Browsing by Author "Stanojlović, Svetlana (23502220700)"

Introduction/Objective The aim of this study was to report visual, refractive, and tomographic outcomes of corneal collagen cross-linking (CXL) in pediatric keratoconus. Methods This retrospective study included 17 eyes of 12 patients with progressive keratoconus who underwent epithelium-off CXL at the age ≤ 18 years. Following data were analyzed at baseline and postoperatively at one, three, six, nine, 12 months for all the patients, and annually where available: uncorrected distant visual acuity (UDVA) and best spectacle-corrected distant visual acuity (CDVA), refraction and corneal tomography. Results Mean UDVA improved significantly from 0.52 ± 0.38 at baseline to 0.24 ± 0.29 logarithm of minimum angle resolution (log MAR) at one year (p = 0.011) and remained stable at two-year follow-up (0.21 ± 0.34 log MAR). Mean CDVA was 0.15 ± 0.21 at baseline and 0.06 ± 0.13 log MAR at one year (p = 0.248). Maximum keratometry showed a significant flattening of 1.30 ± 1.99 D (p = 0.011) after a year and remained stable two years after CXL. Minimum keratometry significantly decreased with a mean change of 1.34 ± 1.37 (p = 0.001). Mean reduction of corneal thickness after CXL was 55.35 ± 64.42 µm (P=0.003). After a year, seven (42%) eyes showed Kmax regression, nine (53%) stabilization, and one (5%) progression. Conclusion In our study CXL effectively prevented progression of keratoconus in 95% of pediatric patients after a year, while improving UDVA and keratometry values. One patient with eye rubbing behavior showed signs of keratoconus progression after CXL treatment. © 2020, 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.

Purpose: The aim of this study is to measure retinal vessel density and flow rate area by optical coherence tomography angiography (OCTA) in patients with autoimmune diseases taking hydroxychloroquine (HCQ). Methods: The cross-sectional study included 98 patients divided into three groups. Group I included patients with the diagnosis of an autoimmune disease, for whom the introduction of HCQ was planned. Group II implied low-risk patients for retinal toxicity (≤5 years of HCQ use), whereas Group III implied patients that were at high-risk (>5 years of drug use). All patients underwent a computerized visual field, central macular thickness by optical coherence tomography, and OCTA measurements. Results: The vascular density was found to be statistically significantly decreased in the high-risk group compared to the control group in the superficial parafoveal zone (P = 0.030), whereas it was decreased compared to the low-risk and control groups in the deep layers whole (P = 0.006, P = 0.010, respectively) and perifoveal zones (P = 0.003, P = 0.010, respectively). The foveal avascular zone was significantly enlarged in the high-risk group compared to the control (P < 0.018). Retinal flow rates did not show statistically significant differences between the groups (P > 0.05). Conclusion: Patients treated with HCQ for more than 5 appear have a significant loss of vascular density in the parafoveal and perifoveal regions, and FAZ area is significantly increased compared to low-risk patients and controls. These findings indicate that OCTA may be beneficial for monitoring high-risk patients and may stratify their risk of further retinal damage. © 2023 Indian Journal of Ophthalmology.

Introduction Primary acquired iris stromal cyst is rare in adults. In this group, they are generally stable lesions which require no treatment. Case outline We describe a rare case of a small primary iris cyst in a 39-year-old patient, associated with unusual signs of irritation. Ultrasound biomicroscopy demonstrated iris stromal cyst measuring 3 × 2 mm. A neodymium-doped yttrium aluminium garnet (Nd:YAG) laser cystotomy was engaged as the least invasive treatment approach. However, the cyst recurred soon after repeated laser treatment and sector iridectomy with excision of the cyst was performed. Five years after surgery there was no evidence of recurrence. Conclusion Although more benign clinical course of primary stromal iris cyst is generally assumed in adults as compared to children, complete cyst removal seems to be mandatory for preventing cyst recurrence regardless of the cyst size or patient age. To the authors’ knowledge this is the first documented report of Nd:YAG laser photodisruption of acquired primary iris stromal cyst in an adult. © 2017, Serbia Medical Society. All rights reserved.

Introduction/Objective The aim of this study was to evaluate the outcome of corneal collagen cross-linking (CXL) in patients with progressive keratoconus. Methods This retrospective single-centered interventional study included 52 eyes of 41 patients who underwent epithelium-off CXL procedure at the age > 18 years. Corneal tomography data, uncorrected, and best spectacle-corrected distant visual acuity (UDVA and CDVA, respectively) were analyzed at baseline and postoperatively over the initial 12-month period. In addition, the natural course of corneal tomographic changes was demonstrated at one, three, six, nine, and 12 months after the CXL procedure. Results At one year, mean UDVA improved significantly from 0.15 ± 0.22 (0.3 min – logMAR – 0 max logMAR) at baseline to 0.06 ± 0.09 logarithm of minimum angle resolution (logMAR) (0.1 min logMAR – 0 max logMAR) (p = 0.024). Mean CDVA was 0.45 ± 0.39 0.45 ± 0.39 logMAR (0.8 min logMAR – 0 max logMAR) at baseline and 0.06 ± 0.13 logMAR (1 min logMAR – 0 max logMAR) at one year (p = 0.039). Maximum keratometry showed a significant flattening of 1.36 D ± 1.53 D (p = 0.0032) at one year after CXL. Minimum keratometry significantly decreased with a mean change of 1.15 ± 1.20 (p = 0.011). Mean anterior and posterior best fit sphere (ABFS and PBFS, respectively) remained stable during the entire follow-up period. Mean reduction of corneal thickness after CXL was 47 ± 61 µm (p = 0.003). At one year, 29 (56%) eyes showed K max regression, 22 (53%) showed stabilization, and one (2%) showed progres-sion. Spearman correlation coefficients were calculated to assess the correlation between difference in preoperative corneal thickness (CT), in posterior elevation corneal thickness (PECT), and minimum corneal thickness, ΔCT (PECT – minCT) and radius difference Δr (r1-r2). Spearman rs > 0.3 proved statisti-cal significance and correlation. Conclusion In our study, CXL effectively prevented progression of keratoconus in 98% of eyes at one year, while improving visual acuity. The effect of CXL can be evaluated at the earliest after six months; at that time, the stability of the corneal shape was provided by following the CXL procedure. The main limitation of this study is the small number of patients included. © 2022, Serbia Medical Society. All rights reserved.