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Peter Cikatricis

Birmingham and Midland Eye Centre

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Loukia Tsierkezou

Manchester Royal Eye Hospital

Samer Elsherbiny

South Warwickshire NHS Foundation Trust

Erika M. Damato

Cambridge University Hospitals NHS Foundation Trust

Bushra Mushtaq

Birmingham and Midland Eye Centre

Yit C. Yang

Wolverhampton Hospital

Arijit Mitra

Birmingham and Midland Eye Centre

Parveen Abdullah

Birmingham and Midland Eye Centre

Randhir Chavan

Birmingham and Midland Eye Centre

Ambreen Sarmad

Birmingham and Midland Eye Centre

P Stavrou

Leeds Teaching Hospitals NHS Trust

Cooperative Institutions

Birmingham and Midland Eye Centre

Sandwell & West Birmingham Hospitals NHS Trust

Royal Stoke University Hospital

Wolverhampton Hospital

University of Birmingham

University College London

Birmingham City Hospital

NIHR Surgical Reconstruction and Microbiology Research Centre

New Cross Hospital

Queen Elizabeth Hospital

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Intracameral Tying-off Of Glaucoma Drainage Device Tubes As A Management Of Hypotony Following GDD Implant Surgery

Investigative Ophthalmology & Visual Science (2012)

Tina Parmar Peter Cikatricis Nikolaos Mavrakanas Velota Sung

Tying

Glaucoma surgery

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Iatrogenic Lateral Rectus Transection Secondary to Dental Implantation Surgery

Peter Cikatricis Sachin M. Salvi John P. Burke

A 48-year-old patient noted right subconjunctival hemorrhage and double vision immediately following dental implant surgery. CT scan confirmed implant screw misplaced into the right orbit, and exploration revealed transection of right lateral rectus muscle belly. Diagnostic and management challenges are discussed.

Orbit (dynamics)

Iatrogenic injury

10.1080/01676830802221961

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Citations (6)

Orbital metastasis from cutaneous melanoma

Eye Reports (2012)

Loukia Tsierkezou Peter Cikatricis Parveen Abdullah Samer Elsherbiny

We report a case of a metastatic cutaneous melanoma to the orbit. A 60-year-old Caucasian male presented with a 2-day history of left-sided ocular pain, lid swelling and chemosis. Initially, this was treated as conjunctivitis with no signs of improvement. Four days later, the patient developed left proptosis, mechanical ptosis, left esotropia and diplopia. Computed tomography scan of the orbit demonstrated marked thickening of the lateral rectus muscle. The patient was treated as pseudotumor. Subsequent biopsy revealed malignant cutaneous melanoma. The patient had a history of cutaneous melanoma excised 15 years previously. Further imaging showed advanced metastatic disease in the brain, the lung and the liver. The patient passed away five months after initial presentation. Cutaneous melanoma metastasizing to the orbit has poor prognosis. Patients often have advanced disease at the time of presentation and orbital metastases may be the initial sign. A detailed history is paramount in making timely diagnosis.

Chemosis

Orbit (dynamics)

Presentation (obstetrics)

10.16964/er.v2i1.40

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Staged Combination Therapy using Ranibizumab and Ozurdex for Retinal Vein Occlusion Macular Edema: The RandO Protocol.

Investigative Ophthalmology & Visual Science (2016)

Peter Cikatricis Ambreen Sarmad Bushra Mushtaq Samer Elsherbiny Randhir Chavan

Retinal Vein

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Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report

Saudi Journal of Ophthalmology (2016)

Ibrahim Elaraoud Hanif Suleman Peter Cikatricis Helen Palmer

A 69-year-old man became aware of people’s speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers and head computed tomography scan were normal. Ophthalmological examination and OCT scan revealed right macular subretinal fluid with choroidal indentation, which prompted urgent further investigations including head MRI revealing extensive leptomeningeal disease. The patient continued to deteriorate and deceased shortly afterwards. This is the first reported case of neoplastic leptomeningeal disease presenting with loss of vision due to choroidal metastasis with localised exudative retinal detachment. Diagnosing neoplastic leptomeningeal disease requires a high index of suspicion from the treating physician. Symptoms may be nonspecific and/or subtle. Combining cerebrospinal fluid cytology from lumbar puncture with contrast-enhanced magnetic resonance imaging of the brain is considered the optimal diagnostic approach.

10.1016/j.sjopt.2016.07.003

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Optical coherence tomography in presumed tuberculous choroidal granulomas

European Journal of Ophthalmology (2011)

Loukia Tsierkezou Peter Cikatricis P Stavrou

10.5301/ejo.2011.8290

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Ophthalmic manifestations of atypical IgD multiple myeloma

BMJ Case Reports (2012)

Matthew R. Edmunds Peter Cikatricis Subhanjan Mukherji Jeremy D. Bowyer

A previously healthy 32-year-old Caucasian female presented with sudden-onset horizontal diplopia following a paroxysm of coughing. She had recently sustained a pubic ramus fracture during an innocuous fall and had also noted a firm lump developing at the right side of her forehead. On examination, she had a right fronto-temporal mass. Visual acuities were 6/6 bilaterally. There was reduced abduction of the right eye, bilateral white, granular corneal opacities and evidence of bilateral optic disc swelling. Haematological investigations revealed normocytic anaemia, hypercalcaemia and raised erythrocyte sedimentation rate (ESR). CT showed lytic foci throughout the skull, ribs, scapulae, spine, pelvis and upper femora. Serum protein electrophoresis revealed immunoglobulin D (IgD)-kappa paraproteinaemia; urine electrophoresis showed free light chain kappa and bone marrow biopsy demonstrated 87% plasma cells. A diagnosis of IgD multiple myeloma was made, with subsequent chemotherapeutic treatment and eventual autologous stem cell transplant resulting in resolution of neuro-ophthalmic manifestations and prolonged disease remission.

Immunoglobulin D

10.1136/bcr-2012-006486

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Citations (7)

OCT characteristics of macular oedema in patients with uveitis

European Journal of Ophthalmology (2011)

Peter Cikatricis Loukia Tsierkezou P Stavrou

10.5301/ejo.2011.7560

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Chapter-54 Primary Phacoemulsification Combined with Drainage Angle Viscodissection in the Management, of Chronic Narrow-Angle/Angle-Closure Glaucoma (CNAG/CACG) and Coexistent Cataract

Jaypee Brothers Medical Publishers (P) Ltd. eBooks (2010)

Peter Cikatricis

Angle-closure glaucoma

10.5005/jp/books/11383_54

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Efficacy and timing of adjunctive therapy in the anti-VEGF treatment regimen for macular oedema in retinal vein occlusion: 12-month real-world result

Peck Lin Lip Peter Cikatricis Ambreen Sarmad Erika M. Damato Randhir Chavan

PurposeVarious combination treatment regimens have been tried to improve the short-term efficacy of intravitreal monotherapy for the treatment of macular oedema (MO) secondary to retinal vein occlusion (RVO). Our study introduces the RandOL protocol (Ranibizumab and Ozurdex with Laser photocoagulation) of initial anti-VEGF therapy, controlling recurrent non-ischaemic MO with an intravitreal steroid and applying laser therapy to non-perfused retina. We describe our 12-month follow-up experience on timing for adjunctive therapy and real-world effectiveness and safety data.MethodsA retrospective analysis was carried out on 66 consecutive treatment-naive RVO patients with MO who received our RandOL treatment regimen. Baseline visual acuity (VA) and central retinal thickness (CRT) were compared with 12-month result.ResultsAt 12 months, 77% had significant VA improvement, 52% had ≥3-line improvement, and 15% were worse. Significant improvements in CRT were observed in 97% (baseline median CRT=531 μm (IQR 435-622) reduced to 245 μm (IQR 221-351, P<0.001) at 12 months); 76% achieved a dry fovea at 1 year. Mean number of total injections required was 5.5 (range 2-11) and 6% required ≥9 injections in 1 year. Although 70% received additional Ozurdex, 82% received ≥1 sessions of laser therapy. The BRVO subgroup achieved better VA and CRT improvement at 1 year, but small numbers limit definitive statistical conclusions.ConclusionsOur real-world results using a combination treatment protocol for RVO-related MO achieved similar desirable anatomical and visual outcomes as with a single-agent therapy with less intravitreal re-treatment rates at first year. Randomised controlled studies are needed to evaluate the role of laser and the ideal timing of combination therapy.

Regimen

Pro re nata

Retinal Vein

Adjunctive treatment

Refractory (planetary science)

10.1038/eye.2017.230

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Citations (19)