Browsing by Author "Stanojlovic, Svetlana (23502220700)"

Introduction. We report a rare case of cataract surgery in a patient with an extreme, widespread anterior staphyloma fol-lowing severe bilateral necrotising anterior scleritis associated with granulomatosis with polyangiitis (GPA). Case report. A 61-year-old man with a history of GPA developed bilateral, rapidly progressive necrotising scleritis and peripheral ulcera-tive keratitis (PUK). Inflammation compromised the entire anterior globe and peripheral cornea in both eyes. More than 90% of the surface area healed within 8 weeks, following the treatment with 3 pulsed doses of methylprednisolone in addi-tion to the cyclophosphamide treatment. Systemic steroid therapy was slowly tapered over a period of 6 months. Ex-traordinary scleral loss with a uveal bulge developed, follow-ing severe necrotising anterior scleritis associated with PUK. Once the full remission had been achieved after 6 months, uncomplicated phacoemulsification was performed in his left eye, the only functional one. Conclusion. Preoperative and postoperative control of inflammation, careful surgical plan-ning, and meticulous surgical techniques are critically im-portant for optimal surgical outcome in such patients. To our knowledge, phacoemulsification in a patient with coexisting uveitic cataract and severe anterior staphyloma has not been previously reported. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Rationale:Eye rubbing (ER) is a proven factor that can trigger the onset and progression of keratoconus (KC). Apart from allergy, ER is a repetitive motor stereotypy. Eye rubbing is frequently observed in children with autism spectrum disorders (ASDs) and in individuals who may be at risk for developing KC. We present a child with ASD who developed progressive KC following standard corneal cross-linking (CXL), most likely because of abnormal ER associated with allergy and repetitive behavior due to ASD symptoms.Patient concerns:A 14-year-old boy was referred to our clinic because of asymmetric visual acuity reduction.Diagnosis:The child was diagnosed as having keratoconus. He had a strong ER habit. The child had been previously diagnosed as having ASD.Interventions:Corneal cross-linking was performed in both the eyes. On account of keratoconus progression, most likely associated with persistent ER habit, he was retreated with CXL in the right eye. Behavioral modification intervention for ER habit reversal was also applied.Outcomes:Corneal cross-linking in combination with behavioral modification intervention for ER habit reversal prevented further KC progression.Lessons:Behavioral interventions are likely to provide positive results in an ER habit reversal in children with ASD. Keratoconus treatment with CXL combined with behavioral management for ER reversal seemed effective in halting keratoconus progression in a young patient with ASD. © 2020 Lippincott Williams and Wilkins. All rights reserved.

Background/Aim. Most cases of herpetic keratitis present a recurrent disease as a result of herpes simplex virus type 1 reactivation from latency in the nearest sensory ganglia. Therefore, understanding the mechanisms of latency and reactivation of the latent virus is an important link in comprehending the onset of the recurrent eye disease itself. Epigenetic regulation of virus reactivation, as a result of the presence of transcriptionally active Latency-Associated Transcript (LAT) region in the latent viral genome, has already been demonstrated in several studies. The activity of the LAT region is directed to the chromatin arrangement. Epigenetic modulation of DNA methylation is associated with folate and vitamin B12 intake or their serum concentrations. To our knowledge, there is no report on the potential role of vitamin B12 and folic acid in herpes simplex virus keratitis reactivation. The aim of this study was to analyze the potential role of folic acid and vitamin B12 in the control of ocular herpes simplex keratitis reactivation. Methods. The study included 50 patients older than 18 years of age with recurrent herpes simplex virus eye disease. Levels of vitamin B12 and folic acid were measured in the acute phase of the disease. All patients were followed up for at least one year and episodes of recurrent herpetic eye diseases were recorded. Results. The recurrence rate of herpetic keratitis was statisticall significantly lower in patients with a higher blood level of vitamin B12. In addition, the recurrence rate of herpetic keratitis was lower in patients with a higher blood level of folic acid. However, statistical significance was lower in comparison with that for vitamin B12. Conclusion. The decreased levels of vitamin B12 and folic acid might have a vital role in herpes simplex keratitis reactivation. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.