knezevic miroslav - Academia.edu (original) (raw)
Papers by knezevic miroslav
International Journal of Clinical Practice, 2020
Article type : Original Paper Comparison of efficacy and safety of parenteral vs parenteral and o... more Article type : Original Paper Comparison of efficacy and safety of parenteral vs parenteral and oral glucocorticoid therapy in Graves' orbitopathy
Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics, Jan 11, 2018
To test the hypothesis that the use of refrigerated fixed combination of dorzolamide 2% plus timo... more To test the hypothesis that the use of refrigerated fixed combination of dorzolamide 2% plus timolol 0.5% solution (COSOPT) is associated with less ocular discomfort compared with the use of this solution kept at room temperature. In this prospective comparative study, 30 primary open-angle patients and 30 healthy subjects filled in the questionnaire on symptoms (Ocular Surface Disease Index) and subjective stinging feeling scale (1-10), at the start of study and 30 days after continuous use of refrigerated fixed combination or placebo eye drops. Results were processed by applying the methods of descriptive (arithmetical mean, standard deviation) and analytical statistics for evaluation of significance of the difference (Student's t-test). Ocular discomfort parameters were significantly lower after the use of refrigerated fixed combination of dorzolamide 2% plus timolol 0.5% solution (t-test, P < 0.0001). Breakup time, Schirmer 1 test, and intraocular pressure values did not ...
Srpski arhiv za celokupno lekarstvo, 2013
Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the... more Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the study was to determine the incidence and causes of the eye injury and to propose measures of the eye injury prevention in children up to 15 years of age. Methods. This was a retrospective study of 552 children with the eye injuries treated at the Clinic of Eye Diseases in Belgrade during the period March 1999 to February 2010. Gender and age of the children, time of injury, the type and site of injuries, visual acuity upon admission and at discharge, as well as the time of surgery in relation to time of injury were analyzed. Results. The ratio between the injured boys and girls was 3.6:1. The highest percentage of injured children was in the group 6-10 years old (39.7%); the injuries were almost evenly distributed according to months during the year and days during the week. The percentages of severe closed and open injuries of the eyeball were almost equal. Visual acuity upon discharge...
Srpski arhiv za celokupno lekarstvo, 2011
Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic fact... more Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. Objective. To 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). Methods. Twenty-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...
Ophthalmic Research, 2009
Purpose: We present the rare case of a young male patient with asymmetric ocular findings: pigmen... more Purpose: We present the rare case of a young male patient with asymmetric ocular findings: pigmentary ocular hypertension associated with nonischemic central retinal vein occlusion (CRVO) in the right eye and pigmentary glaucoma (PG) with progressive glaucomatous optic damage in the left eye. Patients and Methods: A 31-year-old man showed nonischemic CRVO in the right eye and the clinical triad of pigment dispersion syndrome in both eyes, however more marked in the left eye. Best-corrected visual acuity was logMAR 0.3 in the right eye and 1.0 in the left eye at presentation. The single risk for developing PG and CRVO was hyperhomocysteinemia. The patient was a carrier of the methylenetetrahydrofolate reductase C677 homozygous mutation. Results: At 18 months of follow-up, visual acuity remained stable, intraocular pressure was in the normal range, but retinal tomography indicated an increase in glaucomatous optic damage to the nerve fiber layer in almost the complete temporal-inferio...
Graefe's Archive for Clinical and Experimental Ophthalmology, 2010
European Journal of Ophthalmology, 2012
PurPose. To determine ocular pulse volume values in patients with thyroid-associated ophthalmopat... more PurPose. To determine ocular pulse volume values in patients with thyroid-associated ophthalmopathy with normal intraocular pressure, and to test the hypothesis that changes in orbital tissue that accompany thyroid-associated ophthalmopathy can in turn give changes in choroidal perfusion. Methods. In a prospective study, we evaluated 30 eyes of 30 consecutive patients with TAO, and 30 eyes of 30 healthy subjects. Complete ophthalmologic examination including dynamic contour tonometry was done. Possible differences in ocular parameters between the tested groups were assessed. results. No significant difference was found in ocular pulse volume values between the tested subjects (paired test p=0.23). ConClusions. The orbit tissue changes that are involved in thyroid-associated ophthalmopathy do not have much implication on choroidal perfusion, at least when intraocular pressure values remain within the normal range.
Acta chirurgica Iugoslavica, 2012
INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these i... more INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these injuries and their incidence in different age groups. METHODS: This is a retrospective review of medical charts of patients who were hospitalized due to airsoft guns ocular injuries in ten-year period (from 2000 to 2009). Patient?s age, gender, duration of hospitalization, type of treatment and initial and final visual acuity were analyzed. RESULTS: Overall 92 patients with ocular injuries caused by airsoft gun pellets were hospitalized in tenyear period. In all patients only one eye was injured and there were 72 (78.3%) male patients. Injuries involved ocular adnexa, anterior and posterior segment of the eye. On initial examination 41 (44.6%) patients were presented with subconjunctival hemorrhages, 42 (45.6%) with corneal abrasion, 42 (45.6%) patients had corneal edema, 6 (6.5%) had traumatic mydriasis, 90 (97.8%) patients exhibited hyphema, 10 (10.9%) iridodialysis, in 27 (29.3%) patie...
Medical Science Monitor, 2011
Source of support: There were no research contracts or any kind of financial support (grants) for... more Source of support: There were no research contracts or any kind of financial support (grants) for this study Summary Background: External dacryocystorhinostomy (DCR) is often performed under local anesthesia (LA) without adequate knowledge of the pain experienced by the patient. Material/Methods: We subdivided our surgical technique into stages easily understood by the patients (introducing cotton tipped applicators, performing parabulbar injection, creating the incision, bone cracking (opening the ostium), manipulating the nose, intubating, closing the wound, and packing with gauze). A total of 50 patients ranging in age from 31 to 83 years of age (63.64±9.64) underwent external DCR. Each patient was asked 30 minutes after surgery to indicate the intensity of pain experienced at each stage of the surgery and during intramuscular (IM) injection of an antibiotic using a visual analog scale (VAS). Results: Analysis of the VAS-based pain scores indicated 3 statistically equal occurrences of pain coinciding with the opening of the ostium, and receiving both parabulbar anesthetic and IM antibiotic injections. Conclusions: The level of pain experienced during the most unpleasant stage of external DCR (ostium opening) was similar to the pain experienced from an IM injection. Patients can be informed that pain during external DCR with local anesthesia is comparable to receiving an IM gluteal injection.
Journal of Endocrinological Investigation, 2020
Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this st... more Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves’ orbitopathy. Methods This was a multi-centre study of new referrals to 13 European Group on Graves’ Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves’ orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves’ orbitopathy. The distribution of clinical characteristics among the three groups was documented. Results The asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p ...
Bioanalysis, 2017
Aim: The objective of the study was development of hydrophilic interaction liquid chromatography–... more Aim: The objective of the study was development of hydrophilic interaction liquid chromatography–ESI/MS/MS method for the determination of olopatadine in tear matrix. Materials & methods: Separation was performed on Acquity BEH amide column (2.1 × 100 mm, 1.7 μm). The mobile phase was consisted of 0.1% formic acid in water and acetonitrile. Mianserin hydrochloride was implemented as an internal standard. The artificial tear fluid was used as matrix. The tear samples were collected using Schirmer test strips. For the optimization of ultra pressure liquid chromatography conditions, Box–Benhken design was utilized. Results: The optimal values of the ion source and collision cell parameters were found. Quantification was performed in multiple reaction monitoring mode. The optimized method was fully validated. Conclusion: The proposed method was utilized for monitoring of olopatadine in human tear.
Bosnian Journal of Basic Medical Sciences, 2016
The main purpose of this paper is to provide the information about the incidence and types of pat... more The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases). Lacrimal sac-specific pathologies were present in 226 (5.85%) cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34%) cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1) lacrimal stones-dacryoliths, (2) pyogenic granuloma, (3) granulation tissues, (4) reactive lymphoid hyperplasia, and (5) lacrimal sac-specific inflammation (Wegener' s granulomatosis and sarcoidosis). Neoplastic pathology was found in 55/3865 (1.42%) lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction.
British Journal of Ophthalmology, 2015
The epidemiology of Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more The epidemiology of Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000. The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) and inactive GO (63.2% vs 39.9%,…
Medical Oncology, 2011
The most common lacrimal sac pathology is chronic inflammation with or without occlusive fibrosis... more The most common lacrimal sac pathology is chronic inflammation with or without occlusive fibrosis. However, a substantial number of lacrimal sac-specific pathologies were reported throughout the literature which may mimic chronic inflammation and be misdiagnosed. From a tertiary ophthalmic care centre in Serbia, in a single ophthalmic pathology laboratory, during a 7-year period (January 2004 to October 2010), a 599 consecutive lacrimal sac wall biopsy samples routinely obtained during external dacryocystorhinostomy in adult patients with clinically presumed primary acquired lacrimal drainage system obstruction were analysed. Although non-specific lacrimal sac pathology was present in the vast majority of cases (578 biopsy specimens; 96.49%), this report also reveals a relatively substantial number (21 biopsy specimens; 3.51%) of clinically non-suspected or intraoperatively unexpected primary lacrimal sac-specific pathology--among them, six lesions with malignant biological behaviour were identified: one microinvasive squamous cell carcinoma and five malignant lymhoproliferative lesions. Usefulness of routine lacrimal sac wall biopsy during surgery for primary acquired lacrimal drainage system obstruction is undoubtful and commensurate with the constant need for better understanding of the pathological processes that involve lacrimal drainage system.
Medical Science Monitor, 2012
Background: There has been only 1 study on postoperative pain after external dacryocystorhinostom... more Background: There has been only 1 study on postoperative pain after external dacryocystorhinostomy (DCR) that compared pain between 2 groups of patients; 1 group received local anesthesia and the other received general anesthesia. To further characterize the relationship between these 2 types of anesthesia and postoperative pain, we designed a study in which a single patient received these 2 different anesthesia modalities for a short interval on 2 different sides. Material/Methods: There were 50 participants in this study. External DCR was performed on the same participant on both sides using local anesthesia on 1 side and general anesthesia on the other. Postoperative pain was measured using the visual analogue scale (VAS), and localization and timing of pain were reported by the participants. Postoperative nausea and vomiting (PONV) were documented if present. Results: Pain levels were significantly higher with general anesthesia 3 hours post-surgery, and 6 hours post-surgery the pain remains higher following general anesthesia but is borderline insignificant (p=0.051). However, 12 hours post-surgery, there is no significant difference in the pain level (p=0.240). There was no significant difference in the localization of pain with local and general anesthesia. Postoperative nausea is significantly more frequent after general anesthesia, and vomiting only occurs with general anesthesia. Local anesthesia was preferred by 94% of the participants (47 out of 50). Conclusions: The vast majority of patients in our study who have undergone both GA and LA DCR would choose LA again, providing a compelling case for use of the LA technique.
Graefe's Archive for Clinical and Experimental Ophthalmology, 2012
The presence of visible gas on radiography, computed tomography (CT), or magnetic resonance imagi... more The presence of visible gas on radiography, computed tomography (CT), or magnetic resonance imaging (MRI) is associated with various pathological conditions, ranging from severe infections caused by gas-producing organisms to cutaneous and subcutaneous tissue disruption that allows an interface with the air [1]. A high index of suspicion surrounds the finding of gas because of the virulence of conditions such as gas gangrene and necrotizing fasciitis [1–12]. Gas dissecting into the orbital soft tissues as a result of bacterial activity is a rapidly progressive, extremely serious, life-threatening ophthalmological emergency [1–12]. Gas gangrene (myonecrosis) and necrotizing fasciitis can cause necrosis of tissues and systemic shock with multiorgan failure, sometimes within a matter of hours [1–3, 13]. It is well known that the usual causative organisms in gas-producing infection from a contaminated wound are clostridial species: Clostridium perfringens accounts for the majority of cases (over 80 %), while most other cases are caused by other Clostridium species [1–3]. Clostridial infection is always associated with necrosis, and very often associated with poor functional and anatomical outcome [1–4]. However, a variety of other non-clostridial organisms, both aerobes and anaerobes, may also produce infections in which gas is demonstrable: Escherichia coli, Proteus species, Pseudomonas aeruginosa, Bacteroides, Klebsiela pneumoniae, Prevotella species, Staphylococcus aureus, Peptostreptococcus species, Fusobacterium species, and Streptococcus pyogenes are only the species reported most often in the literature [2]. Non-clostridial infections may take various forms, which lead to difficulties in making accurate and prompt diagnoses and are also related to the confusion between gas gangrene and various (bacterial and nonbacterial) lesions that simulate gas gangrene. Aside from the fact that non-clostridial organisms usually involve subcutaneous tissues, they may also involve muscle and simulate clostridial myonecrosis [2, 3]. However, non-clostridial gas infections accompanied by gangrene are not very common, even in immunosuppressed individuals [2, 3]. Since the initial report by Chiari (1893), which concerned a non-clostridial gas-forming infection due to a colon bacillus in the gangrenous lower limb of a diabetic patient [4], fewer than 40 cases of non-clostridial gas-forming infections have been described. Only four such cases have been described in the orbit [5–7, 12], and these are quite different from the present case. With regard to the pathogenesis of gas bubbles of clostridial or non-clostridial etiology, they are liberated by the bacterial fermentation of glucose [4]. In addition, impaired microcirculation may also contribute to gas formation [3, 4]. It is also necessary to mention the benign, non-infectious presence of gas in the orbit, which is known as orbital emphysema. Orbital emphysema is a well-known entity that can arise from nose-blowing, tumor presentation, or after fractures of the orbital floor, and may be self-induced in psychiatric patients [15]. There are no research contracts or any kind of financial support (grants) for this study. No authors have any conflicts of interest.
Background/Aim. Eye enucleation is one of the oldest surgical procedures. The aim of the study wa... more Background/Aim. Eye enucleation is one of the oldest surgical procedures. The aim of the study was to determine the causes of enucleation as seen in a major reference eye center in Serbia. Methods. Retrospective case series involving a review of all enucleation procedures performed in the period between January 2000 and December 2008 at the Institute for Eye Diseases, Clinical Center of Serbia, Belgrade. The collected information included the basic demographic data and diagnosis of the affected eye. The diagnosis was made based on history, clinical and histological examinations. Clinical indications for enucleation were categorized as tumors, glaucoma, trauma, infections and other diseases. A statistical analysis was made using the Student's t-test. Results. There were 586 patients, 315 male and 271 female in our series. The mean age was 57.81, ranging from 3 months to 96 years. The most common cause of enucleations was tumor (76.11%), (p < 0.05). Choroid melanoma was the most common etiology leading to enucleation (81.18%), followed by retinoblastoma (12.34%). A total of 8.02% of enucleations were performed due to glaucoma that was primarily neovascular in 42.55% of cases or caused by trauma in 38.8% of cases. Trauma was the third common etiology of enucleation, and it was acute in 56.26% of cases or resulted in phthisis bulbi in 31.25% of cases. Enucleation caused by inflammation was performed in 2.90% of cases, out of which 52.94% of enucleations occurred after perforation of the cornea. In the group of other diseases the most common cause of enucleation was atrophy of the eye ball. Conclusion. Neoplasm, neovascular glaucoma, acute eye injury and atrophy of the eye ball are the most common causes of enucleation.
h i g h l i g h t s Two novel methods namely; absorbance subtraction (AS) and amplitude modulatio... more h i g h l i g h t s Two novel methods namely; absorbance subtraction (AS) and amplitude modulation (AM) methods were developed. Six recently well established spectrophotometric methods (SRS, RD, RS, EXRS, CM and MCR) were applied. The proposed methods are very simple, accurate, precise. They do not require any sophisticated apparatus or computer programs. g r a p h i c a l a b s t r a c t Zero-order spectra of 40 lg/mL of DOR (-) and TIM (.. .), separately in methanol, and binary of a mixture of DOR and TIM, 20 lg/mL of each (-) and their ratio spectra using the spectrum of TIM (1 lg/mL) as a divisor.
Graves orbitopathy (GO) is an autoimmune disorder of the retrobulbar tissue 1 probably initiated ... more Graves orbitopathy (GO) is an autoimmune disorder of the retrobulbar tissue 1 probably initiated by autoreactive T lymphocytes which trigger a cascade of events including secretion of cytokines, 2 simulating proliferation of orbital fibroblastas, expansion of adipose tissue and secretion of glycosaminoglycans by the orbital fibroblasts. Therefore, immunosuppressants and anti-inflammatory agents are the treatment of choice for moderate-to-severe-and active GO. 3,4 Although different immunosuppressants including biological agents
International Journal of Clinical Practice, 2020
Article type : Original Paper Comparison of efficacy and safety of parenteral vs parenteral and o... more Article type : Original Paper Comparison of efficacy and safety of parenteral vs parenteral and oral glucocorticoid therapy in Graves' orbitopathy
Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics, Jan 11, 2018
To test the hypothesis that the use of refrigerated fixed combination of dorzolamide 2% plus timo... more To test the hypothesis that the use of refrigerated fixed combination of dorzolamide 2% plus timolol 0.5% solution (COSOPT) is associated with less ocular discomfort compared with the use of this solution kept at room temperature. In this prospective comparative study, 30 primary open-angle patients and 30 healthy subjects filled in the questionnaire on symptoms (Ocular Surface Disease Index) and subjective stinging feeling scale (1-10), at the start of study and 30 days after continuous use of refrigerated fixed combination or placebo eye drops. Results were processed by applying the methods of descriptive (arithmetical mean, standard deviation) and analytical statistics for evaluation of significance of the difference (Student's t-test). Ocular discomfort parameters were significantly lower after the use of refrigerated fixed combination of dorzolamide 2% plus timolol 0.5% solution (t-test, P < 0.0001). Breakup time, Schirmer 1 test, and intraocular pressure values did not ...
Srpski arhiv za celokupno lekarstvo, 2013
Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the... more Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the study was to determine the incidence and causes of the eye injury and to propose measures of the eye injury prevention in children up to 15 years of age. Methods. This was a retrospective study of 552 children with the eye injuries treated at the Clinic of Eye Diseases in Belgrade during the period March 1999 to February 2010. Gender and age of the children, time of injury, the type and site of injuries, visual acuity upon admission and at discharge, as well as the time of surgery in relation to time of injury were analyzed. Results. The ratio between the injured boys and girls was 3.6:1. The highest percentage of injured children was in the group 6-10 years old (39.7%); the injuries were almost evenly distributed according to months during the year and days during the week. The percentages of severe closed and open injuries of the eyeball were almost equal. Visual acuity upon discharge...
Srpski arhiv za celokupno lekarstvo, 2011
Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic fact... more Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor in glaucoma. Objective. To 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). Methods. Twenty-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...
Ophthalmic Research, 2009
Purpose: We present the rare case of a young male patient with asymmetric ocular findings: pigmen... more Purpose: We present the rare case of a young male patient with asymmetric ocular findings: pigmentary ocular hypertension associated with nonischemic central retinal vein occlusion (CRVO) in the right eye and pigmentary glaucoma (PG) with progressive glaucomatous optic damage in the left eye. Patients and Methods: A 31-year-old man showed nonischemic CRVO in the right eye and the clinical triad of pigment dispersion syndrome in both eyes, however more marked in the left eye. Best-corrected visual acuity was logMAR 0.3 in the right eye and 1.0 in the left eye at presentation. The single risk for developing PG and CRVO was hyperhomocysteinemia. The patient was a carrier of the methylenetetrahydrofolate reductase C677 homozygous mutation. Results: At 18 months of follow-up, visual acuity remained stable, intraocular pressure was in the normal range, but retinal tomography indicated an increase in glaucomatous optic damage to the nerve fiber layer in almost the complete temporal-inferio...
Graefe's Archive for Clinical and Experimental Ophthalmology, 2010
European Journal of Ophthalmology, 2012
PurPose. To determine ocular pulse volume values in patients with thyroid-associated ophthalmopat... more PurPose. To determine ocular pulse volume values in patients with thyroid-associated ophthalmopathy with normal intraocular pressure, and to test the hypothesis that changes in orbital tissue that accompany thyroid-associated ophthalmopathy can in turn give changes in choroidal perfusion. Methods. In a prospective study, we evaluated 30 eyes of 30 consecutive patients with TAO, and 30 eyes of 30 healthy subjects. Complete ophthalmologic examination including dynamic contour tonometry was done. Possible differences in ocular parameters between the tested groups were assessed. results. No significant difference was found in ocular pulse volume values between the tested subjects (paired test p=0.23). ConClusions. The orbit tissue changes that are involved in thyroid-associated ophthalmopathy do not have much implication on choroidal perfusion, at least when intraocular pressure values remain within the normal range.
Acta chirurgica Iugoslavica, 2012
INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these i... more INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these injuries and their incidence in different age groups. METHODS: This is a retrospective review of medical charts of patients who were hospitalized due to airsoft guns ocular injuries in ten-year period (from 2000 to 2009). Patient?s age, gender, duration of hospitalization, type of treatment and initial and final visual acuity were analyzed. RESULTS: Overall 92 patients with ocular injuries caused by airsoft gun pellets were hospitalized in tenyear period. In all patients only one eye was injured and there were 72 (78.3%) male patients. Injuries involved ocular adnexa, anterior and posterior segment of the eye. On initial examination 41 (44.6%) patients were presented with subconjunctival hemorrhages, 42 (45.6%) with corneal abrasion, 42 (45.6%) patients had corneal edema, 6 (6.5%) had traumatic mydriasis, 90 (97.8%) patients exhibited hyphema, 10 (10.9%) iridodialysis, in 27 (29.3%) patie...
Medical Science Monitor, 2011
Source of support: There were no research contracts or any kind of financial support (grants) for... more Source of support: There were no research contracts or any kind of financial support (grants) for this study Summary Background: External dacryocystorhinostomy (DCR) is often performed under local anesthesia (LA) without adequate knowledge of the pain experienced by the patient. Material/Methods: We subdivided our surgical technique into stages easily understood by the patients (introducing cotton tipped applicators, performing parabulbar injection, creating the incision, bone cracking (opening the ostium), manipulating the nose, intubating, closing the wound, and packing with gauze). A total of 50 patients ranging in age from 31 to 83 years of age (63.64±9.64) underwent external DCR. Each patient was asked 30 minutes after surgery to indicate the intensity of pain experienced at each stage of the surgery and during intramuscular (IM) injection of an antibiotic using a visual analog scale (VAS). Results: Analysis of the VAS-based pain scores indicated 3 statistically equal occurrences of pain coinciding with the opening of the ostium, and receiving both parabulbar anesthetic and IM antibiotic injections. Conclusions: The level of pain experienced during the most unpleasant stage of external DCR (ostium opening) was similar to the pain experienced from an IM injection. Patients can be informed that pain during external DCR with local anesthesia is comparable to receiving an IM gluteal injection.
Journal of Endocrinological Investigation, 2020
Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this st... more Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves’ orbitopathy. Methods This was a multi-centre study of new referrals to 13 European Group on Graves’ Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves’ orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves’ orbitopathy. The distribution of clinical characteristics among the three groups was documented. Results The asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p ...
Bioanalysis, 2017
Aim: The objective of the study was development of hydrophilic interaction liquid chromatography–... more Aim: The objective of the study was development of hydrophilic interaction liquid chromatography–ESI/MS/MS method for the determination of olopatadine in tear matrix. Materials & methods: Separation was performed on Acquity BEH amide column (2.1 × 100 mm, 1.7 μm). The mobile phase was consisted of 0.1% formic acid in water and acetonitrile. Mianserin hydrochloride was implemented as an internal standard. The artificial tear fluid was used as matrix. The tear samples were collected using Schirmer test strips. For the optimization of ultra pressure liquid chromatography conditions, Box–Benhken design was utilized. Results: The optimal values of the ion source and collision cell parameters were found. Quantification was performed in multiple reaction monitoring mode. The optimized method was fully validated. Conclusion: The proposed method was utilized for monitoring of olopatadine in human tear.
Bosnian Journal of Basic Medical Sciences, 2016
The main purpose of this paper is to provide the information about the incidence and types of pat... more The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases). Lacrimal sac-specific pathologies were present in 226 (5.85%) cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34%) cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1) lacrimal stones-dacryoliths, (2) pyogenic granuloma, (3) granulation tissues, (4) reactive lymphoid hyperplasia, and (5) lacrimal sac-specific inflammation (Wegener' s granulomatosis and sarcoidosis). Neoplastic pathology was found in 55/3865 (1.42%) lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction.
British Journal of Ophthalmology, 2015
The epidemiology of Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more The epidemiology of Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000. The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) and inactive GO (63.2% vs 39.9%,…
Medical Oncology, 2011
The most common lacrimal sac pathology is chronic inflammation with or without occlusive fibrosis... more The most common lacrimal sac pathology is chronic inflammation with or without occlusive fibrosis. However, a substantial number of lacrimal sac-specific pathologies were reported throughout the literature which may mimic chronic inflammation and be misdiagnosed. From a tertiary ophthalmic care centre in Serbia, in a single ophthalmic pathology laboratory, during a 7-year period (January 2004 to October 2010), a 599 consecutive lacrimal sac wall biopsy samples routinely obtained during external dacryocystorhinostomy in adult patients with clinically presumed primary acquired lacrimal drainage system obstruction were analysed. Although non-specific lacrimal sac pathology was present in the vast majority of cases (578 biopsy specimens; 96.49%), this report also reveals a relatively substantial number (21 biopsy specimens; 3.51%) of clinically non-suspected or intraoperatively unexpected primary lacrimal sac-specific pathology--among them, six lesions with malignant biological behaviour were identified: one microinvasive squamous cell carcinoma and five malignant lymhoproliferative lesions. Usefulness of routine lacrimal sac wall biopsy during surgery for primary acquired lacrimal drainage system obstruction is undoubtful and commensurate with the constant need for better understanding of the pathological processes that involve lacrimal drainage system.
Medical Science Monitor, 2012
Background: There has been only 1 study on postoperative pain after external dacryocystorhinostom... more Background: There has been only 1 study on postoperative pain after external dacryocystorhinostomy (DCR) that compared pain between 2 groups of patients; 1 group received local anesthesia and the other received general anesthesia. To further characterize the relationship between these 2 types of anesthesia and postoperative pain, we designed a study in which a single patient received these 2 different anesthesia modalities for a short interval on 2 different sides. Material/Methods: There were 50 participants in this study. External DCR was performed on the same participant on both sides using local anesthesia on 1 side and general anesthesia on the other. Postoperative pain was measured using the visual analogue scale (VAS), and localization and timing of pain were reported by the participants. Postoperative nausea and vomiting (PONV) were documented if present. Results: Pain levels were significantly higher with general anesthesia 3 hours post-surgery, and 6 hours post-surgery the pain remains higher following general anesthesia but is borderline insignificant (p=0.051). However, 12 hours post-surgery, there is no significant difference in the pain level (p=0.240). There was no significant difference in the localization of pain with local and general anesthesia. Postoperative nausea is significantly more frequent after general anesthesia, and vomiting only occurs with general anesthesia. Local anesthesia was preferred by 94% of the participants (47 out of 50). Conclusions: The vast majority of patients in our study who have undergone both GA and LA DCR would choose LA again, providing a compelling case for use of the LA technique.
Graefe's Archive for Clinical and Experimental Ophthalmology, 2012
The presence of visible gas on radiography, computed tomography (CT), or magnetic resonance imagi... more The presence of visible gas on radiography, computed tomography (CT), or magnetic resonance imaging (MRI) is associated with various pathological conditions, ranging from severe infections caused by gas-producing organisms to cutaneous and subcutaneous tissue disruption that allows an interface with the air [1]. A high index of suspicion surrounds the finding of gas because of the virulence of conditions such as gas gangrene and necrotizing fasciitis [1–12]. Gas dissecting into the orbital soft tissues as a result of bacterial activity is a rapidly progressive, extremely serious, life-threatening ophthalmological emergency [1–12]. Gas gangrene (myonecrosis) and necrotizing fasciitis can cause necrosis of tissues and systemic shock with multiorgan failure, sometimes within a matter of hours [1–3, 13]. It is well known that the usual causative organisms in gas-producing infection from a contaminated wound are clostridial species: Clostridium perfringens accounts for the majority of cases (over 80 %), while most other cases are caused by other Clostridium species [1–3]. Clostridial infection is always associated with necrosis, and very often associated with poor functional and anatomical outcome [1–4]. However, a variety of other non-clostridial organisms, both aerobes and anaerobes, may also produce infections in which gas is demonstrable: Escherichia coli, Proteus species, Pseudomonas aeruginosa, Bacteroides, Klebsiela pneumoniae, Prevotella species, Staphylococcus aureus, Peptostreptococcus species, Fusobacterium species, and Streptococcus pyogenes are only the species reported most often in the literature [2]. Non-clostridial infections may take various forms, which lead to difficulties in making accurate and prompt diagnoses and are also related to the confusion between gas gangrene and various (bacterial and nonbacterial) lesions that simulate gas gangrene. Aside from the fact that non-clostridial organisms usually involve subcutaneous tissues, they may also involve muscle and simulate clostridial myonecrosis [2, 3]. However, non-clostridial gas infections accompanied by gangrene are not very common, even in immunosuppressed individuals [2, 3]. Since the initial report by Chiari (1893), which concerned a non-clostridial gas-forming infection due to a colon bacillus in the gangrenous lower limb of a diabetic patient [4], fewer than 40 cases of non-clostridial gas-forming infections have been described. Only four such cases have been described in the orbit [5–7, 12], and these are quite different from the present case. With regard to the pathogenesis of gas bubbles of clostridial or non-clostridial etiology, they are liberated by the bacterial fermentation of glucose [4]. In addition, impaired microcirculation may also contribute to gas formation [3, 4]. It is also necessary to mention the benign, non-infectious presence of gas in the orbit, which is known as orbital emphysema. Orbital emphysema is a well-known entity that can arise from nose-blowing, tumor presentation, or after fractures of the orbital floor, and may be self-induced in psychiatric patients [15]. There are no research contracts or any kind of financial support (grants) for this study. No authors have any conflicts of interest.
Background/Aim. Eye enucleation is one of the oldest surgical procedures. The aim of the study wa... more Background/Aim. Eye enucleation is one of the oldest surgical procedures. The aim of the study was to determine the causes of enucleation as seen in a major reference eye center in Serbia. Methods. Retrospective case series involving a review of all enucleation procedures performed in the period between January 2000 and December 2008 at the Institute for Eye Diseases, Clinical Center of Serbia, Belgrade. The collected information included the basic demographic data and diagnosis of the affected eye. The diagnosis was made based on history, clinical and histological examinations. Clinical indications for enucleation were categorized as tumors, glaucoma, trauma, infections and other diseases. A statistical analysis was made using the Student's t-test. Results. There were 586 patients, 315 male and 271 female in our series. The mean age was 57.81, ranging from 3 months to 96 years. The most common cause of enucleations was tumor (76.11%), (p < 0.05). Choroid melanoma was the most common etiology leading to enucleation (81.18%), followed by retinoblastoma (12.34%). A total of 8.02% of enucleations were performed due to glaucoma that was primarily neovascular in 42.55% of cases or caused by trauma in 38.8% of cases. Trauma was the third common etiology of enucleation, and it was acute in 56.26% of cases or resulted in phthisis bulbi in 31.25% of cases. Enucleation caused by inflammation was performed in 2.90% of cases, out of which 52.94% of enucleations occurred after perforation of the cornea. In the group of other diseases the most common cause of enucleation was atrophy of the eye ball. Conclusion. Neoplasm, neovascular glaucoma, acute eye injury and atrophy of the eye ball are the most common causes of enucleation.
h i g h l i g h t s Two novel methods namely; absorbance subtraction (AS) and amplitude modulatio... more h i g h l i g h t s Two novel methods namely; absorbance subtraction (AS) and amplitude modulation (AM) methods were developed. Six recently well established spectrophotometric methods (SRS, RD, RS, EXRS, CM and MCR) were applied. The proposed methods are very simple, accurate, precise. They do not require any sophisticated apparatus or computer programs. g r a p h i c a l a b s t r a c t Zero-order spectra of 40 lg/mL of DOR (-) and TIM (.. .), separately in methanol, and binary of a mixture of DOR and TIM, 20 lg/mL of each (-) and their ratio spectra using the spectrum of TIM (1 lg/mL) as a divisor.
Graves orbitopathy (GO) is an autoimmune disorder of the retrobulbar tissue 1 probably initiated ... more Graves orbitopathy (GO) is an autoimmune disorder of the retrobulbar tissue 1 probably initiated by autoreactive T lymphocytes which trigger a cascade of events including secretion of cytokines, 2 simulating proliferation of orbital fibroblastas, expansion of adipose tissue and secretion of glycosaminoglycans by the orbital fibroblasts. Therefore, immunosuppressants and anti-inflammatory agents are the treatment of choice for moderate-to-severe-and active GO. 3,4 Although different immunosuppressants including biological agents