Browsing by Author "Marić, Vesna (57192098432)"

Introduction This is an observational case report presenting retinitis pigmentosa associated with pseudoexfoliative glaucoma. Case outline A 69-year-old man presented with retinitis pigmentosa. On examination, pseudoexfoliative material was detected on anterior segment structures, and intraocular pressure was 26 mmHg in the right and 24 mmHg in the left eye. The patient was commenced on topical antiglaucomatous therapy (timolol + dorzolamide twice daily, latanoprost once in the evening) to both eyes. Conclusion To the best of our knowledge, this is the first reported case of retinitis pigmentosa associated with pseudoexfoliative glaucoma. Although rare, retinitis pigmentosa and glaucoma can occur in the same eye. © 2017, Serbia Medical Society. All rights reserved.

Introduction/Objective Evaluation of the optic nerve head (ONH) is an inevitable procedure in the diagnosis of glaucoma. One of the most common imaging techniques for a quantitative assessment of the topography of the ONH is the Heidelberg retinal tomography II (HRT II). The aim of this study was to determine quantitative stereometric parameters of the ONH by using HRT II and to investigate any damage of neuroretinal rim in children with suspected glaucoma and compare these data with a group of adults also with suspected glaucoma. Methods This comparative study included 167 children (167 eyes) aged between five and 16 years (mean age of 11 ± 3 years) with suspected juvenile glaucoma and 175 adult participants (175 eyes), aged 55–66 years (mean age of 60 ± 3 years) also with suspected glaucoma. All of them were examined between January 2013 and April 2014. ONH topography and retinal nerve fiber layer thickness measurements were assessed using HRT II. Results Data analysis in this study showed that the average mean values for children/adults were as follows: disc area (mm²) 2.828 ± 0.489/2.663 ± 0.412 (p < 0.001); rim area (mm²) 1.873 ± 0.391/1.667 ± 0.275 (p < 0.001); cup/disc area ratio 0.369 ± 0.125/0.369 ± 0.101 (p = 0.530); mean retinal nerve fiber layer thickness (mm) 0.223 ± 0.078/0.219 ± 0.055 (p = 0.494). Statistically significant difference in damage of neuroretinal rim, between children and adults, was found in the temporal and temporal-inferior segments. Conclusion There were differences in some of the investigated quantitative parameters of the ONH between children and adults, as optic disc size, cup and rim area, and rim volume. By using Moorfields regression analysis, differences in the damage of the neuroretinal rim, when comparing children and adult optic discs, appeared only in the temporal and temporal-inferior segments, which means that optic disc cupping has spread more in the children than in the adults. © 2018, Serbia Medical Society. All rights reserved.

Introduction/Objective Intraocular pressure is an important parameter of eye health, especially when glaucoma is suspected. So far, few studies have been published that aimed to determine the average value of intraocular pressure and central corneal thickness in a healthy population aged 20–30 years. The aim of this study was to determine the distribution of the values of intraocular pressure and central corneal thickness in healthy student population. Methods In a cross-sectional study, intraocular pressure and central corneal thickness were measured on a sample of a healthy population, aged 22–37 years. Intraocular pressure was measured using the Goldmann applanation tonometry method, while central corneal thickness was measured using ultra-sound pachymetry. The analysis of numerical values was done using the methods of descriptive statistics. Results By measuring intraocular pressure and central corneal thickness in 641 subjects (1282 eyes), the average value of intraocular pressure was determined to be 14.79 ± 2.31 mmHg, and central corneal thickness was 553.92 ± 25.56 µm. By comparing two groups of subjects, one male group and the other one female, we determined that there was no statistically significant difference in the average value of intraocular pressure (t-test, p > 0.05), and the average value of central corneal thickness (t-test, p > 0.05) between the sexes. Conclusion The determined average value of intraocular pressure and central corneal thickness is similar to those determined in other cross-sectional studies of this type. No statistically significant difference was found in the intraocular pressure values and the central thickness of the cornea by sex. © 2024, Serbia Medical Society. All rights reserved.

Background/Aim. Trabeculectomy is a safe procedure which effectively reduces the intraocular pressure (IOP). IOP is the most frequent indicator of success after glaucoma surgery. The aim of this work was to evaluate the long-term pressure control in primary open-angle glaucoma (POAG) and in pseudoexfoliative glaucoma (XFG) after primary trabeculectomy without the use of mitomycin-C (MMC), 3 to 5 years after trabeculectomy. Methods. This study involved a retrospective evaluation of 332 consecutive patients (352 eyes), 174 patients (188 eyes) with POAG (mean age of 64.0 ± 8.6 years) and 158 patients (164 eyes) with XFG (mean age of 70.7 ± 8.9 years) who underwent primary trabeculectomy between January 2007 and December 2009 at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade. A successful control of IOP was defined as achieving IOP ≤ 21 mmHg without medication (complete success), or with a single topical medication (qualified success). Results. According to the type of glaucoma POAG/XFG preoperative IOP was 28.4 ± 6.3/30.4 ± 8.4 mmHg, respectively (p = 0.311) and last postoperative IOP was 16.9 ± 5.2/18.7 ± 5.9 mmHg, respectively (p = 0.681). According to the Kaplan-Meier survival curve, the complete success in the group with POAG in 1, 3 and 5 years were 85%, 75% and 58% and in the group with XFG were 82%, 70% and 56%, respectively. There was no statistically significant difference in the complete success rates between the patients with POAG and XFG. Conclusion. The primary goal of surgery was to achieve a sufficiently low IOP without additional medication, thus preventing progression of glaucomatous damage. In our study, the complete success in the group with POAG was achieved in 75% and 58% of the patientsin the period of 3 and 5 years after surgery, respectively and in the group with XFG complete success was achieved in 70% and 56% of the patients respectively. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction. Congenital uveal ectropion (CEU) is a rare, non-progressive condition often accompanied with eyelid ptosis, anterior insertion of the iris, disgenesis of the iridocorneal angle and glaucoma. Case report. We present a case of a seven-year-old girl with a congential unilateral uveal ectropion and a secondary glaucoma which had daily variations from 13 up to 50 mm Hg. The patient had no other abnormalities of the iris or underlying systemic diseases. Introduced local anti-glaucomatous therapy initially normalized intraocular pressure (IOP), but failed to provide long term normalisation. Trabeculectomy normalized the IOP which resulted in the reduction of the cup/disc ratio and restitution of neuroretinal rim. The rim area increased to 1.716 mm2 (0.958 mm2 preoperative) rim volume, was 0.666 mm3 (0.195 mm3 preoperative) while cupdisc (C/D) ratio decreased to 0.330 (0.626 preoperative) as well as linear C/D=0.574 (0.791 preoperative). Neuroretinal rim (NR) was preoperatively preserved in the Ti segment, damaged in T, Ts, N, Ns segments, and borderline in the Ni segment. Postoperatively, neuroretinal rim was preserved in all segments. Conclusion. In the presented case trabeculectomy induced recovery of the nerve tissue of the optic nerve head which was confirmed by Haidelberg Retina Tomograph II (HRT II). The treatment results have been maintained during the follow-up period of nine years without topical or systemic antiglaucomatous therapy. Although CEU is a non-progressive and benign eye disease, associated glaucoma can cause severe optic nerve damage if not detected early and treated properly. As can be seen in the presented case, an adequate treatment can prevent and even reverse optic disc neuropathy. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Optical coherence tomography with angiography (OCT-A) is a non-invasive imaging technique that en-ables three-dimensional visualization of perfusion through the vascular network of the retina and choroid. The possibilities of OCT-A for glaucomatologists will expand in the near future. The possibility of detecting and monitoring glaucoma with this technology will also be expanded. All of these systems will undoubt-edly offer software updates, making it easier for examiners to use the device itself, and thus monitor the disease. OCT-A represents the future in the diagnosis of retinal diseases and glaucoma. © 2023, Serbia Medical Society. All rights reserved.

Background/Aim: Neovascular glaucoma (NVG) is a secondary glaucoma caused by occlusion of the trabecular network of newly formed blood vessels. The aim of this study was to evaluate the efficacy and safety of intravitreal injections of bevacizumab before trabeculectomy with mitomycin C (MMC) for the treatment of NVG. Methods: A prospective and open-label study was conducted from May 2013 to December 2014 on consecutive NVG patients who underwent intravitreal injections of bevacizumab and a primary trabeculectomy with MMC. All patients were followed-up at least for 12 months. Success was defined as an intraocular pressure (IOP) of ≤ 21 mm Hg with or without topical ocular hypotensive medication. Results: Fourteen eyes of 12 diabetic patients fulfilled the respective demands of the inclusion and exclusion criteria. The mean (± standard deviation) follow-up period was 15.0 (± 2.0) months (range, 12 to 19 months). After one year of follow-up, 11 (78.6%) eyes had an IOP ≤ 21 mmHg. The mean IOP was significantly reduced from 42.4 (± 9.7) mmHg preoperatively to 18.4 (± 2.9) mmHg postoperatively (p < 0.0001). Regarding surgical complications, 6 months of trabeculectomy, hyphaema was observed in 3 (21.4%) eyes, macular edema in one (7.1%) eye and recurrence of neovascularization requiring intravitreal bevacizumab injection in 2 (14.2%) eyes. Conclusion: Preoperative intravitreal bevacizumab may be effective as adjunctive treatment for trabeculectomy with mitomycin-C for neovascular glaucoma patients. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

SUMMARY Introduction/Objective Glaucoma diagnosis often induces fear of vision loss and blindness, as well as concerns related to the lifelong use of eye drops and financial expenses, which can lead to certain emotional disorders, depression and anxiety in particular. As these psychological disturbances usually coexist with physical disorders, the aim of the present study was to assess the risk factors for depression in patients with glaucoma. Methods This cross-sectional study involved 132 consecutive glaucoma patients that were seen between September 2018 and December 2019 at the Glaucoma Department of Clinic for Eye Diseases, University Clinical Centre of Serbia, in Belgrade. All participants completed the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale to assess depression and anxiety, respectively. Results The mean age of glaucoma patients was 65.67 ± 8.63 years, whereby the mean age in the group with depression/anxiety was 65.74 ± 7.6 / 64.67 ± 5.51. Prevalence of cardiovascular diseases and previous surgery was statistically significantly greater among glaucoma patients exhibiting depression relative to those that did not report any depressive symptoms (42.6% vs. 15.4%, 66.7% vs. 34.6%, respectively). On the other hand, these two groups were indistinguishable with respect to the evaluated ophthalmological parameters and the number of eye drops used to treat glaucoma. Conclusion Our analyses revealed that low economic status, poor health, prevalence of cardiovascular diseases, history of surgeries, and non-beneficial lifestyle habits such as coffee consumption are the main risk factors for depression. However, none of the investigated clinical ophthalmological characteristics emerged as the risk factors for depression. © 2023, Serbia Medical Society. All rights reserved.

Introduction/Objective Iridocorneal endothelial (ICE) syndrome incudes 3 clinical forms: progressive iris atrophy, Chandler’s syndrome, and Cogan–Reese syndrome. It is characterized by various degrees of iris atrophy, corneal endothelial changes, uveal ectropion, corectopia, peripheral anterior synechiae (PAS) and secondary glaucoma. The aim of the study was to illustrate forms of ICE syndrome, determine frequency of secondary glaucoma with emphasis on cases with uveal ectropion, analyze response to medicament treatment and the need for surgical treatment in intraocular pressure (IOP) control. Methods Patients underwent slit lamp examination, applanation tonometry, gonioscopy, ophthalmoscopy, Humphrey visual field testing and Heidelberg retina tomography. Patients were divided into two groups: group I, without uveal ectropion (22 patients) and group II, with uveal ectropion (14 patients). Results A total of 36 patients were examined in a 10-year period. The average age was 38 years, male to female ratio 1:2. Secondary glaucoma was confirmed in 26 (72.2%) patients, out of which 12 (54.5%) in group I and 14 (100%) in group II. PAS were more frequent in group II. In group I, mean initial IOP was 37 mmHg, and after medicament treatment 26 mmHg. Secondary glaucoma was controlled in 50% and remaining 50% underwent surgical treatment. In group II, mean initial IOP was 49 mmHg, and after medicament treatment 32 mmHg. All 14 patients (100%) underwent surgical treatment in order to achieve IOP control. Conclusion ICE syndrome is a rare, progressive disease, with high incidence of secondary glaucoma, which is more frequent in cases with uveal ectropion. In these cases, medicament treatment is not effective and trabeculectomy with antimetabolite application is necessary. © 2017, Serbia Medical Society. All rights reserved.

Background/Aim. Different surgical interventions have been proposed, including trabeculectomy associated with antiproliferative agents because silicone oil (SO) removal cannot necessarily provide intraocular pressure (IOP) control. The aim of the study was to determine the effi-cacy of trabeculectomy with mitomycin C (MMC) for lowering IOP in patients with open-angle glaucoma (OAG) secondary to emulsified SO after pars plana vitrec-tomy. Methods. A single-center, prospective study was conducted, from December 2014 to December 2019, on 56 consecutive patients with an uncontrolled elevation of IOP after SO removal who were subjected to trabeculec-tomy with mitomycin MMC in that period. The primary end-point was the IOP at the three-year follow-up visit. Complete surgical success was defined as an IOP ranging from 7 mmHg to 18 mmHg without glaucoma medica-tion. Qualified success was defined as IOP ≤ 21 mmHg with one or two topical medications. Results. Fifty-six patients with a mean age of 53.6 [standard deviation (SD)15.5] years had a mean baseline IOP of 42.3 (39.3 to 45.3) mmHg, which reduced to 18.6 (17.9 to 19.3) mmHg three years after surgery (p < 0.0001). Seventeen (30.4%) eyes were classified as a complete success, 21 (37,5%) as a qualified success, and 18 (32.1%) as a fail-ure. In all successfully treated patients, the number of an-tiglaucoma medications was significantly reduced from 2.85 (SD 0.77) to 1.63 (SD 0.62), p < 0.0001. Conclu-sion. Trabeculectomy with MMC may be an option for lowering IOP in patients with OAG secondary to emulsi-fied SO after pars plana vitrectomy, which was not con-trolled with maximum antiglaucomatous medical treat-ment. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction The stump wound complications after above-knee amputation lead to other problems, such as prolonged rehabilitation, delayed prosthetic restoration, the increase in total treatment cost and high mortality rates. Objective To evaluate the safety and outcomes of negative-pressure wound therapy (NPWT) using Vacuum-Assisted Closure (VAC®) therapy in patients with stump complication after above-knee amputation (AKA). Methods From January 2011 to July 2014, AKA was performed in 137 patients at the University Cardiovascular Clinic. Nineteen (12.4%) of these patients (mean age 69.3 ± 9.2 years) were treated with NPWT. The following variables were recorded: wound healing and hospitalization time, rate of NPWT treatment failure, and mortality. Results AKA was performed in 17 (89.5%) patients after the vascular or endovascular procedures had been exhausted, while urgent AKA was performed in two (10.5%) patients due to uncontrolled infection. The time before NPWT application was 3.1 ± 1.9 days and the duration of the NPWT use ranged from 15 to 54 days (mean 27.95 ± 12.1 days). During NPWT treatment, operative debridement was performed in 12 patients. All the patients were kept on culture-directed intravenous antibiotics. The average hospital length of stay was 34.7 days (range 21-77 days). There were four (20.9%) failures during the treatment which required secondary amputation. During the treatment, one (5.3%) patient died due to multi-organ failure after 27 days. Conclusions The use of NPWT therapy in the treatment of AKA stump complication is a safe and effective procedure associated with low risk and positive outcome in terms of wound healing time and further complications. © 2016, Serbia Medical Society. All rights reserved.