Uloga frequency-doubled Nd-YAG lasera (532 nm) u liječenju dijabetičnog makularnog edema

The aim of the study was to compare various laser wavelengths for photocoagulation treatment in clinically significant (focal) macular edema (CSME) in diabetics. Two different laser wavelengths (frequency-doubled Nd:YAG-532 nm vs. argon green-514 nm) were used to treat 54 eyes (28 eyes were treated with double frequency Nd:YAG laser and 26 eyes were treated with argon-green laser) of 35 patients with diabetes mellitus type 2. The mean follow up was 6 months. Therapeutic effect was evaluated by repeat visual acuity testing, color fundus photography and fundus fluorescein angiography. Reduction/elimination of CSME was observed in 73% (n=19) of frequency-doubled Nd:YAG-treated eyes and 75% (n=21) of argon-treated eyes. These results indicate that frequency-doubled Nd:YAG laser (532 nm) is equivalent to argon-green (514 nm) laser in the treatment of CSME. Frequency-doubled Nd:YAG laser (532 nm) therapy is effective in the treatment of CSME in diabetics and has a number of advantages (less scattering and less absorption by macular xanthophyll, ergonomic, high optical efficiency, long operating life-time, etc.).Cilj studije bio je usporediti različite valne duljine lasera rabljenih za fotokoagulacijsku terapiju kod klinički značajnih (fokalnih) makularnih edema u dijabetičara. Rabili smo dvije različite valne duljine lasera (frequency-doubled Nd:YAG-532 nm i argon green-514 nm) kod 54 očiju (28 očiju liječeno je frequency-doubled Nd-YAG laserom, a 24 oka su liječena argon-green laserom) u 35 bolesnika sa šećernom bolešću tip 2. Srednje vrijeme praćenja bilo je 6 mjeseci. Učinkovitost terapije smo procijenili ponovljenim ispitivanjem vidne oštrine, fotografiranjem u boji fundusa i fluoresceinskom angiografijom. Smanjenje/nestanak klinički značajnih makularnih edema zabilježeno je u 73% (n=19) bolesnika liječenih frequency-doubled Nd-YAG laserom i 75% (n=21) bolesnika liječenih argon-green laserom. Ovi rezultati pokazuju da frequency-doubled Nd:YAG laser (532 nm) ima jednaku učinkovitost kao i argon-green laser (514 nm) u liječenju klinički značajnog makularnog edema. Frequency-doubled Nd:YAG laser je učinkovit u liječenju klinički značajnog makularnog edema u bolesnika sa šećernom bolešću i ima niz prednosti (manje rasipanje i manja apsorpcija u makularnom ksantofilu, veća ergonomija, visoka kakvoća optike, dugotrajnost itd.

Učestalost urđenih diskromatopsija u muškoj populaciji Splitsko-dalmatinske županije

A population of 9974 healthy male subjects (aged 15-45 years) was screened for congenital dyschromatopsia. The study group consisted of subjects applying for a driving licence in the Split-Dalmatian County between 1996 and 1999. The aim was to establish colour vision deficiency (dichromats) and borderline deficiencies (anomalous trichromats) in candidates through complete ophthalmologic examination including the Ishihara pseudoisocromatic plates, anomaloscope Nagel II, and Hue Lanthony colour test. The frequency of congenital dyschromatopsias was 8.48 %. This frequency includes 2.39 % dichromats (1.49 % protanops and 0.90 % deuteranopes) and 6.09 % anomalous trichromats (1.27 % protanomals, 4.20 % deuteranomals, 0.21 % extreme protanomals and 0.41 % extreme deuteranomals). It is important to recognise and classify dyschromatopsias according to type and severity in order to avoid misinterpretation of results and consequent unjustified limitations imposed on anomalous trichromats in the selection of a profession.Ustanovljuje se postotak i učestalost urođenih diskromatopsija u Splitsko-dalmatinskoj županiji koje dosad nisu istraživane u .upanijama Hrvatske, na 9974 ispitanika, zdravih muškaraca, kandidata za vozače, u dobi od 15. do 45. godine starosti, a u vremenskom periodu od 1996.-1999. godine. Cilj je bio utvrditi zastupljenost težih oštećenja kolornog vida (dikromata) te lakših i graničnih poremećaja (anomalnih trikromata). Kolorni vid ispitivan je pseudoizokromatskim tablicama Ishihara u ordinaciji medicine rada, a zatim na Rodenstock ortoreter aparatu, anomaloskopu Nagel II i 40 Hue Lantony testom na Klinici za očne bolesti, KB Split, gdje je izvršen i kompletan oftalmološki pregled. Obrađeni i dobiveni rezultati su prikazani grafički. Dobiveno je 8,48 % diskromatopsija, od čega 2,39 % dikromata (protanopa 1,49 %, deuteranopa 0,90 %) i 6,09 % anomalnih trikromata (protanomala 1,27 %, deuteranomala 4,20 %, ekstremnih protanomala 0,21 % i ekstremnih deuteranomala 0,41 %). Od važnosti je da nakon ispitivanja raspoznavanja boja u ordinaciji medicine rada, nađene diskromatopsije identificiramo po vrsti i jačini što je u domeni subspecijaliste oftalmologa kako ekstremni anomalni trikromati ne bi bili oštećeni u odabiru zanimanja krivom interpretacijom rezultata

Effectiveness of Latanoprost (Xalatan™) Monotherapy in Newly Discovered and Previously Medicamentously Treated Primary Open Angle Glaucoma Patients

We evaluated the effectiveness of latanoprost (Xalatan™) monotherapy in primary open angle glaucoma (POAG). Latanoprost is a prostaglandin analogue, the pure 15® epimer of 13,14-dihydro-17-phenyl-18,19,20-trinor-PGF2α- isopropyl ester. As a prodrug it is being activated by enzymatic hydrolysis in the cornea after which it becomes active acid of latanoprost. Latanoprost is lowering the intraocular pressure (IOP) by increasing the uveoscleral outflow. In this study, latanoprost was used once daily as monotherapy what offers much better compliance for the patients than other combinations of drugs, preserving good IOP control. Based on the significant reduction of the IOP, measured on the day 60 of the trial (mean change in IOP was –5.1 mmHg, with 95% confidence interval in range from –5.6 to –4.5), it is concluded that use of latanoprost is advisable when calculating better IOP control, few side-effects and reductions in costs of potential surgical procedures

Primarni ne-Hodgkinov limfom orbite: prikaz slučaja

An 81-year-old male presented with rapidly progressive loss of right eye vision, pain, mechanical ptosis, extraocular motility problems, and binocular diplopia. Orbital image obtained by computed tomography scanning detected right orbital tumor and cytological examination showed non-Hodgkin\u27s lymphoma (small diffuse cells with low grade malignancy). The patient was treated with 12 cycles of chemotherapy (CHOP protocol) over a 2-year period, with good clinical response.Prikazuje se slučaj 81-godišnjeg bolesnika koji je primljen s brzo progredirajućim gubitkom vida na desnom oku, bolovima, mehaničkom ptozom, problemima u ekstraokularnom motilitetu i dvoslikama na oba oka. Kompjutorizirana tomografija orbite otkrila je tumor desne orbite, dok je citološka pretraga ukazala na ne-Hodgkinov limfom (difuzne male stanice niskog stupnja maligniteta). Bolesnik je primio 12 ciklusa kemoterapije (protokol CHOP) kroz dvije godine, uz dobar klinički odgovor

Effectiveness of Latanoprost (Xalatan™) Monotherapy in Newly Discovered and Previously Medicamentously Treated Primary Open Angle Glaucoma Patients

We evaluated the effectiveness of latanoprost (Xalatan™) monotherapy in primary open angle glaucoma (POAG). Latanoprost is a prostaglandin analogue, the pure 15® epimer of 13,14-dihydro-17-phenyl-18,19,20-trinor-PGF2α- isopropyl ester. As a prodrug it is being activated by enzymatic hydrolysis in the cornea after which it becomes active acid of latanoprost. Latanoprost is lowering the intraocular pressure (IOP) by increasing the uveoscleral outflow. In this study, latanoprost was used once daily as monotherapy what offers much better compliance for the patients than other combinations of drugs, preserving good IOP control. Based on the significant reduction of the IOP, measured on the day 60 of the trial (mean change in IOP was –5.1 mmHg, with 95% confidence interval in range from –5.6 to –4.5), it is concluded that use of latanoprost is advisable when calculating better IOP control, few side-effects and reductions in costs of potential surgical procedures

Defective Colour Vision

Zadatak je autora da na jednome mjestu sistematiziraju sve kolorne poremećaje – diskromatopsije te dijagnostičke metode i testove. Vrlo često smo svjedoci neadekvatnom i neispravnom dijagnosticiranju kolornih poremećaja u kliničkom radu. Smatramo da neadekvatno i nesistematski prikazana problematika kolornog vida u literaturi, neinformiranost o odabiru metoda i testova, načinu rada i interpretaciji dobivenih rezultata samog testiranja za svaki pojedini kolorni poremećaj doprinosi krivoj dijagnozi diskromatopsija. S obzirom na to da se osim u oftalmologiji i neurologiji vrlo često ispituje kolorni vid i u ordinacijama medicine rada, nađene diskromatopsije treba staviti pod nadzor oftalmologa kako pojedinac ili grupa ne bi bili oštećeni u odabiru zanimanja ili sličnoga krivom interpretacijom rezultata testiranja. Shvaćanje ozbiljnosti problema i informiranost unaprijedit će strategiju ispitivanja kolornog vida i dati važnost što ranijoj detekciji s ciljem ublažavanja posljedica za pojedinca i za društvo. Budući svakodnevnost ispitivanja kolornog vida nije najbolje definirana ni po načinu ni po uvjetima rada, potrebno je stvoriti jedinstvene kriterije kod dijagnosticiranja svakoga pojedinog kolornog poremećaja u čemu bi trebao pomoći ovaj članak.This review gives a summary of all colour vision disorders (dyschromatopsias) and diagnostic methods and tests. Colour vision is inadequately treated in current literature with regard to the choice of diagnostic methods and the interpretation of results for a single disorder, which contributes to wrong dyschromatopsia diagnosing seen every day in specialist practice. Examination for colour disorders is usually outpatient and is carried out by ophthalmology or neurology departments or occupational health services under the supervision of an ophthalmologist to prevent misinterpretation of results and wrong occupational choices. The problem is very serious, and proper education should be able to provide guidelines for correct and early diagnosis of dyschromatopsia. As the examination is not well defined, it is very important to set unique criteria in diagnosing any single colour vision disorder

In vitro Radioprotective Activity of the Bryozoan Hyalinella punctata

The objective of the present study was in vitro evaluation of radioprotective activity of the freshwater bryozoan Hyalinella punctata on cultured human peripheral blood lymphocytes after irradiation with 2 gy of Co-60 gamma-rays. Since its water extract at concentration 0.001 mg/mL reduced the incidence of radiation-induced micronuclei for almost 30 %, it could be considered as a promising source of new natural products with the aforementined activity. Both the content of sulphur (1.17%) determined by gravimetric method and infrared absorption frequences (76 % similarity with those of bacitracin) of the investigated extract indicate the presence of organic sulphur compound(s) such as cyclic peptides and polypeptides which might be responsible for the observed radioprotectio

Prognostička vrijednost kliničkih i patohistoloških osobitosti melanoma srednje očne ovojnice: retrospektivna studija

The aim of the study was to determine clinical and histopathologic prognostic factors for tumor related survival of patients with uveal melanoma. Clinical and histopathologic records of 20 patients with histologically verified uveal melanomas were retrospectively analyzed. Patients were operated on at University Department of Ophthalmology, Split University Hospital in Split, January 1, 1991 and December 31, 2000. Histopathologic confirmation was obtained from the Hospital Department of Pathology, Forensic Medicine and Cytology, Split University Hospital. Standard histological staining with hemalaun and immunohistochemical staining with primary antibody against melanoma antigen and S-100 protein were performed. Data on the cause of death were collected from death certificates obtained from Hospital Department of Pathology, Forensic Medicine and Cytology and from Split Population Registry, Split-Dalmatia County government. The overall annual incidence of uveal melanoma in Split-Dalmatian County was 0.44 per 100,000. Out of 20 intraocular melanomas, 4 (20%) were located at the ciliary body, 13 (65%) at the choroid, and 3 (15%) at the ciliary body and at the choroid. There was no statistically significant survival difference between groups with different tumor localization (c²=2.747; df=3; p=0.253). The largest tumor diameter was 35 mm and the smallest 9 mm (median 12 mm), and there was no statistically significant correlation between tumor diameter and survival (Spearman\u27s correlation 0.21). Histological study revealed pure spindle A type melanoma in one (5%) case, pure spindle B type melanoma and pure epithelioid type melanoma in 4 (20%) cases each, and mixed type melanoma in 11 (55%) cases. There was no statistically significant survival difference between groups of patients with different histopathologic types of melanoma (χ²=5.312; df=4; p=0.150). Study results indicated that none of the study parameters (localization, tumor diameter and histopathology finding) could be considered a valid prognostic factor of uveal melanoma survival.Cilj studije bio je ustanoviti kliničke i patohistološke prognostičke čimbenike preživljenja od melanoma srednje očne ovojnice kod bolesnika s tom bolešću. Provedena je retrospektivna analiza kliničkih i patohistoloških podataka 20 bolesnika s histološki dokazanim melanomom srednje očne ovojnice. Bolesnici su operirani u Klinici za očne bolesti KB Split u razdoblju od 1. siječnja 1991. do 31. prosinca 2000. godine. Melanomi su patohistološki verificirani u Zavodu za patologiju, sudsku medicinu i citologiju KB Split. Primijenjeno je standardno HE (hemalaun-eozin) bojenje i imunohistokemijsko bojenje na melanoma antigen i S-100 protein. Uzrok smrti utvrđen je uvidom u mrtvozorničke prijave o uzroku smrti u Zavodu za patologiju, sudsku medicinu i citologiju KB Split i u Matičnom uredu Split, Uredu državne uprave Splitsko-dalmatinske županije. Godišnja incidencija melanoma srednje očne ovojnice u Splitsko-dalmatinskoj županiji bila je 0,44 na 100.000 stanovnika. Od 20 intraokularnih melanoma, 4 (20%) su imala polazište iz zrakastog tijela, 13 (65%) iz žilnice, a 3 (15%) su bila smještena u zrakastom tijelu i žilnici. Nije nađena statistički značajna razlika u preživljenju prema lokalizaciji tumora (χ²=2,747; df=3; p=0,253). Najveći promjer tumora iznosio je 35 mm, najmanji 9 mm (medijan 12 mm). Nije utvrđena statistički značajna korelacija između preživljenja i veličine tumora (Spermanova rang korelacija 0,21). Histološka analiza utvrdila je 1 (5%) melanom vretenastog tipa A, 4 (20%) vretenastog tipa B, 4 (20%) epiteloidnog tipa i 11 (55%) miješanog tipa. Nije dokazana statistički značajna razlika u preživljenju ovisno o patohistološkom tipu tumora (χ²=5,312; df=4; p=0,15). Na temelju dobivenih rezultata može se zaključiti kako niti jedan od ispitivanih parametara (lokalizacija, veličina i patohistološki tip tumora) nije valjan prognostički čimbenik preživljenja kod melanoma srednje očne ovojnice

Prognostička vrijednost kliničkih i patohistoloških osobitosti melanoma srednje očne ovojnice: retrospektivna studija

The aim of the study was to determine clinical and histopathologic prognostic factors for tumor related survival of patients with uveal melanoma. Clinical and histopathologic records of 20 patients with histologically verified uveal melanomas were retrospectively analyzed. Patients were operated on at University Department of Ophthalmology, Split University Hospital in Split, January 1, 1991 and December 31, 2000. Histopathologic confirmation was obtained from the Hospital Department of Pathology, Forensic Medicine and Cytology, Split University Hospital. Standard histological staining with hemalaun and immunohistochemical staining with primary antibody against melanoma antigen and S-100 protein were performed. Data on the cause of death were collected from death certificates obtained from Hospital Department of Pathology, Forensic Medicine and Cytology and from Split Population Registry, Split-Dalmatia County government. The overall annual incidence of uveal melanoma in Split-Dalmatian County was 0.44 per 100,000. Out of 20 intraocular melanomas, 4 (20%) were located at the ciliary body, 13 (65%) at the choroid, and 3 (15%) at the ciliary body and at the choroid. There was no statistically significant survival difference between groups with different tumor localization (c²=2.747; df=3; p=0.253). The largest tumor diameter was 35 mm and the smallest 9 mm (median 12 mm), and there was no statistically significant correlation between tumor diameter and survival (Spearman\u27s correlation 0.21). Histological study revealed pure spindle A type melanoma in one (5%) case, pure spindle B type melanoma and pure epithelioid type melanoma in 4 (20%) cases each, and mixed type melanoma in 11 (55%) cases. There was no statistically significant survival difference between groups of patients with different histopathologic types of melanoma (χ²=5.312; df=4; p=0.150). Study results indicated that none of the study parameters (localization, tumor diameter and histopathology finding) could be considered a valid prognostic factor of uveal melanoma survival.Cilj studije bio je ustanoviti kliničke i patohistološke prognostičke čimbenike preživljenja od melanoma srednje očne ovojnice kod bolesnika s tom bolešću. Provedena je retrospektivna analiza kliničkih i patohistoloških podataka 20 bolesnika s histološki dokazanim melanomom srednje očne ovojnice. Bolesnici su operirani u Klinici za očne bolesti KB Split u razdoblju od 1. siječnja 1991. do 31. prosinca 2000. godine. Melanomi su patohistološki verificirani u Zavodu za patologiju, sudsku medicinu i citologiju KB Split. Primijenjeno je standardno HE (hemalaun-eozin) bojenje i imunohistokemijsko bojenje na melanoma antigen i S-100 protein. Uzrok smrti utvrđen je uvidom u mrtvozorničke prijave o uzroku smrti u Zavodu za patologiju, sudsku medicinu i citologiju KB Split i u Matičnom uredu Split, Uredu državne uprave Splitsko-dalmatinske županije. Godišnja incidencija melanoma srednje očne ovojnice u Splitsko-dalmatinskoj županiji bila je 0,44 na 100.000 stanovnika. Od 20 intraokularnih melanoma, 4 (20%) su imala polazište iz zrakastog tijela, 13 (65%) iz žilnice, a 3 (15%) su bila smještena u zrakastom tijelu i žilnici. Nije nađena statistički značajna razlika u preživljenju prema lokalizaciji tumora (χ²=2,747; df=3; p=0,253). Najveći promjer tumora iznosio je 35 mm, najmanji 9 mm (medijan 12 mm). Nije utvrđena statistički značajna korelacija između preživljenja i veličine tumora (Spermanova rang korelacija 0,21). Histološka analiza utvrdila je 1 (5%) melanom vretenastog tipa A, 4 (20%) vretenastog tipa B, 4 (20%) epiteloidnog tipa i 11 (55%) miješanog tipa. Nije dokazana statistički značajna razlika u preživljenju ovisno o patohistološkom tipu tumora (χ²=5,312; df=4; p=0,15). Na temelju dobivenih rezultata može se zaključiti kako niti jedan od ispitivanih parametara (lokalizacija, veličina i patohistološki tip tumora) nije valjan prognostički čimbenik preživljenja kod melanoma srednje očne ovojnice

Treatment of Allergic Conjunctivitis with Olopatadine

Simptomi alergije koji zahvaćaju oko su česti kako u djece tako i u odraslih u cijelom svijetu. Alergijska reakcija u oku kod sensibiliziranih osoba izaziva svrbež, kemozu spojnice, suzenje, crvenilo oka i otok vjeđa. Ovaj rad donosi preliminarne rezultate studije cilj koje je bio odrediti učinkovitost olopatadina u terapiji alergijskog konjunktivitisa. Studija je obuhvatila 20 osoba (11 žena i 9 muškaraca). Bolesnici su liječeni kapima za oči koje su sadržavale 1 mg/mL olopatadina. Promjene u znacima i simptomima su se bilježile 5 minuta nakon prvog ukapavanja i 15 dana nakon početka terapije. Nelagoda, svrbež, crvenilo oka, suzenje i osjećaj stranog tijela su se ocjenjivali ocjenom od 0 do 3. Statistička analiza prikupljenih podataka je pokazala da su se simptomi i znaci uspješno povukli nakon liječenja olopatadinom, ali je bio znatno učinkovitiji u bolesnika s akutnim nego u onih s kroničnim alergijskim poremećajima. Nije zabilježen niti jedan neželjeni učinak lijeka. Kako se radi o preliminarnim rezultatima, bolji uvid u djelotvornost olopatadina ćemo dobiti nakon provođenja čitave studije na puno većem broju ispitanika.Allergy symptoms that affect the eyes are common in adults and children worldwide. Ocular allergies cause itching, chemosis, tearing, redness, and swelling of the eyelids in sensitized individuals. This is a preliminary report on a study aimed at assessing the olopatadine therapy efficacy in resolving the signs and symptoms of allergic conjunctivitis. Twenty patients (11 female and 9 male) were included in the study. They were treated with olopatadine 1 mg/mL solution. Clinical effects were recorded at 5 minutes of the first application and at 15 days of continuous application. Discomfort, itching, eye redness, tearing and foreign body sensation were graded on a scale from 0 to 3. Statistical analysis showed that all symptoms and signs responded favorably to olopatadine therapy. The results also showed olopatadine to be more efficacious in patients with acute than in those with chronic allergic diseases. No side effects were recorded. As these are only preliminary results, more information will be available upon completion of the large-scale study