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Diabetic Retinopathy: HELP
Articles from Greece
Based on 45 articles published since 2008
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These are the 45 published articles about Diabetic Retinopathy that originated from Greece during 2008-2018.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Complications of Diabetes 2016. 2016

Papatheodorou, Konstantinos / Papanas, Nikolaos / Banach, Maciej / Papazoglou, Dimitrios / Edmonds, Michael. ·Diabetes Clinic, Second Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece. · Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland. · Diabetic Foot Clinic, King's College Hospital, London, UK. ·J Diabetes Res · Pubmed #27822482.

ABSTRACT: -- No abstract --

2 Review Ranibizumab in the Treatment of Diabetic Macular Edema: A Review of the Current Status, Unmet Needs, and Emerging Challenges. 2017

Dervenis, Nikolaos / Mikropoulou, Athanasia Maria / Tranos, Paris / Dervenis, Panagiotis. ·Moorfields Eye Hospital, London, UK. nikosdervenis@gmail.com. · Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece. · Ophthalmica Eye Institute, Thessaloniki, Greece. · Aristotle University of Thessaloniki, Thessaloniki, Greece. ·Adv Ther · Pubmed #28484955.

ABSTRACT: Diabetic retinopathy (more specifically diabetic macular edema, DME) is the most common cause of loss of vision in the working population in developed countries. Anti-vascular endothelial growth factor (anti-VEGF) agents considerably changed the treatment algorithms and improved prognosis of center-involving DME. Ranibizumab was the first approved anti-VEGF agent that revolutionized DME treatment. The vast increase in the number of patients undergoing intravitreal treatment and the role of anti-VEGF pharmacotherapy as the mainstay of DME treatment have triggered several challenges. Among them, of considerable interest is the quest for an optimal dosing scheme and the search for combination therapies. Although a significant body of research is directed towards other molecules that could potentially be new therapeutic targets, VEGF inhibition is expected to play an important long-term role in the treatment of DME considering the pathogenesis of the disease. Finally, recent studies revealed that ranibizumab may constitute a significant treatment modality in the management of other diabetic vision-threatening complications including proliferative diabetic retinopathy.

3 Review Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015. 2015

Papanas, Nikolaos / Ziegler, Dan. ·Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece. · Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany. ·Rev Diabet Stud · Pubmed #26676661.

ABSTRACT: Distal symmetric sensorimotor polyneuropathy (DSPN) is the most common neurological manifestation in diabetes. Major risk factors of DSPN include diabetes duration, hyperglycemia, and age, followed by prediabetes, hypertension, dyslipidemia, and obesity. Height, smoking, insulin resistance, hypoinsulinemia, and others represent an additional risk. Importantly, hyperglycemia, hypertension, dyslipidemia, obesity, and smoking are modifiable. Stringent glycemic control has been shown to be effective in type 1, but not to the same extent in type 2 diabetes. Antilipidemic treatment, especially with fenofibrate, and multi-factorial intervention have produced encouraging results, but more experience is necessary. The major comorbidities of DSPN are depression, autonomic neuropathy, peripheral arterial disease, cardiovascular disease, nephropathy, retinopathy, and medial arterial calcification. Knowledge of risk factors and comorbidities has the potential to enrich the therapeutic strategy in clinical practice as part of the overall medical care for patients with neuropathy. This article provides an updated overview of DSPN risk factors and comorbidities.

4 Review Angiogenic growth factors and their inhibitors in diabetic retinopathy. 2010

Praidou, Anna / Androudi, Sofia / Brazitikos, Periklis / Karakiulakis, George / Papakonstantinou, Eleni / Dimitrakos, Stavros. ·2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. praidou2003@yahoo.co.uk ·Curr Diabetes Rev · Pubmed #20594164.

ABSTRACT: Diabetic retinopathy is considered one of the vision-threatening diseases among working-age population. The pathogenesis of the disease is regarded multifactorial and complex: capillary basement membrane thickening, loss of pericytes, microaneuryms, loss of endothelial cells, blood retinal barrier breakdown and other anatomic lesions might contribute to macular edema and/or neovascularization the two major and sight threatening complications of diabetic retinopathy. A number of proangiogenic, angiogenic and antiangiogenic factors are involved in the pathogenesis and progression of diabetic retinal disease, Vascular Endothelial Growth Factor (VEGF) being one of the most important. Other growth factors, which are known to participate in the pathogenesis of the disease, are: Platelet Derived Growth Factor (PDGF), Fibroblast Growth Factor (FGF), Hepatocyte Growth Factor (HGF), Transforming Growth Factor (TGF), Placental Endothelial Cell Growth Factor (PlGF), Connective Tissue Growth Factor (CTGF). Other molecules that are involved in the disease mechanisms are: intergrins, angiopoietins, protein kinase C (PKC), ephrins, interleukins, leptin, angiotensin, monocyte chemotactic protein (MCP), vascular cell adhesion molecule (VCAM), tissue plasminogen activator (TPA), and extracellular matrix metalloproteinases (ECM-MMPs). However, the intraocular concentration of angiogenic factors is counterbalanced by the ocular synthesis of several antioangiogenic factors such as pigment epithelial derived factor (PEDF), angiostatin, endostatin, thrombospondin, steroids, atrial natriuretic peptide (ANP), inteferon, aptamer, monoclonal antibodies, VEGF receptor blocker, VEGF gene suppressors, intracellular signal transduction inhibitors, and extracellular matrix antagonists. Growth stimulation or inhibition by these factors depends on the state of development and differentiation of the target tissue. The mechanisms of angiogenesis factor action are very different and most factors are multipotential; they stimulate proliferation or differentiation of endothelial cells. This review attempts to briefly outline the knowledge about peptide growth factor involvement in diabetic retinopathy. Further ongoing research may provide better understanding of molecular mechanisms, disease pathogenesis and therapeutic interactions.

5 Clinical Trial Atorvastatin for diabetic macular edema in patients with diabetes mellitus and elevated serum cholesterol. 2010

Panagiotoglou, Theonitsa D / Ganotakis, Emmanuel S / Kymionis, George D / Moschandreas, Joanna A / Fanti, Garufalia N / Charisis, Spyridon K / Malliaraki, Niki E / Tsilimbaris, Miltiadis K. ·Retina Service, Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece. ·Ophthalmic Surg Lasers Imaging · Pubmed #20507015.

ABSTRACT: BACKGROUND AND OBJECTIVE: To determine the efficacy of atorvastatin in reducing hard exudates and diabetic macular edema. PATIENTS AND METHODS: An uncontrolled clinical case series included 18 eyes with diabetic maculopathy and an elevated baseline lipid profile. All patients were treated with atorvastatin. Ophthalmologic evaluation, including fundus photography and fluorescein angiography, was performed at presentation and repeated at 3, 6, and 12 months. Hard exudates, hemorrhages, and fluorescein leakage at 12 months were evaluated and compared with baseline findings. RESULTS: Eighteen subjects with diabetic maculopathy received atorvastatin, and a significant decrease in total cholesterol and low-density lipoprotein cholesterol was seen (P < .05). Hard exudates and fluorescein leakage were decreased. No evidence of an association between change in hemorrhage status and treatment was found. CONCLUSION: Oral atorvastatin therapy in patients with diabetes mellitus and dyslipidemia seems to reduce the severity of hard exudates and fluorescein leakage in diabetic maculopathy and could be useful as an adjuvant therapy in the management of diabetic macular edema.

6 Clinical Trial Infliximab for diabetic macular edema refractory to laser photocoagulation: a randomized, double-blind, placebo-controlled, crossover, 32-week study. 2010

Sfikakis, Petros P / Grigoropoulos, Vlassis / Emfietzoglou, Ioannis / Theodossiadis, George / Tentolouris, Nicholas / Delicha, Evi / Katsiari, Christina / Alexiadou, Kleopatra / Hatziagelaki, Erifili / Theodossiadis, Panayiotis G. ·First Department of Propaedeutic and Internal Medicine, Laiko General Hospital, Athens, Greece. psfikakis@med.uoa.gr ·Diabetes Care · Pubmed #20413522.

ABSTRACT: OBJECTIVE: Because many patients with diabetic macular edema (DME) do not respond to focal/grid laser photocoagulation, the only currently approved treatment, alternatives are needed. Based on encouraging preliminary findings, we aimed to assess efficacy and safety of the anti-tumor necrosis factor (TNF) monoclonal antibody infliximab in this condition. RESEARCH DESIGN AND METHODS: This was a single-center, double-blind, randomized, placebo-controlled, crossover study. Eleven patients with sight-threatening DME persisting after two sessions of laser photocoagulation received infliximab (5 mg/kg) intravenously at weeks 0, 2, 6, and 14, followed by placebo at weeks 16, 18, 22, and 30, or vice versa. Blinding was maintained to week 32, when the final assessments were performed. Best corrected visual acuity evaluated by a mixed-models approach for imbalanced crossover design using the percentage difference as the outcome variable was the primary study end point. Data were analyzed on an intention-to-treat basis. RESULTS: Early Treatment of Diabetic Retinopathy Study (ETDRS) scores dropped from 31.6 +/- 5.1 (mean +/- SD) letters read at baseline to 28.8 +/- 11.6 letters read at week 16 in six placebo-treated eyes and improved to 35.4 +/- 11.2 letters read after infliximab. In contrast, visual acuity improved from 23.5 +/- 10.3 at baseline to 30.4 +/- 13.4 letters read at week 16 in eight infliximab-treated eyes and was sustained at completion of placebo treatment (31.4 +/- 12.1 letters read). The excess visual acuity in infliximab-treated eyes was greater by 24.3% compared with that in placebo-treated eyes (95% CI 4.8-43.7; P = 0.017). Infliximab treatment was well tolerated. CONCLUSIONS: The positive results of this small phase III study suggest that larger and longer term trials should be conducted to assess the efficacy of systemic or intravitreal anti-TNF agent administration for primary treatment of DME.

7 Clinical Trial Intravitreal combination of triamcinolone acetonide and bevacizumab (Kenacort-Avastin) in diffuse diabetic macular edema. 2009

Tsilimbaris, Miltiadis K / Pandeleondidis, Vassilios / Panagiototglou, Theoni / Arvanitaki, Vassiliki / Fragiskou, Sofia / Eleftheriadou, Maria / Tsika, Chrysanthi / Papadaki, Theokliti. ·Retina Service, University Eye Clinic of Heraklion, Crete, Greece. tsilimb@med.uoc.gr ·Semin Ophthalmol · Pubmed #19954371.

ABSTRACT: PURPOSE: To evaluate the effect of intravitreal injection of the combination of Triamcinolone Acetonide and Bevacizumab in patients with diabetic macular edema. MATERIALS AND METHODS: Twenty seven eyes of 17 patients with diabetic macular edema were treated with an intravitreal injection of triamcinolone acetonide (2 mg) combined with bevacizumab (1.25 mg). RESULTS: During the 6 months follow-up period 24 eyes (89%) had to repeat the treatment according to the monthly follow-up examination.The mean visual acuity and the central macular thickness improved significantly (P<0.05) throughout the follow-up period. CONCLUSION: Intravitreal combination of Triamcinolone Acetonide and Bevacizumab seems to be effective in improving visual acuity and macular edema in patients with diabetic maculopathy.

8 Article The Synthetic Microneurotrophin BNN27 Affects Retinal Function in Rats With Streptozotocin-Induced Diabetes. 2018

Ibán-Arias, Ruth / Lisa, Silvia / Mastrodimou, Niki / Kokona, Despina / Koulakis, Emmanuil / Iordanidou, Panagiota / Kouvarakis, Antonis / Fothiadaki, Myrto / Papadogkonaki, Sofia / Sotiriou, Aggeliki / Katerinopoulos, Haralambos E / Gravanis, Achille / Charalampopoulos, Ioannis / Thermos, Kyriaki. ·Department of Pharmacology, School of Medicine, University of Crete, Heraklion, Crete, Greece. · Laboratory of Environmental Chemical Processes, Department of Chemistry, University of Crete, Heraklion, Crete, Greece. · Organic Chemistry, Department of Chemistry, University of Crete, Heraklion, Crete, Greece. · Institute of Molecular Biology and Biotechnology, Foundation for Research & Technology-Hellas, University of Crete, Crete, Greece. · Department of Pharmacology, School of Medicine, University of Crete, Heraklion, Crete, Greece thermos@uoc.gr. ·Diabetes · Pubmed #29208634.

ABSTRACT: BNN27, a C17-spiroepoxy derivative of DHEA, was shown to have antiapoptotic properties via mechanisms involving the nerve growth factor receptors (tropomyosin-related kinase A [TrkA]/neurotrophin receptor p75 [p75

9 Article Comparison of digital color fundus imaging and fluorescein angiographic findings for the early detection of diabetic retinopathy in young type 1 diabetic patients. 2018

Kapsala, Z / Anastasakis, A / Mamoulakis, D / Maniadaki, I / Tsilimbaris, M. ·Department of Ophthalmology, Medical School, University of Crete, P.O. Box 2208, 71003 Heraklion, Greece. Electronic address: z.kapsala@med.uoc.gr. · Department of Ophthalmology, Medical School, University of Crete, P.O. Box 2208, 71003 Heraklion, Greece. · Department of Pediatrics, Medical School, University of Crete, P.O. Box 2208, 71003 Heraklion, Greece. ·J Fr Ophtalmol · Pubmed #29191678.

ABSTRACT: 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.

10 Article Macrovascular function indices for the prediction of diabetic retinopathy development in patients with type 2 diabetes. 2017

Gouliopoulos, Nikolaos / Antonopoulos, Alexios S / Siasos, Gerasimos / Moschos, Marilita M / Oikonomou, Evangelos / Kassi, Eva / Tousoulis, Dimitris. ·1 1st Department of Ophthalmology, Gennimatas General Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece. · 2 1st Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece. · 3 Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School and Harvard-MIT Biomedical Engineering Center, Massachusetts Institute of Technology, Boston, USA. · 4 1st Department of Propaedeutic and Internal Medicine, Division of Diabetes, Laiko University Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece. ·Eur J Prev Cardiol · Pubmed #28657342.

ABSTRACT: -- No abstract --

11 Article Plasminogen Activator Inhibitor Type-1 Tag Single-Nucleotide Polymorphisms in Patients with Diabetes Mellitus Type 2 and Diabetic Retinopathy. 2017

Siokas, Vasileios / Dardiotis, Efthimios / Sokolakis, Thomas / Kotoula, Maria / Tachmitzi, Sophia V / Chatzoulis, Dimitrios Z / Almpanidou, Pavlina / Stefanidis, Ioannis / Hadjigeorgiou, Georgios M / Tsironi, Evangelia E. ·a Department of Neurology, Laboratory of Neurogenetics , University of Thessaly, University Hospital of Larissa , Larissa , Greece. · b Department of Ophthalmology, Faculty of Medicine, School of Health Sciences , University of Thessaly , Larissa , Greece. · c Department of Nephrology, Faculty of Medicine, School of Health Sciences , University of Thessaly , Larissa , Greece. ·Curr Eye Res · Pubmed #28632032.

ABSTRACT: BACKGROUND: There is accumulating evidence for genetic susceptibility to the development of diabetic retinopathy (DR). The role of plasminogen activator inhibitor-1 (PAI-1) in DR risk remains controversial. OBJECTIVE: The present study was designed to investigate possible influence of PAI-1 gene region polymorphisms on the risk of DR and on the risk of developing DR early vs late in the course of type 2 diabetes mellitus (T2DM). METHODS: A total of 138 patients with DR, 107 patients with T2DM without DR, and 315 healthy controls were recruited. To cover the majority of the genetic variability across the extended region of PAI-1 gene, five tag single-nucleotide polymorphisms (SNPs) from the HapMap using a pairwise approach and an r RESULTS: A significant effect of rs2070682 on the risk of early DR onset was found in the codominant model of inheritance [odds ratio, OR (95% confidence interval, CI): 5.04 (1.47-17.28), p = 0.018]. However, this association marginally did not survive multiple testing corrections. No other significant association between PAI-1 tag-SNPs and haplotypes was revealed. Furthermore, no significant mutational load effect of PAI-1 tag SNPs on the risk of DR development in T2DM course was found. CONCLUSIONS: In conclusion, the present study does not provide any strong evidence that PAI-1 gene variants are implicated in the risk of DR or the development of DR during T2DM course.

12 Article Model for Risk-Based Screening of Diabetic Retinopathy in People With Newly-Diagnosed Type 2 Diabetes Mellitus. 2017

Chatziralli, Irini / Sergentanis, Theodoros N / Crosby-Nwaobi, Roxanne / Winkley, Kirsty / Eleftheriadis, Haralabos / Ismail, Khalida / Amiel, Stephanie A / Sivaprasad, Sobha. ·Laser and Retina Research Unit, King's College Hospital, London, United Kingdom. · Department of Epidemiology and Biostatistics, University of Athens, Athens, Greece. · Laser and Retina Research Unit, King's College Hospital, London, United Kingdom 3National Institute for Health Research Moorfields Biomedical Research Centre, London, United Kingdom. · Division of Diabetes and Nutritional Sciences, King's College London, United Kingdom. · Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom. ·Invest Ophthalmol Vis Sci · Pubmed #28556866.

ABSTRACT: Purpose: The purpose of this study was to evaluate the role of inflammatory/lipid markers and potential risk factors for diabetic retinopathy (DR) development in newly diagnosed patients with type 2 diabetes mellitus (T2DM). Methods: Participants in this study were 1062 patients with newly diagnosed T2DM. Demographic and clinical data of patients were collected. Assessment of DR status was performed using digital two-field photography. In addition, HbA1c (%), lipid profile, and urinary albumin were measured at recruitment. The following inflammatory markers were also measured: serum C-reactive protein, white blood cells, platelet, adiponectin, IL-4, IL-6, IL-10, vascular endothelial growth factor, tumor necrosis factor-α (TNF-α), IL-1b, IL-1 receptor antagonist (IL-1RA), and monocyte chemotactic protein-1. Univariate and multivariate analyses of the association of various potential risk factors and DR were conducted. Results: Univariate analysis showed that male sex, any cardiovascular event, and HbA1c were positively associated with DR, while IL-1RA, IL-1b, IL-6, and TNF-α were significantly negatively associated with presence of DR in the cohort. Risk factors that remained significantly associated with DR presence at the multivariate analysis were male sex, any cardiovascular event, HbA1c, and IL-1RA. Conclusions: Our study demonstrated that HbA1c levels, male sex, and previous cardiovascular events were risk factors for presence of DR in people with newly diagnosed T2DM, while IL-1RA seemed to have a protective role. The prevalence of DR in our population was 20.2%, reflecting current practice. Our findings may contribute to future risk-based modelling of screening for DR.

13 Article Efficacy of Topical Ofloxacin 0.3 % Administration on Conjunctival Bacterial Flora in Diabetic Patients Undergoing Intravitreal Injections. 2017

Plotas, Panagiotis / Makri, Olga E / Georgalas, Ilias / Pharmakakis, Nikolaos / Vantarakis, Apostolos / Georgakopoulos, Constantine D. ·a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece. · b Laboratory of Public Health, School of Medicine , University of Patras , Patras , Greece. · c Department of Ophthalmology , University of Athens , Athens , Greece. ·Semin Ophthalmol · Pubmed #27487463.

ABSTRACT: PURPOSE: This prospective, randomized case series study aims to evaluate the efficacy of ofloxacin 0.3% eye drops in eradication of conjunctival bacterial flora in diabetic patients undergoing intravitreal injections (IVI). METHODS: Ninety-two diabetic patients (92 eyes) scheduled to undergo intravitreal injection of ranibizumab due to diabetic macular edema were enrolled in the study. Patients were randomly assigned to three different groups. Group 1 (n=32) received ofloxacin eye drops the day before before IVI (four times); patients in Group 2 (n=29) were administered ofloxacin one hour before IVI (every 15 minutes), while Group 3 (n=31) comprised patients that received combined administration of ofloxacin both one day and one hour before IVI (eight doses). Samples were collected from the injection site before and after antibiotic administration. Culture results from BACTEC broth and positive cultures in blood agar and Sabouraud's dextrose agar plates were measured. RESULTS: In Group 1, BACTEC broth positive cultures decreased from 84.4% at baseline to 50% after ofloxacin administration (p=0.007), and blood agar positive cultures reduced from 65.63% to 34.38% (p=0.02). In Group 2, positive cultures significantly decreased in BACTEC broth (from 79.3% at baseline to 48.28%; p=0.027) and in blood agar (from 68.97% to 37.13%; p=0.034). In Group 3, positive cultures decreased from 77.42% at baseline to 32.26% (p=0.0008) and from 58.06% at baseline to 22.58% (p=0.009) in BACTEC broth and blood agar, respectively. No microorganisms were isolated from Sabouraud's dextrose agar plates. CONCLUSIONS: The combined one day/one hour (eight doses) ofloxacin administration in diabetic patients is extremely effective in reducing conjunctival bacterial flora. The application of topical ofloxacin for one day or one hour before IVI is also significantly effective.

14 Article Physical activity and its correlation to diabetic retinopathy. 2017

Praidou, Anna / Harris, Martin / Niakas, Dimitrios / Labiris, Georgios. ·Dept. of Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom; Faculty of Social Sciences, Hellenic Open University, Patra, Greece. Electronic address: praidou2003@yahoo.co.uk. · Dept. of Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom. · Faculty of Social Sciences, Hellenic Open University, Patra, Greece. · Faculty of Social Sciences, Hellenic Open University, Patra, Greece; Dept. of Ophthalmology, Democritus University of Thrace, Alexandroupolis, Greece. ·J Diabetes Complications · Pubmed #27469296.

ABSTRACT: PURPOSE: The lack of physical activity, along with obesity, smoking, hypertension and hyperglycaemia are considered as risk factors for the occurrence of diseases such as diabetes. Primary objective of the study was to investigate potential correlation between physical activity and diabetic retinopathy. PATIENTS AND METHODS: Three hundred and twenty patients were included in the study: 240 patients with diabetes type 2 (80 patients with mild to moderate non-proliferative diabetic retinopathy, 80 patients with severe to very severe non-proliferative diabetic retinopathy and 80 ones with proliferative diabetic retinopathy) were compared with 80 non-diabetic patients (control group). Physical activity of patients was assessed by the international physical activity questionnaire (IPAQ, 2002). HbA1c and BMI were also measured in diabetic patients. Group comparisons were attempted for levels of physical activity and sedentary behavior. RESULTS: Total physical activity was decreased in patients with severe to very severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy as compared to patients with mild to moderate non-proliferative diabetic retinopathy and to the control group (p<0.05). Significant negative correlation was detected between HbA1c levels, BMI and physical activity (both p<0.05). Moreover, significant negative correlation between the severity of diabetic retinopathy and physical activity has been demonstrated (p<0.05). CONCLUSIONS: Increased physical activity is associated with less severe levels of diabetic retinopathy, independent of the effects of HbA1c and BMI.

15 Article HYPERREFLECTIVE FOCI AS AN INDEPENDENT VISUAL OUTCOME PREDICTOR IN MACULAR EDEMA DUE TO RETINAL VASCULAR DISEASES TREATED WITH INTRAVITREAL DEXAMETHASONE OR RANIBIZUMAB. 2016

Chatziralli, Irini P / Sergentanis, Theodoros N / Sivaprasad, Sobha. ·*Laser and Retinal Research Unit, King's College Hospital, London, United Kingdom; †Department of Epidemiology and Biostatistics, University of Athens, Athens, Greece; and ‡NIHR Moorfields Biomedical Research Centre, London, United Kingdom. ·Retina · Pubmed #27258668.

ABSTRACT: PURPOSE: To evaluate the potential role of hyperreflective foci (HF) in predicting visual outcome in patients undergoing treatment for macular edema due to retinal vascular diseases. METHODS: Data and images of 92 patients with macular edema due to diabetes mellitus or branch retinal vein occlusion, treated with either intravitreal dexamethasone implant or ranibizumab, were analyzed. All patients underwent best-corrected visual acuity measurement, slit-lamp examination, spectral domain optical coherence tomography at baseline and at all time points of the follow-up (Month 1, 2, 3, 6, and 9). Generalized least squares random effects linear or logistic regression analysis was used to investigate potential factors associated with the final best-corrected visual acuity and number of HF, respectively. RESULTS: Increasing age (P < 0.001), central retinal thickness (P < 0.001), number of HF (P = 0.028), presence of subretinal fluid (P < 0.001), intraretinal fluid (P < 0.001), intraretinal cysts (P < 0.001), and disruption of ellipsoid zone/external limiting membrane (P < 0.001) were significantly associated with poorer visual outcome. Factors associated with HF were increasing central retinal thickness (P = 0.003), presence of subretinal fluid (P = 0.049), intraretinal fluid (P = 0.002), cysts (P = 0.015), and disruption of ellipsoid zone (P = 0.047). No significant differences in change in best-corrected visual acuity, central retinal thickness, and HF were observed between the two treatment groups. CONCLUSION: Hyperreflective foci are associated with poorer visual outcome in patients with macular edema due to retinal vascular diseases. Similar reductions in HF are achieved by intravitreal steroid and anti-vascular endothelial growth factor agent.

16 Article Prediction of regression of retinal neovascularisation after panretinal photocoagulation for proliferative diabetic retinopathy. 2016

Chatziralli, Irini P / Sergentanis, Theodoros N / Sivaprasad, Sobha. ·Laser and Retinal Research Unit, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. · Department of Epidemiology and Biostatistics, University of Athens, Athens, Greece. · Laser and Retinal Research Unit, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. senswathi@aol.com. · NHIR, Moorfields Eye Hospital, London, UK. senswathi@aol.com. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #26802035.

ABSTRACT: PURPOSE: The purpose of this study was to evaluate the regression of neovascularization elsewhere (NVE) after panretinal photocoagulation (PRP) based on its location in relation to the internal limiting membrane (ILM). METHODS: Participants in this retrospective case series were 47 patients with active NVE within the vascular arcade. All patients were treated with PRP and followed up for at least 12 months. The time to regression of NVE based on its location relative to the ILM on spectral domain-optical coherence tomography (SD-OCT) was analyzed. RESULTS: The proportion of eyes, showing regression of NVE at the end of follow-up period was 19/25 (76 %) in the "below ILM" group and 13/22 (59 %) in the "above ILM" group. The "below ILM" group was associated with a twofold enhanced regression of NVE in comparison to the "above ILM" group (HR = 2.13, p = 0.038). CONCLUSIONS: Regression of NVE is determined by its location relative to the ILM. Patients with "below ILM" NVE were found to show a twofold increased regression rate in comparison with the "above ILM" group, while the proportion of eyes showing regression of NVE at the end of the follow-up period was significantly greater in the "below ILM" than the "above ILM" group.

17 Article "Association between platelet activating factor acetylhydrolase and diabetic retinopathy: Does inflammation affect the retinal status?". 2016

Moschos, Marilita M / Pantazis, Panagiotis / Gatzioufas, Zisis / Panos, Georgios D / Gazouli, Maria / Nitoda, Eirini / Brouzas, Dimitris. ·University Eye Clinic, General Hospital of Athens G. Gennimatas, Greece. Electronic address: moschosmarilita@yahoo.fr. · University Eye Clinic, General Hospital of Athens G. Gennimatas, Greece. Electronic address: pantazispanos@hotmail.com. · Moorfields Eye Hospital, London, UK. Electronic address: zisisg@hotmail.com. · Ipswich Hospital, University of Cambridge, UK. Electronic address: gdpanos@gmail.com. · Department of Basic Medical Science, Laboratory of Biology, Medical School, National & Kapodistrian University of Athens, Greece. Electronic address: mgazouli@med.uoa.gr. · University Eye Clinic, General Hospital of Athens G. Gennimatas, Greece. Electronic address: irenenitoda@yahoo.com. · University Eye Clinic, General Hospital of Athens G. Gennimatas, Greece. Electronic address: brouzas@yahoo.com. ·Prostaglandins Other Lipid Mediat · Pubmed #26791393.

ABSTRACT: AIM: To assess the role of plasma platelet activating factor acetylhydrolase (PAF-AH) in pathogenesis and progression of diabetic retinopathy (DR). MATERIALS AND METHODS: Sixty eight diabetics and 23 age-frequency-matched non-diabetic patients underwent blood sampling and the plasma PAF-AH activity was calculated. The diabetic patients were further classified into two groups, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification, based on indirect fundoscopy and fluorescein angiography. Thirty seven patients with non-proliferative DR (NPDR) and 31 patients with proliferative DR (PDR) were finally included in the study. RESULTS: The plasma PAF-AH activity was increased in diabetic patients with PDR (0.206 μmol/min/ml) compared to control group (0.114 μmol/min/ml, post-hoc Bonferroni comparison test: p<0.0001) and to NPDR group (0.147 μmol/min/ml, post-hoc Bonferroni comparison test: p=0.012). CONCLUSIONS: The activity of PAF-AH in the plasma increases in parallel with DR severity.

18 Article Cross Talk between Lipid Metabolism and Inflammatory Markers in Patients with Diabetic Retinopathy. 2015

Crosby-Nwaobi, Roxanne / Chatziralli, Irini / Sergentanis, Theodoros / Dew, Tracy / Forbes, Angus / Sivaprasad, Sobha. ·NIHR Moorfields Biomedical Research Centre, London EC1V 2PD, UK ; King's College Hospital NHS Foundation Trust, London SE5 9RS, UK. · King's College Hospital NHS Foundation Trust, London SE5 9RS, UK. · Department of Epidemiology and Biostatistics, University of Athens, 11528 Athens, Greece. · King's College London, London SE5 9RS, UK. ·J Diabetes Res · Pubmed #26295054.

ABSTRACT: PURPOSE: The purpose of this study was to examine the relationship between metabolic and inflammatory markers in patients with diabetic retinopathy (DR). METHODS: 208 adult patients with type 2 diabetes participated in this study and were categorized into (1) mild nonproliferative diabetic retinopathy (NPDR) without clinically significant macular edema (CSME), (2) NPDR with CSME, (3) proliferative diabetic retinopathy (PDR) without CSME, and (4) PDR with CSME. Variable serum metabolic markers were assessed using immunoassays. Multinomial logistic regression analysis was performed. RESULTS: Diabetes duration and hypertension are the most significant risk factors for DR. Serum Apo-B and Apo-B/Apo-A ratio were the most significant metabolic risk factors for PDR and CSME. For every 0.1 g/L increase in Apo-B concentration, the risk of PDR and CSME increased by about 1.20 times. We also found that 10 pg/mL increase in serum TNF-α was associated with approximately 2-fold risk of PDR/CSME while an increase by 100 pg/mL in serum VEGF concentration correlated with CSME. CONCLUSIONS: In conclusion, it seems that there is a link between metabolic and inflammatory markers. Apo-B/Apo-A ratio should be evaluated as a reliable risk factor for PDR and CSME, while the role of increased systemic TNF-α and VEGF should be explored in CSME.

19 Article Ocular rigidity and outflow facility in nonproliferative diabetic retinopathy. 2015

Panagiotoglou, Theonitsa / Tsilimbaris, Miltiadis / Ginis, Harilaos / Karyotakis, Nikos / Georgiou, Vaggelis / Koutentakis, Pavlos / Pallikaris, Ioannis. ·Department of Ophthalmology, University Hospital of Heraklion, 71110 Heraklion, Greece ; Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece. · Department of Ophthalmology, University Hospital of Heraklion, 71110 Heraklion, Greece ; Institute of Vision and Optics, School of Medicine, University of Crete, 71110 Heraklion, Greece. · Institute of Vision and Optics, School of Medicine, University of Crete, 71110 Heraklion, Greece. · Department of Social Medicine, School of Medicine, University of Crete, 71110 Heraklion, Greece. · Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece. ·J Diabetes Res · Pubmed #25954761.

ABSTRACT: PURPOSE: To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects. METHODS: Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings. RESULTS: Ocular rigidity was 0.0205 μL(-1) in NPDR group and 0.0202 μL(-1) in control group (P = 0.942). In NPDR1-group, OR was 0.017 μL(-1) and in NPDR2-group it was 0.025 μL(-1) (P = 0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P = 0.151). There was no difference in C between NPDR1-group and NPDR2-group (P = 0.709). CONCLUSIONS: No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.

20 Article Significant reduction of diabetic macular edema following intravitreal ranibizumab injection in the fellow eye. 2014

Rotsos, Tryfon / Symeonidis, Chrysanthos / Triantafillopoulou, Ioanna / Kanellopoulos, Spyridon / Kouris, Anastasios. ·Department of Ophthalmology, General Hospital of Athens, Athens, Greece. ·Int Ophthalmol · Pubmed #25192913.

ABSTRACT: A significant therapeutic effect in the fellow eye after intravitreal ranibizumab injections was observed in a 39-year-old diabetic male. The patient was followed-up with fluorescein angiography (FA) and Optical Coherence Tomography (OCT). On referral, best-corrected visual acuity (BCVA) was 6/60 in the right eye and Counting Fingers in the left eye. FA revealed foveal leakage in both eyes. OCT revealed diabetic and cystoid macular edema (DME-CME) in both eyes. The patient was treated with two intravitreal ranibizumab injections in the left eye. BCVA was 6/15 and 6/30 one month after the last injection. OCT revealed significant improvement (DME elimination and significant CME improvement) in both eyes, despite the fact that only the left eye was treated. It is conceivable that, in this eye, chronic vascular damage was limited and a minimal quantity of ranibizumab had a positive effect on vascular permeability, resulting in DME resolution.

21 Article Effect of macular ischemia on intravitreal ranibizumab treatment for diabetic macular edema. 2014

Douvali, Maria / Chatziralli, Irini P / Theodossiadis, Panagiotis G / Chatzistefanou, Klio I / Giannakaki, Emmanouella / Rouvas, Alexandros A. ·2nd Department of Ophthalmology, Attikon Hospital, Athens, Greece. ·Ophthalmologica · Pubmed #25171753.

ABSTRACT: PURPOSE: To evaluate the impact of macular ischemia on the functional and anatomical outcome after intravitreal injections of ranibizumab for the treatment of diabetic macular edema (DME). PROCEDURES: Participants were 49 patients with diabetes mellitus, divided into two groups based on the presence of ischemia on fluorescein angiography: (i) nonischemic group (n = 32) and (ii) ischemic group (n = 17). All patients were treated with intravitreal ranibizumab and were followed up for 6 months. The main outcome measures were changes in visual acuity (VA) and central foveal thickness (CFT). RESULTS: There was a statistically significant improvement in VA and CFT between baseline and the end of the follow-up in the nonischemic group, while in the ischemic group there was no significant difference in VA but CFT differed significantly at the 6-month follow-up. CONCLUSIONS: Macular ischemia may have a negative impact on functional outcomes 6 months after intravitreal ranibizumab treatment in patients with DME but has no effect on anatomical outcomes.

22 Article Diabetic retinopathy treated with laser photocoagulation and the indirect effect on glycaemic control. 2014

Praidou, Anna / Androudi, Sofia / Brazitikos, Periklis / Karakiulakis, George / Papakonstantinou, Eleni / Tsinopoulos, Ioannis / Dimitrakos, Stavros. ·St. Paul's Eye Unit, Royal Liverpool University Hospital, L7 8XP, UK ; Department of Ophthalmology, Aristotle University, 54124 Thessaloniki, Greece. · Department of Ophthalmology, Aristotle University, 54124 Thessaloniki, Greece. · Department of Pharmacology, School of Medicine, Aristotle University, 54124 Thessaloniki, Greece. ·J Diabetes Res · Pubmed #25136642.

ABSTRACT: PURPOSE: To identify any possible relation between glycaemic control and previous laser photocoagulation for diabetic retinopathy. METHODS: Seventy-two patients with diabetes were included in the study and were separated into 2 groups according to previous treatment (group A) or not (group B) with argon laser photocoagulation. Glycaemic control was estimated by measuring blood levels of HbA1c in four consecutive measurements. RESULTS: Blood levels of HbA1c in group A were significantly lower 3, 6, and 12 months after laser treatment as compared to blood levels of HbA1c before laser treatment (7.1 ± 0.4% versus 7.6 ± 0.9%, 7.2 ± 0.2% versus 7.6 ± 0.9%, and 7.1 ± 0.2% versus 7.6 ± 0.9%, resp., all P < 0.05). Blood levels of HbA1c in group B did not differ significantly in four consecutive measurements. CONCLUSION: Our results suggest that we should anticipate a better glycaemic control in cases of patients with diabetes previously treated with laser photocoagulation.

23 Article Vitamin status as a determinant of serum homocysteine concentration in type 2 diabetic retinopathy. 2014

Fotiou, Pandelis / Raptis, Athanasios / Apergis, George / Dimitriadis, George / Vergados, Ioannis / Theodossiadis, Panagiotis. ·2nd Department of Ophthalmology, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece. · 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece. · Department of Molecular Diagnosis, "Hippokration" General Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece. · Athens Eye Hospital, 45 Vouliagmenis Avenue, 16675 Athens, Greece. ·J Diabetes Res · Pubmed #25006590.

ABSTRACT: We investigated the association of serum homocysteine levels and vitamin status with type 2 diabetic retinopathy. This study included 65 patients with and 75 patients without diabetic retinopathy. Patients with diabetic retinopathy had significantly higher serum homocysteine levels (P < 0.001), higher prevalence of hyperhomocysteinemia (P < 0.001), lower serum folic acid (P < 0.001), and vitamin B12 (P = 0.014) levels than those without diabetic retinopathy. Regression analysis revealed that homocysteine was an independent risk factor for diabetic retinopathy and there was a threshold in its serum level (13.7  μ mol/L), above which the risk of diabetic retinopathy greatly increases (OR = 1.66, P = 0.001). Folic acid was associated with decreased odds for diabetic retinopathy (OR = 0.73, P < 0.001). There was a threshold in serum vitamin B12 level (248.4 pg/mL), below which serum homocysteine concentration significantly increases with decreasing serum vitamin B12 (P = 0.003). Our findings suggest that hyperhomocysteinemia is an independent risk factor for the development and progression of diabetic retinopathy. Decreased serum levels of folic acid and vitamin B12, through raising serum homocysteine concentrations, may also affect the diabetic retinopathy risk.

24 Article Renal injury following intravitreal anti-VEGF administration in diabetic patients with proliferative diabetic retinopathy and chronic kidney disease--a possible side effect? 2014

Georgalas, Ilias / Papaconstantinou, Dimitris / Papadopoulos, Kostas / Pagoulatos, Dionisis / Karagiannis, Dimitris / Koutsandrea, Chryssanthi. ·Department of Ophthalmology, University of Athens, Greece. igeorgalas@yahoo.com. ·Curr Drug Saf · Pubmed #24517109.

ABSTRACT: The use of intravitreal injections of anti-Vascular Endothelial Growth Factor (anti-VEGF) has been used for a broad spectrum of ocular pathologic entities. Although the dose of anti-VEGF agents used for treating eye disease is minute compared with that used intravenously, intraocular administration can lead to systemic absorption and reduce serum VEGF levels. Several systemic side effects, such as hypertension and cardiovascular complications have been rarely reported in the literature. Renal complications of intravenous administration of anti-VEGF, are well known and include a variety of renal pathological damage which can induce proteinuria and hypertension. We describe herein, 2 cases of diabetic patients with preexisting kidney disease who presented severe reduction of their renal function after intraocular administration of anti-VEGF. Although a cause -effect correlation cannot be established unless further studies are performed, we believe that pretreatment counseling should include a discussion outlining the possible risk of aggravating of the renal function in patients with kidney disease. Close cooperation with the patient's nephrologist and close monitoring of the patient may be required, in such cases, in order to monitor the renal function before and after the intravitreal administration of anti-VEGF.

25 Article Comparison of visual acuity charts in young adults and patients with diabetic retinopathy. 2013

Plainis, Sotiris / Kontadakis, George / Feloni, Eftychia / Giannakopoulou, Trisevgeni / Tsilimbaris, Miltiadis K / Pallikaris, Ioannis G / Moschandreas, Joanna. ·Institute of Vision and Optics, University of Crete, Greece. plainis@med.uoc.gr ·Optom Vis Sci · Pubmed #23314130.

ABSTRACT: PURPOSE: To compare visual acuity (VA) assessed in healthy eyes and eyes with diabetic retinopathy (DR) using three different logMAR charts: the Sloan letter European-wide chart, the tumbling E chart, and the Landolt C chart. METHODS: Measurements on one eye of 40 volunteers (aged 29 ± 4 years) without visual impairment and 31 DR patients (aged 70 ± 9 years) with mild/moderate visual impairment were included. Visual acuity was assessed, with habitual refractive correction, using each of the three charts. Bland-Altman charts were constructed, and 95% limits of agreement were calculated to measure agreement. RESULTS: Mean VA in the group of young adults was -0.05 ± 0.10 (Sloan letter), -0.02 ± 0.13 (tumbling E), and 0.00 ± 0.12 (Landolt C) logMAR. Average VA estimates differed to a statistically significant extent between all charts. Mean VA in the DR group was 0.46 ± 0.25 (Sloan letter), 0.48 ± 0.26 (tumbling E), and 0.59 ± 0.28 (Landolt C). A statistically significant difference was observed for average Sloan letter versus Landolt C (p < 0.001) and tumbling E versus Landolt C (p < 0.001) acuities. Moreover, in healthy eyes, a moderate correlation (r = -0.38, p = 0.015) was found between the discrepancy in Sloan letter and Landolt C acuity and the mean VA estimate. The 95% limits of agreement were wide (more than approximately 0.2 logMAR for each comparison) and wider in the DR group chart comparisons than in healthy eyes. CONCLUSIONS: Landolt C charts resulted in worse VA estimates compared with letter and tumbling E charts in both young adults and visually impaired subjects with DR. These differences seem more pronounced in DR patients who exhibit worse VAs. The specific study population must be considered in comparing outcomes from different clinical practices.

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