Browsing by Author "Radosavljević, Aleksandra (56993158000)"

Introduction/Objective The study aims to analyze the thickness of both the ganglion cell layer and the inner plexiform layer (GCL + IPL) among patients suffering from dry and wet form of age-related macular degeneration (AMD). Methods One hundred ninety-five patients with AMD participated in the study, along with 94 healthy individuals (mean age 75.2 ± 7.8 years; range 55–86). They were divided into three groups: the first group, or group I, included 100 patients suffering from wet AMD; the second group, or group II, included 95 patients afflicted with dry AMD; the final 94 patients made up the control group, group III, of healthy individuals without systemic or ocular diseases. Measurements such as the average macular thickness, the average and minimum GCL + IPL thickness, and the GCL + IPL thickness in all six sectors were obtained by Cirrus spectral-domain optical coherence tomography (SD-OCT, Carl Zeiss Meditec, Inc., Dublin, CA, USA). SPSS version 20.0 was used to analyze the data, while the level of statistical significance was set at p < 0.05. Results In the case of patients with wet AMD, the average value for GCL + IPL thickness was 43.13 μm, for patients with dry AMD the value was 66.73 μm, and the average thickness measured for the control group was 86.23 μm. There was a statistically significant difference between the average GCL + IPL and minimum GCL + IPL thicknesses between the groups (p < 0.001). Lower values were noted for patients with wet AMD (p < 0.001) than those with dry AMD. In the latter, the average GCL + IPL and the minimum GCL + IPL thicknesses were lower than those of the healthy participants, at a level of statistical significance (p < 0.001). Conclusion Participants with AMD exhibited thinner GCL + IPL than the healthy participants, as did the participants with wet AMD when compared to the participants with dry AMD. © 2020, Serbia Medical Society. All rights reserved.

Background/Aim. Rhegmatogenous retinal detachment is a potentially blinding condition of the posterior segment of the eye. Currently, the only treatment modality is surgery and surgical options include scleral buckling, pars plana vitrectomy and pneumoretinopexy. Many factors may influence the outcome of the surgery. Well defined indications are essential for achieving the best postoperative results. The aim of this study was to assess anatomical and functional outcome of treatment with scleral buckling for macula-off rhegmatogenous retinal detachments. Methods. This prospective, nonrandomized, interventional study included consecutive patients underwent scleral buckling for macula-off retinal detachment in the tertiary centre for vitreoretinal surgery. Results. A total of 168 consecutive patients (mean age 58.2 ± 13.9 years) were included in the study. Postoperatively, anatomical success was achieved in 152 (90.5%) of the patients. Parameters that influenced the anatomical success included the number of retinal breaks (p = 0.040), lens status (p = 0.041), preoperative proliferative vitreoretinopathy (p < 0.001), patients’ age (p = 0.049), and marginally, the presence of typical symptoms (p = 0.057). Duration of macular detachment, previous ocular trauma and refraction of the eye did not affect the anatomical result. Functional success was evaluated using the postoperative visual acuity and depended mainly on the duration of macular detachment prior the surgery. Visual acuity 0.4 or better was significantly more often achieved if duration of macular detachment was up to seven days (p < 0.001). Refraction and patients’ age did not influence the functional result. Conclusion. Scleral buckling is an efficient surgical procedure for treatment of patients with retinal detachment. Optimal results are achieved if operation is performed within the first seven days of duration of macular detachment. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Introduction. Scleroderma (systemic sclerosis) is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0. 9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0. 9. After a 6- month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis. © 2016, Vojnosanitetski Pregled. All rights reserved.

Background/Aim. Ocular trauma is a significant cause of visual impairment worldwide. The aim of the study was to analyze clinical characteristics of patients with penetrating eye injuries with retained intraocular foreign body (IOFB) in posterior segment of the eye. Methods. The retrospective study enrolled medical records of consecutive patients hospitalized in a five year period (2012-2016) in a tertiary referral center in Serbia. Surgical repair included pars plana vitrectomy and IOFB removal. Postoperative results were evaluated using the best corrected visual acuity (BCVA). Results. Out of 130 patients who suffered penetrating eye injury with retained IOFB, 72 had IOFB in posterior segment of the eye (43 in retina, 25 in vitreous, 3 in ciliary body, 1 on the optic nerve). Patients were predominantly young adults (aged 44.3 ± 14.9 years, 97.2% men). Average BCVA at admission was poor (0.27 ± 0.38, measured by Snellen chart), and 52.8% of patients had BCVA of counting fingers at 1 meter or less. The majority of patients had corneal wound (70.8%), medium sized IOFB (48.6%), iris injury (61.1%) and traumatic cataract (69.4%). Complications included retinal detachment (16.7%) and endophthalmitis (15.3%). Two patients had the eye enucleated due to severe endophthalmitis, which could not be otherwise controlled. Significant risk factors for postoperative outcome were: initial BCVA (p < 0.001), ocular hypotony (p = 0.013), medium size of IOFB (p = 0.037), presence of traumatic cataract (p = 0.036), retinal detachment (p = 0.032) and endophthalmitis (p = 0.045). Conclusion. Treatment of posterior segment penetrating eye injuries remains a challenge due to high frequency of low initial visual acuity, retinal detachment and endophthalmitis, all of which are risk factors for poor visual outcome. Patients with better initial BCVA, normal intraocular pressure and small IOFB have better postoperative results. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Purpose: To analyze clinical characteristics of ocular sarcoidosis in a group of biopsy-proven sarcoid patients treated at the single referral center for sarcoidosis in Serbia. Methods: A prospective study carried out on 88 biopsy-proven sarcoid patients between January 2012 and December 2014. All patients underwent complete ophthalmological examination. Results: Ocular sarcoidosis was present in 32 patients (36.4% of all) and included: eyelid skin lesions (2.3%); orbital inflammation (2.3%); conjunctival lesions (7.9%); anterior uveitis (2.3%); intermediate uveitis (1.1%); posterior uveitis (15.9%); panuveitis (5.7%), and neuro-ophthalmologic manifestations (9.1%). Complications included cataract (20.4%); glaucoma (5.7%); cystoid macular edema (3.4%); epiretinal membrane formation (4.5%); macular atrophy (2.3%); and choroidal neovascularization (1.1%). Binocular visual impairment was present in one patient (1.1%), due to complications of posterior uveitis (macular scars). Conclusions: Patients in Serbia demonstrated ocular sarcoidosis as the first most common site of extrapulmonary sarcoid manifestations, with more often neuro-ophthalmologic lesions than in other European populations. © Taylor & Francis Group, LLC.

Introduction Retinitis pigmentosa (RP) is a group of inherited retinal dystrophies caused by mutations in various genes. The disease leads to progressive photoreceptors loss (rods predominantly) and retinal pigment epithelium alteration. RP can lead to blindness in the advanced stages of the disease, when the central retina is involved, mostly due to the presence of cystoid macular edema (CME). Several therapeutic approaches for CME in RP patients have been attempted but responses have been variable. Case outline A 51-year-old man was referred due to progressive six-month-long blurring of vision in both eyes. The patient underwent complete ophthalmological examination at baseline. Based on the clinical presentation of mottled mid periphery of the retina and characteristic tubular visual field loss, hence typical fluorescein angiography and optical coherence tomography (OCT) findings, the patient was diagnosed as bilateral retinitis pigmentosa sine pigmento with CME. In an attempt to control the edema, treatment was started with dorzolamide, instilled three times daily in each eye, which resulted in reduction of macular edema in a one-month-period, as documented by OCT. This effect was further monitored for five months and was stable. Conclusion In the presented case, we investigate the six-month therapeutic efficacy of dorzolamide for dealing with the CME secondary to RP. Topical carbonic anhydrase inhibitors are considered as the first option for treatment of CME in RP patients, due to their high efficacy and safety. © 2017, Serbia Medical Society. All rights reserved.

Introduction/Objective Dry eye is a multifactorial disease with incidence up to 50% in the general population. It is characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms. Ocular Surface Disease Index (OSDI) questionnaire is designed to provide a rapid assessment of the symptoms. The aim of this study was to evaluate the diagnostic capacity of OSDI. Methods A prospective, randomized and observational study was conducted at the Clinic for Eye Disease, University Clinical Center of Serbia, between December 2018 and February 2019. The OSDI questionnaire was used to rate the severity of dry eye disease. Schirmer I test, tear break-up time test (TBUT), Rose Bengal test and lid-parallel conjunctival folds (LIPCOF) test were performed as a clinical proof of the symptoms. Results A total of 27 patients, 15 male (55.4%) and 12 female (44.6%), with mean age of 60 ± 15 years were included in the study. The average value of OSDI score was 26.37 ± 23.98 (0–80). Schirmer I test and Rose Bengal test for the right and the left eye, as well as the TBUT test for the left eye were positively correlated with OSDI score (Spearman correlation coefficient). Conclusion OSDI questionnaire is a fast, reliable, and inexpensive test. In our study we have found a correlation between the OSDI score and other clinical tests, except with LIPCOF test. At this moment, the questionnaire that could be the gold standard for dry eye disease diagnosis does not exist, therefore further studies concerning this topic are needed. © 2022, Serbia Medical Society. 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.

The objective of our study was to analyze the presence of persistent submacular fluid after apparently successful scleral buckle surgery for macula-off retinal detachment, using Optical Coherence Tomography (OCT), and to correlate these findings to postoperative visual acuity. Prospective study of consecutive patients hospitalized for macula-off retinal detachment, between February 2008 and April 2010, was carried out at the single referral centre for vitreoretinal surgery in Serbia. Outcomes were evaluated 1, 3, 6 and 12 months postoperatively, using OCT and best corrected visual acuity (BCVA). All 48 patients with macula-off retinal detachment had undergone clinically successful scleral buckle surgery, 3 to 30 days (mean 14.2 ± 6.9) after the onset of symptoms. Reattachment was achieved and one month later, patients were divided in two groups, according to the presence of submacular fluid assessed by OCT: group A with detectable residual submacular fluid (40%) and group B without (60%). The mean BCVA one month postoperatively was significantly lower (p<0.01) in the group A (0.11 ± 0.03) opposed to the group B (0.51 ± 0.11). However, after a 12-month-follow-up, BCVA was similar in both groups (0.52 ± 0.17 and 0.54 ± 0.15 respectively, p=0.541), due to the restitution of normal macular architecture confirmed by OCT. The prolonged recovery of visual acuity in patients with macula-off retinal detachment who had undergone successful scleral buckle surgery could be explained with presence of submacular fluid, diagnosed by OCT. However, final visual outcome was favourable, due to the gradual resorption of submacular fluid in a 12-month-period. © 2012 Association of Basic Medical Sciences of FBIH. All rights reserved.

Introduction: Ocular toxoplasmosis is the most common cause of infectious posterior uveitis worldwide. It can be prenatal or postnatal in origin. Despite estimations that postnatal ocular toxoplasmosis is more prevalent, only several cases of proven postnatal ocular toxoplasmosis have been reported in non-epidemic settings. Here, the clinical evolution of ocular toxoplasmosis of conclusively proven postnatal origin in immunocompetent patients is reported. Methodology: Postnatal ocular toxoplasmosis was diagnosed based on clinical diagnosis supported by the longitudinal detection of Toxoplasma gondii-specific IgG, IgM and IgA antibodies in the serum as well as by direct detection of the parasite (bioassay) and/or its DNA (real-time PCR) in aqueous humor. Results: Three cases involved adults in whom ocular toxoplasmosis developed during primary T. gondii infection, as part of the clinical presentation in two and as the sole manifestation in one patient. The fourth patient was a case of inactive ocular toxoplasmosis in a 14-year-old boy, where postnatal infection was confirmed by exclusion of maternal infection. The causative parasite strain was genotyped in only one case and it belonged to genotype II, the dominant type in Europe. One patient acquired the infection in Africa, suggesting an atypical strain. Conclusions: The distinction between prenatal and postnatal ocular toxoplasmosis is only possible in particular clinical situations, and requires extensive laboratory investigation. Genotyping of the parasite strain involved may be important, particularly if atypical strains are suspected, requiring tailored treatment approaches. Copyright © 2021 Lijeskić et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction: Ocular toxoplasmosis is the most common cause of infectious posterior uveitis worldwide. It can be prenatal or postnatal in origin. Despite estimations that postnatal ocular toxoplasmosis is more prevalent, only several cases of proven postnatal ocular toxoplasmosis have been reported in non-epidemic settings. Here, the clinical evolution of ocular toxoplasmosis of conclusively proven postnatal origin in immunocompetent patients is reported. Methodology: Postnatal ocular toxoplasmosis was diagnosed based on clinical diagnosis supported by the longitudinal detection of Toxoplasma gondii-specific IgG, IgM and IgA antibodies in the serum as well as by direct detection of the parasite (bioassay) and/or its DNA (real-time PCR) in aqueous humor. Results: Three cases involved adults in whom ocular toxoplasmosis developed during primary T. gondii infection, as part of the clinical presentation in two and as the sole manifestation in one patient. The fourth patient was a case of inactive ocular toxoplasmosis in a 14-year-old boy, where postnatal infection was confirmed by exclusion of maternal infection. The causative parasite strain was genotyped in only one case and it belonged to genotype II, the dominant type in Europe. One patient acquired the infection in Africa, suggesting an atypical strain. Conclusions: The distinction between prenatal and postnatal ocular toxoplasmosis is only possible in particular clinical situations, and requires extensive laboratory investigation. Genotyping of the parasite strain involved may be important, particularly if atypical strains are suspected, requiring tailored treatment approaches. Copyright © 2021 Lijeskić et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Having in mind that ophthalmologists are coping with the problems of optimizing uveitis treatment on daily basis, there is a need for more precise elaboration of the treatment. This paper presents recommendations for the treatment of noninfectious uveitis on the basis of professional opinion, years of clinical experience in uveitology, and reference data. The recommendations are based on the SUN and IUSG criteria and are aimed at the development of a treatment algorithm. The treatment of non-infectious uveitis implies the management of acute attack, prevention of relapse and resolution of sequelae. Three treatment steps are identified: (1) the use of corticosteroids; (2) immunosuppressants and (3) biologicals. Each of the steps is associated with pertinent indications, dosage and the mode of administration. The treatment approach is based on etiology and severity of the disease as well as the inflammatory process level of activity. Corticosteroids are most commonly used as the first line of uveitis treatment. However, in more severe, refractory forms and because of associated local and systemic side effects, as well as dose-dependence, corticosteroids have been increasingly replaced with immunosuppressants and/or biological agents. © 2018, Serbian Medical Society. All right reserved.

Introduction. Systemic lupus erythematosus (SLE) is a systemic idiopathic autoimmune inflammatory disease, with multiple organ involvement. Severe vaso-occlusive retinopathy is a rare, sight threatening lupus-related manifestation of the disease, which is more common in patients with coexisting antiphospholipid syndrome. Case report. We reported a 36-year-old female with severe vaso-occlusive retinopathy that manifested in the absence of antiphospholipid syndrome. In a 4-year follow-up, despite aggressive systemic corticosteroid and immunosuppressive therapy and panretinal laserphotocoagulation treatment, the disease progressed to retinal neovascularisation, neovascular vitreoretinopathy, neovascular glaucoma and, consecutively, severe visual loss. As the final option for preservation of visual function, pars plana vitrectomy with laserphotocoagulation was performed and had good results. Progression of ophthalmological findings indicated the progression of the systemic disease, as well as neurolupus. Conclusion. Severe vaso-occlusive retinopathy occurred as the ophthalmological manifestation of SLE in the absence of antiphospholipid syndrome, but correlated with neurolupus and led to visual deterioration despite the treatment. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

There are evidence that oxidative stress and inflammation are involved in the pathogenesis of the age-related macular degeneration (AMD). The aim of this study was to analyze the antioxidant defense parameters and inflammatory markers in patients with exudative form of AMD (eAMD), their mutual correlations and association with the specific forms of AMD. The cross-sectional study, included 75 patients with the eAMD, 31 patients with the early form, and 87 aged-matched control subjects. Significantly lower SOD, TAS and albumin values and higher GR, CRP and IL-6 were found in the eAMD compared to the early form (p<0.05). Significant negative correlations were found between GPx and fibrinogen (r = -0.254), TAS and IL-6 (r = -0.999) and positive correlations between uric acid and CRP (r = 0.292), IL-6 and uric acid (r = 0.398) in the eAMD. A significant association of CRP (OR: 1.16, 95% CI: 1.03-1.32, p = 0.018), fibrinogen (OR: 2.21, 95% CI: 1.14-4.85, p = 0.021), TAS (OR: 7.45, 95% CI: 3.97-14.35, p = 0.0001), albumin (OR: 1.25, 95% CI: 1.11-1.41, p = 0.0001) and uric acid (OR: 1.006, 95% CI: 1.00-1.02, p = 0.003) was found with the eAMD. In conclusion it may be suggested, there is a significant impairment of antioxidant and inflammatory parameter levels in eAMD patients. In addition, significant association exists between the tested inflammatory markers and antioxidant parameters with late-eAMD. © 2017 JCBN.

There are evidence that oxidative stress and inflammation are involved in the pathogenesis of the age-related macular degeneration (AMD). The aim of this study was to analyze the antioxidant defense parameters and inflammatory markers in patients with exudative form of AMD (eAMD), their mutual correlations and association with the specific forms of AMD. The cross-sectional study, included 75 patients with the eAMD, 31 patients with the early form, and 87 aged-matched control subjects. Significantly lower SOD, TAS and albumin values and higher GR, CRP and IL-6 were found in the eAMD compared to the early form (p<0.05). Significant negative correlations were found between GPx and fibrinogen (r = -0.254), TAS and IL-6 (r = -0.999) and positive correlations between uric acid and CRP (r = 0.292), IL-6 and uric acid (r = 0.398) in the eAMD. A significant association of CRP (OR: 1.16, 95% CI: 1.03-1.32, p = 0.018), fibrinogen (OR: 2.21, 95% CI: 1.14-4.85, p = 0.021), TAS (OR: 7.45, 95% CI: 3.97-14.35, p = 0.0001), albumin (OR: 1.25, 95% CI: 1.11-1.41, p = 0.0001) and uric acid (OR: 1.006, 95% CI: 1.00-1.02, p = 0.003) was found with the eAMD. In conclusion it may be suggested, there is a significant impairment of antioxidant and inflammatory parameter levels in eAMD patients. In addition, significant association exists between the tested inflammatory markers and antioxidant parameters with late-eAMD. © 2017 JCBN.

Purpose: Age-related macular degeneration (AMD) is the leading cause of the irreversible central visual loss among the elderly in the developed countries. Iron is considered a potent generator of the oxidative damage whose levels increase with age, potentially exacerbating the age-related diseases. The aim of this study was to assess the serum values of iron, and iron-binding proteins (transferrin, ferritin, and haptoglobin) in patients with AMD along with the parameters of the antioxidant defense: superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase, and total antioxidant status (TAS), in order to analyze the possible impact of iron and iron-binding proteins to the development of oxidative stress in AMD patients, and the association of the selected parameters with the AMD. In addition, the aim was to examine the gender differences and calculate the cutoff points of tested parameters that could be associated with AMD. Material and methods: A cross-sectional study included 55 AMD patients aged 71.7 ± 7.36 years and 65 aged-matched control subjects aged 70.25 ± 6.46 years. Results: Significantly lower ferritin (P = 0.025), SOD (P = 0.026), GPx (P = 0.019), and TAS (P < 0.004) values were found in patients with AMD compared to the controls (P < 0.05). Significant association of GPx < 27 U/gHb (odds ratio [OR]: 1.13; 95% confidence interval [CI] 0.78–2.10; P = 0.049), TAS < 1.25 mmol/L (OR: 5.77; 95% CI 0.98–367.0; P < 0.000), ferritin < 84.8 pg/mL (OR: 2.52; 95% CI 1.37–4.62; P = 0.002), and haptoglobin<1.51 g/L (OR: 1.94; 95% CI 1.05–3.56; P = 0.031) was found with the AMD. According to receiver operating characteristic curve analysis, ferritin concentration <84.8 pg/L, GPx < 27 U/gHb, and TAS < 1.25 mmol/L have sufficient predictive ability for AMD. Conclusion: Significantly reduced capacity of the antioxidant defense system and iron-binding storage proteins (ferritin) found in AMD could have an important role in the development of increase oxidative stress in AMD patients. © 2018 Taylor & Francis Group, LLC.

Purpose: Age-related macular degeneration (AMD) is the leading cause of the irreversible central visual loss among the elderly in the developed countries. Iron is considered a potent generator of the oxidative damage whose levels increase with age, potentially exacerbating the age-related diseases. The aim of this study was to assess the serum values of iron, and iron-binding proteins (transferrin, ferritin, and haptoglobin) in patients with AMD along with the parameters of the antioxidant defense: superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase, and total antioxidant status (TAS), in order to analyze the possible impact of iron and iron-binding proteins to the development of oxidative stress in AMD patients, and the association of the selected parameters with the AMD. In addition, the aim was to examine the gender differences and calculate the cutoff points of tested parameters that could be associated with AMD. Material and methods: A cross-sectional study included 55 AMD patients aged 71.7 ± 7.36 years and 65 aged-matched control subjects aged 70.25 ± 6.46 years. Results: Significantly lower ferritin (P = 0.025), SOD (P = 0.026), GPx (P = 0.019), and TAS (P < 0.004) values were found in patients with AMD compared to the controls (P < 0.05). Significant association of GPx < 27 U/gHb (odds ratio [OR]: 1.13; 95% confidence interval [CI] 0.78–2.10; P = 0.049), TAS < 1.25 mmol/L (OR: 5.77; 95% CI 0.98–367.0; P < 0.000), ferritin < 84.8 pg/mL (OR: 2.52; 95% CI 1.37–4.62; P = 0.002), and haptoglobin<1.51 g/L (OR: 1.94; 95% CI 1.05–3.56; P = 0.031) was found with the AMD. According to receiver operating characteristic curve analysis, ferritin concentration <84.8 pg/L, GPx < 27 U/gHb, and TAS < 1.25 mmol/L have sufficient predictive ability for AMD. Conclusion: Significantly reduced capacity of the antioxidant defense system and iron-binding storage proteins (ferritin) found in AMD could have an important role in the development of increase oxidative stress in AMD patients. © 2018 Taylor & Francis Group, LLC.

Introduction Chemical injuries can occur under various circumstances and may cause serious damage to the anterior segment of the eye. Objective The aim of the study was to analyse the frequency of chemical injuries treated in a tertiary referral centre. Methods The medical records of consecutive patients admitted for the chemical injury of the eye to the Clinic for Eye Diseases in Belgrade between January 1999 and December 2008 were retrospectively analysed in order to obtain data about proportions of injuries, demographical characteristics of patients, circumstances under which injuries happened, the chemicals involved, the severity of injury according to the Roper-Hall classification and the length of hospitalization. Results Out of a total of 60,868 hospitalized patients, 148 (2.43/1,000) were treated for chemical injury of the eye, with the highest incidence observed during summer months. Men were over five times more often affected (84.5%) and most of the injured individuals belonged to the working-age population (mean age 44.4±16.2 years). The most common causative agents were alkalis (73.0%), while acids (18.2%) and other substances (8.8%) were less common. None of 35.1% patients for whom data were obtained used any protection while handling the chemicals. The vast majority of injuries were graded as grade II (31.1%) and III (42.6%) and the most severe ones were caused by alkalis. An average length of hospitalization was 17.7±24.1 days and correlated with the severity of injury. Conclusion Chemical injuries are relatively common problem in the Emergency Ophthalmology. Constant education and usage of adequate protective equipment should be advised in order to prevent serious complications.

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.

Introduction Fever of unknown origin is an important diagnostic challenge. Although rare, periodic fever syndromes may often present with a chronic or recurrent febrile condition with a variable temporal pattern of occurrence. Although clinical characteristics often indicate the syndrome in question, there are many atypical forms, and the genotype–phenotype relationship is highly complex, warranting in many cases the designation of a “syndrome spectrum” rather than a syndrome per se. The aim of this paper was to present a boy with recurrent fever of unknown origin. Case outline We hereby present a boy with recurrent fever of unknown origin who was by clinically guided partial exome sequencing found to have a heterozygous variant 434A>G in the TNFRSF1A gene, otherwise connected with tumor necrosis factor receptor-associated periodic fever syndrome. The patient responded well to short courses of glucocorticoids and is no longer subjected to unnecessary antibiotic treatment he had frequently received in the past. Conclusion Periodic fever syndromes should be kept in mind as a differential diagnostic possibility in children with fever of unknown origin. © 2018, Serbia Medical Society. All rights reserved.