The aim of this prospective study was to detect primary open angle glaucoma (POAG) in its early stage in patients at a higher risk of its development, and to identify the risk group with the highest ...prevalence of POAG. The study was conducted at Department of Ophthalmology, Osijek University Hospital Centre, and included 250 patients divided into five groups, as follows: group 1, patients with diabetes type 1 and type 2; group 2, patients with arterial hypertension (blood pressure >140/90 mm Hg); group 3, patients with positive family history of POAG; group 4, patients with myopia between -3.0 and -8.0 diopters; and group 5, control group including patients aged 40 with no risk factors for POAG development. Study results showed that distribution of glaucoma patients was not equal across the groups. The prevalence of POAG in all patients was 5.6%, whereas in patients with positive family history of POAG it was 14%, which was statistically significantly higher than in patients with diabetes and myopia (4% both), as well as in control group. The difference was greatest in comparison to control group. There was no statistically significant difference in glaucoma incidence between the group of patients with positive family history (14%) and patients with systemic hypertension (6%). The results obtained suggest that of all risk factors analyzed, positive family history of POAG is the most important risk factor for glaucoma development in all risk groups.
The aim of the study was to evaluate diagnostic tests for keratoconjunctivitis sicca (Schirmer test, tear break-up time (TBUT) test, and corneal staining with fluorescein and lissamine green dye) in ...patients with blepharospasm. This prospective study included 60 female patients older than 40 with blepharospasm, divided into two groups according to clinical symptoms. For fluorescein test, the surface under the ROC curve was 1.0 with standard error (SE) 0 and 95% confidence interval (95% CI) 0.940-1.0; for Schirmer test, the surface under the ROC curve was 0.817 with SE 0.0555 and 95% CI 0.696-0.905; for lissamine green test, the surface under the ROC curve was 0.813 with SE 0.056 and 95% CI 0.691-0.902; and for TBUT test, the surface under the ROC curve was 0.772 with SE 0.061 and 95% CI 0.645-0.870. According to the results of ROC curve, which determines the sensitivity and specificity of normal values, comparison of diagnostic tests for keratoconjunctivitis sicca used in this study showed that fluorescein test had the best sensitivity and specificity. Schirmer test should be avoided in patients with blepharospasm because its results are influenced by frequent blinking and are not appropriate for study interpretation. Despite the pathologic values of TBUT test (numerically), this test is still acceptable for patients with blepharospasm because its interval takes more time than the interval between two blinks.
The aim of this study was to determine the specificity and sensitivity of the Pelli-Robson and Ishihara diagnostic methods in differing Parkinson’s disease from essential tremor compared to DaTSCAN ...(dopamine transporter scan) findings. The intention was to investigate whether visual dysfunction appears in the early state of Parkinson’s disease. Therefore, we included patients with the symptomatology of parkinsonism lasting between 6 and 12 months. The study included 164 patients of which 59 (36.0 %) suffered from Parkinson’s disease, 51 (31.1 %) from essential tremor, and 54 (32.9 %) healthy patients which presented the control group. The specificity of Pelli-Robson test in confirming Parkinson’s disease was 53 % and the sensitivity 81.4 %. The specificity of Ishihara test in confirming Parkinson’s disease was 88.2 %, and sensitivity 55.9 %. We found that the colour and contrast dysfunction are present as the earliest symptoms of Parkinson’s disease. In this study the Pelli-Robson test is highly sensitive and the Ishihara tables are highly specific in the differential diagnosis between Parkinson’s disease and essential tremor, but neither of these methods fulfils the criteria for the validity of a test. We suggest performing both of these methods to evaluate which patients are indicated for DaTSCAN.
The aim of this prospective study was to determine the possible influence of the silicone oil tamponade after vitrectomy on the early intraocular pressure (IOP) elevation, which is a major risk ...factor for developing secondary glaucoma in patients with vitreal and retinal proliferative changes. The research included 110 patients which were allocated in three groups according to the medical history data. The surgical procedures were performed at the Eye Clinic, University of Zagreb School of Medicine. The control group comprised 40 patients who underwent vitrectomy with air or saline solution tamponade. The second group consisted of 40 patients with retinal detachment and proliferative retinopathy who had vitrectomy with silicone oil tamponade and the third group were 30 patients with diabetic retinopathy who underwent vitrectomy and tamponade with silicone oil. The intraocular pressure was measured and gonioscopy was performed in all patients one month before and after vitrectomy. The results showed that there is no statistically significant difference among IOP values before and after vitrectomy in the control group (p = 0.104) as well as in the preoperative IOP values among all three groups of patients. The data analysis determined that in both groups of patients with silicone oil tamponade after vitrectomy, there is a statistically significant difference in IOP values one month after the surgical procedure (p = 0.000). The mean IOP values in those patients a month after vitrectomy were significantly higher compared to the control group (p < 0.05). Comparison of the IOP one month after vitrectomy between the patients with retinal detachment and those with diabetic retinopathy showed no statistically significant difference (p = 0.331) but the qualitative analysis showed that the IOP one month after vitrectomy was 2 mmHg higher in the diabetic retinopathy group. The results suggest that there is no difference in angle width before and after vitrectomy among different groups of patients. Emulsified silicone oil was confirmed in 18% of patients in the retinal detachment group. In 17% of patients in the diabetic retinopathy group the emulsified oil was found in the angle, whereas a 10% of patients had neovascularization of the angle one month after vitrectomy. The IOP elevation in the early postoperative course may be caused by intravitreal instillation of the silicone oil after vitrectomy. Emulsification of the silicone oil may lead to the early IOP rise; especially in the diabetic patients with angle neovascularization which itself can additionally accelerate the development of the secondary glaucoma.
The aim of the study was to compare the length of treatment and efficiency of applied therapy in two groups of patients with chalazion who underwent surgical procedure or got triamcinolone ...application in chalazion. Our study included 30 patients with chalazions that persisted for about one month. All of them were resistant to applied topical antimicrobial therapy. These patients were devided in two groups. 15 patients underwent surgical procedure that included incision, excochleation and excision of the capsule of chalazion, while other 15 patients underwent triamcinolone aplication directly in chalazion (dosage of 2-4 mg). Patients were followed up a day after therapy, two weeks after therapy and one month after applied therapy. We found that chalazion treatment with triamcinolone application directly in the lesion was to be more comfortable for patients, took less time to treat and needed no additional topical antimicrobial therapy.
The aim of this prospective study was to analyse the quality of life in patients with blepharospasm grade III and IV and to explore whether Botulinum neurotoxin type A treatment improves their ...quality of life. We used a WHOQOL-BREF questionnaire, based on the existing WHO recommendation and its meaningful metric characteristics. The study included 37 patients with either grade/type III or IV blepharospasm who were treated with Botulinum neurotoxin Type A. Each patient completed the WHOQOL-BREF questionnaire by themselves just before the Botulinum Neurotoxin Type A (BT-A) therapy application, when the clinical symptoms of blepharospasm were most manifest and a month and a half after, when the regression of symptoms appeared. Consequently, the application of BT-A resulted in improved changes in terms of quality of life in 3 of the 4 measured fields (psychical and physical health as well as the environmental living conditions).
Objectives: Lutein is a carotenoid and one of the primary pigments with antioxidative effects found in the macula lutea of an eye. The present study aimed to determine the effects of lutein ...consumption in the form of functional food (hen eggs enriched with n-3 PUFAs, selenium, vitamin D and lutein) on macula lutea morphology by using an optical coherence tomography (OCT) in young healthy subjects.
Participants and Methods: Randomized, double-blind, placebo-controlled pilot study included eleven healthy young subjects of both sexes (average age 18 to 28 years), assigned to a Nutri4 group and a control group. The Nutri4 group consumed nutritionally enriched hen eggs, while the control group consumed regular ones during the three-week protocol. At the beginning and end of the protocol, the subjects underwent ophthalmological examinations of the posterior eye segment by OCT. Venous blood was sampled to determine biochemical blood parameters (serum concentration of nutrients, liver enzymes, serum lipid profile, inflammatory markers).
Results: Consumption of Nutri4 eggs led to a significant increase in n-3 PUFAs, lutein and vitamin E concentrations in serum. The average macular thickness (lower outer layer of the macula) was increased in the Nutri4 group, while no significant change was found in the retinal thickness of the control group after the dietary protocol. Urea was raised, and gamma-glutamyl aminotransferase significantly decreased in the Nutri4 group, while aspartate aminotransferase was increased in the control group after the corresponding dietary protocol.
Conclusions: The consumption of enriched hen eggs has a beneficial effect on the thickness and volume of the retina.
Aim: To define the clinical profile of patients with unilateral optic neuritis (ON) presented to our clinic and to identify baseline clinical features and demographic data associated with one-month ...visual acuity (VA) outcome. Methods: Patients with suspected ON referred to our clinic were consecutively assessed for inclusion between February 2017 and November 2019. VA was measured using Snellen charts. Clinical and demographic, baseline and after one-month follow-up data were analyzed in a multivariate model. Results: Overall, 71 patients were included, of which six were considered lost to follow-up. The median age was 50 years old (interquartile range 37-57 years old) and the female to male ratio was 3:1. 14.1 % had a severe attack and 83.1 % recovered completely one month after the diagnosis. Multivariate analysis of data from 65 patients showed that baseline VA of the affected eye (P=0.011) and fellow eye (P=0.015) were factors associated with VA of the affected eye at follow up. Conclusion: Our cohort was older, had a higher female to male ratio and on average, a less severe ON clinical presentation compared to reports from other countries. Baseline VA of both the affected and fellow eye are predictors of one-month VA recovery
After radical prostatectomy (RP), up to 60% of patients with high-risk prostate cancer (PC), such as high Gleason score, extracapsular prostatic extension (ECE), positive margins, seminal vesicle ...involvement (SVI), will develop biochemical relapse and they will require further local treatment. Radiotherapy (RT) to the prostate bed has been used as adjuvant (ART) or salvage (SRT). In patients with high-risk PC, radiotherapy immediately after RP or adjuvant radiotherapy may eradicate residual localized microscopic disease and improve biochemical, progression-free survival, and overall survival. Only a few observational studies have compared RP patients who have received only RT with patients who have received RT with some form of hormonal therapy. A few of them have reported improved progression-free survival with addition of hormonal therapy to SRT, but benefit in overall survival (OS) is not yet known. Key words: Radical Prostatectomy, Adjuvant Radiotherapy, Salvage Radiotherapy Nakon radikalne prostatektomije (RP) vie od 60% pacijenata s visokorizicnim patolokim pokazateljima, kao to su visok Gleason score, ekstrakapsularno irenje, pozitivni rubovi, zahvaceni sjemeni mjehurici, razviti ce biokemijski relaps, te ce zahtijevati daljnji lokalni tretman. Radioterapija na leite prostate moe biti adjuvantna i (salvage) odgodena. Kod karcinoma prostate visokog rizika, radioterapija odmah nakon RP ili adjuvantna radioterapija, moe unititi lokalnu rezidualnu mikroskopsku bolest i povezana je s poboljanim biokemijskim preivljenjem do progresije bolesti i ukupnim preivljenjem. Malo je istraivanja koja su usporedivala operirane pacijente koji su proveli zracenje leita prostate s pacijentima koji su uz RT primili i neku vrstu hormonske terapije. Neka od njih su pokazala poboljano preivljenje do progresije bolesti dodatkom hormonske terapije uz SRT, ali ucinak na ukupno preivljenje je upitan. Kljucne rijeci: radikalna prostatektomija, adjuvantna radioterapija, odgodena radioterapija
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