Testing of the Retinal Visual Acuity in High Myops with Cataracts

In the presence of the media opacities and extreme ametropia, especially in high myopia, often arises a question of expected visual acuity, e.g. after cataract extraction because of the possible degenerative changes of the choroid and retina. In the measurements were enrolled 15 patients between 45 and 60 years of age, 9 female and 6 male. We have tested preoperative retinal visual acuity by the interferometer. One month postoperatively visual acuity was measured by Snellen international charts at a distance of 6 m. Both measurements are calculated using log MAR scale. Measurements were paired and the differences are calculated and analyzed for the significance. No significance was found (p>0.05). It was concluded that measured differences were incidental and interferometer measurements are reliable in predicting post cataract visual acuity in high myopia

Testing of the Retinal Visual Acuity in High Myops with Cataracts

In the presence of the media opacities and extreme ametropia, especially in high myopia, often arises a question of expected visual acuity, e.g. after cataract extraction because of the possible degenerative changes of the choroid and retina. In the measurements were enrolled 15 patients between 45 and 60 years of age, 9 female and 6 male. We have tested preoperative retinal visual acuity by the interferometer. One month postoperatively visual acuity was measured by Snellen international charts at a distance of 6 m. Both measurements are calculated using log MAR scale. Measurements were paired and the differences are calculated and analyzed for the significance. No significance was found (p>0.05). It was concluded that measured differences were incidental and interferometer measurements are reliable in predicting post cataract visual acuity in high myopia

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

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

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

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

Bacterial Keratitis - Empirical Treatment or Therapy According to Antibiotic Sensitivity Report

Bakterijski keratitis je i uz širok spektar dostupnih antibiotika jo. uvijek jedan od vodećih uzroka sljepoće u svijetu. Cilj ovoga rada je prikazati broj bolesnika od bakterijskog keratitisa kojima je modificirana početna antibiotska terapija prema nalazu antibiograma. Za razdoblje 2005.-2006. godine analizirane su povijesti bolesti 44 bolesnika s kliničkom dijagnozom keratitisa. Nađena su 32 bolesnika s kliničkom slikom bakterijskog keratitisa, 3 bolesnika s kliničkom slikom gljivičnog keratitisa i 9 bolesnika s kliničkom slikom virusnog keratitisa. Bris rožnice uzet je u 28 bolesnika, ali je samo u 5 zabilježen pozitivan nalaz. Početna antbiotska terapija modificirana je u 3 bolesnika s gljivičnom etiologijom.Despite a wide spectrum of antibiotics available, bacterial keratitis remains one of the leading causes of blindness in the world. The aim of this report is to give an account of patients with initial treatment modification according to antibiotic sensitivity report. Records of 44 keratitis patients treated during the 2005-2006 period were retrospectively analyzed. There were 32, three and nine patients with a clinical picture bacterial, fungal and viral keratitis, respectively. Corneal scrapings were obtained in 28 patients, and positive results were recorded in only five cases. The initial antibiotic therapy was modified in three patients with fungal agents identified

Comparative Study of Antibacterial and Antifungal Effects of Rigid Gas Permeable Contact Lens Disinfecting Solutions

The aim of this study was to compare antimicrobial efficacy of rigid contact lens disinfecting solutions. We tested five commercially available solutions: Unique pH (Alcon Laboratories), Boston Advance (Polymer Technology Corp.), Nitilens Conditioner GP (Avizor), Total Care (AMO), Boston Simplus (Bausch&Lomb). Their efficacy to disinfect saline solution experimentally contaminated with American Type Culture Collection (ATCC): Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Candida albicans (ATCC 90028) and Staphylococcus epidermidis (isolated from our laboratory) was tested. All tested solutions reduced concentrations of bacteria and fungi below 1000 CFU/mL (Colony forming unit; reduction by 3 log and 1 log, respectively) after the 8 hours period. Overall, all contact lens care solutions showed good disinfecting activity against tested bacteria and fungi, with more variation in their antifungal than in antibacterial efficacy. Results of our study might be valuable when selecting appropriate solutions for non-compliant contact lens wearers

Neurotrofična keratopatija: prikaz slučaja

Neurotrophic keratopathy is a degenerative disease characterized by decreased corneal sensitivity and poor corneal healing. This often results as corneal ulceration with a high risk of corneal perforation. A 36-year-old female presented with perforated neurotrophic corneal ulcer and eyelash in the anterior chamber of the right eye and non-perforated corneal ulcer in the left eye, decreased corneal sensitivity, absent corneal reflex and normal lacrimation. History of previous herpetic keratitis episodes was positive. Medical record review showed heredodegenerative encephalopathy with localized brain atrophy and internal hydrocephalus. The patient has mild mental retardation. Eyelash from the anterior chamber of the right eye was surgically removed through limbal incision using a viscoelastic solution. On the first postoperative day the depth of anterior chamber was normal. Treatment was continued with eye patching and application of antibiotic and vitamin ointments. Perforation and ulcers healed ten days after the surgery and visual acuity improved. After the treatment residual corneal scarring remained on both eyes. The pathophysiology of the neurotrophic ulcer in our patient could be explained by corneal denervation caused by previous herpetic keratitis. Denervation results in decreased cell metabolism, levels of acetylcholine and mitosis. Sensory nerves have a favorable effect on corneal epithelialization via neuromediators such as acetylcholine, substance P, and calcitonin gene-related peptide. This can lead to an epithelial defect even in the absence of direct injury. Early diagnosis and prompt treatment of neurotrophic keratopathy are mandatory to prevent corneal complications such as scarring and perforation.Neurotrofična keratopatija je degenerativna bolest rožnice koju obilježava smanjena osjetljivost rožnice i slabo cijeljenje epitela koje vrlo često rezultira nastankom upale, ulkusa ili perforacije. Prikazan je slučaj žene stare 36 godina s perforiranim neurotrofičkim ulkusom rožnice i trepavicom u prednjoj sobici desnog oka i neperforiranim ulkusom rožnice lijevog oka. Obostrano je bila odsutna osjetljivost rožnica, kornealni refleksi su bili ugašeni, a sekrecija suza normalna. U mladosti je preboljela više epizoda obostranog herpetičnog keratitisa. Od ostalih bolesti u djetinjstvu je bila prisutna heredodegenerativna encefalopatija s manjom atrofijom mozga i internim hidrocefalusom. Bolesnica je blaže mentalno retardirana. Operativnim zahvatom odstranjena je trepavica iz prednje očne sobice uz pomoć viskoelastika, te je liječenje nastavljeno zatvaranjem oka i primjenom antibiotskih i vitaminskih masti. Nakon desetak dana dolazi do zacjeljenja i epiteliziranja ulkusa obostrano, uz uredan izgled prednje očne sobice desno i poboljšanja vidne oštrine. Nakon liječenja ostaju makule na rožnicama oba oka. Patofiziološki mehanizam nastanka neurotrofičkog ulkusa kod naše bolesnice možemo objasniti denervacijom rožnice koja je posljedica herpetičkog keratitisa. Denervacija uzrokuje smanjivanje staničnog metabolizma, razine acetilkolina i mitoze. Osjetni živci imaju povoljan učinak na regeneraciju epitela rožnice putem neuromedijatora kao što su acetilkolin, tvar P i peptid srodan genu kalcitonina. Stoga je oštećenje epitela rožnice moguće i bez izravne ozljede. Rana dijagnoza i pravodobno liječenje neurotrofičke keratopatije ključni su u prevenciji komplikacija kao što su zamućenje ili perforacija rožnice

Tear Film Status in Glaucoma Patients

The purpose of this study was to determine the prevalence of ocular surface disease symptoms and the state of the tear film among patients with glaucoma who are receiving topical intraocular pressure lowering monotherapy. 62 responders were divided in 2 groups: 32 glaucoma patients and 30 healthy individuals. Tear film break-up time (TBUT), Schirmer 1 testing and ocular surface disease questionnaire were performed in both groups. 50% glaucoma patients and 25% control group participants had dry eye symptoms. Advanced disorder in TBUT was found in seven 21.9% glaucoma patients and was not found in the control group. Basal tear secretion measured by Schirmer 1 testing was found reduced in 87% of glaucoma patients and in 16.7% control group patients. Glaucoma patients on topical intraocular pressure lowering monotherapy showed a significantly higher prevalence of ocular surface disease symptoms, significantly reduced basal tear secretion and destabilisation of tear film in comparison with healthy volunteers