Kvaliteta života povezana sa zdravljem u bolesnika s primarnim glaukomom otvorenog kuta

The purpose of this research was to evaluate the relationship between general health-related quality of life (GHRQL) and sociodemographic factors in primary open-angle glaucoma (POAG) patients. A prospective cross-sectional study included 207 glaucoma patients. GHRQL was determined via two self-administered questionnaires: the 36-Item Short Form Survey (SF-36) and the EuroQol-5D (EQ-5D) questionnaire. Male and 50- to 69-year-old glaucoma patients, followed by patients who regularly used antiglaucoma therapy and those without progression of glaucoma reported a significantly higher quality of life as measured by the EQ-5D index and the EQ-5D visual analog scale (VAS) (p<0.05 all). Similarly, the Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-36 had significantly higher values for these patients (p<0.05 all). Furthermore, glaucoma patients with higher education and economic status, glaucoma patients who lived in rural areas, and those who were married achieved higher scores on EQ-5D and SF-36. In conclusion, progression of the disease, female sex, older age, lower education and economic status, urban area and unmarried status negatively affect quality of life in glaucoma patients.Svrha ovoga istraživanja bila je utvrditi odnos između kvalitete života povezane s općim zdravljem (GHRQL) i sociodemografskih čimbenika u bolesnika s primarnim glaukomom otvorenog kuta (POAG). Riječ je o presječnoj studiji u kojoj je sudjelovalo 207 bolesnika s POAG. GHRQL mjerena je pomoću dva upitnika: kratkog upitnika zdravstvenog statusa s 36 pitanja (SF-36) i upitnika EuroQol-5D (EQ-5D). Muškarci i bolesnici s glaukomom u dobi od 50-69 godina, zatim bolesnici koji su redovito koristili antiglaukomsku terapiju i oni bez progresije glaukoma izvijestili su o znatno višoj kvaliteti života mjerenoj indeksom EQ-5D i vizualnom analognom ljestvicom EQ-5D (VAS) (p<0,05 za sve usporedbe). Slično tome, Sažetak fizičkih komponenata (PCS) i Sažetak mentalnih komponenata (MCS) upitnika SF-36 imali su značajno veće vrijednosti za ove bolesnike (p<0,05 za sve usporedbe). Nadalje, ispitanici s visokim stupnjem obrazovanja i ekonomskim statusom, ispitanici koji žive u ruralnim područjima i oni koji su u braku postigli su veće rezultate na EQ-5D i SF-36. Zaključno, napredovanje bolesti, ženski spol, starija životna dob, niži stupanj obrazovanja i ekonomski status, urbano područje življenja i samoća negativno utječu na kvalitetu života bolesnika s glaukomom

UTJECAJ VJEŽBANJA I RAZINE OSPOSOBLJENOSTI NA MIKROCIRKULACIJU RETINE

Aim: To examine differences in retinal microcirculation between people with different degrees of physical fi tness. Methods: The subjects were divided into athletes and non-athletes. Both groups took part in two examinations. The fi rst examination was performed before short-term exercise and the second one immediately after it. First group consisted of 25 athletes (50 eyes), and the second group of 25 non-athletes (50 eyes) who were not previously exposed to acute physical stress. Athletes are defi ned as people who have been engaged in some form of regular physical activity for at least 5 years, and have met certain criteria according to the International Physical Activity Questionnaire (IPAQ). Non-athletes were those who were physically inactive or at least not regularly engaged in physical activity during the same period and did not meet the IPAQ criteria. The subjects were men and women between 18 and 26 years of age who did not have any cardiovascular disease, used drugs affecting the cardiovascular system, nor had an eye disease or a refractive error greater than spherical equivalent of +/-3 diopters. The examination consisted of optical coherence tomography angiography (OCT-A) imaging pre- and post-workout. The parameters taken into account were vascular density (VD) at three different macular areas according to the standard Early Treatment Diabetic Retinopathy Study (ETDRS) grid, i.e., central zone, inner zone and full area; perfusion density (PD), also at the three mentioned zones; and the area of foveal avascular zone (FAZ) in both eyes. The research also included a standardized survey on physical activity of the subjects (IPAQ), which was completed before the examination. The acute physical exercise consisted of the standardized incremental cycling ergometer test (ICET), which was performed on a stationary exercise bike for 5 minutes, at a given load of 12 degrees. On statistical processing of the data obtained, SPSS for Windows (version 13.0, SPSS Inc., Chicago, Illinois, USA) software was used. Results: Baseline measures of VD and PD were similar between the groups. FAZ surface was signifi cantly increased in the athlete group compared with non-athletes both at baseline and after short-term exercise. VD was signifi cantly higher in athletes post-exercise compared with the non-athlete group. Central PD was also signifi -cantly increased after exercise in the athlete group, and not in the non-athlete group. Conclusion: The results obtained in this study demonstrated that athletes exhibited a more intensive vascular reaction to exercise. The parameters in basal conditions did not show signifi cant difference between the two groups, except for FAZ which was larger in athletes. Signifi cant differences present post-workout in other measured values indicated a more dynamic vascular system in physically active individuals.ilj rada: Ispitati razlike u retinalnoj mikrocirkulaciji između osoba s višim i nižim stupnjem tjelesne osposobljenosti. Postupci: Ispitanici su bili podijeljeni na sportaše i nesportaše. Obje skupine pristupile su dvama odvojenim mjerenjima. Prvi pregled obavljen je prije fi zičkog opterećenja, a drugi neposredno nakon njega. Prvu skupinu činilo je 25 sportaša (50 očiju), a drugu 25 nesportaša (50 očiju) koji prethodno nisu bili izloženi akutnom fi zičkom stresu. Sportaše defi niramo kao osobe koje se najmanje 5 godina bave nekim oblikom redovite tjelesne aktivnosti u obliku treniranja nekog sporta, fi tnesa, aerobnog treninga i sl. te ispunjavaju određene uvjete prema međunarodnom upitniku o tjelesnoj aktivnosti (International Physical Activity Questionnaire, IPAQ). Neki sportaši nisu bili fi zički aktivni ili barem ne redovito tijekom istog razdoblja i nisu ispunjavali navedene kriterije IPAQ. Ispitanici su bili muškarci i žene u dobi između 18 i 26 godina koji nisu imali nikakvu srčanožilnu bolest, nisu uzimali lijekove koji utječu na srčanožilni sustav niti su imali ikakvu bolest očiju ili refraktivnu grešku veću od sfernog ekvivalenta +/-3 dioptrije. Prikupljanje podataka provedeno je pomoću optičke koherentne tomografske angiografi je (OCT-A). Analizirani su sljedeći parametri: vaskularna gustoća (VG) u tri različita područja makule prema mreži ETDRS (Early Treatment Diabetic Retinopathy Study): središnja zona, unutarnja zona i puna zona; perfuzijska gustoća (PG), također u tri navedena područja; te površina fovealne avaskularne zone (FAZ). Istraživanje je uključivalo i standardiziranu anketu o tjelesnoj aktivnosti ispitanika (IPAQ) koja se ispunjavala prije samog pregleda. Fizičko opterećenje sastojalo se od standardiziranog testa ICET (incremental cycling ergometer test), koji se izvodio na stacionarnom sobnom biciklu u trajanju od 5 minuta pri zadanom opterećenju od 12 stupnjeva, nakon čega su ispitanicima izmjereni puls i saturacija. Također, prije same vježbe ispitanicima su izmjerene srčana frekvencija i saturacija u mirovanju. Za statističku obradu dobivenih podataka primijenjen je softverski sustav SPSS for Windows (verzija 13.0, SPSS Inc., Chicago, Illinois, SAD). Rezultati: Mjerenja u bazalnim uvjetima pokazala su slične vrijednosti VGi PG između skupina. Površina FAZ bila je statistički značajno veća u skupini sportaša u usporedbi s nesportašima i u bazalnim uvjetima i nakon tjelovježbe. Nakon tjelovježbe VG i središnji PG pokazali su statistički značajno povećanje u sportaša, dok u nesportaša nije bilo razlike prije i nakon tjelovježbe. Zaključak: Rezultati dobiveni u ovoj studiji pokazali su da sportaši imaju intenzivniju vaskularnu reakciju na vježbanje. Parametri u bazalnim uvjetima nisu pokazali značajnu razliku između dviju skupina osim za FAZ, koja je bila veća u sportaša. Značajne razlike bile su prisutne nakon treninga u drugim izmjerenim vrijednostima i ukazuju na dinamičniji vaskularni sustav u fi zički aktivnih pojedinaca

HALLUCINATORY EXPERIENCES IN VISUALLY IMPAIRED INDIVIDUALS: CHARLES BONNET SYNDROME – IMPLICATIONS FOR RESEARCH AND CLINICAL PRACTICE

Background: Charles Bonnet syndrome (CBS) refers to visual hallucinations that occur in individuals with preserved cognitive functions associated with visual impairment. Methods: This article reviews occurence of visual hallucinations in subjects with CBS by journals published in English in the Pubmed database in the period 1992-2018. Criteria for selection of appropriate papers were sufficient information and perspicuous view on pathogenesis, epidemiology, clinical presentation and treatment possibilities of CBS. Results: Most commonly, visual hallucinations in patients with CBS are complex, repetitive and stereotyped. Such individuals have preserved insight that those percepts are not real, and there is an absence of secondary explanatory delusions and hallucinations within other modalities. Seeing as the aforementioned percepts do not share all the characteristics of hallucinations, it remains unresolved how they should be referred to. Terms as release hallucinations, one that is reflecting its underlying pathogenesis, or confabulatory hallucinatory experiences have been proposed. Moreover, CBS has also been referred to as phantom vision syndrome and may occur in any ophthalmological disease. It is not particularly connected with loss of function along any level of the visual pathway. Although this syndrome is mostly associated with age-related macular degeneration, glaucoma and cataract, it could be related to almost any other ophthalmological conditions. The incidence of CBS alongside with mostly other ocular pathology is rising as population is ageing. Conclusions: Nonetheless, CBS remains commonly underreported, under recognized and/or misrecognized. Albeit the treatment recommendations and guidelines are not yet fully established, it is important to raise awareness of this specific and distinct condition, which inevitably implicates many differential diagnostic deliberations

NEW INSIGHTS INTO SCHIZOPHRENIA: A LOOK AT THE EYE AND RELATED STRUCTURES

Background: Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances. Methods: To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018. Results: Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a - wave activity in the photoreceptors or b - wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus. Conclusion: Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment

Macular Thickness after Glaucoma Filtration Surgery

The aim of present study was to analyze early postoperative changes in the macular area using optical coherence to- mography (OCT) after uncomplicated glaucoma filtration surgery. This prospective study included 32 patients (34 eyes) with open-angle glaucoma, which underwent trabeculectomy with or without use of mitomycin C. Exclusion criteria were macular edema, uveitis, age-related macular degeneration, blurred optical media, secondary glaucoma and angle-clo- sure glaucoma. All standard clinical examinations were made before surgery, at the 2nd day, 1 week and 1 month after surgery. Tomography of the macula was performed during every examination using Cirrus HD OCT for the analysis of central subfield thickness. Results show that thickening of the macula was slightly higher 1 week and 1 month after op- eration in comparison with baseline end 2nd day postoperativelly. There was no significant difference in the change of macular thickness in patients who have used topical prostaglandins compared with those who have used other topical medications. Also, there was no difference in macular changes between patients treated with or without mitomycin C. In conclusion, we found a slight subclinical increase in macular thickness after uncomplicated trabeculectomy, for which we considered that was the result in reduction of intraocular pressure after glaucoma surgery. Macular thickening after glaucoma filtering surgery could be a physiological reaction to the stress of the retina caused by a sudden reduction of intraocular pressure and it is the consequence of altered relationship between capillary pressure and interstitial fluid pressure

Ophthalmic Disorders in Posterior Reversible Encephalopathy Syndrome Associated with Preeclampsia

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity presented with different symptoms such as visual disturbances, headaches, seizures, severe hypertension and altered mental status. It has been recognized in a different pathological conditions, although preeclampsia/eclampsia is the most common cause of PRES. The pathogenesis of PRES is still not fully understood, but it seems that failure of cerebrovascular autoregulation causing vasogenic edema, cerebral vasoconstriction, and disruption of the blood brain barrier plays an important role. Cortical blindness, hypertensive retinopathy, serous retinal detachment (SRD), central retinal artery and vein occlusions, retinal or vitreous hemorrhages, anterior ischemic optic neuropathy (AION) and Purtscher’s retinopathy are ophthalmic disorders that may occur in PRES associated with preeclampsia. Among these, cortical blindness is the best documented complication of preeclampsia. Magnet resonance imaging (MRI) is a gold standard to establish the diagnosis of PRES because clinical findings are not sufficiently specific. Typically, there are bilateral cortical occipital lesions with hyperdensity on T2-weighted MRI. Blindness due to occipital lesions is reversible and the vision loss is usually regained within 4 h to 8 days

Metabolički čimbenici rizika, suočavanje sa stresom i psihološko zdravlje u bolesnika sa senilnom makularnom degeneracijom

The aim of this study was to determine the relationship between the risk factors (age, obesity, hypertension, hyperlipidemia, smoking, consumption of alchohol and drugs, positive family history, and exposure to sunlight), coping with stress, psychological well-being and age-related macular degeneration (ARMD). Forty patients with ARMD (case group) and 63 presbyopes (control group) participated in the study. Patient data were collected through general information questionnaire including patient habits, the COPE questionnaire that showed the way the patients handling stress, and the GHQ that analyzed the psychological aspects of their quality of life. These questionnaires were administered to the patients during ophthalmologic examination. The study involved 46 (44.66%) men and 57 (55.33%) women. Statistical analysis showed that the major risks for the development of ARMD were elevated cholesterol, triglycerides and LDL cholesterol in plasma. A significantly higher number of ARMD patients had a positive family history when compared with presbyopes. This study showed presbyopes to cope with emotional problems significantly better and to have a lower level of social dysfunction when compared with ARMD patients. However, it is necessary to conduct further studies in a large number of patients to determine more accurately the pathophysiological mechanisms of metabolic factors as well as the impact of the disease on the quality of life in patients with ARMD.Cilj ovoga istraživanja bio je utvrditi povezanost između rizičnih čimbenika (dob, pretilost, hipertenzija, hiperlipidemija, pušenje, konzumacija alkohola i lijekova, pozitivna obiteljska anamneza, izloženost sunčevom zračenju), suočavanja sa stresom, psihološkog aspekta kvalitete života i senilne makularne degeneracije (SMD). U istraživanje su bili uključeni bolesnici oboljeli od SMD (n=40) koji su činili ispitivanu skupinu i prezbiopi (n=63) koji su činili kontrolnu skupinu. Podatci su se prikupili ispunjavanjem upitnika kojim su se dobili opći podatci i opisale navike bolesnika, upitnika COPE kojim su se ispitali načini reagiranja na stres te upitnika GHQ kojim se analizirao psihološki aspekt kvalitete života. Navedeni upitnici bili su osobno uručeni ispitanicima prilikom oftalmološkog pregleda. U istraživanje je bilo uključeno 46 (44,66%) muškaraca i 57 (55,33%) žena. Statistička obradba pokazala je da najveći rizik za obolijevanje od SMD predstavljaju povišene razine kolesterola, triglicerida i LDL kolesterola u krvi. Značajno veći broj bolesnika u ispitivanoj skupini imao je pozitivnu obiteljsku anamnezu u odnosu na kontrolnu skupinu. Ovo istraživanje pokazalo je da prezbiopi značajno bolje reagiraju u osjećajima usmjerenom suočavanju te da imaju niži stupanj socijalne disfunkcije u odnosu na bolesnike oboljele od SMD. Međutim, potrebno je provesti daljnja istraživanja na velikom broju bolesnika kako bi se točnije utvrdili patofiziološki mehanizmi metaboličkih čimbenika, kao i utjecaj bolesti na kvalitetu života u bolesnika sa SMD

INTEGRIRANA SKRB U MOSTARU: PRIORITET ZA ZDRAVSTVENI SUSTAV

Introduction: Integrated care could be defi ned differently and that is why the following terms can be found in the literature: integrated health, coordinated care, comprehensive care, seamless care, or trans-mural care. It has become a worldwide trend in health care reforms and new organizational arrangements focusing on more coordination between professionals and institutions and integrated forms of care or service provision. The Agency for Quality and Accreditation in Health Care in the Federation of Bosnia and Herzegovina (AKAZ) is using accreditation standards as a tool for quality improvement process aiming to increase the capacity of health care institutions in the Federation of Bosnia and Herzegovina in order to provide safe and quality care for the citizens. In the Agency, it is fi rmly believed that a wisely set and well-organized integrated care can help health professionals deliver health care in accordance with patient needs and even expectations. Aim: The aim of the study was to fi nd out how to implement measures for integration of health care, to fi nd out whether there are any gaps in the health care system, and how to bridge to the application of the best solutions of integrated care in the city of Mostar and Herzegovina-Neretva Canton (HNC). Methods: In this paper, we used feedback and results from the workshop held at the Federal Public Health Institute in Mostar as part of lectures for participants of the course within the Integrated Health Care module held in June 2019. The Integrated Health Care module is part of the Continuous Professional Education for Health Managers in the Federation of Bosnia and Herzegovina. Participants were experienced experts in different fi elds of medicine and pharmacists divided into two groups. Results: Participants identifi ed the most common problems for both primary and hospital physicians, such as unclear referral system to specialist examination, inappropriate patient expectations from primary care, lack of communication between primary care and hospital care, and inadequate use of clinical practice guidelines. To solve these problems, both groups stressed the importance of common strategy documents and guidelines, which should provide clear framework for cooperation and integration including levels of competence and service prices. Furthermore, effi cient information system is crucial for the integration or digitalization of, in strategy documents, agreed mechanisms of coordination and integration. Third, the growing proportion of elderly population should be taken in consideration, including the need of hospice and development of geriatric medicine in the Canton. Participants discussed and compared the results with feedback and results from three workshops held several years before. Discussion: The results of our study stressed the importance of better communication among different sectors, institutions and levels of health care involved in the treatment of patients, pointed to some measures for integration including standardized models of communication, training and education and highlighted priorities for integration. Analysis indicated the necessity for the following: regular analysis of unnecessary or inappropriate referrals and evaluation of such practices, as well as of any duplication of tests and prescriptions (failure to control costs); joint planning of preventive treatments (including the ministry and public health authorities); and clear responsibilities regarding screening programs and patient path analysis. Conclusions: Strong commitment of health care authorities and vision of integrated care and collaborative networks, as well as good communication and leadership were highlighted as key integrated care facilitators. Health care institutions at all levels of care have to organize multidisciplinary teams to work more on better and effective communication and to exchange information among key stakeholders in the system.Uvod: Integrirana skrb može se različito defi nirati i to je razlog zbog kojeg se u literaturi mogu naći sljedeći pojmovi: integrirano zdravlje, koordinirana njega, sveobuhvatna njega, besprijekorna njega ili transmuralna njega. Postala je svjetski trend u reformama zdravstva i novim organizacijskim aranžmanima koji su usredotočeni na veću koordinaciju između stručnjaka, institucija i pružatelja usluga. Agencija za kvalitet i akreditaciju u zdravstvu u Federaciji Bosne i Hercegovine koristi akreditacijske standarde kao alat za poboljšanje kvalitete s ciljem povećanja kapaciteta zdravstvenih ustanova u Federaciji Bosne i Hercegovine za pružanje sigurne i kvalitetne skrbi za građane. U Agenciji čvrsto vjeruju da mudro postavljena i dobro organizirana integrirana skrb može pomoći zdravstvenim radnicima da pruže zdravstvenu skrb u skladu s potrebama, pa čak i očekivanjima pacijenta. Cilj: Otkriti i analizirati kako se provode mjere za integraciju zdravstvene zaštite, postoje li nedostatci u zdravstvenom sustavu i kako ih premostiti za primjenu najboljih rješenja integrirane skrbi u gradu Mostaru i Hercegovačko-neretvanskoj županiji. Metode: U ovom smo radu koristili povratne informacije i rezultate radionice Federalnog zavoda za javno zdravstvo u Mostaru u sklopu predavanja za polaznike tečaja u okviru modula Integrirana zdravstvena zaštita održanog u lipnju 2019. Integrirani modul zdravstvene zaštite je dio kontinuiranog stručnog usavršavanja za zdravstvene menadžere u Federaciji Bosne i Hercegovine. Sudionici radionice bili su iskusni liječnici specijalisti različitih specijalnosti i farmaceuti podijeljeni u dvije skupine. Rezultati: Sudionici su odredili najčešće poteškoće za uspostavljanje integrirane zdravstvene zaštite kako za primarne, tako i za bolničke liječnike, a to su: nejasan sustav upućivanja na specijalistički pregled, neprimjereno očekivanje pacijenta od liječnika primarne zdravstvene zaštite, nedostatak komunikacijskog kanala između primarne i tercijarne bolničke skrbi i nedosljedna uporaba smjernica za kliničku praksu. Za rješavanje ovih problema obje skupine ističu važnost zajedničkih strateških dokumenata i smjernica koje bi trebale dati jasan okvir za suradnju i integraciju uključujući razinu stručnosti i cijene usluga. Nadalje, učinkovit informacijski sustav ključan je za integraciju ili digitalizaciju, u strateškim dokumentima, dogovorenih mehanizama koordinacije i integracije. Treće, potrebno je uzeti u obzir starenje populacije, nužne potrebe za hospicijima i razvoj gerijatrijske medicine u Županiji. Sudionici su raspravljali i uspoređivali svoje rezultate s povratnim informacijama i rezultatima ostalih triju istovjetnih radionica održanih ranijih godina. Rasprava: Rezultati naše studije istaknuli su važnost bolje komunikacije između različitih sektora, institucija i razina zdravstvene zaštite uključenih u liječenje pacijenata te istaknuli određene mjere integracije uključujući standardizirane modele komunikacije, obuke i obrazovanja te istaknute prioritete integracije. Analiza je ukazala na potrebu za sljedećim: redovitim analizama nepotrebnih ili neprikladnih uputnica i procjenom takve prakse, kao i podvostručenja testova i recepata (propust u kontroli troškova); zajedničko planiranje preventivnih tretmana i jasne odgovornosti u vezi s programima probira i analizom puta pacijenta. Zaključci: Snažna predanost zdravstvenih vlasti, vizija integrirane skrbi i suradničke mreže, kao i dobra komunikacija i vodstvo istaknuti su kao ključni pokretači integrirane skrbi. Zdravstvene ustanove sa svih razina skrbi moraju organizirati multidisciplinske timove koji će raditi na boljoj i učinkovitijoj komunikaciji i razmjeni informacija između ključnih dionika u sustavu

Ocular Findings in Patients with Chronic Renal Failure undergoing Haemodialysis

The aim of this paper was to evaluate the ocular findings in patients with chronic renal failure (CRF) undergoing haemodialysis (HD). In 64 patients undergoing haemodialysis (30 female and 34 male), aged 24–83 years (mean 58 years) on haemodialysis 1–213 months (mean 47 months) complete ocular examination were performed: visual acuity (VA), intraocular pressure (IOP), biomicroscopic examination and fundoscopy. On right eye sixty-nine percent of patents had VA 0.6 or better, and on left eye 84% of patients had VA 0.6 or better. Mean IOP before dialysis was 15 mmHg and after dialysis was 14 mmHg. In 9 patients (14%) we found corneo-conjunctival calcium deposits. No correlation of ocular calcification and parathyroid hormone (PTH) level or calcium and phosphate product were observed. 39 (60%) patients had cataract. Hypertensive vascular changes were seen in 44 (68%) patients and in 6 (7%) patients age-related macular degeneration. Seven patients had diabetes mellitus and in 5 diabetic retinopathy was observed. Patients with CRF or who are receiving HD represent unique group of patients. Pathologic change could be found in many tissue and organs, therefore we suggest ocular examination more frequently in dialysis patients