Bilateral Amaurosis Caused by Salmonella enteritidis Infection

The aim of this paper was to show the potential of Salmonella enteritidis infection to eventually result in visual impairment. A case of salmonellosis in a 6-year-old boy, caused by intake of a cake made from eggs infected with Salmonella enteritidis, is presented. Prolonged duration of the disease was followed by complete remission of neurologic complications and persistent amaurosis with bilateral optic nerve atrophy. A severe form of Salmonella enterocolitis with neurologic involvement can lead to optic nerve lesion with consequential loss of vision

The Appereance of Pars Planitis in Multiple Sclerosis

The aim of the study was to investigate the clinical association of multiple sclerosis and pars planitis (or intermediate uveitis), as well as to determine the incidence of pars planitis in multiple sclerosis patients. During the period of one year authors examined 42 patients with multiple sclerosis divided into two groups. First group consisted of 23 patients with history of optic neuritis and the second group consisted of 19 patients who have never had optic neuritis. The mean age of patients in the first group was 31.7±5.1 years and in the second group 29.1±8.1 years. Pars planitis was found in 12 patients with multiple sclerosis. Age, sex and degree of neurological disability had no influence on the appearance of pars planitis. Although optic neuritis is considered to be the most common ocular manifestation of multiple sclerosis, the significant number of patients with multiple sclerosis has pars planitis

Imaju li ortoptičke vježbe utjecaj na djecu i adolescente s poremećajem nedostatka pažnje s hiperaktivnošću i istodobno insuficijencijom konvergencije?

The aim was to determine whether improvement of near point of convergence (NPC) and binocular vision after orthoptic exercises had any impact on children and adolescents diagnosed with attention deficit/hyperactivity disorder (ADHD) and convergence insufficiency (CI). In this clinical trial, 50 children and adolescents aged 6 to 18 years diagnosed with ADHD and CI received orthoptic therapy that included home-based exercises (pencil push-ups and stereograms) and office-based therapy on synoptophore. Binocular vision and NPC were measured before, during and after therapy. Study subjects showed significant improvement (p<0.05) in NPC and binocular vision after orthoptic exercises. We found statistically significant correlation between stereovision improvement (Lang I) and near point of convergence, suggesting that improvement of binocular function is possible in children with ADHD and CI. Our results showed that NPC enhancement improved stereovision in patients with ADHD. Since progress of binocular function has positive effect on near work and diminishes visual symptoms in children and adolescents with ADHD and CI, it might be reasonable to suppose that orthoptic therapy helps these children improve concentration as well. Further studies are needed to determine whether it might have positive impact on attention.Cilj je bio ustanoviti imaju li ortoptičke vježbe koje smanjuju simptome insuficijencije konvergencije (IK) i unaprjeđuju stereovid utjecaj i na djecu koja uz dijagnozu IK imaju i poremećaj pažnje s hiperaktivnošću (attention deficit/hyperactivity disorder, ADHD). Ortoptička terapija je provedena na 50 djece s ADHD-om i istodobno dijagnosticiranom IK. Terapija je uključivala vježbe kod kuće i vježbe u ortoptičkom kabinetu na sinoptoforu. Mjerena je bliza točka konvergencije (BTK) i binokularni vid na stereotestovima i sinoptoforu prije, tijekom i poslije terapije. Ispitanici su pokazali značajno poboljšanje (p<0,05) u BTK i testovima binokularnog vida nakon ortoptičkih vježbi. Pronađena je statistički značajna korelacija između poboljšanja BTK i stereovida (Lang I.), što upućuje na zaključak da je poboljšanje binokularnog vida moguće u djece i adolescenata s IK i ADHD-om. Prema rezultatima našeg istraživanja ortoptička terapija dovodi do poboljšanja BTK i istodobnog poboljšanja binokularnog vida u djece s ADHD-om i IK. Kako unaprjeđenje binokularnog vida ima pozitivan učinak na kvalitetu rada na blizinu i istodobno smanjuje nespecifične vidne simptome koje često imaju djeca s ADHD-om i IK, moguće je da ortoptička terapija može utjecati i na poboljšanje koncentracije, što mislimo da je razumno dalje ispitati. Potrebna su daljnja ispitivanja koja bi utvrdila utječu li ortoptičke vježbe i kako na koncentraciju i pažnju

Prostatic Carcinoma Metastatic to the Optic Nerve

Optic nerve can be infiltrated with various tumors and inflammatory processes, with a considerable prevalence of primary over secondary tumors. Metastases of gastric carcinoma to the optic nerve are less frequently, and those of prostatic carcinoma very infrequently observed. A 66 year-old man presented with metastasis to the optic nerve with consequential vision loss to the level of light perception developed two years after prostatic surgery. Systemic therapy with methylprednisolone resulted in a satisfactory vision function recovery. According to literature data, prostatic carcinoma metastases to the optic nerve occur very rarely. In our patient with the optic nerve infiltration found on the first clinical examination, papillary edema was associated with the signs of optic nerve functional impairment (visual acuity, visual field, unilateral RAPD). An infiltrative process involving a distal portion of the optic nerve usually does not cause papillary alterations, and produces a clinical picture of retrobulbar optic neuropathy, such as that observed in our patient on the second clinical examination, showing the signs of optic nerve damage

Je li središnja debljina rožnice čimbenik rizika za pseudoeksfolijativni glaukom?

The aim of the study was to compare central corneal thickness measurements among patients with pseudoexfoliation glaucoma, primary open angle glaucoma, and normal subjects. The study included 60 eyes divided into three groups: group 1 of 24 eyes pseudoexfoliation glaucoma; group 2 of 20 eyes with primary open angle glaucoma; and group 3 of 16 normal eyes. Central corneal thickness was measured using an ultrasound pachymeter, and intraocular pressure was measured by use of applanation tonometer. Statistical methods were employed on between-group comparison of the values obtained by central corneal thickness measurement. The mean central corneal thickness was similar across the three study groups, with no statistically significant difference among normal eyes, open angle glaucoma eyes and pseudoexfoliation glaucoma eyes (mean ± SD: 570±40, 558±41 and 564±25 mm, respectively). Accordingly, central cornea was not thinner in patients with pseudoexfoliation glaucoma than in either normal subjects or patients with open angle glaucoma. However, the possibility of differences that may have emerged in case of a larger sample size should also be taken in consideration. In conclusion, central corneal thickness was not demonstrated to be a risk factor for the development of pseudoexfoliation glaucoma in our patient series.Cilj ispitivanja bio je usporediti središnju debljinu rožnice u bolesnika sa pseudoeksfolijativnim glaukomom, primarnim glaukomom otvorenog kuta i zdravih ispitanika. Studija je obuhvatila podatke o 60 očiju podijeljenih u tri skupine. Prva je skupina uključivala 24 očiju osoba sa pseudoeksfolijativnim glaukomom, druga skupina 20 očiju bolesnika s primarnim glaukomom otvorenog kuta, a treća skupina 16 očiju zdravih osoba. Središnja debljina rožnice mjerila se ultrazvučnim pahimetrom, a očni tlak aplanacijskom tonometrijom. Nije bilo statistički značajne razlike srednje vrijednosti (±SD) središnje debljine rožnice između triju skupina, koja je mjerila 570±40 mm u kontrolnoj skupini zdravih očiju, 558±41 mm u skupini očiju s primarnim glaukomom otvorenog kuta i 564±25 mm u skupini očiju sa pseudoeksfolijativnim glaukomom. Dakle, nije utvrđena manja središnja debljina rožnice u bolesnika s pseudoeksfolijativnim glaukomom u usporedbi s onom kod bolesnika s primarnim glaukomom otvorenog kuta i zdravih ispitanika. Nije dokazano da bi manja središnja debljina rožnice bila čimbenik rizika za nastanak pseudoeksfolijativnog glaukoma, iako se ne može isključiti mogućnost drukčijih rezultata uz veći broj ispitivanih bolesnika

Corticosteroid therapy in patients with non-arteritic anterior ischemic optic neuropathy [Kortikosteroidi u liječenju bolesnika s nearteritičkom prednjom ishemičkom optičkom neuropatijom]

Non-arteritic anterior ischemic optic neuropathy is one of the most common conditions affecting the optic nerve in the elderly. It may lead to severe visual loss. Typical symptoms are painless impairment of visual function accompanied by relative afferent pupillary defect, edema of the optic disc and visual field defects. Aim is to present 38 patients with nonarteritic anterior ischemic optic neuropathy who were treated with corticosteroid therapy. This prospective study involved 38 patients, 20 men and 18 women aged 60-75 years who were treated with corticosteroid therapy. The study included patients with visual acuity in the affected eye from 0.1 to 0.8 according to Snellen. Every patient underwent clinical examination, the Octopus 900 perimetry in G program, laboratory testing, while the compressive optic neuropathy was rule out with MSCT of the brain and orbits. The most common forms of visual field defect are altitudinal defect and diffuse depression. Corticosteroid therapy led to recovery in 65% of patient, in 30% of patients did not change, while the deterioration occurred in 5% of patients

Automated Static Perimetry: The Influence of Myopic Anisometropia on Evaluation of Visual Field

The aim of study was to establish which level of myopic refractive error influences visual field defects in automated static perimetry, if these defects are typical, and if optimal correction normalized the visual field. The study included 100 patients (200 eyes) divided into three groups according to the severity of the myopic refractive error: group A (till –3.25 Dsph), group B (–3.50 Dsph to –5.25 Dsph) and group C (–5.50 Dsph to –8.00 Dsph). The control group included 20 emmetropes (40 eyes). This study confirms that optimal corrected and uncorrected myopia up to –3.25 Dsph does not produce quantitative visual field defects, when tested by static automated perimetry. Even in optimally corrected myopics, with myopia higher than –5.50 Dsph, visual field defects on gray scale can be found. Defects are in the intermediary zone with more prominent defects in the upper quadrants. Visual field indices (MD, MS, LV, RF) were completely normalized

Corticosteroid Therapy in Patients with Non-arteritic Anterior Ischemic Optic Neuropathy

Non-arteritic anterior ischemic optic neuropathy is one of the most common conditions affecting the optic nerve in the elderly. It may lead to severe visual loss. Typical symptoms are painless impairment of visual function accompanied by relative afferent pupillary defect, edema of the optic disc and visual fi eld defects. Aim is to present 38 patients with nonarteritic anterior ischemic optic neuropathy who were treated with corticosteroid therapy. This prospective study involved 38 patients, 20 men and 18 women aged 60–75 years who were treated with corticosteroid therapy. The study included patients with visual acuity in the affected eye from 0.1 to 0.8 according to Snellen. Every patient underwent clinical examination, the Octopus 900 perimetry in G program, laboratory testing, while the compressive optic neuropathy was rule out with MSCT of the brain and orbits. The most common forms of visual fi eld defect are altitudinal defect and diffuse depression. Corticosteroid therapy led to recovery in 65% of patient , in 30% of patients did not change, while the deterioration occurred in 5% of patients