Therapeutic approaches in neovascular glaucoma

Clinica Ofta Total Sibiu, Facultatea de Medicină, Universitatea „Lucian Blaga” din Sibiu, RomâniaSummary. Neovascular glaucoma (NVG) is a severe type of secondary glaucoma caused by a variety of conditions, such as diabetic retinopathy, central vein occlusion and central retinal vein branches, or ischemic eye syndrome. NVG is a devastating type of glaucoma with a poor prognosis. It is caused by neovascularization in the angle of the anterior chamber, which affects the drainage of aqueous humor in the presence of an open angle and subsequently contracts, fibrosis to become a secondary closed angle.Introducere. Glaucomul neovascular (GNV) este un tip sever de glaucom secundar cauzat de o varietate de afecțiuni, cum ar fi retinopatia diabetică, ocluzia venei centrale și ramurile venei centrale a retinei sau sindromul ischemic ocular. GNV este un tip devastator de glaucom cu prognostic rezervat. Este cauzat de neovascularizație în unghiul camerei anterioare, care afectează drenarea umoarei apoase în prezența unui unghi deschis și ulterior se contractă, se fibrozează pentru a deveni un unghi închis secundar. Scopul studiului este de a arăta diferite metode de tratament și urmărire în glaucomul neovascular. Materiale și metode. Am studiat un număr de 52 de cazuri de glaucom neovascular cauzate de următoarele afecțiuni: retinopatie diabetică, ocluzie a venei centrale a retinei și sindrom ischemic ocular. Tratamentul a fost medical, laser și chirurgical. Tratamentul laser transcleral cu laserul Cyclo G6 a fost aplicat în 11 cazuri. Rezultate. Tratamentul chirurgical a fost asociat cu fotocoagularea panretiniană și injecția intravitreană cu bevacizumab, aflibercept. În majoritatea cazurilor am reușit să păstrăm vederea restantă și să reducem durerea. Tratamentul laser cu laserul Iridex prin ciclofotocoagulare transclerala oferă o soluție de necesitate. Concluzii. Glaucomul neovascular este o patologie foarte dificilă și este foarte greu de gestionat. Tratamentul trebuie să înceapă foarte devreme. Utilizarea fotocoagulării panretiniene și a injecției intravitreene poate reduce neovascularizarea irisului și a unghiului și poate normaliza PIO. Chirurgia se impune cu antimetaboliți și agenți antifibrotici pentru a evita fibroza bulei de filtrație. Tratamentul laser cu laserul Iridex, ciclofotocoagulare transclerală este de luat în considerare, deoarece este miniinvaziv și repetitiv

TFOS European ambassador meeting:Unmet needs and future scientific and clinical solutions for ocular surface diseases

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019

INTERNAL AUDIT AN FIRST AID SOLUTION WHO CAN LEAD TO EFFICIENT USE OF EU FUNDS FOR RURAL ECONOMIC DEVELOPMENT IN ROMANIA

In 2007, the real stake for Romania in the relationship with the European Union was not the effective adhesion, which was a certain fact but only a matter of time. The real stake was Romanias capacity in absorbing the substantial funds that the union would provide access to. In other words the real stake at that moment was the adequate capacity of community funds absorption. According to the analyse of the Authority for Coordination of Structural Instruments, between 2007-2013, Romania had and still has at its disposal, funds in total amount of 19,2 mld EURO or 81 mld RON that should be absorbed by the end of 2015 (this amount does not include the agricultural funds). Taking into account that at the moment our country absorbed almost 9 mld RON, which means 11,06% from the total amount, in order to attract the entire sum it would be necessary that by the end of 2015, payments of approx. 14 mld should be performed yearly, amount 7 times higher than in 2010. In conformity with the report prepared by the Council Tax and recently published, at the end of 2010, Romania was the last country, out of 6 analised, regarding the absorption rate between 2007-2013 of 8,6%, behind Bulgaria (10,2%), Czech Republic (12,4%), Poland (20,4%),Estonia (26%) and Latvia Republic (29%). Regarding the European fund dedicated to the rural development, Payments Agency for Rural Development and Fisheries approved 30.500 projects through the National Project of Rural Development 2007-2013, from the official starting date – 3 rd of March 2008, until the15 th of July 2011, in amount of approx of 4 mio EURO. This amount represents approx. 40% from the total sum dedicated to the Romanian agriculture, rate that was achieved in 4 and a half years. In order to spent the rest of 60%, Romania has at its disposal 2 and a half years. As a first measure in this situation, I consider that the development of rural segment can be influenced by the internal audit department, which can insure and advise through its actions a better fund administration and a substantial improvement of the public activities. This department can also help the Agency to fulfil its targets through a methodical and systematic approach, action which would also improve the efficiency and efficacy of the system, of the administration processes and controlling process

Reframing business reporting in a Big Data world

This paper investigates the challenges raised by the “datafication” of the business environment in the area of performance management. Big Data and its powerful analytics are now essential elements of the business landscape, and the mindset of managers and decision-makers has a crucial impact on how the opportunities offered by these new technologies can be capitalised. Our focus is on how and to what extent business performance management models need to be reviewed and reframed in this era of Big Data. We propose a model, called Balanced ScoreCard System Thinking, that may insure an integrative, highly dynamic and agile construction. This “top-down-bottom-up” approach assess the way in which every segment of the Balance Score Card is affected by Big Data and Business Analytics. These findings may enable business leaders to develop a more agile and forward-looking approach to performance management, which is only made possible through these new technologies of data analytics

IMPACT OF IFRS ADOPTION ON ROMANIAN COMPANIES

Accounting globalization follows the transformation of the accounting system into an economic and financial model, able to inform more correctly and rapidly the users of the accounting information, amongst which the investors and the creditors are clearly delimited. Within this context, the need of a harmonized and well oriented accounting system has become imperative. The adoption of a set of international accounting standards in Europe is intended to provide uniform and high quality financial information on the financial markets which would consolidate the global market efficiency, reducing the cost of capital accessing for European companies. There are numerous opinions according to which the IFRS adoption could be an element of abolishing the discrepancies between the accounting systems, offering at the same time a high level of transparency of the financial information. Our objective is to analyze the opportunity of implementing the IAS/IFRS referential by the Romanian companies, as well as their instant reaction within this context

USING DEPENDENCY STRUCTURE MATRIX IN OPTIMAZING FINANCIAL AUDIT PROCESS

This paper presents a new approach in evaluating risks of material misstatements in financial audit using dependency structure matrices (DSM). This perspective allows the identification of significant audit risks and can be used by audit managers to optimise resource allocation by focusing on higher risk areas. DSM matrix is widely used in other areas such as industrial production, design engineering and risk management. This approach is not used in financial audit so far. The financial crisis has diminished the activity of the audit clients and has imposed smaller audit fees. The auditors have to optimize their processes in order to maintain the quality of audit, even to improve it for the same audit remuneration. DSM matrix is a solution for this problem. This article points out have to use DSM matrix in financial audit process in order to optimize the allocation of resources, while maintaining audit quality. Our research aims to improve the risk evaluation stage in the financial audit process using DSM matrix to evaluate higher risk areas. We used the Project DSM Tool for representing significant accounts in the Purchase to pay process for a financial audit. Dependencies between accounts were used for creating a DSM matrix that depicts higher risk areas. Also, for each account, several resource allocation parameters such as costs and number of hours to be used for performing audit procedures on that account (from both audit team and client personnel). Our research suggests that DSM can provide useful information in detecting risk areas in significant classes of transactions identified in a risk based audit and we recommend using DSM matrix in the planning phase of the audit in order to avoid redundancies in the audit execution phase. This is important considering that the European Commission recommends in the Green Paper for Audit to improve the quality of audits following the setbacks to the profession caused by the financial crisis

Comparing the Accuracy of Four Intraocular Lens Formulas in Eyes with Two Types of Widely Used Monofocal Lens Implants

The present study aimed to compare the accuracy of intraocular lens calculation formulas Barrett Universal II, Hoffer Q, Holladay 1, and SRK/T in the prediction of postoperative refraction for two widely used monofocal implants: SN60WF and ZCB00. All eyes were divided based on axial length (<22 mm, 22–24.5 mm, and >24.5 mm) and lens type. The mean and median of the absolute refractive error (AE) were calculated for all four formulas, using manufacturer-recommended lens constants as well as optimized constants. The subgroup analysis showed that the Barrett Universal II formula had the smallest mean absolute error in three groups (with short, medium, and long axial length) before and after lens factor optimization, and Holladay 1 had the best results in two groups (of medium and long axial length), and SRK/T in one short axial length group, as well as one medium AL group after A-constant optimization. This study hints at the versatility of the Barrett Universal II formula, a fourth-generation formula that is now widely available on most optical biometers and provides a useful tool of calculation for eyes of all axial lengths even without lens constant optimization