Hydrolytic Activity of Mitochondrial F1FO-ATP Synthase as a Target for Myocardial Ischemia-Reperfusion Injury: Discovery and In Vitro and In Vivo Evaluation of Novel Inhibitors.

F1FO-ATP synthase is the mitochondrial complex responsible for ATP production. During myocardial ischemia, it reverses its activity, hydrolyzing ATP and leading to energetic deficit and cardiac injury. We aimed to discover novel inhibitors of ATP hydrolysis, accessing the druggability of the target within ischemia(I)/reperfusion(R) injury. New molecular scaffolds were revealed using ligand-based virtual screening methods. Fifty-five compounds were tested on isolated murine heart mitochondria and H9c2 cells for their inhibitory activity. A pyrazolo[3,4-c]pyridine hit structure was identified and optimized in a hit-to-lead process synthesizing nine novel derivatives. Three derivatives significantly inhibited ATP hydrolysis in vitro, while in vivo, they reduced myocardial infarct size (IS). The novel compound 31 was the most effective in reducing IS, validating that inhibition of F1FO-ATP hydrolytic activity can serve as a target for cardioprotection during ischemia. Further examination of signaling pathways revealed that the cardioprotection mechanism is related to the increased ATP content in the ischemic myocardium and increased phosphorylation of PKA and phospholamban, leading to the reduction of apoptosis.

Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature.

Aim: To describe the currently available evidence regarding the efficacy and safety of preoperative tumor marking using indocyanine green (ICG) prior to laparoscopic or robotic colorectal resections. Methods: A systematic search for relevant studies was conducted using the following databases: Embase (OVID), MEDLINE® (OVID), APA PsycInfo (OVID), Global Health (OVID) and HMIC Health Management Information Consortium (OVID) through June 2022 reported according to PRISMA 2020 guidelines. Primary outcome was the detection rate of the tumor sites preoperatively marked with ICG. Secondary outcomes were timing of ICG injection in days prior to the operation and technique-related complications. Results: Eight single center studies, published between 2008 and 2022, were identified yielding a total of 1,061 patients, of whom 696 were preoperatively tattooed with ICG. Injection dosage of diluted ICG ranged from 0.1-1.5 ml. Four studies used the saline test injection method prior to ICG injection. When the marking was placed within one week, the visualization rate was 650/668 (97%), whereas when it was longer than one week, the detection rate was 8/56 (14%). No severe complications were reported. Conclusion: Preoperative tumor marking using ICG prior to minimally invasive colorectal resections is safe and effective, allowing intraoperative tumor site location when performed up to a week prior to surgery without disturbing the surgical view in potential mild complications.

NSD2 maintains lineage plasticity and castration-resistance in neuroendocrine prostate cancer.

The clinical use of potent androgen receptor (AR) inhibitors has promoted the emergence of novel subtypes of metastatic castration-resistant prostate cancer (mCRPC), including neuroendocrine prostate cancer (CRPC-NE), which is highly aggressive and lethal 1 . These mCRPC subtypes display increased lineage plasticity and often lack AR expression 2-5 . Here we show that neuroendocrine differentiation and castration-resistance in CRPC-NE are maintained by the activity of Nuclear Receptor Binding SET Domain Protein 2 (NSD2) 6 , which catalyzes histone H3 lysine 36 dimethylation (H3K36me2). We find that organoid lines established from genetically-engineered mice 7 recapitulate key features of human CRPC-NE, and can display transdifferentiation to neuroendocrine states in culture. CRPC-NE organoids express elevated levels of NSD2 and H3K36me2 marks, but relatively low levels of H3K27me3, consistent with antagonism of EZH2 activity by H3K36me2. Human CRPC-NE but not primary NEPC tumors expresses high levels of NSD2, consistent with a key role for NSD2 in lineage plasticity, and high NSD2 expression in mCRPC correlates with poor survival outcomes. Notably, CRISPR/Cas9 targeting of NSD2 or expression of a dominant-negative oncohistone H3.3K36M mutant results in loss of neuroendocrine phenotypes and restores responsiveness to the AR inhibitor enzalutamide in mouse and human CRPC-NE organoids and grafts. Our findings indicate that NSD2 inhibition can reverse lineage plasticity and castration-resistance, and provide a potential new therapeutic target for CRPC-NE.

Unilateral hypertensive choroidopathy as a sole manifestation in malignant hypertension: optical coherence tomography angiography findings-case report.

BACKGROUND: We present a case of hypertensive choroidopathy due to malignant hypertension with exudative retinal detachment as a sole finding. We use OCT- angiography for initial diagnosis and report findings from extensive follow up. CASE PRESENTATION: A 51-year-old female with no past medical history, presented to our clinic with painless loss of vision in her left eye. Fundus examination revealed only exudative retinal detachment in her left eye that was confirmed with Optical Coherence Tomography. Fluorescein angiography showed hyperfluorescent spots with leakage in late phases. OCTA manifested a focal dark area in the choriocapillaris slab corresponding to flow signal voids, signifying regions of non-perfusion. Her blood pressure was 220/120 mmHG. Complete blood work -up failed to reveal any other possible etiology. During follow-up period of 9 months blood pressure normalized, patient regained visual function and choriocapillaris perfusion was completely restored. DISCUSSIONS AND CONCLUSIONS: Hypertensive choroidopathy with exudative retinal detachment can be the only sign of malignant hypertension and no pre-existing history of a systemic disease is required in order to become apparent. OCTA reveals areas of non-perfusion at choriocapillaris level, proving that it is an essential tool in the diagnosis and follow up of patients with hypertensive choroidopathy. Finally, we propose that early diagnosis prevents permanent damage of the RPE and leads to complete choroidal remodeling and better visual outcomes.

Preoperative tumor marking with indocyanine green prior of robotic colorectal resections.

This prospective case-series study aimed to assess the usefulness of preoperative colonoscopic marking of colorectal tumors using Indocyanine Green (ICG) fluorescence in patients that underwent robotic surgical colorectal resections. Consecutive patients that were eligible for colorectal resection with intent to cure in a single hospital (Athens Medical Center), from February 2022 to June 2022, were included. ICG solution was injected into the submucosal layer at 2 opposite sites (180 degrees apart) distal to the tumor, without submucosal elevation. Identification of the tumor marking was then performed after switching to near-infrared (NIR) fluorescence mode. During the robotic procedure, qualitative evaluation of fluorescence was performed by the surgical team (primary surgeon, first assistant, second assistant, research fellow). All 10 patients underwent robotic surgical approach and operations included right-sided colectomy (n = 1), left-sided colectomy (n = 6) and low anterior resection (n = 3). Visualisation of this dye with near-infrared light was very clear with bright intensity in all patients when the marking was performed one day prior of surgery. Preoperative tumor marking with ICG was identified intraoperatively in all cases and the techinque was easily reproducible.

Pathophysiological Responses of Pinna nobilis Individuals Enlightens the Etiology of Mass Mortality Situation in the Mediterranean Populations.

Due to the rapid decrease of Pinna nobilis populations during the previous decades, this bivalve species, endemic in the Mediterranean Sea, is characterized as 'critically endangered'. In addition to human pressures, various pathogen infections have resulted in extended reduction, even population extinction. While Haplosporidium pinnae is characterized as one of the major causative agents, mass mortalities have also been attributed to Mycobacterium sp. and Vibrio spp. Due to limited knowledge concerning the physiological response of infected P. nobilis specimens against various pathogens, this study's aim was to investigate to pathophysiological response of P. nobilis individuals, originating from mortality events in the Thermaikos Gulf and Lesvos and Limnos islands (Greece), and their correlation to different potential pathogens detected in the diseased animals. In isolated tissues, several cellular stress indicators of the heat shock and immune response, apoptosis and autophagy, were examined. Despite the complexity and limitations in the study of P. nobilis mortality events, the present investigation demonstrates the cumulative negative effect of co-infection additionally with H. pinnae in comparison to the non-presence of haplosporidian parasite. In addition, impacts of global climate change affecting physiological performance and immune responses result in more vulnerable populations in infectious diseases, a phenomenon which may intensify in the future.

The Effect of Whole-Body Cryostimulation in Healthy Adults : Whole-Body Cryostimulation According to Gender and Smoking Status.

INTRODUCTION: Whole-body cryostimulation (WBC) refers to the therapeutic application of extremely cold dry air for a short period of time. The method has beneficial results in various diseases as well as the recovery of athletes. The effects of WBC in healthy individuals have not been extensively investigated. PURPOSE: We aim to explore differences in the effects of WBC on blood pressure (BP), oxygen saturation (SpO2), and heart rate (HR) in healthy adults (not athletes) as well as differences according to gender and smoking status. MATERIALS AND METHODS: Fifty adults (male/female: 32/18) smokers/nonsmokers: 26/24) were included in the study. WBC was performed in a cryochamber at -85 °C for 3 min. Systolic BP (SBP) and diastolic BP (DBP), HR, and SpO2 were measured before and immediately after WBC. RESULTS: Males and females differed significantly in SBP after WBC (138.1 ± 13.0 vs 128.5 ± 17.0 mmHg, respectively, p = 0.029), SpO2 after WBC (96.6 ± 1.8 vs 98.3 ± 1.5%, respectively, p = 0.001) and HR after WBC (60.1 ± 9.6 vs 70.2 ± 7.7 bpm, respectively, p < 0.001). In males, SpO2 remained unchanged before and after WBC, whereas in women SpO2 increased by 1.0 ± 1.4% (p = 0.038) (Table 2). HR after WBC displayed a downward trend by -9.8 ± 5.9% in males compared to an upward trend by 3.6 ± 15.1 in females (p < 0.001). Nonsmokers displayed higher increase in SBP after WBC (4.3 ± 9.0% in smokers compared to 13.3 ± 13.2% in nonsmokers, p = 0.007). Smokers presented an increase by 1.0 ± 1.6% in SpO2, while in nonsmokers, SpO2 decreased by 0.8 ± 2.1% following WBC (p = 0.001). CONCLUSIONS: Our results suggest that WBC affects the cardiovascular and the respiratory system differently in males versus females and smokers versus nonsmokers. More studies are needed in order to fully explore the effects of WBC in these population groups in order to design individualized treatment protocols.

Clinical Outcome and Prognostic Factors of Sepsis, Septic Shock and Prolonged Hospitalization, of Patients Presented with Acute Obstructive Pyelonephritis.

Objective: To investigate prognostic factors of outcome of acute obstructive pyelonephritis (AOP). Materials and Methods: Patients with AOP were prospectively evaluated and logistic regression analysis was applied to identify factors associated with the duration of hospital stay and occurrence of sepsis and septic shock. Results: Based on CT scan findings, 62 patients were found to have AOP and subjected to emergency drainage. The main etiology of obstruction was lithiasis (70.9%). Double-J stent and percutaneous nephrostomy were introduced in 48 and 14 patients, respectively. Urosepsis and septic shock were diagnosed in 20 (32%) and 6 (9.7%) patients, respectively. None of the patients died of sepsis. In univariative analysis, older age, high neutrophils, increased serum creatinine, higher Charlson comorbidity index (CCI) score, any CCI score ≥1, diabetes mellitus (DM) longer operation time (OT), and multiresistant stains were risk factors of sepsis. Gender, type of drainage, laterality, white blood cell count, neutrophils rate >80%, C-reactive protein, and the presence of malignancy or lithiasis were not. Age, DM, and CCI score ≥1 were associated with prolonged hospitalization. None of the factors was associated with shock. In multivariative models, age (odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.02-1.16, p = 0.010), multiresistant strains (OR: 16.36, 95% CI: 1.97-135.71, p = 0.006), OT >20 minutes (OR: 1.03, 95% CI: 1.00-1.07, p = 0.048), and elevated creatinine (OR: 1.68, 95% CI: 1.001-2.84, p = 0.049) were independent prognostic factors of sepsis, and DM (OR: 30.8%, CI: 8.86%-52.8%, p = 0.007) was a prognostic factor of longer hospitalization. Conclusions: One-third of AOP patients will develop sepsis. Older age, elevated serum creatinine, longer OT presence of multiresistant strains, and DM are independent factors of worse outcome.

How Effective Is Retrograde Semirigid and Flexible Ureteroscopic Lithotripsy for the Treatment of Large Ureteral Stones Equal of or Greater than 15 mm? Results from a Single Center.

PURPOSE: To present the results and complications of retrograde ureteroscopic lithotripsy for treatment of large ureteral stones. METHODS: Nineteen patients were treated for ureteral stones ≥15 mm detected in CT or plain KUB film. Endoscopy was performed with either a semirigid or flexible ureteroscope. Stone fragmentation was performed using a 30 W Holmium laser. RESULTS: The mean stone size was 20.7 mm (range 15-30). The mean duration of the operation was 82 min (45-140). Measures to prevent retropulsion of fragments into the kidney were not routinely applied. A subsequent RIRS during the same session was necessary in 2 cases. After a single procedure a stone free state was achieved in 15 cases (78.9%), while 4 others required a second session (ESWL or second ureterolithotripsy, 2 cases each). In only 1 patient, the stone-free state was not achieved after a 1.2 procedure per patient (overall success rate 94.7%). The mean duration of hospitalization was 1.9 days (range 1-5). Three patients experienced postoperative pyelonephritis and 2 others prolonged hematuria. CONCLUSION: Endoscopic lithotripsy is safe and effective in treating large ureteral stones. After a single endoscopic procedure, approximately 4 out of 5 patients are expected to become stone free. This rate increases to 95% with a second session of lithotripsy.

Incidence and Risk Factors for Skull Implant Displacement After Cranial Surgery.

OBJECTIVE: Various complications that can occur during and after cranial surgery have been investigated extensively. One of the less frequent complications has thus far received little attention, however: displacement of the skull implant after craniotomy or craniectomy. The purpose of this study is to identify prognostic factors for the development of skull implant displacement (SID). METHODS: In this study, 9087 cranial surgeries performed between 2002 and 2017 were retrospectively examined for the occurrence of SID. Because a first analysis of the investigated data revealed that a notable number of SIDs occurred after a cranioplasty (CP) performed after a decompressive craniectomy (DC), we focused our investigation on these cases. A total of 669 DCs and 329 subsequently performed CPs were analyzed. Several factors were analyzed unadjusted as possible factors influencing the risk for the development of SID. RESULTS: A total of 13 implant dislocations occurred after CP (3.95%). Fixation technique is the only factor that seems to have had a significant influence, specifically not using miniplates as the fixation technique, which was associated with a higher risk of SID (P = 0.043). However, if fixation techniques are distinguished in more detail, no significant advantage of the miniplates over titanium clamps can be proven (P = 0.123). None of the remaining observed factors showed a statistically provable impact in our data. CONCLUSIONS: A notable number of SIDs only occur after CPs that follow a DC. An advantage in successful placement was observed when fixation of the skull implant during cranioplasty was performed using miniplates.

Phacoemulsification in Eyes With Posttrabeculectomy Choroidal Detachment.

Four patients developed choroidal detachment within 3 months after trabeculectomy, documented with b-scan ultrasonography (BUS) and ultrasound biomicroscopy (UBM). Intraocular pressure (IOP) of the patients ranged from 3 to 5 mm Hg. Patients were treated with cycloplegia and steroids without complete resolution of detachment. Twelve months later all patients had developed visually significant cataracts and underwent phacoemulsification and intraocular lens implantation. Procedures were uncomplicated. Visual acuity ranged 0.1 to 0 LogMAR in the first postoperative month. IOP demonstrated an increase of 6 to 8 mm Hg, which was maintained up to 1 year postoperatively. BUS and UBM in the first postoperative month demonstrated a complete resolution of choroidal detachment in all our cases. These patients with choroidal detachment underwent safe and effective phacoemulsification procedures. In addition, choroidal detachment resolved in all our patients, possibly because of intraoperative and postoperative IOP spikes, as well as long-term IOP elevation because of effect of cataract surgery on bleb function.

Location of submacular hemorrhage as a predictor of visual outcome after intravitreal ranibizumab for age-related macular degeneration.

PURPOSE: To evaluate the anatomical and functional outcomes in patients with submacular hemorrhage (SMH) due to age-related macular degeneration (AMD) treated with ranibizumab, and to evaluate the potential role of the SMH location in the final outcome after treatment. METHODS: Participants in this study were 12 treatment-naïve patients with SMH due to neovascular AMD who were treated with intravitreal ranibizumab and had at least 12 months' follow-up. All patients underwent best-corrected visual acuity measurement and optical coherence tomography at baseline and at every visit posttreatment, while fluorescein angiography was done at baseline and at the discretion of the physician thereafter. RESULTS: Of the patients, 83.4% showed improvement or stabilization in best-corrected visual acuity after treatment at the 12-month follow-up, with a mean number of 7.3±2.9 injections. Patients with SMH surrounding the foveal area in 360° presented worse anatomical and functional outcomes compared to those with SMH adjacent to the fovea. CONCLUSION: Intravitreal ranibizumab seems to be safe and effective, either improving or stabilizing visual acuity, in patients with SMH due to wet AMD. The location of the SMH may predict the final outcome after treatment.

European Crohn's and Colitis Organisation Topical Review on IBD in the Elderly.

This ECCO topical review of the European Crohn's and Colitis Organisation [ECCO] focuses on the epidemiology, pathophysiology, diagnosis, management and outcome of the two most common forms of inflammatory bowel disease, Crohn's disease and ulcerative colitis, in elderly patients. The objective was to reach expert consensus to provide evidence-based guidance for clinical practice.

Survival in granular cell astrocytomas.

BACKGROUND: Granular cell astrocytomas (GCAs) are rarely encountered aggressive glial neoplasms. Treatment options comprise surgery, radiotherapy, and chemotherapy. Due to the small number of cases, a standard therapeutic regimen for GCA does not exist. MATERIAL AND METHODS: We report on the case of a 64-year-old woman with GCA subjected to tumor biopsy followed by radiochemotherapy with temozolomide. We provide clinical, histopathologic, and magnetic resonance imaging findings as well as a complete follow-up. To assess the relation of age, gender, time of publication, and different treatment options with survival we performed log-rank tests and calculated Cox regression models and hazard ratios in data from all available reports on GCA. RESULTS: A significant difference in survival rates in favor of adjuvant therapy (radiotherapy or radiochemotherapy) at 12 months was found. Age > 70 years at the time of diagnosis had a significantly unfavorable impact on survival at 12 months. Although not statistically significant, a tendency toward higher probability of survival at 12 months was found in cases reported after 2002. In surgically treated patients, we could not find a significant impact of extent of resection on survival. A significant impact of gender on survival was not found. CONCLUSION: Adjuvant therapy is significantly related to a higher probability of survival at 12 months and may therefore be recommended for patients with a GCA. Further analysis of these rare neoplasms is warranted.

An atypical case of choroidal neovascularization associated with pseudoxanthoma elasticum treated with intravitreal bevacizumab: a case report.

BACKGROUND: Pseudoxanthoma elasticum is an inherited disorder that is associated with accumulation of pathologic elastic fibers in the skin, vascular walls and Bruch's membrane in the eye. Choroidal neovascularization is one of the most common causes of acute vision loss in these patients. We report an atypical case of suspected choroidal neovascularization associated with pseudoxanthoma elasticum. CASE PRESENTATION: A 47-year-old Caucasian woman with pseudoxanthoma elasticum and angioid streaks was referred because of decreased and distorted vision in her right eye of one week's duration. Visual acuity was 6/12 in the right eye and 6/6 in the left eye. Fundus examination revealed angioid streaks and white intraretinal macular deposits bilaterally. Fluorescein angiography did not reveal any obvious leakage in the right eye while optical coherence tomography revealed subretinal fluid associated with an adjacent intraretinal hyperreflective structure. Autofluoresence imaging showed focal areas of increased autofluorescence corresponding to the deposits in both eyes. Over the following year the patient underwent five intravitreal injections of bevacizumab (Genentech/Roche,US) in the right eye, which resulted in visual acuity improving to 6/9 with regression of the hyperreflective structrure and complete resolution of subretinal fluid. CONCLUSIONS: Traditionally, fluorescein angiography is effective in the detection of choroidal neovascularization in patients with pseudoxanthoma elasticum. In our case, optical coherence tomography revealed subretinal fluid and an adjacent hyperreflective structure while fluorescein angiography did not reveal any obvious leakage. The sole presence of subretinal fluid does not necessarily imply the presence of choroidal neovascularization and certainly retinal pigment epithelium dysfunction could also explain subretinal fluid in these patients. However, the complete absorption of the fluid and the disappearance of the previously evident hyperreflective structure following treatment, led us to suspect choroidal neovascularization as the primary cause of the above findings. The poor natural course of choroidal neovascularization in these patients increases the importance of early detection and should result in the adaptation of a low-threshold strategy concerning the initiation of treatment.

Response of corneal hysteresis and central corneal thickness following clear corneal cataract surgery.

PURPOSE: To evaluate the effect of routine phacoemulsification in corneal viscoelastic properties determined by corneal hysteresis (CH) and central corneal thickness (CCT) and to explore the impact of phaco energy on the above parameters. METHODS: Forty-one eyes of 41 patients undergoing cataract surgery were enrolled in this prospective study. CH and CCT were measured preoperatively, 1 day and 1 week postoperatively. CCT measurement was performed using a non-contact optical pachymeter followed by ocular response analyzer (ORA) examination. Intraoperatively ultrasound time, average phaco power and effective phaco time (EPT) were recorded. RESULTS: Mean CH was 10.05±1.86 mmHg preoperatively, 8.25±1.85 mmHg 1 day and 9.12±1.37 mmHg 1 week postoperatively (p<0.001). The mean CCT was 534±37.33 µm preoperatively, 592.22±46.34 µm 1 day and 563.21±49.84 µm 1 week postoperatively (p<0.001). CCT and CH were statistically significantly correlated preoperatively (p=0.01, r=0.396). This correlation was not sustained on the first postoperative day (p=0.094, r=0.265) and was re-established 1 week postoperatively (p=0.002, r=0.568). On the first postoperative day, the CCT increase was positively correlated with EPT (p=0.009, r=0.404), which was not found between CH change and EPT. CONCLUSION: Structural corneal alterations following cataract surgery resulted in a statistical change in CH and CCT. These two parameters responded in a different manner that clearly demarcates their different nature. On the first postoperative day, CCT increase was correlated at a statistically significant level with intraoperative EPT. This correlation was not found with CH reduction. Other factors, besides cornea oedema or phacoemulsification energy, could be responsible for this CH modification.

Recurrence of macular edema in retinal vein occlusions after treatment with intravitreal ranibizumab (Lucentis).

OBJECTIVE: To evaluate the recurrence of macular edema (ME) in a mixed group of patients with branch (BRVO) and central (CRVO) retinal vein occlusion after early onset treatment with intravitreal injections of ranibizumab. DESIGN: Nonrandomized, uncontrolled prospective clinical trial. PARTICIPANTS: Forty patients were enrolled in our study. Twenty-two patients had BRVO and 18 patients had CRVO. METHODS: All patients had a minimum follow-up of 12 months. All patients had fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) at presentation. The time period between RVO occurrences and initial examination and treatment was <1 month. Every patient was treated with 2 consecutive intravitreal injections of ranibizumab (0.5 mg) 1 month apart. Assessment was carried out on a monthly basis and injection was carried out if necessary, based on OCT findings. RESULTS: Recurrence of ME occurred in 13 patients (13/22, 59%) in the BRVO group, whereas in the CRVO group occurred in all patients (18/18, 100%). Mean time interval of these recurrences from last injection was 2.4 months and 1.2 months for BRVO and CRVO groups, respectively. Mean period of ME reabsorption was 2.5 months for the BRVO group and 3.5 months for the CRVO group. CONCLUSIONS: Recurrent ME occurred in 77.5% of our patients. These recurrences occurred sooner, were more prominent and lasted longer in patients with CRVO.

Spontaneous development of macular ischemia in a case of racemose hemangioma.

PURPOSE: To report a rare case of racemose hemangioma which developed spontaneous macular ischemia. METHODS: A 32-year-old healthy Caucasian lady presented complaining of recent deterioration of vision in her left eye. At presentation, her best corrected visual acuity (BCVA) was 20/20 in her right eye and counting fingers in her left eye (LE). Fundus examination and fluorescein angiography were performed. The patient had regular follow-up appointments over a period of 8 years. RESULTS: Fundus examination and fluorescein angiography revealed findings consistent with arteriovenous communications of the retina or racemose hemangioma, in the posterior pole of the LE with the presence of macular ischemia. Complete and systemic examination was unremarkable, excluding the possibility of Wyburn-Mason syndrome. Eight years after presentation, findings and BCVA in the LE have remained stable, with no extension of the retinal ischemia or development of neovascularization. CONCLUSION: Although extensive retinal ischemia has been reported to result in complications such as retinal or iris neovascularization, in our case the macular ischemia has not expanded further over a period of 8 years. However, due to this macular ischemia the patient unfortunately lost her central vision.

Bilateral central serous retinopathy following laser in situ keratomileusis for myopia.

UNLABELLED: We describe the case of a 54-year-old white man who experienced bilateral central serous chorioretinopathy following laser in situ keratomileusis for myopia. Postoperatively, the uncorrected visual acuity was 20/20 in both eyes. One month later, the patient reported a decrease of vision in both eyes. Dilated fundus examination, fluorescein and indocyanine green angiography, and optical coherence tomography showed bilateral central serous chorioretinopathy. Photodynamic therapy was performed twice, and visual acuity improved. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.