Usporedba morfologije glave vidnoga živca u bolesnika s primarnim glaukomom otvorenog kuta i nearteritičkom ishemijskom optičkom neuropatijom

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.Svrha ovoga rada bila je utvrditi oštećenje ganglijskih stanica mrežnice i morfološke promjene glave vidnoga živca u ispitanika s primarnim glaukomom otvorenog kuta (POAG) i nearteritičkom prednjom ishemijskom optičkom neuropatijom (NAION). Prva skupina ispitanika sastojala se od 40 očiju s POAG, druga skupina od 40 očiju s NAION i treća skupina od 40 očiju s refrakcijskom anomalijom (kontrolna skupina).Svim ispitanicima napravljena je automatizirana perimetrija i analiza topografije glave vidnoga živca pomoću konfokalne skenirajuće laserske oftalmoskopije (CSLO)-HRT II. Smanjena mrežnična osjetljivost prevladavala je u bolesnika s POAG, dok su se u bolesnika s NAION defekti očitovali u obliku koncentrično suženog vidnog polja i kvadrantnih ispada. Topografske promjene glave vidnoga živca ispitivane pomoću HRT II ukazale su na to da je u bolesnika s POAG i NAION oštećen jednak broj sektora. Veći broj sektora u gornjem dijelu glave vidnoga živca bio je oštećen u bolesnika s NAION. Morfologija glave vidnoga živca značajno se razlikovala između bolesnika s POAG i NAION, pokazujući veće stanjenje neuroretinalnog ruba i veću dubinu ekskavacije u bolesnika s POAG

NEW INSIGHTS INTO SCHIZOPHRENIA: A LOOK AT THE EYE AND RELATED STRUCTURES

Background: Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances. Methods: To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018. Results: Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a - wave activity in the photoreceptors or b - wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus. Conclusion: Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment

Kvaliteta života povezana sa zdravljem u bolesnika s primarnim glaukomom otvorenog kuta

The purpose of this research was to evaluate the relationship between general health-related quality of life (GHRQL) and sociodemographic factors in primary open-angle glaucoma (POAG) patients. A prospective cross-sectional study included 207 glaucoma patients. GHRQL was determined via two self-administered questionnaires: the 36-Item Short Form Survey (SF-36) and the EuroQol-5D (EQ-5D) questionnaire. Male and 50- to 69-year-old glaucoma patients, followed by patients who regularly used antiglaucoma therapy and those without progression of glaucoma reported a significantly higher quality of life as measured by the EQ-5D index and the EQ-5D visual analog scale (VAS) (p<0.05 all). Similarly, the Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-36 had significantly higher values for these patients (p<0.05 all). Furthermore, glaucoma patients with higher education and economic status, glaucoma patients who lived in rural areas, and those who were married achieved higher scores on EQ-5D and SF-36. In conclusion, progression of the disease, female sex, older age, lower education and economic status, urban area and unmarried status negatively affect quality of life in glaucoma patients.Svrha ovoga istraživanja bila je utvrditi odnos između kvalitete života povezane s općim zdravljem (GHRQL) i sociodemografskih čimbenika u bolesnika s primarnim glaukomom otvorenog kuta (POAG). Riječ je o presječnoj studiji u kojoj je sudjelovalo 207 bolesnika s POAG. GHRQL mjerena je pomoću dva upitnika: kratkog upitnika zdravstvenog statusa s 36 pitanja (SF-36) i upitnika EuroQol-5D (EQ-5D). Muškarci i bolesnici s glaukomom u dobi od 50-69 godina, zatim bolesnici koji su redovito koristili antiglaukomsku terapiju i oni bez progresije glaukoma izvijestili su o znatno višoj kvaliteti života mjerenoj indeksom EQ-5D i vizualnom analognom ljestvicom EQ-5D (VAS) (p<0,05 za sve usporedbe). Slično tome, Sažetak fizičkih komponenata (PCS) i Sažetak mentalnih komponenata (MCS) upitnika SF-36 imali su značajno veće vrijednosti za ove bolesnike (p<0,05 za sve usporedbe). Nadalje, ispitanici s visokim stupnjem obrazovanja i ekonomskim statusom, ispitanici koji žive u ruralnim područjima i oni koji su u braku postigli su veće rezultate na EQ-5D i SF-36. Zaključno, napredovanje bolesti, ženski spol, starija životna dob, niži stupanj obrazovanja i ekonomski status, urbano područje življenja i samoća negativno utječu na kvalitetu života bolesnika s glaukomom

Početno kliničko iskustvo s implantacijom Ahmedove glaukomske valvule kod refraktornog glaukoma dječje dobi

The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of IOP below 23 mm Hg (with or without antiglaucoma medications) and changes in visual acuity. Complications were recorded. After AGV implantation, IOP values ranged from 18 mm Hg to 23 mm Hg (except for one eye with postoperative hypotonia due to suprachoroid hemorrhage, where the postoperative IOP value was 4 mm Hg). The number of antiglaucoma medications was reduced, i.e. four patients had two medications, one patient had one medication, and the others did not need antiglaucoma medication on the last follow-up visit. One eye had suprachoroid hemorrhage, one eye had long-term persistent uveitic membrane, and two eyes had tube-cornea touch. In conclusion, AGV implantation appears to be a viable option for the management of refractory pediatric glaucoma and shows success in IOP control. However, there was a relatively high complication rate limiting the overall success rate.Svrha rada je prikazati sigurnost i učinkovitost implantacije Ahmedove glaukomske valvule (AGV, New World Medical, Inc., Rancho Cucamonga, CA, SAD) kod refraktornog glaukoma dječje dobi tijekom jednogodišnjeg praćenja. Proveden je retrospektivni pregled nalaza 10 očiju u djece mlađe od 11 godina u kojih je ugrađena AGV zbog medikamentima nekontroliranog glaukoma u razdoblju od 2010. do 2014. godine. Pratila se visina intraokularnog tlaka (IOT) i vidna oštrina, a također su bilježene komplikacije. Rezultati su pokazali da su nakon implantacije AGV vrijednosti IOT-a bile od 18 mm Hg do 23 mm Hg (osim kod jednog oka s poslijeoperacijskom hipotonijom zbog suprakoroidnog krvarenja, gdje je poslijeoperacijski IOT bio 4 mm Hg). Broj antiglaukomskih lijekova bio je smanjen: četvoro bolesnika su imali po dva lijeka, jedan je imao jedan lijek, a svi ostali nisu trebali dodatne lijekove na posljednjem pregledu. Kod jednog oka se pojavilo suprakoroidno krvarenje, kod jednog dugotrajna upalna membrana, a kod dva oka kontakt cjevčice s rožnicom. Zaključuje se da implantacija AGV predstavlja izbor u liječenju refraktornog glaukoma dječje dobi i ima uspjeha u kontroli IOT-a. Međutim, relativno velik broj komplikacija ograničava konačan uspjeh

EFEKT NAVODNJAVANJA I GNOJIDBE DUŠIKOM NA PRINOS SJEMENA SOJE S KORELACIJOM U ODNOSU NA KONCENTRACIJU BJELANČEVINA I ULJA

The paper presents the result of a triennial field experiment (2013‒15), aiming to determine the influence of irrigation, nitrogen fertilization, and cultivars, as well as their interactions on the yield and chemical properties of the soybean seeds. Four soybean cultivars (Lucija, Vita, Ika and Tena) of different maturity groups were investigate as a sub‐subplot factor (C). The main plot factor (A - irrigation) resulted in a statistically very significant (P≤0.01) seed yield in all three years, and it was found out by an analysis of variance. The subplot factor (B - nitrogen fertilization) had an impact on the grain yield depending on the research year, while sub‐subplot factor (C-cultivar) significantly affected all examined traits. The factor interactions and their significance varied by the research years. The seed yield achieved in 2013 (3883 kg ha-1) indicated a great importance of all factors’ interaction. The correlations between a seed yield and a protein and oil concentration were determined during the research.U radu su prikazani rezultati trogodišnjih poljskih pokusa (2013. – 2015.), s ciljem utvrđivanja utjecaja navodnjavanja, gnojidbe dušikom i sorte te njihove interakcije na prinos i kemijska svojstva zrna soje. Ispitivane su četiri sorte soje (Lucija, Vita, Ika i Tena) različitih grupa zriobe kao pod‐podčimbenik (C). Analizom varijance utvrđeno je da se glavni čimbenik (A – navodnjavanje) statistički vrlo značajno (P≤0,01) odrazio na prinos zrna u svima trima godinama. Podčimbenik (B – gnojidba dušikom) imao je utjecaja na prinos zrna zavisno o godini istraživanja, dok je pod‐podčimbenik (C – sorta) značajno utjecao na sva ispitivana svojstva. Interakcije čimbenika i njihova značajnost razlikovale su se prema godini istraživanja. Ostvareni prinos zrna u 2013. godini (3883 kg ha-1) ukazuje na veliko značenje međusobnoga djelovanja svih čimbenika. Tijekom istraživanja utvrđene su korelacije između prinosa sjemena i koncentracije bjelančevina i ulja

ECONOMICS AND PRODUCTION OF PEPPER (Capsicum annuum L.) ON THE FAMILY FARM ĐAMBIĆ FROM ĐAKOVO

Za potrebe ovoga rada obavljena su istraživanja tijekom 2009. godine na obiteljskom poljoprivrednom gospodarstvu Đambić u Širokom Polju. Na površini od jednog hektara praćeni su i evidentirani agrotehnički zahvati, tehnologija i organizacija uzgoja začinske paprike. Na temelju prikupljenih podataka, izračunatih normi i izrađene tehnološke karte utvrđen je utrošak od 41,5 sati rada strojeva i 950,74 sati rada ljudi po hektaru. Podatci pokazuju da je proizvodnja radno intenzivna s velikim utroškom ljudskog rada. Ukupni troškovi iznose 41.174,80 kn, a uz prinos od 1 t ha-1 i vrijednost proizvodnje od 70.000,00 kn, ostvarena dobit je 28.825,20 kn. Na temelju koeficijenta ekonomičnosti proizvodnje od 1,70 utvrđeno je da je proizvodnja začinske paprike ekonomična, a na 100 kn uloženih u proizvodnju ostvareno je 70 kn dobiti.For purposes of this research work was carried out during 2009 on the family farm Đambić at Široko Polje. The area of one hectare was monitored and agricultural operations, technology and organization of growing condiment peppers recorded. Based on the data collected, calculation and made technological norms the consumption of 41.5 hours machine work and 950.74 hours of labor people per hectare were established. The data show that the production was labor intensive with large expenditure of human labor. Total costs amounted to 41174.80 HRK, with the yield of 1 t ha-1 and the output value of 70000.00 HRK, the operating profit was 28825.20 HRK. On the basis of production efficiency coefficient of 1.70 it was determined that the production of pepper was profitable, and the 100 HRK invested in the production realized 70 HRK profit

Notes on diagnosing preperimetric glaucoma with the confocal scanning laser ophthalmoscopy

U posljednje se vrijeme pojavilo mnogo novih dijagnostičkih metoda za dijagnosticiranje i liječenje glaukoma, kao što su Heidelberg retina tomograph (HRT2), Optical coherence tomography (OCT) i scanning laser polarimetry (GDx). Ovim prikazom željeli smo istražiti upotrebu HRT2 uređaja u ranoj dijagnostici glaukoma i pokazati da se kod nekih pacijenata kojima je dijagnosticira preperimetrijski glaukom mogu otkriti strukturalne promijene vidnoga polja uz pomoć HRT2. Obradili smo skupinu pacijenata koji nisu imali promjene u vidnom polju ali kod kojih je kvantitativna morfološka analiza vidnoga živca pomoću HRT2 konfokalnoga laserskog skeniranja otkrila rane strukturne promjene na vidnom živcu. Bolesnici koji su uključeni u skupinu preperimetrijskoga glaukoma imali su povišeni intraokularni tlak iznad 21 mmHg mjeren pomoću Goldmannovoga aplanacijskog tonometra. Izgled vidnoga živca klinički nije bio uredan što je uključivalo lokalizirani ili generalizirani gubitak vlakana vidnoga živca uz povećani c/d odnos iznad 0.7. Vidno polje ispitano je uređajem Humphrey Field Analyzer (24-2 full threshold strategy) koje je pokazalo uredan nalaz. Skeniranje je vidnih živaca provedeno pomoću HRT2 uređaja, a analiza dobivene trodimenzionalne slike vidnih živaca izvedena je pomoću Moorfields Regression Analysis (MRA). MRA je pokazala kako su analizirani vidni živci prema parametrima izvan normalnoga raspona. U zaključku želimo istaknuti važnost razmatranja svih parametara koji su važni za dijagnozu i praćenje glaukomske bolesti u kliničkoj praksi. Pojavom novijih dijagnostičkih uređaja kao što je HRT2 dobiva se još jedan parametar koji svakako treba uključiti u dijagnostičku shemu.In the past few years many new diagnostic methods for diagnosing and monitoring glaucoma have appeared, such as Heidelberg Retina Tomograph (HRT), Optical Coherence Tomography (OCT) and Scanning Laser Polarimetry (GDx). With this review we wanted to evaluate the use of Heidelberg Retina Tomograph (HRT2) in early glaucoma detection and we wanted to show that in some patients with diagnosed preperimetric glaucoma we can detect structural changes of the optic nerve head (ONH) with the help of HRT2. We evaluated a group of patients who did not experience any changes in visual field but who had early changes of ONH, which was discovered by a quantity orphological analysis of ONH with the help of confocal laser scanning system. Patients included in the analysis had intraocular pressure (IOP) above 21mmHg as measured with Goldmann applanation tonometer. The appearance of the ONH was clinically abnormal with localized or general damage of optic nerve fibers and cup/disc ratio above 0.7. Visual field assessment was performed by Humphrey Field Analyzer (24-2 full threshold strategy) and showed no visual field defects. Scanning of ONH was performed by HRT2 scanning laser ophthalmoscope. The analysis of appearance of scanned ONH was performed using Moorfields Regression Analysis (MRA). According to MRA of the scanned optic nerve head for the above mentioned patients, ONH was outside normal distribution range. In conclusion, we want to accentuate the importance of considering all of the parameters for diagnosing glaucoma in clinical praxis. With new diagnostic methods such as HRT2 we can get an additional parameter that should be included in the glaucoma diagnostic algorithm

Visual Evoked Potential Can Be Used to Detect a Prediabetic Form of Diabetic Retinopathy in Patients with Diabetes Mellitus Type I

The aim of this study was to evaluate the usefulness of visual evoked potential (VEP) testing in detecting retinal ganglion cell damage in patients with Diabetes Mellitus type I (DMI). VEP arise before diabetic retinopathy signs become ophthalmoscopically detectable. VEP testing was performed in 45 patients divided into three groups; 15 children with recently discovered DMI, 15 children with long-lasting DMI, and 15 healthy children as the control group. A statistically significant difference in VEP P100 wave amplitudes (Z=4.02, p<0.001) and latencies (Z=–4.66, p<0.001) was found between children with established DMI and those with recently discovered DMI. Amplitude values decrease progressively and latency values increase progressively in children with DMI as the years pass. Progressive increases in VEP latency values are a direct sign of retinal ganglion cell damage, which takes place even before the first ophthalmoscopically detectable signs of diabetic retinopathy arise. Therefore, VEP should be considered as a valid method for detecting prediabetic retinopathy, which could contribute greatly to the prevention of diabetic retinopathy complications

COOPERATION ENCOURAGEMENT OF THIRD GRADE ELEMENTARY SCHOOL STUDENTS

U radu su prikazani aspekti razvoja i evaluacije suradničkih odnosa među učenicima, realizirani kao akcijsko istraživanje s učenicima trećeg razreda osnovne škole. Provođenje akcijskog istraživanja uvelike nam pomaže da u skladu s postavljenim ciljevima mijenjamo odgojno-obrazovnu praksu. Osnovni cilj istraživanja usmjeren je na poticanje učenika na kvalitetnu komunikaciju, toleranciju i međusobnu suradnju te učeničko zadovoljstvo sudjelovanjem u radioničkom obliku nastave. Rad na istraživanju odvijao se u dvije faze. U prvoj fazi akcijskog istraživanja osmišljavane su programske aktivnosti i sadržaji, kao i organizacija pedagoških radionica. U drugoj fazi akcijskog istraživanja paralelno su se odvijale realizacije aktivnosti i evaluacija samog procesa koja je obuhvatila ispitivanje mišljenja učenika i kritičkih prijatelja. Rezultati su pokazali kako učenici vole raditi u timu te kako im nije problem pružiti nekome pomoć ili ju tražiti od prijatelja. Nekolicina učenika izjasnila se kako više voli raditi samostalno. Učenici su naučili koliko je suradnja važna u našemu životu te da zajedničkim radom postižemo željene ciljeve i razvijamo socijalne vještine koje nas definiraju ne samo kao učenike nego i kao ljude izvan učionice

Compliance among Soft Contact Lens Wearers

Contact lens compliance is proven to be crucial for preventing lens wear- related complications because of the interdependence of the steps in lens care regime and their infl uence on lens system microbial contamination. Awareness of the patients’ lens handling compliance as well as correct recognition of non-compliant behaviours is the basis for creating more targeted strategies for patient education. The aim of this study was to investigate compliance among soft contact lens (SCL) wearers in different aspects of lens care handling and wearing habits. In our research 50 asymptomatic lens wearers fi lled out a questionnaire containing demographic data, lens type, hygiene and wearing habits, lenses and lens care system replacement schedule and self-evaluation of contact lens handling hygiene. We established criteria of compliance according to available manufacturer’s recommendations, prior literature and our clinical experience. Only 2 (4%) of patients were fully compliant SCL wearers. The most common non-compliant behaviours were insuffi cient lens solution soaking time (62%), followed by failure to daily exchange lens case solution and showering while wearing lenses. 44% of patients reported storing lenses in saline solution. Mean lens storage case replacement was 3.6 months, with up to 78% patients replacing lens case at least once in 3 months. Average grade in self evaluating level of compliance was very good (4±0.78) (from 1-poor level of hygiene to 5-great level of hygiene). Lens wearers who reported excessive daily lens wear and more than 10 years of lens wearing experience were also found to be less compliant with other lens system care procedures. (t= –2.99, df=47, p<0.0045 and t= –2.33, df= 48, p<0.024, respectively). Our study indicates that almost all patients had some degree of non-compliance in lens system maintenance steps. Most common non-compliant behaviours were the ones that are crucial for maintaining lens sterility and preventing infection. Despite the low objective compliance rate, self grading was relatively high. Therefore, these results indicate the need for patient education and encouragement of better lens wearing habits and all of the lens maintenance steps at each patient visit