Retinoblastoma – a literature review and our experience

Retinoblastoma is the most common malignant eye tumor in children that is lethal if left untreated. The contemporary treatment modalities aim not only to save life, but also to preserve the eyes as an organwith form vision and the wich would greatly reflect on the quality of children’s lives. Historically, enucleation was the first successful therapeutic approach to reduce mortality, followed more than 100 years ago by the radiation therapy as the first attempt to save the eyes. Over the last two decades, conservative treatment of retinoblastoma has undergone an impressive development, allowing complete cure with minimal sequelae when timely diagnosed and treated. Today’s treatment protocol includes combination of selective chemotherapy, radiation therapy, laser therapy and, if necessary, systemic chemotherapy. The goal of this article is to review the up-to-date conservative management of retinoblastoma and to emphasize the importance of general practitions and pediatricians for timely diagnosis

Laser therapy in ROP: a literature review and our experience

Introduction: Retinopathy of prematurity (ROP) is a serious, vision threatening disease and among the leading causes of irreversible loss of vision. It affects prematurely born children, predominantly prior to the 32nd GW or with a body weight at birth below 1500 g. The highest risk for the development of ROP includes the time period of two weeks before to two weeks after the supposed due date. Materials and Methods: We included 10 prematurely born children with ROP requiring therapy. All of the children were screened by indirect ophthalmoscopy and the condition was documented by RetCam imaging. The treatment was conducted by the application of 810 nm diode laser. Results: Nine out of the 10 children were born before 32 GW and were with a body weight at birth below 1500 g. The disease was bilateral in 9 of the children. Laser therapy was applied to all 10 children and 18 eyes. Discussion and Conclusion: The active ophthalmological screening of all children born before 32 GW and with a body weight at birth below 1500 g, including all new-born children at risk, and the application of early laser treatment are the basis for the prevention of the development of irreversible visual loss

Coats disease ‒ case report

Coats disease is a rare, in about 90% of cases unilateral idiopathic eye pathology. It is characterized by telangiectatic and aneurysmally altered retinal blood vessels and progressive intra- and subretinal exudation, which can lead to exudative retinal detachment. Most often the symptoms manifest in the advanced stages. Purpose: To report a case with Coats disease. 10 year old boy, admitted to the Eye Clinic of the University Alexandrovska Hospital – Sofia, with leucocoria and strabismus of the right eye. Method: Full ophthalmic and orthoptic examination, OCT. Results: 3B stage of Coats disease of the right eye was established. The chance for improvement after surgery was evaluated as very little, so our patient remained under observation with protective glasses and prevention of complications. Conclusion: It is of great importance to early diagnose the disease, so to have more treatment options

Familial exudative vitreoretinopathy. Case reports

Фамилната ексудативна витреоретинопатия (ФЕВР) е рядко генетично и клинично хетерогенно заболяване, дължащо се на нарушен процес на съдова диференциация, водещо до непълна васкуларизация на ретината. ФЕВР се определя като състояние, наподобяващо ретинопатия на недоносеното, но с изразена фамилна предиспозиция при липсата на анамнеза за преждевременно раждане и/или кислородотерапия. Характерна за ФЕВР е, както асиметрията на патологичния процес в двете очи при един и същи пациент, така и голямата вариабилност на симптомите в членовете на една фамилия. Представяме два клинични случая на този рядък синдром.Familial exudative vitreoretinopathy (FEVR) is a rare genetic and clinically heterogeneous disease, due to a disorder of the vascular differentiation leading to incomplete vascularisation of the peripheral retina. FEVR resembles ROP changes but has clear family predisposition and no history of prematurity or/and oxygen therapy. Patient and interfamily asymmetry of the retinal disorders is specific for FEVR. We report two cases of this rare condition

Vitamin D status in children with myopia

Introduction. A dramatic increase of myopia worldwide has been observed in recent years. New risk factors for the development of myopia have been the target of numerous investigations. The basis of our research is the correlation between serum levels of vitamin D [25(OH)D] and myopia itself.Purpose: To find out the relationship between serum levels of 25(OH) D and myopia. Patients and methods: The study included 222 children with different refraction status. Full ophthalmologic examination, cycloplegic refraction, echobiometry were performed. The serum levels of 25(OH)D were measured by liquid chromatographic mass spectrometry (level of insufficiency < 80 nmol/L).Results: The average patients’ age (51% boys and 48,2% girls) was 11,7 y (SD ± 3,03). They were subdivided into two groups – children with myopia (84,7%) and those without myopia (15,3%). The mean serum 25(OH)D level of all tested was 61,48 nmol/L (16-140 nmol/L; SD ± 20,15); of myopia – 59,67 nmol/L (16-140 nmol/L; SD ± 19,30) and of the non-myopia group – 71,91 nmol/L (33-111 nmol/L; SD ± 21,79). There was a statistically significant difference in serum levels between the two groups (Р = 0,001). The risk of myopia was higher with the decrease of 25(OH)D values (OR = 1,028 ; 95% CI 1,008-1,048). Conclusion. In our investigation group we established low serum levels of 25(OH)D which indicated the need for conducting a population study of its status among Bulgarian children. The correlation between the higher risk of myopia and the vitamin D scarcity has to be further studied, also considering the factor of outdoor/sun-exposure time.

Interactions between endothelial cells and electrospun methacrylic terpolymer fibers for engineered vascular replacements

A compliant terpolymer made of hexylmethacrylate (HMA), methylmethacrylate (MMA), and methacrylic acid (MAA) intended for use in small diameter vascular graft applications has been developed. The mechanical properties and in vitro biostability of this terpolymer have been previously characterized. The goal of this investigation was to examine the interactions between endothelial cells and the new terpolymer and to evaluate endothelial cell function. Electrospinning was used to produce both oriented and random terpolymer fiber scaffolds. Smooth solution cast films and tissue culture polystyrene were used as negative and positive controls, respectively. Human blood outgrowth endothelial cells and human umbilical vein endothelial cells were incubated with the test and control samples and characterized with respect to initial cell attachment, proliferation, viability, and maintenance of the endothelial cell phenotype. It was found that the terpolymer is cytocompatible allowing endothelial cell growth, with random fibers being more effective in promoting enhanced cellular activities than oriented fibers. In addition, endothelial cells cultured on these substrates appeared to maintain their phenotype. The results from this study demonstrate that electrospun HMA:MMA:MAA terpolymer has the potential to be used successfully in fabricating small diameter blood vessel replacements

Recombinant Human Interleukin-11 Treatment Enhances Collateral Vessel Growth After Femoral Artery Ligation

We investigated the role of recombinant human interleukin-11 (rhIL-11) on in vivo mobilization of CD34+/VEGFR2+ mononuclear cells and collateral vessel remodeling in mouse model of hindlimb ischemia