Intravitrealna primjena bevacizumaba u liječenju neovaskularnog glaukoma

The aim of the study was to assess short-term efficacy of intravitreal bevacizumab in a series of patients with neovascular glaucoma. Eleven patients with neovascular glaucoma and symptomatic elevation of intraocular pressure were treated with 1.25 mg/0.1 mL of bevacizumab. In three patients, intravitreal bevacizumab was administered preoperatively, one day before pars plana vitrectomy. Additional therapy was only performed if topical medication failed to result in satisfactory control of intraocular pressure. Patients were followed-up for a minimum of 8 weeks. In all study patients, intravitreal application of bevacizumab resulted in marked regression of iris neovascularization within the first three postoperative days. Appropriate control of intraocular pressure was achieved in seven patients, whereas four patients required additional therapy for intraocular pressure regulation. No side effects of intravitreal bevacizumab were recorded. Thus, intravitreal bevacizumab seems to be a potent adjunct in the management of neovascular glaucoma. Additional studies of bevacizumab long-term safety and efficacy are warranted.Cilj ove studije bio je procijeniti kratkotrajni učinak intravitrealne primjene bevacizumaba u skupini bolesnika s neovaskularnim glaukomom. U studiju je bilo uključeno jedanaestoro bolesnika s neovaskularnim glaukomom i simptomatskim povišenjem očnog tlaka. Kod svih bolesnika primijenjen je bevacizumab u dozi od 1,25/0,1 mL intravitrealno. Kod troje bolesnika je bevacizumab primijenjen jedan dan prije pars plana vitrektomije. Dodatna antiglaukomska terapija primijenjena je samo kod onih bolesnika u kojih očni tlak nije bio dobro kontroliran lokalnom antiglaukomskom terapijom. Najkraće razdoblje praćenja bolesnika bilo je 8 tjedana. Intravitrealna primjena bevacizumaba dovela je kod svih bolesnika do značajne regresije neovaskularizacije šarenice, što je trećega dana od primjene bevacizumaba potvrđeno biomikroskopski te fluoresceinskom angiografijom. U sedmoro bolesnika je očni tlak bio dobro kontroliran samo lokalnom antiglaukomskom terapijom. Kod četvoro bolesnika bilo je potrebno daljnje kirurško antiglaukomsko liječenje. Nisu zabilježene nuspojave kao niti komplikacije za vrijeme ili poslije intravitrealne injekcije bevacizumaba. Zaključuje se kako se intravitrealna primjena bevacizumaba čini dobrom dodatnom metodom u kombinaciji s ostalim terapijskim modalitetima liječenja neovaskularnog glaukoma. Dodatne studije kojima se ispituje dugotrajniji učinak i sigurnost intravitrealne primjene bevacizumaba su u tijeku i one će doprinijeti boljem razumijevanju farmakokinetike, toksičnosti i putova primjene bevacizumaba u liječenju neovaskularnog glaukoma

Morfološke i angiografske promjene periferne mrežnice u bolesnika sa senilnom makularnom degeneracijom [Morphologic and angiographic peripheral retinal changes in patients with age related macular degeneration]

Age related macular disease (AMD), are the most prominent cause of central visual acuity loss in population older than 55 y. Wet form is more serious condition, because in short time, if not treated, central visual acuity can be permanently lost, so the estimation of the progression risk from dry to wet type, becomes important. Recent data suggest, that at retinal periphery, can exists some important morphologic changes like peripheral drusen and reticular pigmentary changes, that usually are connected more frequently with wet AMD form . Estimation of disease progression has been usually done with standard fundus cameras that can scan only the posterior pole and medial part of the retina which is approximately 45-50 degree of all retina. The wide field camera which is used in this study, was able to scan almost 200 degree of retina, documented peripheral retinal changes and their angiographic characteristics. The aim of the study was to compare morphologic characteristics of peripheral retinal changes in patients with AMD with healthy control group, and to compare morphologic and angiographic characteristics of peripheral retinal changes between two types of AMD. In study was included 152 patients with signs of AMD and 150 healthy controls . Statistically significant difference were observed in frequency of drusen, reticular pigmented degenerations and „paving stone“ degenerations, which are more frequently observed in AMD group. „White without pressure“ degeneration were more frequently observed in control healthy group. Drusen are statistically significantly occurred and more widely spreaded in dry type of AMD . There were no statistically significant difference between wet and dry type of AMD, nor in type , frequency or localization of morphologic and angiographic characteristics of peripheral retinal changes

Morphologic and angiographic peripheral retinal changes in patients with age related macular degeneration

Senilna makularna degeneracija (SMD), jedna je od vodećih bolesti oka s gubitkom vidne oštrine populacije starije od 55 g. Vlažni oblik senilne makularne degeneracije je mnogo ozbiljnije stanje jer, ukoliko se ne liječi, u kratkom vremenskom roku dovodi do gubitka centralne vidne oštrine. Novije spoznaje sugeriraju da se ključne morfološke značajke nalaze i na periferiji mrežnice, a njihovo prisustvo povezano je sa težim oblicima senilne makularne degeneracije ili može imati važne implikacije za rizik napredovanja bolesti. Dostupnost perifernih promjena vizualizaciji i dokumentaciji do sada bila je ograničena na radove koji su koristili sistem standardnih fundus kamera sa širinom kuta od maksimalno 45- 50 stupnjeva. Sistem širokokutne fundus kamere,koji je korišten u ovom istraživanju, omogućava vizualizaciju i dokumentaciju periferije do 200 stupnjeva. Cilj ovog rada bio je usporediti pojavnost, proširenost i lokalizaciju morfoloških promjena periferne mrežnice u skupini bolesnika sa senilnom makularnom degeneracijom s morfološkim karakteristikama zdrave kontrolne skupine ispitanika, te ispitati angiografske karakteristike perifernih promjena mrežnice unutar skupine bolesnika sa SMD-om. U studiju je uključeno 152 ispitanika s kliničkom slikom senilne makularne degeneracije i 150 kontrolnih zdravih ispitanika starijih od 50 godina. Morfološkom analizom svih očiju sa SMD-om, ustanovljena je statistički značajna razlika u pojavnosti druza, retikularnih pigmentnih promjena i „paving stone“ promjena koje se češće javljaju u skupini bolesnika sa SMD-om u odnosu na kontrolnu skupinu. “White without pressure“ ili blijedilo bez pritiska - degenerativna je promjena koja se statistički značajno češće javlja u kontrolnoj skupini. Usporednom analizom morfoloških i angiografskih perifernih promjena uočava se statistički značajna razlika samo u pojavnosti druza koje su češće vizualizirane u suhom tipu SMD-a. Nije uočena statistički značajna razlika za sve ostale ispitivane morfološke i angiografske promjene između suhog i vlažnog tipa SMD-a, s obzirom na proširenost ili lokalizaciju prema ekvatoru oka.Age related macular disease (AMD), are the most prominent cause of central visual acuity loss in population older than 55 y. Wet form is more serious condition, because in short time, if not treated, central visual acuity can be permanently lost, so the estimation of the progression risk from dry to wet type, becomes important. Recent data suggest, that at retinal periphery, can exists some important morphologic changes like peripheral drusen and reticular pigmentary changes, that usually are connected more frequently with wet AMD form . Estimation of disease progression has been usually done with standard fundus cameras that can scan only the posterior pole and medial part of the retina which is approximately 45-50 degree of all retina. The wide field camera which is used in this study, was able to scan almost 200 degree of retina, documented peripheral retinal changes and their angiographic characteristics. The aim of the study was to compare morphologic characteristics of peripheral retinal changes in patients with AMD with healthy control group, and to compare morphologic and angiographic characteristics of peripheral retinal changes between two types of AMD. In study was included 152 patients with signs of AMD and 150 healthy controls . Statistically significant difference were observed in frequency of drusen, reticular pigmented degenerations and „paving stone“ degenerations, which are more frequently observed in AMD group. „White without pressure“ degeneration were more frequently observed in control healthy group. Drusen are statistically significantly occurred and more widely spreaded in dry type of AMD . There were no statistically significant difference between wet and dry type of AMD, nor in type , frequency or localization of morphologic and angiographic characteristics of peripheral retinal changes

Morphologic and angiographic peripheral retinal changes in patients with age related macular degeneration

Senilna makularna degeneracija (SMD), jedna je od vodećih bolesti oka s gubitkom vidne oštrine populacije starije od 55 g. Vlažni oblik senilne makularne degeneracije je mnogo ozbiljnije stanje jer, ukoliko se ne liječi, u kratkom vremenskom roku dovodi do gubitka centralne vidne oštrine. Novije spoznaje sugeriraju da se ključne morfološke značajke nalaze i na periferiji mrežnice, a njihovo prisustvo povezano je sa težim oblicima senilne makularne degeneracije ili može imati važne implikacije za rizik napredovanja bolesti. Dostupnost perifernih promjena vizualizaciji i dokumentaciji do sada bila je ograničena na radove koji su koristili sistem standardnih fundus kamera sa širinom kuta od maksimalno 45- 50 stupnjeva. Sistem širokokutne fundus kamere,koji je korišten u ovom istraživanju, omogućava vizualizaciju i dokumentaciju periferije do 200 stupnjeva. Cilj ovog rada bio je usporediti pojavnost, proširenost i lokalizaciju morfoloških promjena periferne mrežnice u skupini bolesnika sa senilnom makularnom degeneracijom s morfološkim karakteristikama zdrave kontrolne skupine ispitanika, te ispitati angiografske karakteristike perifernih promjena mrežnice unutar skupine bolesnika sa SMD-om. U studiju je uključeno 152 ispitanika s kliničkom slikom senilne makularne degeneracije i 150 kontrolnih zdravih ispitanika starijih od 50 godina. Morfološkom analizom svih očiju sa SMD-om, ustanovljena je statistički značajna razlika u pojavnosti druza, retikularnih pigmentnih promjena i „paving stone“ promjena koje se češće javljaju u skupini bolesnika sa SMD-om u odnosu na kontrolnu skupinu. “White without pressure“ ili blijedilo bez pritiska - degenerativna je promjena koja se statistički značajno češće javlja u kontrolnoj skupini. Usporednom analizom morfoloških i angiografskih perifernih promjena uočava se statistički značajna razlika samo u pojavnosti druza koje su češće vizualizirane u suhom tipu SMD-a. Nije uočena statistički značajna razlika za sve ostale ispitivane morfološke i angiografske promjene između suhog i vlažnog tipa SMD-a, s obzirom na proširenost ili lokalizaciju prema ekvatoru oka.Age related macular disease (AMD), are the most prominent cause of central visual acuity loss in population older than 55 y. Wet form is more serious condition, because in short time, if not treated, central visual acuity can be permanently lost, so the estimation of the progression risk from dry to wet type, becomes important. Recent data suggest, that at retinal periphery, can exists some important morphologic changes like peripheral drusen and reticular pigmentary changes, that usually are connected more frequently with wet AMD form . Estimation of disease progression has been usually done with standard fundus cameras that can scan only the posterior pole and medial part of the retina which is approximately 45-50 degree of all retina. The wide field camera which is used in this study, was able to scan almost 200 degree of retina, documented peripheral retinal changes and their angiographic characteristics. The aim of the study was to compare morphologic characteristics of peripheral retinal changes in patients with AMD with healthy control group, and to compare morphologic and angiographic characteristics of peripheral retinal changes between two types of AMD. In study was included 152 patients with signs of AMD and 150 healthy controls . Statistically significant difference were observed in frequency of drusen, reticular pigmented degenerations and „paving stone“ degenerations, which are more frequently observed in AMD group. „White without pressure“ degeneration were more frequently observed in control healthy group. Drusen are statistically significantly occurred and more widely spreaded in dry type of AMD . There were no statistically significant difference between wet and dry type of AMD, nor in type , frequency or localization of morphologic and angiographic characteristics of peripheral retinal changes

Morphologic and angiographic peripheral retinal changes in patients with age related macular degeneration

Senilna makularna degeneracija (SMD), jedna je od vodećih bolesti oka s gubitkom vidne oštrine populacije starije od 55 g. Vlažni oblik senilne makularne degeneracije je mnogo ozbiljnije stanje jer, ukoliko se ne liječi, u kratkom vremenskom roku dovodi do gubitka centralne vidne oštrine. Novije spoznaje sugeriraju da se ključne morfološke značajke nalaze i na periferiji mrežnice, a njihovo prisustvo povezano je sa težim oblicima senilne makularne degeneracije ili može imati važne implikacije za rizik napredovanja bolesti. Dostupnost perifernih promjena vizualizaciji i dokumentaciji do sada bila je ograničena na radove koji su koristili sistem standardnih fundus kamera sa širinom kuta od maksimalno 45- 50 stupnjeva. Sistem širokokutne fundus kamere,koji je korišten u ovom istraživanju, omogućava vizualizaciju i dokumentaciju periferije do 200 stupnjeva. Cilj ovog rada bio je usporediti pojavnost, proširenost i lokalizaciju morfoloških promjena periferne mrežnice u skupini bolesnika sa senilnom makularnom degeneracijom s morfološkim karakteristikama zdrave kontrolne skupine ispitanika, te ispitati angiografske karakteristike perifernih promjena mrežnice unutar skupine bolesnika sa SMD-om. U studiju je uključeno 152 ispitanika s kliničkom slikom senilne makularne degeneracije i 150 kontrolnih zdravih ispitanika starijih od 50 godina. Morfološkom analizom svih očiju sa SMD-om, ustanovljena je statistički značajna razlika u pojavnosti druza, retikularnih pigmentnih promjena i „paving stone“ promjena koje se češće javljaju u skupini bolesnika sa SMD-om u odnosu na kontrolnu skupinu. “White without pressure“ ili blijedilo bez pritiska - degenerativna je promjena koja se statistički značajno češće javlja u kontrolnoj skupini. Usporednom analizom morfoloških i angiografskih perifernih promjena uočava se statistički značajna razlika samo u pojavnosti druza koje su češće vizualizirane u suhom tipu SMD-a. Nije uočena statistički značajna razlika za sve ostale ispitivane morfološke i angiografske promjene između suhog i vlažnog tipa SMD-a, s obzirom na proširenost ili lokalizaciju prema ekvatoru oka.Age related macular disease (AMD), are the most prominent cause of central visual acuity loss in population older than 55 y. Wet form is more serious condition, because in short time, if not treated, central visual acuity can be permanently lost, so the estimation of the progression risk from dry to wet type, becomes important. Recent data suggest, that at retinal periphery, can exists some important morphologic changes like peripheral drusen and reticular pigmentary changes, that usually are connected more frequently with wet AMD form . Estimation of disease progression has been usually done with standard fundus cameras that can scan only the posterior pole and medial part of the retina which is approximately 45-50 degree of all retina. The wide field camera which is used in this study, was able to scan almost 200 degree of retina, documented peripheral retinal changes and their angiographic characteristics. The aim of the study was to compare morphologic characteristics of peripheral retinal changes in patients with AMD with healthy control group, and to compare morphologic and angiographic characteristics of peripheral retinal changes between two types of AMD. In study was included 152 patients with signs of AMD and 150 healthy controls . Statistically significant difference were observed in frequency of drusen, reticular pigmented degenerations and „paving stone“ degenerations, which are more frequently observed in AMD group. „White without pressure“ degeneration were more frequently observed in control healthy group. Drusen are statistically significantly occurred and more widely spreaded in dry type of AMD . There were no statistically significant difference between wet and dry type of AMD, nor in type , frequency or localization of morphologic and angiographic characteristics of peripheral retinal changes

Ophthalmologist in Patients’ Eyes

It seems that patient\u27s knowledge about ophthalmologist\u27s work is very insufficient, especially about what type of examination should be undertaken for refraction condition during the »simple« eye check-up and which serious systemic diseases could be discovered thorough eye examinations. The aim of the study was to determine patients\u27 knowledge about ophthalmologist examinations during the check-up for refraction condition, knowledge about differences between ophthalmologists and opticians, main sources of patients\u27 ophthalmologic cognition and the main reasons for coming to special locations. Patients (311) were examined by applying the questionnaire, immediately before the eye check-up at three various refraction units. Statistical analysis used Chi-square test and test of significance between proportions, except for patients’ age where Student t-test was used. Differences were statistically significant at p=0.05. The findings show that the patients’ knowledge about eye examination during the check-ups for refraction abnormalities was not satisfactory. Twenty-two percent (22%) of examined patients did not know the differences between ophthalmologists and opticians and 16 % believed that after computer testing of refraction further ophthalmologic examinations were not necessary. The main sources of medical cognition were the mass media while twenty percent (20%) of the participating patients named doctor’s lectures as the source of their cognition. This study revealed that a lot of work needs to be done to improve patients\u27 education and indirectly for better screening of very serious systemic diseases and blind threatening diseases which could be discovered during the first visit for spectacle prescription

Phacoemulsification and Silicone Oil Removal Through The Planned Posterior Capsulorhexis

The purpose of the study was to present operative technique and results of a passive hydrodynamic expression of silicone oil through planned posterior capsulorhexis during cataract surgery in patients after pars plana vitrectomy. The retrospective analysis was done on 57 eyes with cataract after a previous pars plana vitrectomy, operated on between 2001 and 2004 at the Clinical hospital »Sestre milosrdnice« Zagreb. Preoperative and postoperative best corrected visual acuity (BCVA), preoperative and postoperative intraocular pressure (IOP), and postoperative complications were reviewed. Visual acuity improved or stabilized in all patients with an attached retina. Retinal detachment occurred in 11 eyes. Transient vitreous hemorrhage, that resolved within 1 week of surgery without treatment, was observed in 4 eyes. Asymptomatic intraocular lens (IOL) decentration occurred in 2 eyes. Our findings suggest that silicone oil removal and cataract surgery can be performed as a single procedure in selected patients in the absence of macular pucker and retinal reproliferation, and in a presence of a stable retina

Common Variant in Myocilin Gene Is Associated with High Myopia in Isolated Population of Korčula Island, Croatia

Aim To study the association between genetic variants in myocilin and collagen type I alpha 1 genes and high myopia in an isolated island population. Methods A total of 944 examinees from the genetic epidemiology study conducted on the island of Korčula, Croatia, were included in the study. We selected 2 short nucleotide polymorphisms (SNP) available in our genome-wide scan set of SNPs that were previously associated with high myopia and used them to replicate previous claims of possible association. Results Nineteen cases of high myopia, defined as the refraction of ≤-6.00 diopters, were identified and included in the analysis. We showed that rs2075555 in the COL1A1 gene was not associated with high myopia. In contrast, rs2421853 in the myocilin gene was significantly associated in both bivariate (P = 0.006) and age- and sex-adjusted analysis (P = 0.049). Conclusion Myocilin seems to be a very strong candidate for explaining some of the pathophysiological pathways leading to the development of both glaucoma and high myopia. As our finding was obtained in a relatively underpowered sample, further research and replication of these results is needed