Papers by Konstantinos Balaskas
UNIVERSITE DE LAUSANNE - FACULTE DE BIOLOGIE ET DE MEDECINE Médecine Ophtalmologie Etude clinique... more UNIVERSITE DE LAUSANNE - FACULTE DE BIOLOGIE ET DE MEDECINE Médecine Ophtalmologie Etude clinique et angiographique lors de la Syphilis Oculaire THESE préparée sous la direction du Docteur Yan Guex-Crosier et présentée à la Faculté de biologie et de médecine de l'Université de Lausanne pour l'obtention du grade de DOCTEUR EN MEDECINE par Konstantinos BALASKAS Médecin diplômé de la Grèce Originaire d'Athènes (Grèce) ι Lausanne 2012 Une recrudescence des cas de syphilis a été observée ces dernières années. Son diagnostic clinique reste particulièrement difficile en l'absence de signe pathognomonique. Sur le plan oculaire elle présente un vaste spectre de manifestations diverses lui ayant valu le surnom de « la grande imitatrice ». Sa rareté et son hétérogénéité ont empêché l'identification et la vérification statistique des facteurs liés à un pronostic défavorable. Le but de cette étude a été d'explorer les paramètres cliniques et para-cliniques déterminant la...
Investigative Ophthalmology & Visual Science, Jun 10, 2020
Ten-year visual outcomes in patients with treated neovascular age related macular degeneration re... more Ten-year visual outcomes in patients with treated neovascular age related macular degeneration receiving anti-VEGF therapy | IOVS iovs.arvojournals.org/article.aspx
Klinische Monatsblätter für Augenheilkunde, 2012
Klinische Monatsblätter für Augenheilkunde, 2012
An increased prevalence of ocular syphilis has been reported in recent years reflecting a trend t... more An increased prevalence of ocular syphilis has been reported in recent years reflecting a trend towards liberalisation of sexual practices in the era of Highly Active Anti-retroviral Treatment for HIV infection [1][2]. In view of the protean nature of the disease, pathognomonic features that could guide differential diagnosis of ocular inflammation towards syphilis are lacking. Ocular involvement can antedate or follow systemic manifestations of syphilitic infection, ranging widely and potentially involving all ocular tissue [3][4]. We report here an unusual case of chronic fever and fatigue the cause of which remained elusive for a period of three years, despite extensive investigations, until the development of bilateral panuveitis, raising the suspicion of syphilitc infection
Klinische Monatsblätter für Augenheilkunde, 2011
Klinische Monatsblätter für Augenheilkunde, 2011
Klinische Monatsblätter für Augenheilkunde, 2011
Acute retinal necrosis syndrome is clinically defined by the presence of peripheral necrotizing r... more Acute retinal necrosis syndrome is clinically defined by the presence of peripheral necrotizing retinitis associated with severe occlusive vasculitis caused primarily by herpes simplex virus and varicella zoster virus. Previously considered as an exclusively retinal pathology, choroidal involvement, as demonstrated by indocyanine green angiography, has not been extensively studied. Indocyanine green angiography was performed in 4 patients with ARN. Observed angiographic patterns included: 1. a characteristic triangular area of hypo-perfusion, 2. hypofluorescent lobular patches and areas of fuzzy choroidal vascular hyperfluorescence, and 3. isolated hypofluorescent lobular patches of the contralateral eye. Marked choroidal hypo-perfusion on indocyanine green angiography was associated with extensive retinal ischemia. Treatment included a combination of antiviral agents and corticosteroids complemented by prophylactic acetylsalicylate. Indocyanine green angiography may provide important information regarding choroidal vascular involvement in ARN. It may also permit the timely identification of sub-clinical contralateral eye involvement.
Journal Français d'Ophtalmologie, 2010
Occlusion de branche artérielle rétinienne ; Maladie de Takayasu ; Scanographie ; Ischémie oculai... more Occlusion de branche artérielle rétinienne ; Maladie de Takayasu ; Scanographie ; Ischémie oculaire Résumé Nous rapportons un cas d'occlusion de branche artérielle rétinienne chez une jeune patiente atteinte d'une maladie de Takayasu. Une femme de 35 ans, avec une anamnèse de maladie de Takayasu révélée il y a 5 ans, consulta en urgence pour une baisse soudaine de l'acuité visuelle et une amputation du champ visuel de l'oeil gauche depuis une heure. L'examen a révélé une occlusion de la branche supérieure temporale de l'artère centrale rétinienne, en absence d'autres signes classiques d'ischémie oculaire associés à une maladie de Takayasu. Trois des six critères introduits par le Collège Américain de Rhumatologie pour le diagnostic de la maladie de Takayasu ont été constatés. Trois mois plus tard, l'acuité visuelle était stabilisée à 7/10 e , avec correction, grâce à l'existence d'une artère ciliorétinienne. La manifestation d'une occlusion de branche artérielle rétinienne chez une femme si jeune est suffisamment rare. Une recherche de la littérature a révélé un seul rapport de maladie de Takayasu ayant comme manifestation oculaire une occlusion artérielle. Ce qui rend notre cas exceptionnel est l'absence d'autres signes d'ischémie oculaire et le fait que les artères sous-clavières et carotides étaient atteintes à un degré modéré. © 2009 Elsevier Masson SAS. Tous droits réservés. ଝ Le texte de cet article est également publié en intégralité sur le site de formation médicale continue du Journal français d'Ophatalmologie-www.e-jfo.fr-, sous la rubrique « Cas clinique » (consultation gratuite pour les abonnés).
Current Eye Research, 2013
New treatments against long-lasting uveitis need to be tested. Our aim was to develop a six-week ... more New treatments against long-lasting uveitis need to be tested. Our aim was to develop a six-week model of uveitis in rabbits. Rabbits were presensitized with an s.c. injection of Mycobacterium tuberculosis H37RA emulsified with TiterMax Gold adjuvant. Uveitis was induced at day 28 and 50, by intravitreal challenges of antigen suspension. Ocular inflammation was assessed till euthanasia at day 71 after s.c. injection of M. tuberculosis H37RA by: (a) the number of inflammatory cells in aqueous humor (AH); (b) the protein concentration in AH; (c) the clinical score (mean of conjunctival hyperaemia, conjunctival chemosis, oedema and secretion); (d) the microscopical score (mean presence of fibrin and synechiae, aqueous cell density and aqueous flare grade, as scored by slit lamp). At the sites of presensitization injection, rabbits presented flat nodules which progressively vanished. The first challenge induced a significant increase in the four parameters (p < 0.05 the Wilcoxon/Kruskal-Wallis test). The AH contained 764 ± 82 cells/µl and 32 ± 0.77 mg protein/ml. During the following days, inflammatory parameters decreased slightly. The second intravitreal challenge increased inflammation (3564 ± 228 cells/µl AH and 31 ± 1 mg protein/ml), which remained at a high level for a longer period of time. We developed a model of long-term uveitis, which could be maintained in rabbits for at least six weeks. Such a model could be used to test the efficacy of either new drugs or various drug delivery systems intended to deliver active agents during a few months.
British Journal of Ophthalmology, 2013
Macular telangiectasia (MacTel) type 2 is a bilateral disease of unknown origin exhibiting charac... more Macular telangiectasia (MacTel) type 2 is a bilateral disease of unknown origin exhibiting characteristic changes of the macular deep capillary network and neurosensory retina.1–3 Originally considered a predominantly vascular disorder, the introduction of novel imaging techniques has altered prevailing impressions of its underlying pathophysiology, suggesting a significant role of structural changes to the neurosensory retina. The MacTel study, a major multicenter observational study, attempts to shed light on the natural history of the disease and to identify optimal surrogates of disease progression that could be used as end points in interventional clinical trials. In view of the exploratory nature of the study, various imaging modalities were used at baseline and on annual follow-up visits to investigate their contribution to disease diagnosis and their role in offering clues on disease progression. These modalities included colour fundus imaging (CFI), fundus fluorescein angiography (FFA), autofluorescence imaging (AF), optical coherence tomography (OCT) and indocyanine green angiography (ICGA). All obtained images were sent to the Reading Centre at Moorfields Eye Hospital, UK, where the diagnosis was confirmed. During the MacTel study, it has been established that there are characteristic changes on CFI, AF, FFA and OCT that uniquely identify the disease.4 ,5 The primary aim of this project is to determine whether ICGA is helpful in establishing the diagnosis of MacTel and, therefore, whether its inclusion in the MacTel imaging protocol was justified. The secondary aim was to identify any changes specific to MacTel on ICGA over the course of …
Acta Ophthalmologica, 2013
Purpose An analysis was performed with a view of determining potential associations between typic... more Purpose An analysis was performed with a view of determining potential associations between typical patterns seen on autofluorescence (AF) imaging in patients with Macular Telangiectesia (MacTel) type 2 and distance visual acuity at presentation as well as visual change over a 2-year follow-up period, thus ascribing predictive value to AF patterns in MacTel. Methods A subgroup of 135 patients (229 eyes) enrolled in the MacTel study underwent AF imaging. Images were graded at the Moorfields Eye Hospital Reading Centre. Recorded AF patterns at baseline and at two years included the typical pattern of increased central AF due to loss of foveal masking, localized decreased AF at the end of a retinal vessel and a large area of decreased AF. Best-corrected visual acuity (BCVA) was measured by means of the Early Treatment for Diabetic Retinopathy Study charts at baseline and after two years. Statistical associations were derived by means of a generalized linear model. Results Presence of increased macular AF (p=0.004), a large area of decreased AF (p<0.001) or decreased AF at the end of a retinal vessel (p<0.001) at baseline were significantly associated with worse BCVA. Presence of increased macular AF (p<0.001) or of localized decreased AF at the end of a retinal vessel (p<0.001) and the absence of a large area of decreased AF (p<0.001) were predictive of a subtle, but statistically significant drop in BCVA at 2 years. Conclusion The typical pattern of increased central AF at baseline is encountered in patients with worse BCVA in MacTel type 2 and is also predictive of further subtle visual loss in a period of two years. Decreased AF is found in patients with worse baseline BCVA though no further visual loss at two years is observed.
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Papers by Konstantinos Balaskas