Ocular manifestations of diabetes mellitus: a general overview

Introduction: Diabetes is on the rise – according to the World Health Organization (WHO) over 400 million people worldwide are affected. Elevated blood sugar levels pose a risk for the lives of these patients as well as a serious deterioration in their quality of life. Apart from diabetic retinopathy, which poses an immediate risk to vision, virtually any part of the visual-sensory system can be irreversibly damaged. The objective of the study is to evaluate the prevalence of different eye complications in patients with type two diabetes and to propose guidelines for early diagnosis, clinical evaluation and treatment.Contingent and Methods: A total of 1654 adult patients hospitalized at the Clinic of Ophthalmology in the Alexandrovska Hospital were clinically evaluated including OCT scanning and visual field testing. Results: Approximately 13% of the patients (212) had type two diabetes as a concomitant disease. The most common eye manifestation of diabetes was cataract found in 73% of the patients. Other ocular manifestations of diabetes included primary open-angle glaucoma (POAG), secondary glaucoma, retinopathy and vitreal bleeding, retinal detachment, ischemic optic neuropathy, oculomotor dysfunction and eye-lid inflammation.Conclusion: Diabetes mellitus bears a significant risk for ocular complications and visual disability. The disease can affect any part of the visual system ‒ the sensory, the oculomotor and the adjacent tissues (eyelids and tear production and outflow). Patients with diabetes require regular follow up and timely intervention to prevent irreversible damage to the visual system

Atypical suamous papilloma of the conjunctiva

Papillomas are benign tumors of human skin and mucous membranes caused by human papillomavirus (HPV). The virus causes abnormal epithelial cell growth. The formations vary in shape, size and location. The conjunctival papillomas are one of the most common benign tumors of the squamous epithelium of the conjunctiva. They rarely undergo malignant transformation. Purpose: To present a clinical case with proven atypical squamous papilloma of the conjunctiva. Materials: 58-year-old patient was admitted to the Eye Clinic of University Alexandrovska hospital for the first time. Methods: A complete ophthalmologic examination, ultrasonography, surgery and pathohistological diagnosis were performed. Results: Thorough excision of the tumor lesion in healthy tissue was performed. The pathological diagnosis revealed atypical squamous papilloma of the conjunctiva. Conclusion: The diagnosis can only be confirmed pathohistologically. A good relationship between ophthalmologist and pathologist is necessary for the successful diagnosis and subsequent treatment

Mean Age of Patients with and without Type 2 Diabetes Mellitus during Surgical Treatment of Age-Related Cataract

Introduction: Age-related cataract is one of the most common causes of preventable blindness. Type 2 diabetes is a non-infectious epidemic disease with an ever-increasing number of diseased patients. Cataract is one of the leading causes of reduced vision in diabetics. The preferred treatment method is phacoemulsification. The aim of the present study was to compare the mean age of patients with and without diabetes type 2 at the time of cataract surgery. Materials and methods: After informed consent and approval by the Ethics Commission of the Medical University of Sofia, 176 patients admitted to the Clinic of Ophthalmology at the University Hospital „Alexandrovska“ for surgical treatment of cataract were randomized. Inclusion criteria: diagnosed age-related cataract, requiring surgical treatment. Patients were divided into two groups – diabetic type 2 and non-diabetic patients. Inclusion criteria for the group of diabetics: medical history of diabetes type 2 and administration of anti diabetic medications. Results: The average age of patients undergoing cataract surgery was 70.81 years. The average ageof patients with diabetes type 2 was 65.89 years, and that of non-diabetics – 71.74 years. Diabetes type 2 was established at 15.91 % of patients (19 men and 9 women). Conclusion: Patients with diabetes type 2 develop age-related cataract, requiring surgical treatment, at an earlier age compared to non-diabetics. The transparency of the lens in diabetic patients is of particular importance for the diagnosis and treatment of the diabetic retinopathy. Follow-up by an ophthalmologist and maintenance of strict blood glucose control are necessary to reduce the incidence of vision loss, caused by cataract and diabetic retinopathy

Análisis del Maltrato Físico en la Familia y su Influencia en Variables del Contexto Educativo [Analysis of the Physical Abuse in the Family and its Influence in Variables of the Educational Context]

This study analyzes the relationship between physical abuse in the family context and its influence on the educational context variables (academic performance and social behavior). A total of 2.852 students aged between 12 and 17 years participated in the study. The results highlight that the students who were abused in the family have higher numbers of fail marks, a lower level of social acceptance in the peer group as well as a greater involvement in the dynamics of bullying in both, the role of aggressor and as the victim. The results are discussed in relation to the importance of the type of family socialization based on coercion and abuse and behavior of students in the classroom

Normal tension glaucoma – case report

Normal tension glaucoma (NTG), reffered to also as low-tension glaucoma, represents a glaucomatous optic neuropathy classified as a type of Primary open angle glaucoma (POAG). It is characterized by a higher tendency of damage to the optic nerve at relatively low levels of intraocular pressure (IOP), as well as asymmetric pathological process in both eyes of the same patient. A number of IOP-independent factors play a significant role in the progression of the disease and often lead to difficulties in diagnosis and optimal therapy in these patients. We report a typical clinical case of a patient with NTG

Childhood glaucoma

Въведение: Глаукомата в детска възраст е сравнително рядко, но сериозно застрашаващо зрението заболяване. По литературни данни засяга 1 на 10 000 до 12 500 новородени. Заболяването има значителни различия по отношение на етиопатогенезата, клиниката и лечението в сравнение с глаукомата при възрастни. Цел: Целта на настоящата статия е да представи алгоритъм за диагностика и проследяване на деца с глаукома, както и резултатите от изследване на деца с първична конгенитална глаукома. Материали и Методи: Под обща маскова анестезия са изследвани 18 очи на 9 деца. Изследвани са вътреочното налягане, централната роговична дебелина и хоризонтален роговичен диаметър. Резултати: При 3 от децата заболяването засяга само едното око, a при останалите 6 и двете очи. Средната възраст на изследваните деца е 6 месеца и 5 дни. Заключение: Глаукомата в детска възраст е актуален, значим, широко дискутиран медико-социален проблем. При всички деца с глаукома или съмнение за такава трябва да се предложи пакет от изследвания, които се правят в определена последователност, струват пари и отнемат време. Без тяхна помощ обаче е абсолютно невъзможна правилната диагноза, стадирането на болестта и предлагането на адекватна терапия. Повече от половината от пациентите с ПКГ стигат до слепота.Introduction: Childhood glaucoma is a relatively rare but seriously sight threatening disease. According to the literature it affects 1 out of 10 000 to 12 500 newborns. It has ethiopathological, clinical and therapeutic differences from the adult glaucoma. Aim: The aim of the current study is to present an algorithm for diagnosis and follow-up of patients with glaucoma and the results of the examination of 9 children with primary congenital glaucoma Methods and Materials: We have examined under general mask anestesia 18 eyes of 9 children (3 boys and 6 girls): intraocular pressure of each eye; central corneal sickness and horizontal corneal diameter. Results: Three of the children had unilateral disease and in the rest the diseases affected both eyes. The average age of the examined children was 6 months and 5 days. Conclusion: Childhood glaucoma is a relevant, significant and widely-discussed medico-social problem. In all cases of children with glaucoma or suspicion for such a package of tests should be performed which are costly and time-consuming. However, without these tests it is absolutely impossible to give an accurate diagnosis and hence initiate a proper therapy. More than half of the patients with primary congenital glaucoma become blind

Targeted expression of human FSH receptor Asp567Gly mutant mRNA in testis of transgenic mice: role of the human FSH receptor promoter.

AIM: To specifically express the Asp567Gly human follicle-stimulating hormone receptor (FSHR) under the control of its promoter to evaluate the phenotypic consequences in the presence of normal pituitary function. METHODS: We produced transgenic mice overexpressing the Asp567Gly human FSHR under the control of a 1.5kb 5'-flanking region fragment of its promoter. RESULTS: Mice were phenotypically normal and fertile. In males, mRNA could be detected in the testis and the brain, indicating that the 1.5kb promoter fragment drives expression not only in the gonads. The testis weight/body weight ratio and the testosterone levels in transgenic and non-transgenic littermates were similar. By in situ hybridisation we found that the transgenic FSHR was highly expressed in Sertoli cells, spermatocytes and round spermatids. However, a radioligand receptor assay failed to show a significant difference in total FSHR binding sites in testis homogenates of transgenic and wild type animals, suggesting that the transgenic FSHR is probably not translated into functional receptor protein. CONCLUSION: A 1.5kb 5'-region of the human FSHR drives mRNA expression of the transgene in the testis but leads to ectopic expression in germ cells and in the brain. No phenotypic consequences could be documented due to the lack of protein expression