Analysis of the influence of type of diabetes mellitus on the development and type of glaucoma.

AIM: Main the goal of the research is to analyze the occurrence of glaucoma in patients with diabetes mellitus type 1 (DM type 1) and diabetes mellitus type 2 (DM type 2). PATIENTS AND METHODS: The study involved 140 patients, 34 with DM type 1 and 106 with DM type2. In relation to the type of glaucoma to the patients are divided into two groups: Primary and Secondary glaucoma. According to the stage of diabetic retinopathy (DR) patients were analyzed in three groups: non-proliferative, preproliferative and proliferative DR. Since ophthalmological parameters were analyzed: best corrected visual acuity (BCVA), intraocular pressure (IOP), visual field (VF) of computerized perimetry, excavatio optic nerve (E/D) by optic coherent tomography (OCT). RESULTS: Applying the test of quotient chance found that subjects with DM type 1 have a 5.94 times greater chance of developing secondary glaucoma, but is of primary (P <0.0001). In patients with DM type 2, where the chance of getting the subjects of secondary glaucoma 4.43 times larger than that of the primary (P = 0.0002). CONCLUSION: Patients with DM type have great chance of developing secondary glaucoma of the primary. Primary glaucoma more common in NPDR but secondary glaucoma more common in PDR.

Optic neuritis as first clinical manifestations the multiple sclerosis.

AIM: To analyze the clinical signs of multiple sclerosis (MS) and show that optic neuritis is one of the first event, which indicates the development of disease. PATIENTS AND METHODS: The study involved 89 cases in which it confirmed MS at the time of the March 2009-2011. Since ophthalmological parameters were analyzed visual acuity (VA), visual field (VF), and retinal nerve fibre layer (RNFL) thickness of peripapillary rim by optic coherent tomography (OCT). RESULTS: Ten(10) patients had ON as the first clinical manifestation of the disease which was statistically significant (X(2) =9,7 p=0,01) compared to the manifestation of other clinical signs of disease. In VF, centrocecal scotomas were predominant in 50% of the subjects; the RNFL thinning of the neuroretinal rim was verified in all patients, most often in the upper quadrant. A month after pulse corticosteroid therapy, visual acuity in all patients with ON ranged from 0.6 to 1.0. CONCLUSION: ON is one of the first MS clinical manifestation. In VF, the most common disturbances are in the centrocecal area. The RNFL thinning was verified in all patients with OCT.

Relation between near work and myopia progression in student population.

AIM: To determine relation between near work and myopia progression in student population. Causes of myopia occurrence are not sufficiently explained. METHODS: This retrospective-prospective, descriptive research included 100 students with verified myopia up to -3 Dsph. Ophthalmological examination and measurement diopter-hours variable (Dh) were done twice, in the period from January 2011 until January 2012. RESULTS: A multivariate regression analysis of impact on the difference of distance visual acuity without correction to the right and left eye and difference of automatic computer refractometry in cycloplegia of both eyes indicates that, diopter-hours variable (Dh) had statistically significant impact on increase of distance visual acuity difference (right eye OR: I measurement-Dh 1.489, II measurement-Dh 1.544, p<0.05; left eye OR: I measurement-Dh 1.602, II measurement-Dh 1.538, p<0.05) and automatic computer refractometry in cycloplegia (right eye OR: I measurement 1.361, II measurement 1.493, p<0.05; left eye OR: I measurement 0.931, II measurement 1.019, p<0.05) during both measurements. CONCLUSION: Near work cause the increase of myopia. This research opened a perspective for other researches on the impact of near work on myopia.

Influence of the optic disc size on cup diameter in patients with glaucoma simplex chronicum.

INTRODUCTION: The relationship between the optic disc size, neuroretinal rim and cup diameter is the key in identifying glaucomatous changes in optic nerve head. Like some other biological characteristics, changes of the optic disc differ among healthy populations, thus hindering detection of pathological changes. MATERIAL AND METHODS: From the total number of 90 patients, we selected those that have optic disc diameter less than 1.30 mm, greater than 2.10 mm, as well as patients with a size of disc diameter ranging from 1.31mm to 2.09 mm. In all patients after anamnesis and standard ophthalmologic examination (best corrected visual acuity-BCVA, Goldman aplanatic tonometry, pachymetry, gonioscopy), we also performed the OCT analysis of the optic nerve head. RESULTS AND DISCUSSION: Glaucomatous changes in small optic discs may remain unnoticed unless there is a high degree of suspicion. The assesment of the optic disc size is an important, but often overlooked component of the diagnostic evaluation in glaucoma. There was a statistically significant strong positive correlation between the size of the optic disc diameter and cup diameter, larger optic disc diameter means greater cup diameter. Due to the large variation in the cup size in healthy subjects, the assessment of the morphology of the neuroretinal rim or cup diameter can be more helpful in evaluation of glaucomatous optic disc damage than the value of C/D ratio itself. CONCLUSION: Evaluation of the optic disc size and C/D ratio is an essential part in diagnostic procedure and management of glaucoma. OCT analysis in patients with small optic disc diameter showed the least sensitivity in all three categories (normal, abnormal and uncertain OCT results). The OCT results in the small optic disc diameter are the least reliable in the diagnosis of glaucoma. More complexed long-term study is needed to evaluate this complicated relations between optic disc diameter, C/D ratio, neuroretinal rim and other important clinical factors in emerging glaucoma disease.

[Congenital optic disc excavatio]. / Kongenitalna eskavacja papile nervi optici.

We presented a case of congenital optic disk pit, rare congenital abnormality in the patient 23 years old male. Stereoscopic fundus examination revealed oval, gray defect of nerve tissue located in the temporal quadrant of optic nerve. We noticed and exophthalmus. Laboratory test showed slightly elevated thiroid tests. In the follow-up period of two years visual acuity was stabile while visual field showed deep parapapilar scotoma.