Je li tablica ETDRS bolja od Snellenove tablice u procjeni vidne oštrine kod operacije katarakte?

This study was designed to explore practical differences between visual acuity (VA) scores measured on Snellen chart versus ETDRS chart, to grade cataracts using LOCS III system, and to compare VA on both charts depending on cataract grade and type. Prospective evaluation of uncorrected and best-corrected visual acuity was carried out on the eye scheduled for cataract surgery preoperatively and postoperatively on the Snellen and ETDRS charts. The study was carried out at Department of Eye Diseases, Clinical Center of Serbia, during a two-year period. Inclusion criteria were met by 540 patients who underwent testing, surgery, data collection and analysis. The mean VA score was better on ETDRS than on Snellen chart. The mean difference was 6.05 letters or 1.21 lines. VA results correlated with all types of cataract regardless of the chart used, with the highest statistical significance (p<0.0001) for subcapsular cataract. The ETDRS chart was found to be more discriminative and precise than Snellen chart, especially for poor VA.Cilj studije bio je procijeniti razlike vidne oštrine mjerene Snellenovom tablicom nasuprot tablici ETDRS, odrediti stupanj katarakte primjenom sustava LOCS III i usporediti vidnu oštrinu dobivenu pomoću oba optotipa ovisno o tipu i stupnju katarakte. Provedena je prospektivna procjena nekorigirane i najbolje korigirane vidne oštrine primjenom tablica Snellen i ETDRS prije i nakon operacije katarakte. Ova dvogodišnja studija izvedena je na Klinici za očne bolesti Kliničkog centra Srbije. Kriterije za uključivanje u studiju ispunilo je 540 bolesnika koji su podvrgnuti testiranju, operaciji, prikupljanju i analizi podataka. Srednja vrijednost zbroja vidne oštrine procijenjena tablicom ETDRS bila je bolja u usporedbi sa Snellenovom tablicom. Srednja vrijednost bila je 6,05 slova ili 1,21 linija. Rezultati vidne oštrine korelirali su sa svim tipovima katarakte bez obzira na tablicu koja se primijenila, s najvećom statističkom značajnošću (p<0,0001) za subkapsularnu kataraktu. Grafikon ETDRS pokazao se više diskriminativnim i preciznijim nego Snellenov, osobito za slabu vidnu oštrinu

Long-term outcome of strabismus and ptosis surgery in a mother and daughter with congenital fibrosis of extraocular muscles

Background. Congenital fibrosis of extraocular muscles (CFEOM) is a very rare congenital condition, characterized by variable amounts of restriction of the extraocular muscles, with or without ptosis. The aim of this report was to deseribe a severe, atypical, exposure-induced corneal stromal lysis in two patients. Case report. A mother and a daughter with a severe CFEOM were presented. The surgery of both extraocular muscles and ptosis led to a fair outcome in mother even 30 years after, and a very good outcome in daughter 4 years after the treatment. Conclusion. Though frequently challenging and disappointing the outcome of surgery of both extraocular muscles and ptosis in CFEOM can be favorable even in rather severe cases. To the best of our knowledge, the atypical keratolysis we described has not been highlighted in the literature on CFEOM so far

Dijagnostička vrednost tri jednostavna i brza testa za suvo oko – nabori konjunktive paralelni ivici kapka, visina meniskusa suza i test grananja suza

Introduction/Objective The objective of this paper was to assess the diagnostic value of three simple dry eye (DE) tests: lid parallel conjunctival folds (LIPCOF), tear meniscus height (TMH), and tear ferning (TF). Methods LIPCOF, TMH, and TF diagnostic DE tests were performed in 100 patients. Eighty of them were referred to us by rheumatologists and general practitioners either during evaluation for Sjögren’s syndrome, or because of DE symptoms. The control group was composed of 20 patients, with no DE-related symptoms. Ocular Surface Disease Index questionnaire was used for DE symptoms’ evaluation. Results of LIPCOF, TMH, and TF tests were compared with results of the Copenhagen criteria DE tests i.e., tear fluorescein breakup time, Schirmer I and Rose Bengal tests. Ability of the tests to recognize DE in various grades according to Dry Eye Work Shop (DEWS) report score system was assessed. Results Compared to the Copenhagen criteria, sensitivity of LIPCOF and TMH was high (92.8% and 83.5%, respectively), while specificity was low (34.4% and 49.2%, respectively). TF had low sensitivity (59.1%) but high specificity (82.7%). Mean values of both LIPCOF and TMH differed significantly (F = 7.222, p < 0.001 and F = 11.802, p < 0.001, respectively) between the control group and all DEWS grades, but not among different grades of DE. Conclusion TMH and LIPCOF diagnostic tests showed high sensitivity, which makes them excellent screening DE tests. Low sensitivity of TF suggests that it is not truly a good screening test on its own, but its high specificity is of definite value.Uvod/Cilj Cilj ovog rada je da se proceni dijagnostička vrednost tri jednostavna testa za suvo oko: nabori konjunk- tive paralelni ivici kapka (NKPIK), visina meniskusa suza (VMS) i test grananja suze (GS). Metode Dijagnostički testovi NKPIK, VMS i GS su izvedeni kod 100 pacijenata, od kojih nam je 80 upućeno na pregled od strane reumatologa i nadležnih oftalmologa, tokom ispitivanja na Sjogrenov sindrom ili zbog simptoma suvog oka. Kontrolnu grupu je činilo 20 pacijenata bez simptoma suvog oka. Simptomi su evaluirani primenom upitnika o indeksu bolesti površine oka. Rezultati testova NKPIK, VMS i GS su upoređeni sa vrednostima rezultata testova za suvo oko po Kopenhaškim kriterijumima, a to su: vreme prekida suznog filma obojenog fluoresceinom, merenje sekrecije suza bez anestezije tokom pet minuta Šimero- vom trakom (Schirmer I) i bojenje površine oka vitalnom bojom Rose Bengal. Takođe je procenjena sposobnost testova da prepoznaju različite stadijume po sistemu gradiranja bolesti Dry Eye Work Shop (DEWS). Rezultati Poređenjem sa grupom testova po Kopenhaškim kriterijumima, NKPIK i VMS su pokazali visoku senzitiv- nost (92,8% i 83,5%), dok im je specifičnost bila niska (34,4% i 49,2%). GS je imao nisku senzitivnost (59,1%), ali visoku specifičnost (82,7%). Prosečne vrednosti testova NKPIK i VMS se statistički značajno razlikuju između kon- trolne grupe i svih stadijuma bolesti po gradaciji DEWS, ali ne i između različitih stadijuma bolesti suvog oka. Zaključak Testovi VMS i NKPIK su pokazali visoku senzi- tivnost, što ih čini odličnim testovima za skrining bole- sti suvog oka. Niska senzitivnost testa GS ga ne svrstava u dobre skrining testove, ali njegova visoka specifičnost mu daje dijagnostičku vrednost.This paper is a part of a doctoral thesis: Dačić-Krnjaja B. Diagnostic value of group of simple and rapid tests for dry eye diseases (dissertation). Belgrade, University of Belgrade; 2018

Argon-plasma coagulation as a primary therapeutic method for the treatment of flat duodenal adenomas

Background. Argon-plasma coagulation is a method for tissue coagulation that uses high-frequency electric energy and ionized argon gas. It is used in endoscopic haemostasis and in coagulation of smaller, superficial lesion on gastrointestinal mucosa such as flat adenomas, but also in reduction of tumor tissue. Case report. We presented a patient with flat adenoma duodeni. Adenoma had been treated with argon plasma coagulation, in one act, and with a complete restitution of mucosa in further follows up. Conclusion. Argon plasma can be efficiently used in coagulation of superficial lesion of gastrointestinal mucosa, that belongs to the type of flat adenomas, as well as other superficial lesions of mucosa that require endoscopic mucosectomy from smaller, bordered spaces