[Normal tension glaucoma or syndrome of chronic ocular ischemia]. / Glaucom cu tensiune normala sau sindrom de ischemie soculara cronica?

Chronic ischemia related to a manifest ophthalmic artery stenosis, determines extremely rare ischemic chronic modifications at the level of the optic nerve, with progressive optic atrophy and visual fun ction alteration. It is presented the case of a 59 years patient, who was hospitalized in Clinic of Ophthalmology, Emergency Clinic Districtual Hospital, for decreased vision of the left eye. Fundus eye examination reveals normal aspect of papilla of the right eye and glaucomatous like modification of the left eye, confirmed by perimetry and OCT exams, which present typical glaucomatous lesions. Doppler examination revealed an enormous thrombus at the level of the left internal carotid, with more than 90% stenosis. In this context the diagnosis was chronic ocular ischemia, atypical form. lschemic ocular syndrome presents polymorphic clinic aspects, the most frequent are the ischemic lesions of posterior pole of the eye: retinal hemorrhages, neovascularization, ischemic edema, red cherry macula, cotton-wool spots. lschemic optic neuropathy is less frequent presented, and pseudo-glaucomatous lesion of optic nerve with papillary excavation is exceptional.

[Laser trabeculoplasty--a review]. / Trabeculoplastia laser--trecere in revista a literaturii.

Laser therapy in open angle glaucomas represents an important step in their management, a topic of intense research during the second part of the XXth century. The initial enthousiasm generated by spectacular results obtained with minimal risks and complications, was soon tampered by their short survival. Nowadays, laser therapy is considered a second or third line therapy, alternative to surgery or intermediate stage between medication and surgery. There are selected cases in which laser therapy may be first line treatment in open angle glaucomas.

[Assessment of systane in severe dry eye]. / Evaluarea eficacitatii systane in formele severe de ochi uscat.

The study proposes the evaluation of the Systane effect on people that have severe dry eye sensation, with cornea or conjunctive complications. In order to do this, a study protocol has been adopted which meant comparing the values of lacrimal film break-up time, before and after Systane treatment, comparing cornea and conjunctive staining, comparing the crystallization test before and after treatment, comparing the conjunctival impression before and after treatment, and the general acceptability of Systane. The study results have shown that in severe dry eye cases, Systane increases lacrimal film break-up time by 2-3 seconds than the initial value, as well as considerable reduction in cornea/conjunctival staining and in conjunctival hyperemia in Sicca keratoconjunctivitis. After treatment, conjunctival impression have shown the proliferation of conjunctival and goblet cells, with normal morphologic aspect of the new-formed cells. In every case, the regenerating effect on epithelia of Systane was obvious, which is determined by the direct action of the HP-guar, forming a protective layer with lubrication effect, helpful to the initiation of tissue repairing processes.

[Conjunctival stamp in diabetic patients]. / Amprenta conjunctivala la bolnavii diabetici.

UNLABELLED: The authors have suggested to reveal conjunctiva stamp changes in diabetic patients. A set of patients aged between 50 - 80 and having been diagnosed with diabetes mellitus were available for our study, therefore they have been ophthalmologically examined; both Schrimer and BUT tests have been performed. We removed conjunctiva stamps which, after being fixed and Giemsa stained, they were investigated by photonic microscopy. As to compare them we removed conjunctiva stamps from a group of control which was also Schrimer and BUT tested. RESULTS AND CONCLUSIONS: Both Schrimer and BUT tests pleaded for lacrimal hyposecretion in most of the diabetic patients; their conjunctiva stamps presented changes at the levels of both epithelial and calyciforme cells. Conjunctiva stamps were significantly changed in the old patients with a long lasted diabetes evolution pleading for the diagnosis of lacrimal hyposecretion syndrome (dry eye syndrome) in those patients.

[Sicca syndrome in major collagen diseases]. / Sindromul Sicca în colagenozele majore.

The purpose of this paper is to diagnose the patients with ocular sicca syndrome in major collagenosis, to evaluate the clinical and histopathological lesions, related to stage of the disease and to establish significant correlations between the different clinical tests for qualitative and quantitative determination of lacrimal tear and the severity of ocular disorders. Dry eye disease is a very common disorder of tear film in collagen diseases. The gender ratio is 6/1 female/man. The most severe dry eye symptoms are also presented at women. The diagnostic and the treatment of dry eye rest difficult because of lack of accepted diagnostic criteria and lack of standardized, specific diagnostic tests. The results of this study have revealed that the ophthalmologic examination is necessary to all the patients with collagenosis who present ocular symptoms. The ophthalmological exam will contain qualitative and quantitative tests of lacrimal evaluation and a methodic biomicroscopic examination of corneo-conjunctival surface without and with vital staining. Rheumatoid arthritis is the collagen diseases which most frequently associates ocular sicca syndrome in mild and medium clinical forms.

[Uveal melanoma]. / Melanomul malign uveal.

The paper present a clinic and histological study, including all cases of uveal malignant tumours, hospitalized in Ophthalmological Clinic of Craiova in the last 15 years. The follow-up period of cases were 4 years. The diagnosis was established by clinic and paraclinic examination (imaging methods-- MRI, CT, Echo) and histologic examination. The histologic examination has been done for all cases. There were investigated several parametres: tumour cytology, the level of pigmentation, intravascular embolus, sclera infiltration, vascular invasion, vascular pattern, tumoral necrosis, mitotic activity. The histologic aspects of tumoral progression were: the high level mitotic activity, high surface area of intratumoral necrosis, the infiltrative process to the vessels, sclera, and ciliary body. The arcuat and network vascular patterns were involved in the systemic metastasis and local invasion. The most predominant type of cellularity related with a severe evolution of cases were the epithelioid cells and the mixed type cells.

[General and local risk factors in infectious keratitis]. / Factori agravanti locali si generali în cheratitele infectioase.

PURPOSE: The paper presents a study of corneal ulcers at aged persons for the identification of etiologic and aggravates factors that may have a negative influence for the prognostic of the diseases. MATERIAL AND METHOD: We have performed a retrospective study using a lot of aged patients with corneal ulcers, hospitalized in 2002-2003 period. The data were obtained by both clinical examination (anamnesis and ocular examination) and by the laboratory exams (microbiologic exam). RESULTS AND DISCUSSIONS: We have analyzed by the epidemiological point of view, the distribution of cases with the age, sex, provenance area, and profession. We have demonstrated a predominant repartition of cases in the 7-th decade (45%) and for the masculine patients (in 60% of cases). The patients from rural area represented 75% of cases. In relationship with the etiology, the traumatic ulcers represent 25%, microbial keratitis 45% associated with local or general aggravating factors. Microbiological exam has revealed in principal non pathogen or pathogen germs in 10 cases (staphylococcus), moderate virulence germs in 5 cases (streptococcus) or very virulent germs (escherichia colli and pyocyanic bacillus) in 2 cases. CONCLUSIONS: The evolution of corneal ulcers at aged people is determined by etiologic and aggravating factors. The improvement of the evolution and of the prognosis depends on the most precocious application of local and general therapeutic measures.

[Neovascular glaucoma--retrospective study]. / Glaucomul neovascular--studiu clinic retrospectiv.

The paper realized the retrospective evaluation of all cases of neovascular glaucoma hospitalized in Clinic of Ophthalmology of Craiova in the last 15 years. Neovascular secondary glaucoma represents 3,9% of all glaucomas. The most important etiologic factors were the central venous occlusion, diabetic retinopathy, carotid occlusion, intraocular tumors, chronic uveitis, Fuchs heterochromy. Neovascular secondary glaucoma is characterized by important hypoxic tissues destructions, presented of all levels that lead to neovessels formation with irreversible anatomic and functional losing of ocular globe. The identification of neovascular glaucoma causes and their treatment is important to prevent that diseases.

[Histological particularities of sclerocorneal limbus--implications in ocular pathology]. / Particularitati histologice ale limbului sclero-corneean; implicatii în patologia oculara.

The study tried to compare the sclerocorneal limbus in human eyes and animal eyes, using the same histological technique (preserving in paraphine and stained with hematoxylin-eosine, trichromic Goldner-Szekelly and orceine method). The sclerocorneal limbus represents the passage zone between cornea and sclera, and its importance for medical practice, consists on the implications of this area in the ocular physiology. We have demonstrated in this study that the two structures are not interrupted briefly; the corneal epithelium at the limbus send in the deeper structure a ramification which represents a modality of stronger anchorage of subjacent conjunctiva. At that level it is detectable a gradual translation between corneal conjunctival tissue and scleral conjunctival tissue. The vascular and neural structures are important in this area with an important role in ocular surgery, their presence of this level permeating the cicatrisation.

[Primary juvenile glaucoma--clinical and genetic aspects]. / Glaucomul juvenil primitiv--aspecte clinice si genealogice.

PURPOSE: We have done a retrospective study of juvenile glaucoma cases hospitalized between 1993-2002. MATERIAL AND METHOD: 52 primary juvenile glaucoma patients were available for our clinical and genealogical investigations. RESULTS: In this study we have analyzed the distribution of cases per year, the age of appearance of the diseases, and the distribution in function of the sex and the genealogical factors. Genealogic analyze was performed by statistical methods: Weinberg and penetrance. CONCLUSIONS: Under 16 years, juvenile glaucoma diagnosis was mostly established by examining the children for visual acuity disorders caused by different ametropies, especially progressive rapid myopia. Genealogical exams confirmed an autosomal recessive transmission with incomplete variable penetrance but the possibility of polygenic multifactorial heredity may be also considered.

[Optic nerve lesions in diabetes mellitus]. / Leziuni ale nervului optic în diabet.

The present paper is a retrospective study revealing some optic nerve lesions on a group of 1.700 diabetic patients which belonged to the common casuistry of the Ophthalmologic Clinic and Diabetic and Nutrition Diseases Clinic in Craiova. A reduced frequency of optic neuropathy in diabetic persons was established such as: 27 patients (1.58%). Affected optic nerve may present various clinical aspects among which ischemic optic neuropathy is predominant (59.20%) followed by secondary optic atrophy, ischemic optic post neuropathy (33.40%) and juxtabulbar optic neuritis (7.40%).