Eirini-Kanella Panagiotopoulou

The purpose of this report is to document the occurrence of transient central retinal artery occlusion (CRAO) as a rare and serious ocular complication in a patient with granulomatosis with polyangiitis (GPA), emphasizing the potential vision-threatening nature of this condition. A 49-year-old male with a known diagnosis of GPA presented with transient CRAO. The case was analyzed to understand the ocular manifestations associated with GPA and the challenges in its management. The patient exhibited a transient CRAO, highlighting the potential for severe ocular complications in the context of GPA. Transient CRAO is a rare but serious vision-threatening complication of GPA. This case underscores the importance of early diagnosis and timely management in patients with ocular manifestations of GPA. Financial disclosure: No financial support was received for this case report. None of the authors has any proprietary interests or conflicts of interest related to this submission. It is not simultaneously being considered for publication at any other journal.

Background/Objectives: Western societies introduce school-based or school-linked programs in order to improve the physical health status of students and prevent the negative impact of the late diagnosis of a series of diseases and conditions. Preschool visual acuity (VA) screening represents an established school-based approach aimed at the early detection of amblyopia risk factors and vision-related learning difficulties. In this study, we report the methods and outcomes of the first officially organized kindergarten-based VA screening program in Greece, implemented using the Democritus Digital Visual Acuity Test (DDiVAT) screening suite and involving trained educators as part of the screening workflow. The present analysis focuses on the operational performance and screening outcomes within this defined setting. Methods: This study was a kindergarten-based screening. Each kindergarten was equipped with the DDiVAT screening framework, which consisted of a 32-inch, 4K, Android Smart TV with the DDiVAT application preinstalled, a site-license granting access to the secure DDiVAT database, and two vouchers for teachers to participate in the official lifelong DDiVAT training program. Results: From 2476 enrolled students, 207 (8.36%) were referred due to suboptimal presenting VA in one or both eyes. Average VA ranged from logMAR 0.11 to 0.07, which is consistent with former reports. Conclusions: No major technical difficulties were encountered, suggesting that DDiVAT may represent a feasible digital approach for preschool VA screening in real-world educational settings.

Background: The present study assesses the effectiveness and tolerability of preservative-free travoprost in patients with primary open-angle glaucoma (POAG), focusing on intraocular pressure (IOP) reduction and ocular surface health over a six-month period. Methods: The study was prospectively designed and conducted at the University General Hospital of Alexandroupolis, Greece. A total of 45 patients diagnosed with either POAG or ocular hypertension (OHT) were included in the study; all were either newly diagnosed or had previously discontinued prostaglandin therapy due to intolerance. Of these, 39 participants completed the study. All subjects were administered preservative-free travoprost once daily. Clinical evaluations were conducted at baseline (T0), and at 1 month (T1), 3 months (T3), 6 months (T6) and 12 months (T12) following treatment initiation. The primary outcomes encompassed reductions in intraocular pressure (IOP), Schirmer test values, tear break-up time (TBUT), conjunctival hyperemia, as well as measurements of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness. Visual field parameters were also assessed. Results: A significant reduction in IOP was observed at T1, T3, T6 and T12 compared to baseline (p < 0.01). Schirmer test scores improved significantly from T0 to all subsequent time points (p < 0.01). Conjunctival hyperemia decreased significantly across follow-ups, while TBUT showed no significant change (p > 0.05). No significant changes were noted in mean deviation (MD), pattern standard deviation (PSD), RNFL, or GCC thickness over six months. Conclusion: Preservative-free travoprost effectively reduces IOP while improving ocular surface health, particularly in tear production and conjunctival hyperemia.

Background/Objectives: The aim of this study was to evaluate the correlation between the visual curve (ViC) and Area of the Curve (AoC) indices and the subjective perception of vision-related quality of life in patients who had undergone pseudophakic presbyopia correction. The central hypothesis was that AoC indices would show stronger correlations with vision-specific quality-of-life measures than single-point visual acuity (VA) assessments. Methods: A total of 100 patients who underwent bilateral pseudophakic presbyopia correction at the University Hospital of Alexandroupolis, Greece, were included in the study. Six months following surgery, visual acuity was assessed at nine distances using the DDART tool. The AoC was calculated using VA data from four, five, six, and nine distances, and further categorized into Near Vision AoC (AoCN) and Distance Vision AoC (AoCD). Participants also completed the NEI-VFQ-25 questionnaire to evaluate their subjective vision-related quality of life. Results: Statistically significant correlations were observed between AoC values and NEI-VFQ-25 total scores (r = 0.668–0.682, p < 0.001), near activity subscale scores (r = 0.656–0.686, p < 0.001), and distance activity subscale scores (r = 0.733–0.758, p < 0.001). In all analyses, the AoC indices derived from ViC demonstrated stronger correlations with quality-of-life scores than those observed with AoC-derived DCT and single VA measurements, even when the AoC was computed using only four measurement points. Conclusions: The AoC metric is a superior indicator of vision-specific quality of life compared to isolated VA measurements. AoC effectively captures the multifaceted nature of functional vision following presbyopia correction.

Introduction: This case report aims to showcase the successful application of electron hypofractionated radiotherapy in the treatment of eyelid basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Cases Presentation: Two cases are presented involving a 91-year-old Greek female with nodular BCC and an 88-year-old Greek male with ulcerative SCC. Both cases were treated with electron 10MeV irradiation using an ELEKTA 5-15MV linear accelerator. In the first case, a patient with advanced dementia presented with left-upper-eyelid nodular BCC. Following confirmation through biopsy and imaging, hypofractionated electron-beam radiotherapy was chosen, leading to gradual recession of the lesion and no recurrence at the one-year follow-up. In the second case, an elderly male with comorbidities had right-upper-eyelid ulcerative SCC. After systemic evaluation ruled out metastasis, the patient underwent hypofractionated radiotherapy, resulting in unexpected lesion shrinkage, resolution, and absence of recurrence at the 6-month and one-year follow-ups. Conclusions: Hypofractionated electron-beam radiotherapy emerges as an effective and well-tolerated alternative for eyelid tumors, particularly in cases where surgical excision is challenging or contraindicated.

Background/Objectives: Swept-Source Optical Coherence Tomography (SS-OCT) is a novel optical biometry technology with limited published data on its reliability compared to the gold standard, partial coherence interferometry (PCI). This study aims to assess the agreement between an SS-OCT biometer (Argos) and a PCI device (IOLMaster 500) in terms of biometry values, intraocular lens (IOL) power calculation and mean prediction error (ME). Methods: In this prospective comparative study, axial length (AL), anterior chamber depth (ACD), flat (K1), steep (K2) and mean (Km) keratometry values, astigmatism power, J0, and J45 vector components, white-to-white distance (WTW), and IOL power calculations for nine IOL models using four formulas were compared in cataract patients. Refractive outcomes were assessed in eyes implanted with SN60WF and Panoptix IOLs, with ME calculated for each module and formula for both IOLs postoperatively. Results: This study included 133 eyes (mean age: 66.0 ± 10.95 years). Argos measured significantly higher ACD and steeper keratometry values than IOLMaster, albeit without significant differences in AL, astigmatism power, WTW, J0, and J45. Mean IOL power differences were within the clinically acceptable threshold (0.50 D), except for SN6ATx with Hoffer Q and Haigis, and Clareon with Haigis. For Panoptix and SN60WF, IOLMaster demonstrated a more hyperopic ME than Argos with SRK/T, Holladay 1, and Hoffer Q; however, this was without clinically significant differences. Conclusions: Argos and IOLMaster 500 presented differences in ACD, keratometry values, and IOL power calculation. However, both devices showed non-clinically significant differences in IOL power calculation and ME in the majority of formulas.

This is a case report describing the uncommon finding of a cystic-like lesion and its management in the anterior chamber of a male patient after cataract surgery.

Purpose: To validate the Democritus Digital Acuity and Reading Test (DDART) as a distance VA (dVA) test against a series of prevalent conventional distance vision charts. Setting: Ophthalmology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece; Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece; and Ophthalmica Institute of Ophthalmology & Microsurgery, Thessaloniki, Greece. Design: Prospective multicenter validation study. Methods: The distance best spectacle-corrected visual acuity (dBSCVA) was compared in normal (NVG) and low (LVG) vision participants against 4 prevalent conventional distance vision charts (ETDRS, Snellen, Landolt C, and Tumbling E) by a predefined 2.5-symbol noninferiority margin and intraclass correlation coefficients (ICCs). DDART's test–retest (TRT) reliability was assessed with ICCs. Results: 534 participants (471 and 63 with normal and low vision, respectively) were included in the study. The mean difference between dBSCVA measured with DDART and conventional charts ranged between −0.84 and +0.85 symbols, without exceeding the 2.5-symbol noninferiority margin. ICCs indicated an excellent level of agreement for all patient groups (from 0.848 to 0.985). TRT reliability indicated differences below 1 symbol both for the NVG and LVG, with ICCs ranging between 0.912 and 0.964 for the 4 DDARTs. Conclusions: DDART was a valid web-based dVA test that provided reliable measurements in clinical and telemedical settings, both for normal and low vision patients.

The primary objective of this study was to objectively compare the visual performance of patients following premium pseudophakic presbyopia corrections in different light combinations for near- and intermediate-vision activities of daily living (ADLs). This is a prospective, comparative study. A total of 75 patients populated three study groups: G1-patients with bilateral trifocal implantation, G2-patients with bilateral bifocal implantation, and G3-patients with bilateral monofocal implantation. All participants addressed 10 ADLs in nine combinations of light temperature (3000 K, 4000 K, and 6000 K) and light intensity (25 fc, 50 fc, and 75 fc) and declared their subjectively optimal light combination while reading. G2 and G3 had the best total ADL scores in 6000 K/75 fc, while G1 had the best total ADL score in 4000 K/75 fc. Total ADL, easy ADL, and moderate difficulty ADL scores were significantly better in G2, while difficult ADL score was significantly better in G1. The majority of all groups selected 6000 K/75 fc as the most comfortable light combination, and no group selected 3000 K and 25 fc. In conclusion, trifocal patients benefit from intense daylight, while bifocal and monofocal patients benefit from intense, cold lighting. Trifocal patients present superior near-vision capacity in difficult near-vision daily tasks, while bifocal patients present superiority in easy and moderate-difficulty ADLs.

(1) Background: While smartphones are among the primary devices used in telemedical applications, smart TV healthcare apps are not prevalent despite smart TVs’ penetrance in home settings. The present study’s objective was to develop and validate the first smart TV-based visual acuity (VA) test (Democritus Digital Visual Acuity Test (DDiVAT)) that allows a reliable VA self-assessment. (2) Methods: This is a prospective validation study. DDiVAT introduces several advanced features for reliable VA self-testing; among them: automatic calibration, voice recognition, voice guidance, automatic calculation of VA indexes, and a smart TV-based messaging system. Normal and low vision participants were included in the validation. DDiVAT VA results (VA_DDiVAT) were compared against the ones from: (a) the gold-standard conventional ETDRS (VA_ETDRS), and, (b) an independent ophthalmologist who monitored the self-examination testing (VA_RES). Comparisons were performed by noninferiority test (set at 2.5-letters) and intraclass correlation coefficients (ICCs). DDiVAT’s test-retest reliability was assessed within a 15-day time-window. (3) Results: A total of 300 participants (185 and 115 with normal and low vision, respectively) responded to ETDRS and DDiVAT. Mean difference in letters was −0.05 for VA_ETDRS–VA_RES, 0.62 for VA_RES–VA_DDiVAT, and 0.67 for VA_ETDRS–VA_DDiVAT, significantly lower than the 2.5 letter noninferiority margin. ICCs indicated an excellent level of agreement, collectively and for each group (0.922-0.996). All displayed letters in DDiVAT presented a similar difficulty. The overall accuracy of the voice recognition service was 96.01%. ICC for VA_DDiVAT test-retest was 0.957. (4) Conclusions: The proposed DDiVAT presented non-significant VA differences with the ETDRS, suggesting that it can be used for accurate VA self-assessment in telemedical settings, both for normal and low-vision patients.