Endophthalmitis in war and peace penetrating eye injuries

Background/Aim. Nowadays, eye injuries are a leading cause of one-eye disease or blindness worldwide. The aim of this study was to comparatively analyze the frequency of endophthalmitis following war and peace eye injuries. Methods. All the patients went through the detailed ophthalmologic examinations, prophylactic antibiotic treatment, and pars plana vitrectomies (VPP), or other required surgical interventions. Results. Inside the period from 1991 to 1998, 647 patients with eye injuries were hospitalized, out of which 500 with penetrating eye injuries. In the period 1999−2004, 611 patients with eye injuries, were treated, out of which 297 had penetrating eye injuries. Out of 500 patients with war penetrating eye injuries, in 286 of the cases intrabulbar foreign bodies (IFB) were detected. The signs of endophthalmitis were observed in 26 eyes (5.2%) at admission. Out of totally 297 peace penetrating eye injuries, 196 (66%) were IBF. In 25 eyes (8.4%) endophthalmitis was observed. Conclusion. In our study, the frequency of posttraumatic endophthalmitis following penetrating war eye injuries was relatively low, even lower than the frequency of endophthalmitis following peace eye injuries

Photorefractive keratectomy for correction of myopia: Our one-year experience

Background/Aim. Photorefractive keratectomy (PRK), after laser in situ keratomileusis (LASIK), is commonly performed refractive surgical method worldwide. The aim of this study was to examine the effectiveness and safety of PRK in correction of various strengths of myopia and to assess how much corneal tissue is being removed with one diopter sphere (Dsph) correction by using different optical zones (OZ). Methods. A prospective study with a follow-up period of 6 months included 55 patients of which 100 myopic eyes were treated by PRK method (one eye was included in 10 patients). Myopic eyes with a preoperative best corrected visual acuity (BCVA) = 1.0 (20/20) were analysed. In order to assess the effectiveness of PRK operated myopic eyes were divided into four groups according to the dioptric power: 1)≤ -1.75 Dsph (n = 26); 2) from -2 to -3.75 Dsph (n = 44); 3) from -4 to -6.75 Dsph (n = 23), and 4) ≥ -7 Dsph (n = 7). Myopic eyes with preoperative BCVA ≤ 0.9 (amblyopic eyes) were excluded from the study, as well as eyes with astigmatism > -1.5 Dcyl. To assess the effectiveness of PRK we examined the percentage of eyes in the mentioned groups, which derived uncorrected visual acuity (UCVA) 6 months after the intervention to the following: a) UCVA = 1.0 (20/20) and b) UCVA ≥ 0.5 (20/40). To assess the safety of PRK we examined the frequency of intraoperative and postoperative complications. To estimate how much corneal tissue was removed with one Dsph correction by using different OZ, we used preoperative and postoperative (after 6 months) central pachymetry values expressed in μm and volume of cornea (central 7 mm) expressed in mm³. In that sense, we used only the myopic eyes with clear preoperative spherical refraction. The total number of these eyes was 27, of which 16 eyes were treated using a 6.5 mm OZ and 11 eyes using a 7 mm OZ. Results. Refractive spherical equivalent (RSE) for all eyes was in the range from -0.75 to -8.75 Dsph, and preoperative mean value of RSE with standard deviation (mean RSE ± SD) was -3.32 ± 1.83 Dsph. Six months after PRK, 91% of eyes had UCVA = 20/20, and 99% of eyes had UCVA ≥ 20/40. In the first group (≤ -1.75 Dsph) preoperative mean RSE ± SD was -1.34 ± 0.32 Dsph, six months after PRK, 96% of eyes had UCVA = 20/20, and 100% of eyes had UCVA ≥ 20/40. In the second group (from -2 to -3.75 Dsph) preoperative mean RSE ± SD was - 2.95 ± 0.57 Dsph, six months after PRK, 89% of eyes had UCVA = 20/20, and 100% of eyes had UCVA ≥ 20/40. In the third group (from -4 to -6.75 Dsph) preoperative mean RSE ± SD was - 4.93 ± 0.70 Dsph, six months after PRK, 100% of eyes had UCVA = 20/20. In the fourth group (≥ - 7 Dsph) preoperative mean RSE ± SD was -7.71 ± 0.67 Dsph, six months after PRK, 57% of eyes had UCVA = 20/20, and 86% of eyes had UCVA ≥ 20/40. There were no intraoperative complications while postoperative complications occurred in 2 patients - in both cases in one eye (2%). In that cases, epithelial defects were detected. In the group of eyes that were treated by 6.5 mm OZ mean RSE ± SD was -2.45 ± 0.99 Dsph, the ablation depth per 1 Dsph was 17.54 ± 5.58 μm and ablated volume of central 7 mm cornea by 1 Dsph was 0.43 ± 0.18 mm³. In the group of eyes that were treated by 7 mm OZ mean RSE ± SD was -3.32 ± 2.26 Dsph, the ablation depth per 1 Dsph was 23.73 ± 6.91 μm and ablated volume of central 7 mm cornea by 1 Dsph was 0.61 ± 0.31 mm³. Conclusion. PRK is effective and safe refractive surgical method for correcting myopia up to -8 .75 Dsph. OZ size is the main factor determining the depth of the excimer laser ablation of the corneal tissue volume consumed by 1 Dsph. Higher OZ value determines higher consumption of cornea tissue

Evolution of cataract surgery: Smaller incision - less complications

Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ≥ 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome

Disaster risk monitoring in risk management policy

Climate change has been observed in South East Europe (SEE) through higher temperature, changing precipitation and run-off patterns, and extreme weather, leading to reported increasing incidence of weather-induced disasters in many countries of the region such as floods, droughts, wild fires, strong winds, heat and cold waves, etc. As part of climate change adaptation policies and investments, SEE countries have to focus on reduction of their vulnerability and planning measures to mitigate natural disaster risks. This paper presents the implications of climate change resulting in extreme weather and it analyzes the capabilities of Serbia and its business sector to mitigate and manage the impact of extreme events. The main results of desk and field research carried out in 2016 on disaster risk mitigation are given, as well as emergency preparedness and management and reporting practices in the country, manufacturing, finance and insurance enterprises to reduce the current and future vulnerabilities. The methods used are linear regression and statistical tools. Taking into account the projected impact of climate change for SEE and Serbia by the World Bank's studies, the reduction of the current and future vulnerabilities to climate change risk is very important. Since the aim of this paper is to highlight the importance of investing in risk management knowledge and practices of disaster risk monitoring in risk management policy, the research can contribute to the reduction of the weather-related disaster risks, losses and it can initiate necessary actions for climate change

The effect of intravitreal administration of bevacizumab on macular edema and visual acuity in age-related macular degeneration with subfoveolar choroidal neovascularisation

Background/Aim. Age-related macular degeneration (AMD) is a leading cause of the loss of central visual acuity in population older than 70 years. We can distinguish wet and dry form of AMD. The aim of the study was to present our early results in treatment of the wet (neovascular) form of AMD with intravitreal administration of bevacizumab. Methods. The study included 39 patients. Each patient underwent a complete ophthalmological examination, fluorescein angiography (FA) and optical coherence tomography (OCT). All the patients received 1.25 mg of intravitreal bevacizumab (0.05 mL of commercial phial of Avastin®). The total of three doses was given with a one-month interval between doses. Results. Among 39 patients, 24 were women and 15 men. The average best corrected visual acuity (BCVA) was improved from 0.09 before the therapy to 0.24 after the administration of all the three doses of bevacizumab (p < 0.001). The average central macular thickness (CMT) measured by OCT was improved from 474 μm in the beginning to 341 μm after the administration of all the three doses of the drug (p < 0.001). There were no side effects. Conclusions. Our short-term experience indicates that intravitreal administration of three doses of bevacizumab in one-month intervals between the doses leads to a significant reduction of macular edema and improvement of BCVA in patients with neovascular AMD

Mikrofiltracija i antioksidativni kapacitet kompozicije ekstrakta lekovitih biljaka, voća i medicinske gljive Ganoderma lucidum

This paper presents kinds of extraction and cross-flow filtration of composition of 46 healthful and aromatic herbs, 8 fruits and fungi Ganoderma lucidum. Those extracts are part of Bitter 55, which have significant antioxidant capacity. Antioxidative activities of plant extracts have been determined by DPPH test using method of Blois. Bitter 55 which was kept at the green bottle in the dark has EC50 = 141.07 μl/ml and it was stable during 150 days. Synthetic anti-oxidants BHT (ditertbutilhydroxytoluen, EC50 = 6.2 μgml-1), trolox (vitamin E analog soluble in water, EC50 = 6.8 μgml-1) were used for comparison. EC50 values were calculated as concentration of the extract necessary to decrease DPPH radical concentration for 50 %. Bitter 55 contents 35% vol of alcohol (wheat origin), 88.22 g/l total extract and slice of medicinal mushroom Ganoderma lucidum (1 % w/v) which was extracted 30 days before analyzes. The main problem in practical applications of MF is the reduction of permeate flux with time, caused by the accumulation of feed components in the pores. During microfiltration bitter herbal liquor, the function of filtrate flux is decreased with VCR. Dependence of decreasing flux with VCR can be separated in three periods. For the first, starting period, rapid decrease of filtrate flux is characteristic. Second period is defined with much smaller decrease of the flux than in the first phase. Third period has as characteristic minor decrease of flux and can be defined as steady state. Steady state emerges after τs = 80 min.Sastojci lekovitog bilja i voća koji pokazuju potencijalnu antioksidativnu sposobnost su različite bioaktivne komponente, kao što su različiti fenoli, polifenoli, fenolne kiseline, flavonoidi, tanini i dr. Na tržištu se nalaze biljni ekstrakti od 12, 25 pa sve do 56 lekovitih i aromatičnih biljaka i voća. Dodatak medicinske gljive Ganoderma lucidum, biljnom ekstraktu od 54 lekovitih i aromatičnih biljaka, predstavlja dobro rešenje. Ekstrakcijom gljive Ganoderma (Ganoderma lucidum) zajedno sa lekovitim i aromatičnim biljem, zadržavaju se sve aktivne vrednosti biljaka, uz postizanje dodatnih lekovitih svojstava gljive. Ovakav proizvod, na bazi ekstrakata lekovitog i aromatičnog bilja, voća i gljive Ganoderma, je interesantan sa aspekta mogućih lekovitih svojstava. On može biti deklarisan ili kao gorki biljni liker u komercijalnoj prodaji ili čak kao dijetetski suplement za prodaju u apotekama. Takav proizvod u svakom slučaju predstavlja, kako zdravstveno tako i nutritivno, bolje rešenje od drugih alkoholnih pića. U radu su prikazani načini ekstrakcije i mikrofiltracije 46 lekovitih i aromatičnih biljaka, gljive Ganoderma lucidum i 8 voćnih vrsta koji čine kompoziciju Bittera 55. Utvrdjeno je da gorki biljni liker - Bitter 55 sadrži značajan antioksidativni potencijal. Potencijalna antioksidativna aktivnost određivana je DPPH testom, metodom po Blois-u.1 Vrednost EC50 uzorka BITTER-a 55 koji je stajao u zatamnjenoj boci u mraku je 139,47 μl/ml rastvarača i nije se promenila tokom 150 dana čuvanja. Sintetički antioksidansi BHT (ditercbutil-hidroksitoluen) i troloks (analog vitamina E rastvoran u vodi) imaju vrednosti EC50 redom 6,2 i 6,8 μg/ml. Vrednost EC50 predstavlja koncentraciju ekstrakta koja za 50% smanjuje koncentraciju DPPH radikala (praćeno preko inhibicije apsorpcije rastvora DPPH na 517nm)

Management of penetrating ocular injuries and endophthalmitis in thirteen-year follow-up period

Introduction: Ocular trauma is one of the most common causes of unilateral morbidity and blindness in the world today. Objective: Frequency of penetrating ocular injuries and endophthalmitis after injuries caused by explosive weapons during the war in former Yugoslavia in the period 1991-1999 as well as eye injuries in the period 2000-2004 was examined. Method: During 1991-1999, 647 patients with eye injuries were hospitalized at Eye Clinic, MMA, out of whom 500 cases with penetrating eye injuries. In 2000-2004 period, 601 patients with eye injuries were treated, out of whom 297 had penetrating eye injuries (including patients from Montenegro and Republica Srpska). All patients underwent thorough ophthalmological examination, antibiotic treatment and VPP or other required surgical interventions. Results: All 500 patients from the first period had severe penetrating eye injuries. Intrabulbar foreign bodies (IFB) were detected in 286 cases, while 214 cases with penetrating eye injuries had no intrabulbar foreign bodies. Almost all patients had multiple head and body injuries as well. Endophthalmitis was observed in 29 eyes (5.2%) upon admission to hospital. In the second observed period (2000-2004), 196 (66%) out of 297 penetrating eye injuries had IOFB, and 101 (34%) was without IOFB. Endophthalmitis was observed in 34 eyes (8.4%). Conclusion: War eye injuries are a special group of injuries. Relatively low percent of posttraumatic endophthalmitis is definitely worth attention, especially in comparison with peacetime eye penetrating injuries