 mm Hg were used to calculate the scleral rigidity coefficient. All measurements were taken at the same time of day, to eliminate any possible diurnal variation. RESULTS: The mean ocular rigidity coefficient was 0.0126 mm Hg/microL (95% confidence interval [CI], 0.0112-0.0149). A statistically significant positive correlation between the rigidity coefficient and age of the patient was found (P = 0.02), whereas similar findings were not observed for the examined ocular parameters (axial length, P = 0.09; and corneal thickness, P = 0.12). No correlation was found for patients with diabetes mellitus (P = 0.39), age-related macular degeneration (P = 0.55), and hypertension (P = 0.45). CONCLUSIONS: The present study provides quantitative data on the ocular rigidity coefficient based on measurements in a large series of living human eyes. A positive correlation between the ocular rigidity coefficient and the patient's age was documented.

Adult↗
PubMed2004

Treatment of atopic eyelid disease using topical tacrolimus following corticosteroid discontinuation in a patient with open-angle glaucoma.

PURPOSE: To report a case of atopic eyelid disease treatment using topical tacrolimus in a patient with open-angle glaucoma following corticosteroid discontinuation. DESIGN: Interventional case report. METHODS: A 59-year-old white man with a history of treated open-angle glaucoma (latanoprost 0.005%) was referred to our department for atopic eyelid disease. The patient had received previous treatment with topical corticosteroid ointments (hydrocortisone acetate 1%/dexamethasone 0.1% ointments) that, even though they were effective in controlling atopic eyelid disease, were complicated by markedly elevated intraocular pressure (IOP) (steroid responder). Topical steroids were discontinued while other treatment modalities (such as eyelid hygiene, artificial tears, topical antihistamine drugs, topical mast cell stabilizers, or topical/oral antibiotics) were proven ineffective. RESULTS: Topical tacrolimus 0.03% ointment (Protopic; Fujisawa, Dublin, Ireland) was applied to the eyelid skin twice daily. An improvement of eyelid inflammation was observed while eczematous skin lesions and erosions were resolved within 15 days. After 6 months of continued topical tacrolimus treatment, there was no evidence of atopic dermatitis recurrence. During this period IOP remained controlled without any evidence of deregulation. CONCLUSIONS: Treatment of atopic eyelid disease with topical tacrolimus, following corticosteroid discontinuation in a steroid responder patient with open-angle glaucoma, seems to be an effective alternative treatment to corticosteroids without the risk of IOP increase.

Administration, Topical↗
PubMed2004

Retinal microvascular surgery: a feasibility study.

PURPOSE: To evaluate the feasibility of microvascular surgery at the level of the retinal vasculature. METHOD: Porcine eyes were used, and eyecups were prepared under an operating microscope. Several classic microvascular maneuvers were explored, such as vascular puncturing, catheterization, mobilization, intravascular injections, and various combinations of the same. Instruments used ranged from disposable 30-gauge needles to an Er:YAG laser. Commercially available 10-0 nylon sutures, fine polyimide tubes, and custom-made fine glass tubes were used for vascular catheterization. RESULTS: Puncturing, mobilization, catheterization, and intravascular injection of retinal arteries and veins were possible. The connection of two remote retinal vessels with a fine tube was also achieved with the combination of these maneuvers. CONCLUSIONS: The feasibility of performing several microvascular maneuvers on retinal arteries and veins was demonstrated in porcine eyes. Further experimentation and development of these findings in a living animal model could lead to the development of such microvascular maneuvers in humans.

Anastomosis, Surgical↗
PubMed2002

Attenuation of ocular wall pulsation in eyes containing a gas bubble after vitrectomy.

PURPOSE: To evaluate the effect of an intraocular gas bubble on ocular wall pulsation. METHODS: Eight patients that underwent vitrectomy with intraocular gas injection for various reasons were studied. Ocular pulsation was evaluated in a semi-quantitative way by means of Goldman applanation tonometry in both eyes before and after the operation. Vitreous cavity gas fill in the operated eye was estimated by means of indirect ophthalmoscopy and was correlated with ocular pulsation. The follow up lasted until the gas totally disappeared. RESULTS: Ocular pulsation disappeared postoperatively in the operated eye and gradually reappeared when the gas fill diminished. Pulsation returned to preoperative level when the gas disappeared from the vitreous cavity. A negative statistical correlation between ocular pulsation and gas fill could be documented. CONCLUSION: The compressible nature of the intraocular gas bubble results in absorption of the vascular pulsation and prevents its transfer to the ocular wall. This leads to attenuation or even cancellation of ocular wall pulsation when a gas bubble exists within the eye.

Eye↗
PubMedDate not supplied

Contact transscleral ciliary body photodynamic therapy in pigmented rabbits using verteporfin and diode laser: evaluation of treatment parameters.

PURPOSE: To evaluate the treatment parameters necessary for achieving ciliary body photodynamic damage, enough to significantly reduce IOP, using verteporfin and a diode laser. DESIGN: Animal study. METHODS: The right eye ciliary body of 30 pigmented rabbits was irradiated using verteporfin (Visudyne) and a diode laser. Photosensitizer dose ranged from 0.375 to 2 mg/kg. Three adjacent laser spots were applied 0.5 mm behind limbus at 12 o'clock position using a contact transscleral technique. The laser power was ranging from 10 to 70 mW and the duration of irradiation from 1 to 5 min per spot. The left eyes of the rabbits were used as controls. Animals were sacrificed 24 hours after the procedure and their eyes were evaluated by means of light and electron microscopy. A step-by-step approach was adopted with adjustment of experimental parameters according to histological findings. The end point was to identify the irradiation parameters necessary for induction of photodynamic damage while minimizing thermal damage. Subsequently, 10 more animals were used in order to verify the effectiveness of these irradiation parameters in reducing the intraocular pressure. RESULTS: The therapy parameters that led to photodynamic effect avoiding thermal damage were laser power of 25 mW, irradiation time of 3 min per spot, and verteporfin dose of 1 mg/kg. Transscleral ciliary body irradiation using these parameters resulted in vascular thrombosis of ciliary vessels and in substantial edema, resulting in separation of the two ciliary epithelium layers. These parameters were applied to 4 rabbits, resulting in a mean IOP reduction of 1.8 mmHg +/- 1.2 that lasted for 4 days. An increase of the laser power to 35 mW tested in 6 additional animals, resulted in mean IOP reduction of 2.2 mmHg +/- 1.2, lasting 6 days; some minimal thermal damage was seen with the later settings. CONCLUSION: The combination of verteporfin and 690 nm diode laser is effective for the induction of ciliary body photodynamic damage, which results in significant but temporary IOP reduction, after transscleral PDT in pigmented rabbits. With appropriate parameter selection, intraocular pressure reduction can be achieved while thermal damage is kept to a minimum.

Animals↗