Ivan Marjanovic - Academia.edu (original) (raw)
Papers by Ivan Marjanovic
IntroductionAn altered perfusion of the optic nerve head has been proposed as a pathogenic factor... more IntroductionAn altered perfusion of the optic nerve head has been proposed as a pathogenic factor
in glaucoma.
ObjectiveTo evaluate changes of haemodynamic parameters in the retrobulbar arterial circulation after
a decrease of elevated intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG).
MethodsTwenty-six patients were examined, 14 men and 12 women, 21 up to 50 years old and 5 below,
all with previously diagnosed and treated POAG, and all examined at the Eye Clinic, Clinical Centre of
Serbia. IOP was measured both with a Goldmann aplanation tonometer and dynamic contour tonometer. Central corneal thickness was measured with ultrasound pachymeter. Imaging of the retrobulbar
arterial circulation by colour Doppler was performed at the Neurology Clinic, Clinical Centre of Serbia.
It involved measuring of haemodynamic parameters of the ophthalmic artery, central retinal artery, and
posterior ciliary arteries. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured,
and resistive index (RI) and pulsatility index (PI) were calculated.
ResultsHaemodynamic arterial parameters PSV and EDV in the ophthalmic and central retinal artery
after decrease of IOP were lower, while RI and PI were higher. In the posterior ciliary arteries PSV, EDV
and PI were lower, and RI was higher.
ConclusionChanges of the retrobulbar arterial circulation after elevated IOP in POAG patients are important for approach and treatment, while the role of vascular factors in the supplement of the optic disc
neuroretinal rim could be a key for progression backlash of glaucoma and the radix of neuroprotection.
Vojnosanitetski pregled, 2014
Background/Aim. Heidelberg retina tomography II (HRT II) haves been employed to quantitatively as... more Background/Aim. Heidelberg retina tomography II (HRT II) haves been employed to quantitatively assess the topography of optic discs in eyes with high-pressure glaucoma (HPG) and normal-pressure glaucoma (NPG), in order to determine which of global and segmental optic disc parameters will prove to be most suitable for monitoring the progression of these two conditions. Methods. The results of 73 eyes of 73 patients with HPG and NPG were analyzed in relation to age, refractive error, quality of HRT images and stereometric parameters. Results. A statistically significant difference (p < 0.05) between the global baseline and follow-up results was found in: rim volume, maximum cup depth and cup shape measure (in the HPG group), and C/D ratio, cup volume, rim volume and cup shape measure (in the NPG group). The baseline and follow-up results of the retinal nerve fiber layer in the temporal and inferotemporal sectors show a significant difference in both groups. Conclusion. Several HRT stereometric parameters are useful for monitoring the progression of changes of the optic disc and local retina in eyes with HPG and NPG. Both segmental and global scanning is of importance in glaucoma progression analysis.
Vojnosanitetski pregled, 2013
Primary open-angle glaucoma is a multifactorial and progressive neuropathy, characterised by the ... more Primary open-angle glaucoma is a multifactorial and progressive neuropathy, characterised by the acquired loss of ganglion cells of the retina and their axons. One of the risk factors for primary open-angle glaucoma is myopia over 5 diopters (D). The aim of our work was to investigate two groups of patients with primary open-angle glaucoma and myopia by using confocal scanning laser ophthalmoscopy, and to find out if the size of refractive error influences optic disk morfometric characteristics. Methods. One hundred eyes of one hundred patients with primary open-angle glaucoma and myopia were involved in our study. All the patients were classified into two groups, the first one with myopia < 5 D, and the second one with myopia 5 D. The Heidelberg retina tomograph is a technique we used in our study. We analized morfometric parameters of patients optic discs, with the aim to find a correlation between the parameters in each group separeatly, and also to find differences between the same parameters from both groups. Results. There were significant differences in disc area, cup area, rim area and mean RNFL thickness between the two groups. The size of damage of neuroretinal rim in the group with high myopia was 27%, and in the group with lower myopia 14%. The most frequently damaged segment of neuroretinal rim in the patients with high myopia was nasal segment and in the patients with low myopia infero-temporal one. The least frequently damaged segment of neuroretinal rim in both groups was temporal one. Conclusion. Optic discs of glaucomatous patients with high myopia have bigger diameter, also bigger and more irregularly distributed damaged zone of neuroretinal rim, and also thinner retinal nerve fiber layer compared to glaucomatous patients with lower myopia.
Vojnosanitetski pregled, 2013
Uloga konfokalne skening laser oftalmoskopije u stereometrijskoj diferencijaciji o ne papile kod ... more Uloga konfokalne skening laser oftalmoskopije u stereometrijskoj diferencijaciji o ne papile kod okularne hipertenzije, normotenzivnog glaukoma i primarnog glaukoma otvorenog ugla Abstract Background/Aim. Primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) demonstrate the same structural changes in the optic disc along with visual field defects but only POAG includes an abnormal elevation of intraocular pressure. Heidelberg retina tomograph based on confocal scanning laser ophthalmoscopy (HRT) and Moorfields regression analysis (MRA) have been employed to quantitatively assess the topography of eye papilla. We measured stereographic parameters of eye papilla in patients with POAG, NTG, and ocular hypertension (OH) using an HRT in order to determine whether HRT topographic parameters can be used to differentiate those conditions. Methods. The results of 145 eyes of 145 patients with OH, NTG and POAG were analyzed by age, refractive error, quality of HRT images, stereometric and MRA parameters. Results. Significant differences were found between NTG and other two groups for a majority of the HRT parameters, and also no differences between OH and POAG patients for a majority of the investigated parameters, except thickness of retinal nerve fiber layer. By reading the MRA no differences were found in the distribution of mostly damaged and mostly preserved neuroretinal rim sectors between NTG and POAG patients, and also all sectors of the neuroretinal rim in OH patients were preserved. Conclusion. HRT stereometric parameters are useful to differentiate patients with OH and NTG, and also for differentiation between NTG and POAG patients, but most of parameters showed no difference between OH and POAG patients. MRA may serve to confirm the diagnosis of OH, but not for precise distinction between NTG and POAG. Apstrakt Uvod/Cilj. Primarni glaukom otvorenog ugla (POAG) i normotenzivni glaukom (NTG) pokazuju jednake strukturalne promene u opti kom disku zajedno sa defektom vidnog polja, ali samo POAG podrazumeva abnormalno povišen intraokularni pritisak. Heidelbergova retinalna tomografija (HRT) bazirana na konfokalnoj skening laser oftalmoskopiji i Moorfields regresiona analiza (MRA) koriš eni su u našoj studiji za kvantitavnu procenu topografije o ne papile. Primenom HRT mereni su stereometrijski paramet-ri opti kih diskova bolesnika sa okularnom hipertenzijom (OH), NTG i POAG. Cilj rada bio je da se odredi primenjivost HRT parametara u OH, NTG i POAG. Metode. Rezultati nalaza 145 o iju od 145 bolesnika sa OH, NTG i POAG analizirani su po starosti, refrakcionoj grešci, kvalitetu HRT fotografija i stereometrijskim parametrima. Rezultati. Utvr ena je statisti ki zna ajna razlika izme u bolesnika sa NTG i druge dve grupe bolesnika za ve inu parametara, kao i odsustvo razlike izme u OH i POAG grupe za ve inu parametara, izuzev za debljinu retinalnog sloja nervnih vlakana. Nalazi MRA pokazali su da nije bilo Volumen 63, Broj 3 VOJNOSANITETSKI PREGLED Strana 305 Gvozdenovi R, et al. Vojnosanit Pregl 2013; 70(3): 304-308. razlike u distribuciji ošte enih i o uvanih sektora neuroretinalnog oboda izme u bolesnika sa NTG i POAG, kao i da su svih šest sektora neuroretinalnog oboda kod bolesnika sa OH bili o uvani. Zaklju ak. Stereometrijski parametri HRT korisni su u diferencijaciji bolesnika sa OH i NTG, kao i bolesnika sa NTG i POAG, ali ve ina parametara ne pokazuje razliku izme u OH i POAG. Tako e, MRA može poslužiti za potvrdu dijagnoze OH, ali ne i za preciznu diferencijaciju NTG i POAG. Klju ne re i: glaukom; glaukom, otvorenog ugla; hipertenzija, okularna; dijagnoza, diferencijalna; dijagnosti ke tehnike, oftalmološke.
Vojnosanitetski pregled, 2009
A term &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;ocular hypertension&amp;amp;amp;... more A term &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;ocular hypertension&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is used when IOP is found to be &amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II) results that show very early, subtle changes in retinal neurofibre layers (RNFL) in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio), but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. During a 5-year study period (2002-2007), 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT), central corneal thickness (CCT) determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nenr optic (PNO) examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D) ratio, which was followed during the control examination by each segment, as well as PNO in global. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413) comparing to the last one. In diagnosing ocular hypertension and its conversion to glaucoma, HRT II is used for quantitative evaluation of retinal topography and for quantitative monitoring of topographical changes, especially regarding the increase of C/D ratio and loss of rim volume tissue, which enables to see and register subtle structural changes in optic nerve head and RNFL that are so characteristic for glaucoma, which cannot be seen by an ophthalmoscope. With these results, according to risk factors for glaucoma, one can confirm the diagnosis of ocular hypertension and its conversion to primary open-angle glaucoma. In this study HRT II revealed conversion of ocular hypertension into glaucoma in 10% of the patients.
Srpski arhiv za celokupno lekarstvo
Ocular blood flow (OBF) disturbances could be involved both in the pathogenesis and in progressio... more Ocular blood flow (OBF) disturbances could be involved both in the pathogenesis and in progression of glaucomatous damage. The aim of the study was to compare the retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior cilliary arteries (SPCA) after decreasing the elevated intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients by using color Doppler imaging (CDI). We examined 60 patients (21 male and 39 female) with diagnosed and treated POAG. Thirty-nine patients had increased IOP (> 25 mm Hg). Peak-systolic velocity (PSV), end-diastolic velocity (EDV), Pourcelot resistance index (RI), and pulsatility index (PI) were assessed in the OA, CRA, and SPCA. IOP was measured both with the Goldmann Applanation tonometer (GAT) and with the Dynamic Contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) was measured using DCT. The retrobulbar parameters between the baseline and after IOP ...
Graefe's Archive for Clinical and Experimental Ophthalmology, 2008
To investigate the correlation between ocular pulse amplitude and visual field defects in patient... more To investigate the correlation between ocular pulse amplitude and visual field defects in patients with glaucoma, ocular hypertension, and glaucoma suspicion when measured with the Pascal Dynamic Contour Tonometer, and to verify if the ocular pulse amplitude is an independent predictor for visual field parameters. Seventy-seven eyes (42 patients) with glaucoma, ocular hypertension or glaucoma suspicion were examined. Ocular pulse amplitude was measured with the dynamic contour tonometer by one investigator masked to the visual field data. Visual fields were performed within three months of ocular pulse amplitude measurement by the Octopus or Humphrey Field Analyser, and were analysed with Peridata Software. Mean defect, pattern standard deviation ( radical Loss Variance) and regression analysis of those parameters (Trend Indices) were correlated with the ocular pulse amplitude for each eye. Forty-nine eyes had glaucoma, 14 had ocular hypertension, and 14 were glaucoma suspects. The mean follow-up was 46.5 (range 6-96) months. There was a significant correlation between OPA and MD and OPA and PSD, even after correction for IOP (and diagnostic group and eye): the estimated slope equals 2.68 (S.E. = 0.82, p = 0.003) and -0.86 (S.E. = 0.33, p = 0.014), respectively. There was even a weak correlation between OPA and the evolution of MD (dB/year). The slope estimate for OPA equals 0.070 (S.E. = 0.033), p = 0.037. However, after correction for IOP (and diagnostic group and eye), the strength of the relationship is reduced and the evidence disappears: the slope estimate for OPA now equals 0.039 (S.E. = 0.041), p = 0.34. There is no evidence for an association between OPA and the evolution of Trend-PSD. A small ocular pulse amplitude, as measured with a dynamic contour tonometer, is correlated with moderate to severe glaucomatous visual field loss and might be a risk factor for the development of glaucomatous visual field defects.
Srpski arhiv za celokupno lekarstvo
Ultrasound has an important role in the diagnostics of the posterior segment of the eye, when cli... more Ultrasound has an important role in the diagnostics of the posterior segment of the eye, when clinical examination is not possible. One of problems is congenital cataract. Using ultrasound biometry it is possible to measure the axial length of the eye in all ages and axial growth from the very beginning to its termination. To ratify growth of the infant's eye with and without congenital cataract, and to determine the accuracy of ultrasound measuring with and without general anaesthesia. In our study we analyzed 30 patients (48 eyes) who had congenital cataract in one or both eyes (observed group) and 20 patients (40 eyes) in whom no eye disease was diagnosed (control group). The observed group of 30 patients (48 eyes) with congenital cataract was divided according to age into three subgroups: 1) 4-12 months, 11 patients, 18 eyes; II) 13-24 months, 7 patients, 11 eyes; III) 25-36 months, 12 patients, 19 eyes. In control group we analyzed 20 patients (40 eyes) without congenital c...
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2014
Vojnosanitetski pregled. Military-medical and pharmaceutical review, 2014
Rupture of an abdominal aortic aneurysm (AAA) is a potentially lethal state. Only half of patient... more Rupture of an abdominal aortic aneurysm (AAA) is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR). We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient's comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80%) it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. ...
Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology / edited by the Gaetano Conte Academy for the study of striated muscle diseases, 2013
Myotonic dystrophy type 1 (DM1) is the most common form of muscular dystrophy in adults. It affec... more Myotonic dystrophy type 1 (DM1) is the most common form of muscular dystrophy in adults. It affects many organs and systems besides muscle. Aim of this study was to assess frequency of erectile dysfunction (ED) and hypogonadism, the correlation between them and the impact of ED on quality of life (QoL) in patients with DM1. A series of 25 men (aged from 22 to 58 years) with a diagnosis of DM1 was analyzed. Muscular Impairment Rating Scale (MIRS) was used to assess severity of muscular involvement. Erectile function was assessed using the short form of the International Index of Erectile Function test (IIEF-5). Levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were assessed. All patients completed the Serbian version of the SF-36 questionnaire as a measure of health-related QoL. ED was present in 18 (72%) of patients. Seven (28%) patients were euogonadic, 16 (64%) had compensated hypogonadism and 2 (8%) had primary hypogonadism. ED was somewhat m...
Srpski arhiv za celokupno lekarstvo, 2008
Keratometry is a measurement curvature of the central 2-3 mm of the anterior cornea and main meri... more Keratometry is a measurement curvature of the central 2-3 mm of the anterior cornea and main meridians (horizontal and vertical) and secondary calculation of the full optic power of the cornea. Congenital cataract is opacity of the lens that a neonate is coming to life with. To measure a real curvature of the horizontal and vertical meridians of the cornea in the babies with and without congenital cataract (mostly with diseases of the eye adnexes) in one or both eyes, and to compare it. We examined 30 patients (60 eyes) with congenital cataract in one or both eyes (48 eyes were with and 12 eyes without congenital cataract), the study group, and 15 patients (30 eyes) with diseases of the eye adnexes, the control group. All patients were hospitalized at our clinic in the period 2002-2004, and were 2-36 months old. Keratometric measurements of the cornea in the study group: the eyes with congenital cataract 40-45.5 D, the eyes without congenital cataract 40-42.8 D. Keratometric measurements of the cornea in the control group were 39.9-45 D. There was no statistically significant difference between the horizontal and vertical meridian measurements of the cornea&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s curvature neither in the study nor in the control group.
Vojnosanitetski pregled, 2010
Surgical treatment is the only method of abdominal aorta aneurysm (AAA) treatment. According to d... more Surgical treatment is the only method of abdominal aorta aneurysm (AAA) treatment. According to data of the available literature, elective open, i.e., conservative, reconstruction (OR) is followed by 3%-5% mortality, as well as by numerous comorbide conditions inside the early postoperative course (the first 30 days after the surgery) that occur in 20%-30% of the operated on. The aim of the study was to present preliminar results of a comparative clinical retrospective study of early postoperative morbidity and mortality in AAA reconstruction using endovascular (EVAR) and open surgical techniques. This comparative clinical retrospective study included 59 patients, electively operated on for AAA within the period January 2008-March 2009, divided into two groups. The group I counted 29 (49%) of the patients who had been submitted to EVAR by the use of Excluder stent. The group II consisted of 30 (51%) of the patients operated on using OR. All of the patients were males, 50-87 years old (mean 67.6 year in the group I, and 54-86 years (mean 68.3 years) in the group II. All tha patients had AAA larger than 50 mm, in the group I 50-105 mm (mean 68 mm), and in the group II 50-84 mm (mean 65 mm). Preoperative comorbide conditions of any patients were similar (coronary disease, obstructive lung disease, chronical renal insufficiency). Patients operated on as emergency cases due to rupture or due to symptomatic aneurysm (threthening rupture) were excluded. The analysed parameters were the duration of surgical operation, intraoperative and operative blood substitution, postoperative morbidity, the duration of postoperative hospitalization, and hospital mortality. The obtained results showed a statistically significantly shorter time taken by EVAR surgery (average 95 min, ranging 70-180 min) as compared to OR surgery (average 167 min, ranging 90-300 min). They also showed statistically significantly less blood loss in the patients operated on by the use of EVAR surgery (average blood compensation 130 mL, ranging 0-1050 mL) as compared to OR surgery (average blood compensation 570 mL, ranging 0-2.000 mL). Also, general complications as wound infection, no restoration of intestines peristalsis, febrility, proteinic and electolytic disbalance, lung and heart decompensation were statistically significantly less following EVAR than OR surgery. Postoperative hospitalization was also statistically significantly shorter after EVAR than after OR surgery (average 4.2 days, ranging 3-7 days; 10.6 days, ranging 8-35 days, respectively). Finally, within this 13-month study there was no mortality following EVAR surgery, while two patients died after OR surgery. In the patients with elective AAA reconstruction endovascular reconstruction is shown to be far more safer and minimally invasive procedure than open conventional aorta reconstruction.
Srpski arhiv za celokupno lekarstvo, 2011
Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe... more Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe and powerful, but often complicated by transient postoperative intraocular pressure rises. In prevention of this complication, we frequently use two potent alpha-adrenergic agonists--brimonidine and apraclonidine. The aim of this study was to compare brimonidine 0.2% and apraclonidine 0.5% efficacy and safety in prevention of intraocular pressure elevation after ALT. This was a prospective, randomized, double-masked and comparative study. This study included 27 POAG patients, 15 received 0.2% brimonidine, and 12 received 0.5% apraclonidine before laser surgery (22 eyes in both groups). Intraocular pressure readings were taken 1, 2, 3, 24 hours and 7 days after ALT. Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test was used to analyse data between two groups, and chi2 test to compare data within groups. Value p less than 0.05 was considered statistically significant. We found statistically significantly lower IOP in eyes that received 0.2% brimonidine at readings taken 1 hour after ALT (p = 0.001). There were no statistically significant differences in other IOP readings between two groups. A single preoperative drop of brimonidine 0.2% had similar efficacy and safety as apraclonidine 0.5% in preventing transient IOP elevations after ALT.
Srpski arhiv za celokupno lekarstvo, 2010
To evaluate the correlation of central corneal thickness (CCT) with refractive error and keratome... more To evaluate the correlation of central corneal thickness (CCT) with refractive error and keratometry in a group of patients eligible for laser keratorefractive surgery, which may serve as a bias in studies on intraocular pressure (IOP) measurement
Medicinski pregled, 2012
Any factor causing constriction of the neck may lead to an increase in intraocular pressure. A ti... more Any factor causing constriction of the neck may lead to an increase in intraocular pressure. A tight necktie may result in increasing intraocular pressure, which could lead to an erroneous diagnosis and treatment of ocular hypertension or even glaucoma. This study was aimed at evaluating the effect of a tight necktie on intraocular pressure measurement using Goldmann applanation tonometry. This study included forty eyes of 20 patients with primary open angle glaucoma and 20 healthy controls (all male). Intraocular pressure was measured without a necktie, 3 minutes after placing a tight necktie and 3 minutes after loosening it. Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test was used to analyze the data between two groups. The intraocular pressure measurements were subjected to paired t-test. The va lue p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 was considered statistically significant. A possible correlation between the age of subjects and intraocular pressure values was analyzed using linear regression (Pearson). A statistically significant difference was found in intraocular pressure readings in all three measurements between two tested groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). When analyzed within groups, statistical significance in intraocular pressure readings was found after loosening the necktie (&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No correlation between the age of subjects and increased intraocular pressure was found in either tested group of subjects after the necktie had been tightened (r2 = 0.006, p = 0.70 for primary open angle patients, r2 = 0.07, p = 0. 22 for healthy controls). Wearing a tight necktie for a limited period of time during the day could be considered as a possible risk factor for glaucoma development.
Srpski arhiv za celokupno lekarstvo, 2011
Srpski arhiv za celokupno lekarstvo, 2009
The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO)... more The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO) and measuring of its retrobulbar diameter. With B-scan, by Schraeder&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r = 0.109; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values), even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.
Vojnosanitetski pregled, 2014
Background/Aim. Several factors may have influence on systemic circulation. Additionally, periphe... more Background/Aim. Several factors may have influence on systemic circulation. Additionally, peripheral circulation also demonstrates sex differences, in young women presenting significantly lower finger blood flow in comparison to men of the same age, a finding that disappears in women after menopause. The aim of this study was to compare the retrobulbar hemodynamic parameters measured by means of color Doppler imaging in women and men with open-angle glaucoma and elevated intraocular pressure. Methods. A total of 52 eyes from 52 open-angle glaucoma (OAG) patients, with elevated intraocular pressure (IOP), were included in this cross-sectional study. Peak-systolic velocity (PSV), end-diastolic velocity (EDV), and Pourcelot resistivity index (RI) were assessed in the ophtalmic artery (OA), central retinal artery (CRA), and posterior cilliary arteries (PCA). IOP was measured both with Goldmann Applanation tonometer (GAT) and with the dynamic contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) appeared during the DCT measurement. Results. The retrobulbar hemodynamic parameters did not show any difference between men and post-menopausal women. Conclusion. The results of our study did not find any difference between sexes in patients with open-angle glaucoma and elevated intraocular pressure.
Srpski arhiv za celokupno lekarstvo, 2012
It is important to know the risk factors for visual field defect progression in order to predict ... more It is important to know the risk factors for visual field defect progression in order to predict the future development of glaucoma. To investigate the influence of visual field initial sensitivity on the rate of visual field progression. A minimum of five visual fields were performed using computerized perimetry (Octopus) over a mean followup 4-year period (48.85 +/- 17.84 months) in 64 persons (114 eyes) with primary open angle glaucoma. The rate of change of the whole central visual field and each of the seven regions of the field were measured by linear regression analysis of the mean sensitivity value versus time. Based on the slope of the regression line of visual field mean sensitivity over time the eyes were divided into two groups: the group with stable and the group with progressive visual field.The comparison of the mean sensitivity of the whole central visual field between the groups was performed using the Mann-Whitney U-test. The Spearman rang correlation coefficient and the Spearman probability p values were calculated to assess the mean sensitivity of the whole central visual field and of each visual field regions determined at the beginning of the study. The initial mean sensitivity of the whole central visual field was lower in the group with progressive visual field (16.62 +/- 6.35 dB). Correlation between the initial mean sensitivity and the slope of the regression line was negative. The lowest mean sensitivity was in the group with progressive visual field in the upper temporal (13.73 +/- 7.35 dB), nasal (14.74 +/- 7.23 dB) and upper nasal (15.03 +/- 7.75 dB) regions. The lower mean sensitivity value of the visual field, especially in the nasal and upper nasal visual field regions, carries a greater risk for delayed progressive loss of the visual field in persons with glaucoma.
IntroductionAn altered perfusion of the optic nerve head has been proposed as a pathogenic factor... more IntroductionAn altered perfusion of the optic nerve head has been proposed as a pathogenic factor
in glaucoma.
ObjectiveTo evaluate changes of haemodynamic parameters in the retrobulbar arterial circulation after
a decrease of elevated intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG).
MethodsTwenty-six patients were examined, 14 men and 12 women, 21 up to 50 years old and 5 below,
all with previously diagnosed and treated POAG, and all examined at the Eye Clinic, Clinical Centre of
Serbia. IOP was measured both with a Goldmann aplanation tonometer and dynamic contour tonometer. Central corneal thickness was measured with ultrasound pachymeter. Imaging of the retrobulbar
arterial circulation by colour Doppler was performed at the Neurology Clinic, Clinical Centre of Serbia.
It involved measuring of haemodynamic parameters of the ophthalmic artery, central retinal artery, and
posterior ciliary arteries. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured,
and resistive index (RI) and pulsatility index (PI) were calculated.
ResultsHaemodynamic arterial parameters PSV and EDV in the ophthalmic and central retinal artery
after decrease of IOP were lower, while RI and PI were higher. In the posterior ciliary arteries PSV, EDV
and PI were lower, and RI was higher.
ConclusionChanges of the retrobulbar arterial circulation after elevated IOP in POAG patients are important for approach and treatment, while the role of vascular factors in the supplement of the optic disc
neuroretinal rim could be a key for progression backlash of glaucoma and the radix of neuroprotection.
Vojnosanitetski pregled, 2014
Background/Aim. Heidelberg retina tomography II (HRT II) haves been employed to quantitatively as... more Background/Aim. Heidelberg retina tomography II (HRT II) haves been employed to quantitatively assess the topography of optic discs in eyes with high-pressure glaucoma (HPG) and normal-pressure glaucoma (NPG), in order to determine which of global and segmental optic disc parameters will prove to be most suitable for monitoring the progression of these two conditions. Methods. The results of 73 eyes of 73 patients with HPG and NPG were analyzed in relation to age, refractive error, quality of HRT images and stereometric parameters. Results. A statistically significant difference (p < 0.05) between the global baseline and follow-up results was found in: rim volume, maximum cup depth and cup shape measure (in the HPG group), and C/D ratio, cup volume, rim volume and cup shape measure (in the NPG group). The baseline and follow-up results of the retinal nerve fiber layer in the temporal and inferotemporal sectors show a significant difference in both groups. Conclusion. Several HRT stereometric parameters are useful for monitoring the progression of changes of the optic disc and local retina in eyes with HPG and NPG. Both segmental and global scanning is of importance in glaucoma progression analysis.
Vojnosanitetski pregled, 2013
Primary open-angle glaucoma is a multifactorial and progressive neuropathy, characterised by the ... more Primary open-angle glaucoma is a multifactorial and progressive neuropathy, characterised by the acquired loss of ganglion cells of the retina and their axons. One of the risk factors for primary open-angle glaucoma is myopia over 5 diopters (D). The aim of our work was to investigate two groups of patients with primary open-angle glaucoma and myopia by using confocal scanning laser ophthalmoscopy, and to find out if the size of refractive error influences optic disk morfometric characteristics. Methods. One hundred eyes of one hundred patients with primary open-angle glaucoma and myopia were involved in our study. All the patients were classified into two groups, the first one with myopia < 5 D, and the second one with myopia 5 D. The Heidelberg retina tomograph is a technique we used in our study. We analized morfometric parameters of patients optic discs, with the aim to find a correlation between the parameters in each group separeatly, and also to find differences between the same parameters from both groups. Results. There were significant differences in disc area, cup area, rim area and mean RNFL thickness between the two groups. The size of damage of neuroretinal rim in the group with high myopia was 27%, and in the group with lower myopia 14%. The most frequently damaged segment of neuroretinal rim in the patients with high myopia was nasal segment and in the patients with low myopia infero-temporal one. The least frequently damaged segment of neuroretinal rim in both groups was temporal one. Conclusion. Optic discs of glaucomatous patients with high myopia have bigger diameter, also bigger and more irregularly distributed damaged zone of neuroretinal rim, and also thinner retinal nerve fiber layer compared to glaucomatous patients with lower myopia.
Vojnosanitetski pregled, 2013
Uloga konfokalne skening laser oftalmoskopije u stereometrijskoj diferencijaciji o ne papile kod ... more Uloga konfokalne skening laser oftalmoskopije u stereometrijskoj diferencijaciji o ne papile kod okularne hipertenzije, normotenzivnog glaukoma i primarnog glaukoma otvorenog ugla Abstract Background/Aim. Primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) demonstrate the same structural changes in the optic disc along with visual field defects but only POAG includes an abnormal elevation of intraocular pressure. Heidelberg retina tomograph based on confocal scanning laser ophthalmoscopy (HRT) and Moorfields regression analysis (MRA) have been employed to quantitatively assess the topography of eye papilla. We measured stereographic parameters of eye papilla in patients with POAG, NTG, and ocular hypertension (OH) using an HRT in order to determine whether HRT topographic parameters can be used to differentiate those conditions. Methods. The results of 145 eyes of 145 patients with OH, NTG and POAG were analyzed by age, refractive error, quality of HRT images, stereometric and MRA parameters. Results. Significant differences were found between NTG and other two groups for a majority of the HRT parameters, and also no differences between OH and POAG patients for a majority of the investigated parameters, except thickness of retinal nerve fiber layer. By reading the MRA no differences were found in the distribution of mostly damaged and mostly preserved neuroretinal rim sectors between NTG and POAG patients, and also all sectors of the neuroretinal rim in OH patients were preserved. Conclusion. HRT stereometric parameters are useful to differentiate patients with OH and NTG, and also for differentiation between NTG and POAG patients, but most of parameters showed no difference between OH and POAG patients. MRA may serve to confirm the diagnosis of OH, but not for precise distinction between NTG and POAG. Apstrakt Uvod/Cilj. Primarni glaukom otvorenog ugla (POAG) i normotenzivni glaukom (NTG) pokazuju jednake strukturalne promene u opti kom disku zajedno sa defektom vidnog polja, ali samo POAG podrazumeva abnormalno povišen intraokularni pritisak. Heidelbergova retinalna tomografija (HRT) bazirana na konfokalnoj skening laser oftalmoskopiji i Moorfields regresiona analiza (MRA) koriš eni su u našoj studiji za kvantitavnu procenu topografije o ne papile. Primenom HRT mereni su stereometrijski paramet-ri opti kih diskova bolesnika sa okularnom hipertenzijom (OH), NTG i POAG. Cilj rada bio je da se odredi primenjivost HRT parametara u OH, NTG i POAG. Metode. Rezultati nalaza 145 o iju od 145 bolesnika sa OH, NTG i POAG analizirani su po starosti, refrakcionoj grešci, kvalitetu HRT fotografija i stereometrijskim parametrima. Rezultati. Utvr ena je statisti ki zna ajna razlika izme u bolesnika sa NTG i druge dve grupe bolesnika za ve inu parametara, kao i odsustvo razlike izme u OH i POAG grupe za ve inu parametara, izuzev za debljinu retinalnog sloja nervnih vlakana. Nalazi MRA pokazali su da nije bilo Volumen 63, Broj 3 VOJNOSANITETSKI PREGLED Strana 305 Gvozdenovi R, et al. Vojnosanit Pregl 2013; 70(3): 304-308. razlike u distribuciji ošte enih i o uvanih sektora neuroretinalnog oboda izme u bolesnika sa NTG i POAG, kao i da su svih šest sektora neuroretinalnog oboda kod bolesnika sa OH bili o uvani. Zaklju ak. Stereometrijski parametri HRT korisni su u diferencijaciji bolesnika sa OH i NTG, kao i bolesnika sa NTG i POAG, ali ve ina parametara ne pokazuje razliku izme u OH i POAG. Tako e, MRA može poslužiti za potvrdu dijagnoze OH, ali ne i za preciznu diferencijaciju NTG i POAG. Klju ne re i: glaukom; glaukom, otvorenog ugla; hipertenzija, okularna; dijagnoza, diferencijalna; dijagnosti ke tehnike, oftalmološke.
Vojnosanitetski pregled, 2009
A term &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;ocular hypertension&amp;amp;amp;... more A term &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;ocular hypertension&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is used when IOP is found to be &amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;21 mmHg on two consecutive occasions, in the absence of detectable glaucomatous damage. The aim of this study was to determine the significance and contribution of Heidelberg Retinal Tomography II (HRT II) results that show very early, subtle changes in retinal neurofibre layers (RNFL) in the optic nerve head that are specific for glaucoma itself (the loss of neuroretinal rim area and an increase of Cup/Disc ratio), but are not possible to register by an ophthalmoscope. Also, when the results of the functional tests remain unchanged, that confirms the conversion of ocular hypertension into glaucoma. During a 5-year study period (2002-2007), 29 patients with ocular hypertension were examined. The frequency of control examinations, based on the presence of risk factors for glaucoma development, was 3-6 months. The examination also included IOP measurements with Goldmann Applanation Tonometry (GAT), central corneal thickness (CCT) determination by pachymetry, the examination of chamber angle using indirect gonioscopy, visual field tests by computerized perimetry and also papillae nenr optic (PNO) examination by using HRT II. The application of HRT II enables a great number of stereometric parameters of optic disc, the most important being the rim area and Cup/Disc (C/D) ratio, which was followed during the control examination by each segment, as well as PNO in global. In the examination period, three cases of conversion of ocular hypertension into a primary open-angle glaucoma were found. In the group of patients with ocular hypertension, HRT II results after six months did not show a significant increase in C/D ratio. No significant loss of rim area or rim volume was found either. In three cases of conversion, HRT II results after 3 months showed an increase of C/D ratio and also a significant loss in rim volume at first examination (0.413) comparing to the last one. In diagnosing ocular hypertension and its conversion to glaucoma, HRT II is used for quantitative evaluation of retinal topography and for quantitative monitoring of topographical changes, especially regarding the increase of C/D ratio and loss of rim volume tissue, which enables to see and register subtle structural changes in optic nerve head and RNFL that are so characteristic for glaucoma, which cannot be seen by an ophthalmoscope. With these results, according to risk factors for glaucoma, one can confirm the diagnosis of ocular hypertension and its conversion to primary open-angle glaucoma. In this study HRT II revealed conversion of ocular hypertension into glaucoma in 10% of the patients.
Srpski arhiv za celokupno lekarstvo
Ocular blood flow (OBF) disturbances could be involved both in the pathogenesis and in progressio... more Ocular blood flow (OBF) disturbances could be involved both in the pathogenesis and in progression of glaucomatous damage. The aim of the study was to compare the retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior cilliary arteries (SPCA) after decreasing the elevated intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients by using color Doppler imaging (CDI). We examined 60 patients (21 male and 39 female) with diagnosed and treated POAG. Thirty-nine patients had increased IOP (> 25 mm Hg). Peak-systolic velocity (PSV), end-diastolic velocity (EDV), Pourcelot resistance index (RI), and pulsatility index (PI) were assessed in the OA, CRA, and SPCA. IOP was measured both with the Goldmann Applanation tonometer (GAT) and with the Dynamic Contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) was measured using DCT. The retrobulbar parameters between the baseline and after IOP ...
Graefe's Archive for Clinical and Experimental Ophthalmology, 2008
To investigate the correlation between ocular pulse amplitude and visual field defects in patient... more To investigate the correlation between ocular pulse amplitude and visual field defects in patients with glaucoma, ocular hypertension, and glaucoma suspicion when measured with the Pascal Dynamic Contour Tonometer, and to verify if the ocular pulse amplitude is an independent predictor for visual field parameters. Seventy-seven eyes (42 patients) with glaucoma, ocular hypertension or glaucoma suspicion were examined. Ocular pulse amplitude was measured with the dynamic contour tonometer by one investigator masked to the visual field data. Visual fields were performed within three months of ocular pulse amplitude measurement by the Octopus or Humphrey Field Analyser, and were analysed with Peridata Software. Mean defect, pattern standard deviation ( radical Loss Variance) and regression analysis of those parameters (Trend Indices) were correlated with the ocular pulse amplitude for each eye. Forty-nine eyes had glaucoma, 14 had ocular hypertension, and 14 were glaucoma suspects. The mean follow-up was 46.5 (range 6-96) months. There was a significant correlation between OPA and MD and OPA and PSD, even after correction for IOP (and diagnostic group and eye): the estimated slope equals 2.68 (S.E. = 0.82, p = 0.003) and -0.86 (S.E. = 0.33, p = 0.014), respectively. There was even a weak correlation between OPA and the evolution of MD (dB/year). The slope estimate for OPA equals 0.070 (S.E. = 0.033), p = 0.037. However, after correction for IOP (and diagnostic group and eye), the strength of the relationship is reduced and the evidence disappears: the slope estimate for OPA now equals 0.039 (S.E. = 0.041), p = 0.34. There is no evidence for an association between OPA and the evolution of Trend-PSD. A small ocular pulse amplitude, as measured with a dynamic contour tonometer, is correlated with moderate to severe glaucomatous visual field loss and might be a risk factor for the development of glaucomatous visual field defects.
Srpski arhiv za celokupno lekarstvo
Ultrasound has an important role in the diagnostics of the posterior segment of the eye, when cli... more Ultrasound has an important role in the diagnostics of the posterior segment of the eye, when clinical examination is not possible. One of problems is congenital cataract. Using ultrasound biometry it is possible to measure the axial length of the eye in all ages and axial growth from the very beginning to its termination. To ratify growth of the infant's eye with and without congenital cataract, and to determine the accuracy of ultrasound measuring with and without general anaesthesia. In our study we analyzed 30 patients (48 eyes) who had congenital cataract in one or both eyes (observed group) and 20 patients (40 eyes) in whom no eye disease was diagnosed (control group). The observed group of 30 patients (48 eyes) with congenital cataract was divided according to age into three subgroups: 1) 4-12 months, 11 patients, 18 eyes; II) 13-24 months, 7 patients, 11 eyes; III) 25-36 months, 12 patients, 19 eyes. In control group we analyzed 20 patients (40 eyes) without congenital c...
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2014
Vojnosanitetski pregled. Military-medical and pharmaceutical review, 2014
Rupture of an abdominal aortic aneurysm (AAA) is a potentially lethal state. Only half of patient... more Rupture of an abdominal aortic aneurysm (AAA) is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR). We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient's comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80%) it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. ...
Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology / edited by the Gaetano Conte Academy for the study of striated muscle diseases, 2013
Myotonic dystrophy type 1 (DM1) is the most common form of muscular dystrophy in adults. It affec... more Myotonic dystrophy type 1 (DM1) is the most common form of muscular dystrophy in adults. It affects many organs and systems besides muscle. Aim of this study was to assess frequency of erectile dysfunction (ED) and hypogonadism, the correlation between them and the impact of ED on quality of life (QoL) in patients with DM1. A series of 25 men (aged from 22 to 58 years) with a diagnosis of DM1 was analyzed. Muscular Impairment Rating Scale (MIRS) was used to assess severity of muscular involvement. Erectile function was assessed using the short form of the International Index of Erectile Function test (IIEF-5). Levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were assessed. All patients completed the Serbian version of the SF-36 questionnaire as a measure of health-related QoL. ED was present in 18 (72%) of patients. Seven (28%) patients were euogonadic, 16 (64%) had compensated hypogonadism and 2 (8%) had primary hypogonadism. ED was somewhat m...
Srpski arhiv za celokupno lekarstvo, 2008
Keratometry is a measurement curvature of the central 2-3 mm of the anterior cornea and main meri... more Keratometry is a measurement curvature of the central 2-3 mm of the anterior cornea and main meridians (horizontal and vertical) and secondary calculation of the full optic power of the cornea. Congenital cataract is opacity of the lens that a neonate is coming to life with. To measure a real curvature of the horizontal and vertical meridians of the cornea in the babies with and without congenital cataract (mostly with diseases of the eye adnexes) in one or both eyes, and to compare it. We examined 30 patients (60 eyes) with congenital cataract in one or both eyes (48 eyes were with and 12 eyes without congenital cataract), the study group, and 15 patients (30 eyes) with diseases of the eye adnexes, the control group. All patients were hospitalized at our clinic in the period 2002-2004, and were 2-36 months old. Keratometric measurements of the cornea in the study group: the eyes with congenital cataract 40-45.5 D, the eyes without congenital cataract 40-42.8 D. Keratometric measurements of the cornea in the control group were 39.9-45 D. There was no statistically significant difference between the horizontal and vertical meridian measurements of the cornea&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s curvature neither in the study nor in the control group.
Vojnosanitetski pregled, 2010
Surgical treatment is the only method of abdominal aorta aneurysm (AAA) treatment. According to d... more Surgical treatment is the only method of abdominal aorta aneurysm (AAA) treatment. According to data of the available literature, elective open, i.e., conservative, reconstruction (OR) is followed by 3%-5% mortality, as well as by numerous comorbide conditions inside the early postoperative course (the first 30 days after the surgery) that occur in 20%-30% of the operated on. The aim of the study was to present preliminar results of a comparative clinical retrospective study of early postoperative morbidity and mortality in AAA reconstruction using endovascular (EVAR) and open surgical techniques. This comparative clinical retrospective study included 59 patients, electively operated on for AAA within the period January 2008-March 2009, divided into two groups. The group I counted 29 (49%) of the patients who had been submitted to EVAR by the use of Excluder stent. The group II consisted of 30 (51%) of the patients operated on using OR. All of the patients were males, 50-87 years old (mean 67.6 year in the group I, and 54-86 years (mean 68.3 years) in the group II. All tha patients had AAA larger than 50 mm, in the group I 50-105 mm (mean 68 mm), and in the group II 50-84 mm (mean 65 mm). Preoperative comorbide conditions of any patients were similar (coronary disease, obstructive lung disease, chronical renal insufficiency). Patients operated on as emergency cases due to rupture or due to symptomatic aneurysm (threthening rupture) were excluded. The analysed parameters were the duration of surgical operation, intraoperative and operative blood substitution, postoperative morbidity, the duration of postoperative hospitalization, and hospital mortality. The obtained results showed a statistically significantly shorter time taken by EVAR surgery (average 95 min, ranging 70-180 min) as compared to OR surgery (average 167 min, ranging 90-300 min). They also showed statistically significantly less blood loss in the patients operated on by the use of EVAR surgery (average blood compensation 130 mL, ranging 0-1050 mL) as compared to OR surgery (average blood compensation 570 mL, ranging 0-2.000 mL). Also, general complications as wound infection, no restoration of intestines peristalsis, febrility, proteinic and electolytic disbalance, lung and heart decompensation were statistically significantly less following EVAR than OR surgery. Postoperative hospitalization was also statistically significantly shorter after EVAR than after OR surgery (average 4.2 days, ranging 3-7 days; 10.6 days, ranging 8-35 days, respectively). Finally, within this 13-month study there was no mortality following EVAR surgery, while two patients died after OR surgery. In the patients with elective AAA reconstruction endovascular reconstruction is shown to be far more safer and minimally invasive procedure than open conventional aorta reconstruction.
Srpski arhiv za celokupno lekarstvo, 2011
Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe... more Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe and powerful, but often complicated by transient postoperative intraocular pressure rises. In prevention of this complication, we frequently use two potent alpha-adrenergic agonists--brimonidine and apraclonidine. The aim of this study was to compare brimonidine 0.2% and apraclonidine 0.5% efficacy and safety in prevention of intraocular pressure elevation after ALT. This was a prospective, randomized, double-masked and comparative study. This study included 27 POAG patients, 15 received 0.2% brimonidine, and 12 received 0.5% apraclonidine before laser surgery (22 eyes in both groups). Intraocular pressure readings were taken 1, 2, 3, 24 hours and 7 days after ALT. Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test was used to analyse data between two groups, and chi2 test to compare data within groups. Value p less than 0.05 was considered statistically significant. We found statistically significantly lower IOP in eyes that received 0.2% brimonidine at readings taken 1 hour after ALT (p = 0.001). There were no statistically significant differences in other IOP readings between two groups. A single preoperative drop of brimonidine 0.2% had similar efficacy and safety as apraclonidine 0.5% in preventing transient IOP elevations after ALT.
Srpski arhiv za celokupno lekarstvo, 2010
To evaluate the correlation of central corneal thickness (CCT) with refractive error and keratome... more To evaluate the correlation of central corneal thickness (CCT) with refractive error and keratometry in a group of patients eligible for laser keratorefractive surgery, which may serve as a bias in studies on intraocular pressure (IOP) measurement
Medicinski pregled, 2012
Any factor causing constriction of the neck may lead to an increase in intraocular pressure. A ti... more Any factor causing constriction of the neck may lead to an increase in intraocular pressure. A tight necktie may result in increasing intraocular pressure, which could lead to an erroneous diagnosis and treatment of ocular hypertension or even glaucoma. This study was aimed at evaluating the effect of a tight necktie on intraocular pressure measurement using Goldmann applanation tonometry. This study included forty eyes of 20 patients with primary open angle glaucoma and 20 healthy controls (all male). Intraocular pressure was measured without a necktie, 3 minutes after placing a tight necktie and 3 minutes after loosening it. Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test was used to analyze the data between two groups. The intraocular pressure measurements were subjected to paired t-test. The va lue p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05 was considered statistically significant. A possible correlation between the age of subjects and intraocular pressure values was analyzed using linear regression (Pearson). A statistically significant difference was found in intraocular pressure readings in all three measurements between two tested groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). When analyzed within groups, statistical significance in intraocular pressure readings was found after loosening the necktie (&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No correlation between the age of subjects and increased intraocular pressure was found in either tested group of subjects after the necktie had been tightened (r2 = 0.006, p = 0.70 for primary open angle patients, r2 = 0.07, p = 0. 22 for healthy controls). Wearing a tight necktie for a limited period of time during the day could be considered as a possible risk factor for glaucoma development.
Srpski arhiv za celokupno lekarstvo, 2011
Srpski arhiv za celokupno lekarstvo, 2009
The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO)... more The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO) and measuring of its retrobulbar diameter. With B-scan, by Schraeder&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r = 0.109; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values), even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.
Vojnosanitetski pregled, 2014
Background/Aim. Several factors may have influence on systemic circulation. Additionally, periphe... more Background/Aim. Several factors may have influence on systemic circulation. Additionally, peripheral circulation also demonstrates sex differences, in young women presenting significantly lower finger blood flow in comparison to men of the same age, a finding that disappears in women after menopause. The aim of this study was to compare the retrobulbar hemodynamic parameters measured by means of color Doppler imaging in women and men with open-angle glaucoma and elevated intraocular pressure. Methods. A total of 52 eyes from 52 open-angle glaucoma (OAG) patients, with elevated intraocular pressure (IOP), were included in this cross-sectional study. Peak-systolic velocity (PSV), end-diastolic velocity (EDV), and Pourcelot resistivity index (RI) were assessed in the ophtalmic artery (OA), central retinal artery (CRA), and posterior cilliary arteries (PCA). IOP was measured both with Goldmann Applanation tonometer (GAT) and with the dynamic contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) appeared during the DCT measurement. Results. The retrobulbar hemodynamic parameters did not show any difference between men and post-menopausal women. Conclusion. The results of our study did not find any difference between sexes in patients with open-angle glaucoma and elevated intraocular pressure.
Srpski arhiv za celokupno lekarstvo, 2012
It is important to know the risk factors for visual field defect progression in order to predict ... more It is important to know the risk factors for visual field defect progression in order to predict the future development of glaucoma. To investigate the influence of visual field initial sensitivity on the rate of visual field progression. A minimum of five visual fields were performed using computerized perimetry (Octopus) over a mean followup 4-year period (48.85 +/- 17.84 months) in 64 persons (114 eyes) with primary open angle glaucoma. The rate of change of the whole central visual field and each of the seven regions of the field were measured by linear regression analysis of the mean sensitivity value versus time. Based on the slope of the regression line of visual field mean sensitivity over time the eyes were divided into two groups: the group with stable and the group with progressive visual field.The comparison of the mean sensitivity of the whole central visual field between the groups was performed using the Mann-Whitney U-test. The Spearman rang correlation coefficient and the Spearman probability p values were calculated to assess the mean sensitivity of the whole central visual field and of each visual field regions determined at the beginning of the study. The initial mean sensitivity of the whole central visual field was lower in the group with progressive visual field (16.62 +/- 6.35 dB). Correlation between the initial mean sensitivity and the slope of the regression line was negative. The lowest mean sensitivity was in the group with progressive visual field in the upper temporal (13.73 +/- 7.35 dB), nasal (14.74 +/- 7.23 dB) and upper nasal (15.03 +/- 7.75 dB) regions. The lower mean sensitivity value of the visual field, especially in the nasal and upper nasal visual field regions, carries a greater risk for delayed progressive loss of the visual field in persons with glaucoma.