Topography of Generically Folded Spacecapes: Towards a Cognitive Metatheory in Architectural Design

If we visualize philosophy as a science of the sciences (in the tradition of Hans Heinz Holz), then theories within the philosophical framework are always meta-theories of the respective field of interest in question with which philosophy is actually dealing. Hence, a philosophy of architecture in particular, shows up as a meta-theory of theories of architecture with respect to all the possible conditions that are necessary to actually constitute its characteristic field of interest (including the social modes of communication). As we can easily see, it is also a cognitive meta-theory in the first place (i.e. one of the human condition). If then, traditionally, philosophy can also be visualized as being primarily constituted by four components that turn to its topic, namely by means of historical analysis, scientific approach, aesthetical and ethical conceptualizations, respectively, we can recognize that the second and the third overlap somehow with the architectural activities. This is certainly true since the establishment of architecture as a field of activity of its own, separated from building and engineering, as was achieved in the epoch of the Italian Renaissance by Brunelleschi, Alberti, and others.Peer Reviewe

Severe hypotony and filtering bleb leak after intravitreal injection of ranibizumab

We report a case of a patient with age-related macular degeneration, who had undergone trabeculectomy nine years earlier, and developed severe hypotony and bleb leak after treatment with intravitreal injections of ranibizumab. Although the incident is rare, in patients with longstanding filtering blebs, who need treatment with antivascular endothelial growth factors, close follow-up may be advocated, since the occurrence of bleb rupture could lead to permanent vision loss

Comparative studies of RNFL thickness measured by OCT with global index of visual fields in patients with ocular hypertension and early open angle glaucoma

Sergios Taliantzis, Dimitris Papaconstantinou, Chrysanthi Koutsandrea, Michalis Moschos, Michalis Apostolopoulos, Gerasimos GeorgopoulosAthens University Medical School, Department of Ophthalmology, Athens, GreecePurpose: To compare the functional changes in visual fields with optical coherence tomography (OCT) findings in patients with ocular hypertension, open angle glaucoma, and suspected glaucoma. In addition, our purpose is to evaluate the correlation of global indices with the structural glaucomatous defect, to assess their statistical importance in all the groups of our study, and to estimate their validity to the clinical practice.Methods: One hundred sixty nine eyes (140 patients) were enrolled. The patients were classified in three groups. Group 1 consisted of 54 eyes with ocular hypertension, group 2 of 42 eyes with preperimetric glaucoma, and group 3 of 73 eyes with chronic open angle glaucoma. All of them underwent ophthalmic examination according to a prefixed protocol, OCT exam (Stratus 3000) for retinal nerve fiber layer (RNFL) thickness measurement with fast RNFL thickness protocol and visual fields (VF) examination with Octopus perimeter (G2 program, central 30–2 threshold strategy). Pearson correlation was calculated between RNFL thickness and global index of VF.Results: A moderate correlation between RNFL thickness and indices mean sensitivity (MS), mean defect (MD) and loss variance (LV) of VF (0.547, -0.582, -0.527, respectively; P < 0.001) was observed for all patients. Correlations of the ocular hypertension and preperimetric groups are weak. Correlation of RNFL thickness with global indices becomes stronger as the structural alterations become deeper in OCT exam. Correlation of RNFL thickness with the global index of VF, in respective segments around optic disk was also calculated and was found significant in the nasal, inferior, superior, and temporal segments.Conclusion: RNFL average thickness is not a reliable index for early diagnosis of glaucoma and for the follow-up of patients with ocular hypertension. Segmental RNFL thickness seems to be a more reliable index. Deep structural alterations with OCT examination constitute an important indication of early functional changes, even if they are not still detected with achromatic perimetry. The MD index of VF seems to be more sensitive for the follow-up of patients with ocular hypertension.Keywords: glaucoma, ocular hypertension, OCT, visual fields, RNFL thicknes

Nd: YAG capsulotomy for posterior capsule opacification after combined clear corneal phacoemulsification and vitrectomy

Ilias Georgalas1, Petros Petrou2, George Kalantzis2, Dimitrios Papaconstantinou2, Chrysanthi Koutsandrea2, Ioannis Ladas21Department of Ophthalmology, “G. Gennimatas” Hospital of Athens, NHS, Athens, Greece; 2Department of Ophthalmology, University of Athens, Athens, GreecePurpose: To evaluate the efficacy and safety of Neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) following combined phacoemulsification and vitrectomy for the treatment of cataract in association with macular hole (MH) or epiretinal membrane (ERM).Methods: Retrospective clinical study of 34 eyes of 34 patients who underwent combined cataract surgery and vitrectomy, developed PCO, and subsequently underwent Nd:YAG laser capsulotomy. Follow-up examinations included visual acuity measurement, evaluation of intraocular lens (IOL) centration, intraocular pressure (IOP) measurement, and dilated fundus examination.Results: Nd:YAG laser capsulotomy was performed in all 34 eyes. The mean age of the patients was 65.08 years (range 45–87) and the mean follow up period was 11.05 months (range 4–23). The mean time elapsed between the last intraocular operation and the development of PCO was 10.00 months for patients with previous ERM and 15.33 for those with MH (P = 0.001, t-test for equality of means). None of our patients developed recurrence of MH, retinal detachment, IOL dislocation, or permanent IOP elevation.Conclusion: In our study, the most remarkable observation is that no complication occurred after the YAG capsulotomy, possibly because the eyes were vitrectomized and vitreous seems to play an important role in the occurrence of post-Nd:YAG complications. In addition we noted that PCO seems to occur earlier in the eyes undergoing combined surgery for cataract and ERM when compared with those where combined phacoemulsification and vitrectomy are performed for cataract and MH.Keywords: Nd:YAG capsulotomy, phacoemulsification, vitrectom

Metastasis rates and sites after treatment for choroidal melanoma by proton beam irradiation or by enucleation

Chryssanthi Koutsandrea, Marilita M Moschos, Michael Dimissianos, Gerasimos Georgopoulos, Ioannnis Ladas, Michael ApostolopoulosDepartment of Ophthalmology, Athens University, Athens, GreecePurpose: To investigate tumor thickness and location, the interval of time between treatment for choroidal melanoma (proton beam irradiation or enucleation) and diagnosis of metastatic disease, and rates and sites of metastasis.Design: Retrospective, interventional, noncomparative case series.Methods: Follow-up of 152 patients with primary choroidal melanoma, between 1992 and 2006 (14 years). One hundred and twenty-one patients were treated with proton beam irradiation and 31 patients were treated with enucleation. Baseline and annual or semiannual ophthalmic examination, B-scan ultrasonography, systemic and laboratory evaluations (liver enzymes, chest X-ray, ultrasonography or magnetic resonance imaging of the liver) were performed according to a standard protocol.Results: Nineteen patients (12.5%) were diagnosed with metastasis during follow-up time after treatment for choroidal melanoma. Thirteen patients (10.7%) of the irradiation group and 6 patients (19.3%) of the enucleation group were diagnosed with metastasis. Eight patients (6.6%) of the irradiation group and 5 patients (16.1%) of the enucleation group were diagnosed with liver metastasis. Ocular complications after proton beam irradiation were recorded. Fifty-nine patients (48.7%) of the irradiation group presented with cataract. Other complications were retinal detachment, retinopathy, vitreous haemorrhage, iris neovascularization, neovascular glaucoma, optic neuropathy, and corneal opacification.Conclusions: In our series, 10.7% of the irradiation group and 19.3% of the enucleation group were diagnosed with metastasis. The liver was the most common site of metastasis in both groups. Cataract was the most common complication in the irradiation group.Keywords: melanoma, metastasis, irradiation, enucleatio