POTENTIAL ROLE OF VISUALLY EVOKED POTENTIAL AND ELECTRORETINOGRAPHY

Glaucoma is a widely distributed progressive optic neuropathy characterized by progressive damage and loss of retinal ganglion cells of the retina and optic nerve, optic disc excavation increasing and usually, but not always, high intraocular pressure, which eventually results in gradual changes in the visual field. In our study, we tried to determine the potential role and place of electrophysiological researches (PERG and VEP) in the early detection of glaucoma optic neuropathy, comparing the electrophysiological parameters (P100 and A) and numeric parameters in ophthalmic patients studied. The results obtained in our study show that the application of PERG methods detects early damage to the retinal ganglion cells, whereas the same changes were not observed by VEP analysis, suggesting a potential role of predictive PERG analysis in the early diagnosis of pre-perimetric glaucoma

Clinical, histopathological and immunohistological study of lymphoid disorders in the parotid gland of patients with Sjögren's syndrome

Bacground/Aim. Sjögren's syndrome is a chronic autoimmune systemic disease characterized by polyglandular tissue destruction, leading to keratoconjunctivitis sicca and xerostomia. These patients have 44-fold increased risk of developing salivary gland lymphoma, of which 80% are marginal zone (MALT) type. Having in mind that criteria for distinguishing benign lymphoepithelial lesions from MALT lymphoma are obscure, the aim of this study was to provide practical information that could be integrated into diagnostic practice. Methods. Among 32 parotidectomies, 27 cases were identified as having benign lymphoepithelial disorders and 5 cases low grade MALT lymphoma. Histological sections were stained routinely with hematoxylin and eosin (H&E and special stains. Immunohistochemical study was performed by LSAB2 method, by using primary antibodies for CD20, CD3, Kappa and Lambda light chains and Cytokeratin (Dako Denmark). Results. The 27 patients with Sjögren's sialoadenitis (22 women and 5 men), and 5 patients with MALT lymphoma (only women) were included in this analysis. According to the Ann Harbor Classification, all patients with MALT lymphoma had stage IE. Both groups of patients had an indolent clinical course, except permanent, rapid parotid enlargement in the patients with MALT lymphoma. Histologically, the periductal lymphoid infiltrate, gradually extended to the acini, completely replacing them by a sea of polyclonal lymphocytes, immunoblasts, germinal centers and plasma cells (confirmed immunohistochemically), but sparing the ducts and preserving lobular appearance. The histological feature of salivary gland MALT lymphoma included heterogeneous B-cell infiltrate that totally or subtotally had effaced the normal glandular structure. Malign lymphoepithelial lesions, representing infiltration of the ductal and epithelial structures by monoclonal neoplastic Bcells, positive for CD20, were highlighted by antibody to cytokeratin. Conclusion. The optimal diagnosis of salivary gland MALT lymphoma requires careful integration of clinical, morphological and immunohistochemical results

Subconjunctival Infection due to Dirofilaria Repens - Case Report

Summary The aim of the survey was to present the clinical course and surgical treatment of the first case of human ocular dirofilariosis on the territory of the city of Niš, in the southeast Serbia. Male patient, 57 years old, visited an ophthalmologist because of extreme swelling and redness of the eyelids of the right eye, scratches and pain in his right eye. On standard examination on biomicroscope, temporally 3 mm from the limbus, intrapalpebrally, a mobile parasite was observed in the subconjunctival space. Complete extraction of the living parasites, 13 cm long, was performed. A sample of the nematode based on morphological and morphometric characteristics was identified as Dirofilaria repens-like. The diagnosis was confirmed with molecular methods. For ocular dirofilariosis, surgical methods and complete extraction of the parasite are the only ways to achieve complete recovery

Komparativna analiza genske varijabilnosti i nivoa cirkulišućih faktora nekroze tumora, HSP 70 i Fas/FasL u primarnom glaukomu otvorenog ugla

Genetic heterogeneity of primary open-angle glaucoma, and concentration changes of various inflammation and immune response mediators in the blood, aqueous humor or tissues, indicate the involvement of different genetic mechanisms and immune system activity in the pathogenesis of POAG. The aim of study was to determine the interdependent clinical, genetic and biochemical findings in POAG-HTG patients. Distribution of genetic polymorphisms for TNF-α -308 G/A and - 863 C/A in DNA samples was examined using PCR-RFLP, the concentrations of circulating TNF-α and HSP 70 in a plasma and concentration of sFas and sFasL in the aqueous humor were measured by commercial ELISA tests. Their association with quantitative clinical parameters was examined. This study included 357 subjects: 81 POAG-HTG, 35 PEXG, 77 with senile cataract and 164 healthy subjects age-sex matched. Furthermore, 35 samples of aqueous humor of POAG-HTG patients , 24 PEXG and 29 with senile cataract were treated. The results showed that serum concentration of TNF-α was significantly higher in patients with glaucoma. Genotypes GG TNF-α (-308) and CC TNF-α (-863) were significantly higher in POAGHTG. No significant association between TNF-α (-308) G/A and TNF-α (-863) C/A polymorphism and investigated clinical parameters was found in POAG-HTG. HSP 70 concentration significantly affects MD, RNFL Avg, Sup and Inf in POAG-HTG patients. There is a significant negative correlation between Fas concentration and RNFL Inf, and negative correlation of FasL with MD and RNFL Avg in POAG-HTG. The study concluded that serum TNF-α is a powerful cytokine with potent significant role in the pathogenesis of glaucoma and glaucoma neuropathy. HSP 70, sFas and sFasL play a role in pathogenesis of POAG and may be indicators of the development and progression of glaucoma neuropathy. It has been shown that TNF-α (- 863) A allelic polymorphism has a protective role in the pathogenesis of POAG

Komparativna analiza genske varijabilnosti i nivoa cirkulišućih faktora nekroze tumora, HSP 70 i Fas/FasL u primarnom glaukomu otvorenog ugla

Genetic heterogeneity of primary open-angle glaucoma, and concentration changes of various inflammation and immune response mediators in the blood, aqueous humor or tissues, indicate the involvement of different genetic mechanisms and immune system activity in the pathogenesis of POAG. The aim of study was to determine the interdependent clinical, genetic and biochemical findings in POAG-HTG patients. Distribution of genetic polymorphisms for TNF-α -308 G/A and - 863 C/A in DNA samples was examined using PCR-RFLP, the concentrations of circulating TNF-α and HSP 70 in a plasma and concentration of sFas and sFasL in the aqueous humor were measured by commercial ELISA tests. Their association with quantitative clinical parameters was examined. This study included 357 subjects: 81 POAG-HTG, 35 PEXG, 77 with senile cataract and 164 healthy subjects age-sex matched. Furthermore, 35 samples of aqueous humor of POAG-HTG patients , 24 PEXG and 29 with senile cataract were treated. The results showed that serum concentration of TNF-α was significantly higher in patients with glaucoma. Genotypes GG TNF-α (-308) and CC TNF-α (-863) were significantly higher in POAGHTG. No significant association between TNF-α (-308) G/A and TNF-α (-863) C/A polymorphism and investigated clinical parameters was found in POAG-HTG. HSP 70 concentration significantly affects MD, RNFL Avg, Sup and Inf in POAG-HTG patients. There is a significant negative correlation between Fas concentration and RNFL Inf, and negative correlation of FasL with MD and RNFL Avg in POAG-HTG. The study concluded that serum TNF-α is a powerful cytokine with potent significant role in the pathogenesis of glaucoma and glaucoma neuropathy. HSP 70, sFas and sFasL play a role in pathogenesis of POAG and may be indicators of the development and progression of glaucoma neuropathy. It has been shown that TNF-α (- 863) A allelic polymorphism has a protective role in the pathogenesis of POAG

Komparativna analiza genske varijabilnosti i nivoa cirkulišućih faktora nekroze tumora, HSP 70 i Fas/FasL u primarnom glaukomu otvorenog ugla

Genetic heterogeneity of primary open-angle glaucoma, and concentration changes of various inflammation and immune response mediators in the blood, aqueous humor or tissues, indicate the involvement of different genetic mechanisms and immune system activity in the pathogenesis of POAG. The aim of study was to determine the interdependent clinical, genetic and biochemical findings in POAG-HTG patients. Distribution of genetic polymorphisms for TNF-α -308 G/A and - 863 C/A in DNA samples was examined using PCR-RFLP, the concentrations of circulating TNF-α and HSP 70 in a plasma and concentration of sFas and sFasL in the aqueous humor were measured by commercial ELISA tests. Their association with quantitative clinical parameters was examined. This study included 357 subjects: 81 POAG-HTG, 35 PEXG, 77 with senile cataract and 164 healthy subjects age-sex matched. Furthermore, 35 samples of aqueous humor of POAG-HTG patients , 24 PEXG and 29 with senile cataract were treated. The results showed that serum concentration of TNF-α was significantly higher in patients with glaucoma. Genotypes GG TNF-α (-308) and CC TNF-α (-863) were significantly higher in POAGHTG. No significant association between TNF-α (-308) G/A and TNF-α (-863) C/A polymorphism and investigated clinical parameters was found in POAG-HTG. HSP 70 concentration significantly affects MD, RNFL Avg, Sup and Inf in POAG-HTG patients. There is a significant negative correlation between Fas concentration and RNFL Inf, and negative correlation of FasL with MD and RNFL Avg in POAG-HTG. The study concluded that serum TNF-α is a powerful cytokine with potent significant role in the pathogenesis of glaucoma and glaucoma neuropathy. HSP 70, sFas and sFasL play a role in pathogenesis of POAG and may be indicators of the development and progression of glaucoma neuropathy. It has been shown that TNF-α (- 863) A allelic polymorphism has a protective role in the pathogenesis of POAG

HUMAN OCULAR DIROFILARIOSIS: CLINICAL AND EPIDEMIOLOGICAL FEATURES

Dirofilarioses are zoonoses caused by filaria of the genus Dirofilaria, the parasites of domestic and wild animals. People are just random carriers of this parasite. In Europe, human dirofilariosis is caused by two species: Dirofilaria repens ( D. repens, also known as a species of The Old World ), usually with the superficial localization of infection, and D. immitis, which is present throughout the world, and causes, beside superficial, visceral dirofilariosis. So far, based on the data from reference literature, it can be observed that in Serbia about 34 cases of human dirofilariosis have been diagnosed and published. It is assumed that the prevalence of this parasitosis is significantly higher as our country is an endemic area for dirofilariosis in dogs and the region where species of mosquitoes, which are transitory hosts and vectors of Dirofilaria spp., are present. The clinical picture of dirofilariosis depends on the type and location of the parasite in the human body. In our country, patients diagnosed with dirofilariosis had subcutaneous or subconjunctival infection in the majority of cases. Ocular dirofilariosis may affect the orbit and the periorbital region, the skin of the eyelids, the conjunctiva, the Tenon membrane, a retrobulbar space or has an intrabulbar localization. These patients may have a severe disability, and surgery alone can be complicated due to localization. The aim of this review is to highlight the importance of this unexpected important zoonoses, with special emphasis on the importance within the ophthalmic practice

RARE METASTASES OF MALIGNANT MELANOMA

Melanomas are malignant neoplasms that originate from melanocytes. The most common are on the skin and mucous membranes. Choroidal melanomas are quite different from cutaneous melanomas with regard to presentation, metastases, and treatment. We report two cases of metastatic gastric malignant melanoma of the eye and skin, with reference to the literature. The first patient was a woman aged 23 years, who underwent gastrectomy 22 months after enucleation of the eye due to malignant choroid melanoma. The second patient was a man, 72 years old, who underwent surgery 28 months before because of malignant melanoma of the skin of the forehead. Paraffin sections, 4 μm thick were stained using a classic method, as well as immunohistochemical DAKO APAAP method, using a specific S - 100 antibody and Melan A antibodies. The stomach is considered a rare place for the development of metastases. Metastases in the stomach are often limited to the submucosal as well as the serousmuscular layer, as noted in one of our patients. Metastatic melanoma of the gastrointestinal tract should be suspected in any patient with a history of malignant melanoma and new gastrointestinal symptoms. Because of the similarity between certain common histopathological types of malignant melanoma, primarily achromatic, and types of primary cancers of the stomach, the following immunohistochemical studies are needed: Melan A and S - 100 protein ( markers of malignant melanoma ), as well as mucins: MUC5AC, MUC2 and CDX2 ( markers of different types of primary gastric carcinoma)

A retrospective review of 139 major and minor salivary gland tumors

Aim To describe demographic and histomorphological characteristics of 139 patients with epithelial salivary gland tumors in the Southeastern Serbia population. Methods A total number of 139 patients with epithelial tumors arising in major and minor salivary glands in the period 2010-2012 was evaluated. After standard tissue proceeding, the routine haematoxylin-eosin (HE) and histochemical alcian blue-periodic acid-Schiff (AB - PAS) methods were used for histomorphological examination. Results Among 139 patients, 102 (73.38%) had benign, and 37 (26.62%) malignant tumors. The majority of tumors were localized in the parotid gland, in 117 (84.17%) patients. Among benign tumors there were 50 (49.02%) pleomorphic adenoma, 48 (47.06%) Warthin’s tumor, two (1.96%) myoepithelioma, and two (1.96%) oncocytoma. In the group of malignant tumors the most common was mucoepidermoid carcinoma, in 12 (32.43%) patients, carcinoma ex pleomorphic adenoma in six (16.22%), adenoid cystic carcinoma in five (13.51%), and oncocytic carcinoma in three (8.11%) patients. Conclusion Benign tumors were more common than malignant ones, with predominance of pleomorphic adenoma. Malignant tumors are less common than benign in the large salivary glands, and more common in the minor salivary glands. Histochemical AB-PAS method helps in the diagnosis of mucinous salivary gland carcinoma

Ocular surface disease incidence in patients with open-angle glaucoma

Introduction. Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sjögren and non-Sjögren) and evaporative (extrinsic and intrinsic) form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride - BAK), which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration. Objective. The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy. Methods. Retrospective analysis of examined patients with open-angle glaucoma was used. Results. Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma). Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed. Conclusion. OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied