Theodoros Filippopoulos

Athens Vision Eye Institute · Ophthalmology

Prologue Glaucoma surgery has been, for many decades now, dominated by the universal gold standard which is trabeculectomy augmented with antimetabolites. Tubes also came into the scene to complement what we use to call conventional or traditional glaucoma surgery. More recently we experienced a changing glaucoma surgery environment with the “adve...

Purpose: To examine the generalizability, discuss limitations, and critically appraise recommendations on the management of Primary Angle Closure Suspects (PACS) that emerged as a result of recent randomized clinical trials challenging the widely accepted clinical practice of offering laser peripheral iridotomy (LPI) to PACS patients. To synthetiz...

Surgical intervention in patients with severe glaucoma remains controversial, especially in unilateral cases with a minimally affected fellow eye. Many question the benefit of trabeculectomy in such cases due to high complication rates and prolonged recovery. In this retrospective, non-comparative, interventional case series we aimed to determine t...

Purpose To describe the case of a monocular patient with ocular mucous membrane pemphigoid (MMP) and open angle glaucoma refractory to medical treatment, who was successfully managed with ab interno goniotomy at the time of cataract surgery. Methods A 63-year-old woman with a history of severe MMP presented with exacerbation of the disease in both...

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 ey...

To determine the safety and efficacy of fresh, human sclera allografts as a patch graft material in glaucoma drainage device (GDD) surgery. Retrospective, noncomparative, interventional, consecutive case series. All GDD cases operated between 2008 and 2013 in which fresh human corneoscleral rims were used immediately after the central corneal butto...

Purpose: To investigate the changes of anterior segment morphology in patients with narrow angles using a rotating Scheimpflug camera before and after laser peripheral iridotomy (LPI). Materials and methods: Forty-six eyes of 46 patients classified as primary angle closure suspect, primary angle closure, primary angle closure glaucoma, acute ang...

To compare the effect of ab interno trabeculectomy with trabeculectomy. Retrospective, cohort study. A total of 115 patients who underwent ab interno trabeculectomy (study group) compared with 102 patients who underwent trabeculectomy with intraoperative mitomycin as an initial surgical procedure (trabeculectomy group). Inclusion criteria were open...

A 31-year-old woman with morning glory optic disc anomaly (MGDA) developed acute retrobulbar optic neuritis and a bullous macular detachment. MRI demonstrated truncation of the perineural space of the affected optic nerve as well as focal optic nerve enhancement. Optical coherence tomography (OCT) showed retinoschisis associated with the macular de...

Posterior lamellar corneal procedures are gaining widespread acceptance as the surgical procedure of choice in cases of endo­thelial dysfunction. These offer more rapid visual recovery and more predictable refractive outcomes compared to penetrating keratoplasty. Originally developed by Melles and modified by Terry, deep lamellar endothelial kerato...

Purpose: To present the experience with Trabectome for the treatment of adult open-angle glaucoma. Methods: The main outcome measures were intraocular pressure (IOP), glaucoma medications, and secondary surgery in patients that were followed for at least one year. Success is IOP < 21 mmHg and 20% reduction of IOP compared to preoperative levels, an...

SPARC is a matricellular protein that is highly expressed in remodeling tissues, including the trabecular meshwork and ciliary body. The hypothesis for the study was that SPARC contributes to the regulation of intraocular pressure (IOP). The IOPs of SPARC-null mice, their corresponding wild-type (WT), and heterozygous animals were compared. Diurnal...

To describe periorbital changes induced by chronic topical therapy with daily bimatoprost 0.03% (Lumigan, Allergan Inc., Irvine, CA, U.S.A.). A clinical investigation of 5 nonconsecutive patients with unilateral glaucoma treated daily with topical bimatoprost 0.03% for up to 4 years prior to presentation. In eyes treated with bimatoprost 0.03% the...

Retinal ganglion cells (RGCs) are the only output neurons of the retina, and their degeneration after damage to the optic nerve or in glaucoma is a well established system for studying apoptosis in the central nervous system. Frequently used procedures for assessing RGC number in retinal flat mounts suffer from two problems: RGC densities are not u...

Despite late modifications and enhancements, traditional penetrating glaucoma surgery is not without complications and is reserved for patients in whom pharmacologic treatment and/or laser trabeculoplasty do not suffice to control the intraocular pressure. This article critically reviews recent advances in penetrating glaucoma surgery with particul...

To investigate the association between seatbelt use and (1) the spectrum of ocular injuries and (2) visual acuity outcomes after motor vehicle accidents (MVAs) with airbag deployment. Single-center retrospective observational case series. Forty-seven patients involved in MVAs with airbag deployment. Medical record review of all patients evaluated a...

The role of heat shock proteins (Hsp) in injury response has been well established, but it is now becoming apparent that the phosphorylation state of Hsp27 may be a critical determinant of its ability to act in a protective capacity. In this study, the expression of Hsp27 and its phosphorylation were evaluated in an experimental glaucoma model in B...

The DBA/2 mouse has been used as a model for spontaneous secondary glaucoma. We attempted to determine the in vivo time course and spatial distribution of retinal ganglion cells (RGCs) undergoing apoptotic death in DBA/2 mice. Female DBA/2 mice, 3, 9-10, 12, 15, and 18 months of age, received intravitreal injections of Annexin-V conjugated to Alexa...

Our purpose was to evaluate the accuracy, reproducibility and predictive ability of two non-invasive tonometers developed for intraocular pressure (IOP) measurements in the mouse. The prototype impact-rebound tonometer (I-R) and a prototype optical interferometry tonometer (OIT) utilizing a fiberoptic pressure sensor, were compared. Enucleated eyes...

To evaluate the relationship between retinal ganglion cell (RGC) size, density distribution, and survival in senescent DBA2/NNia mice that develop pigmentary glaucoma. To evaluate the validity of nearest neighbor distance (NND), a measure of focal density for surviving RGCs in the retina, as a method to quantify RGC loss in mice. Fifteen-month-old...

In glaucoma, retinal ganglion cells (RGCs) die by apoptosis, generally attributed to an elevated intraocular pressure (IOP). We now describe the impact of elevated IOP in the rat on expression of caspase 8 and caspase 9, initiators of the extrinsic and intrinsic caspase cascades, respectively. Activation of both caspases was demonstrated by the pre...

Increased intraocular pressure (IOP) leads, by an unknown mechanism, to apoptotic retinal ganglion cell (RGC) death in glaucoma. We now report cleavage of the autoinhibitory domain of the protein phosphatase calcineurin (CaN) in two rodent models of increased IOP. Cleaved CaN was not detected in rat or mouse eyes with normal IOP. In in vitro system...

To quantify the extent and pattern of retinal ganglion cell (RGC) loss in the DBA2/NNia glaucomatous mouse strain as a function of age and compare it with ganglion cell loss in a nonglaucomatous strain. All the ganglion cells in retinas of DBA/2NNia and C57/BL6 mice of various ages (five eyes per age group in 3-month intervals from 3 to 18 months o...

To evaluate the applicability of rebound tonometry for measurement of IOP in the mouse eye. An induction-impact (I/I) tonometer, which operates on the rebound principle, was scaled down and adapted to determine IOP of the mouse eye. IOP measurement using this concept is based on contacting the eye with a probe and detecting the motion as the probe...