[Less frequent etiology in uveitis]. / Uveitele cu etiologie mai putin frecventa.

This material intends to present three clinical observations regarding the uveitis etiology, that is represented by the association of some etiological factors less known: Toxoplasma gondii, Listeria monocytogenes, Leptospira icterohaemorrhagiae. The uveitis described here have been severe in the fast evolution and with trends of reappearence. This work demonstrates that the strict etiological antibacteria and antiparasite therapy is not enough and only corticotherapy is able to fight against the accentuated inflammatory phenomena that go along with type of uveitis.

[Tears' immunology in acute eye diseases]. / Imunologia lacrimilor în afectiuni oculare acute.

The aim of the study is to research the immunoglobulins' concentration into the tears liquid and into the blood serum at the patients with acute affections of the anterior ocular pole. The study was accomplished on two groups of patients: one group with herpetic Keratitis, the other with anterior uveitis, the second having a different etiology--that the viral one. Another group of patients with senile cataract was used like witness-group. The immunoglobulins concentration were detected into the serum and into the tears by the Mancini method of the radial immunodiffusion. The results indicate a general immunodefficiency signed by the decrease of IgG and IgM into the serum on the one hand, and the increase of local defense mechanisms reflected on the growing of IgA and IgG level into the tears, on the other hand.

[Evolution of ocular infection in diabetes mellitus patients]. / Evolutia infectiilor oculare la bolnavii cu diabet zaharat.

PAPER AIM: The paper presents the infectious complications at patients with diabetes mellitus, and the evolution of these complications with the type of diabetes and the treatment with orale hypoglycemic agents or insulin. MATERIAL AND METHOD: The survey was fulfilled in the Clinic of Ophthalmology of Craiova and in the Metabolic Diseases clinic, during a period of 10 years. RESULTS: We surveyed 497 hospitalized patients, and we noticed different infectious complications: kerato-endothelitis in 9 cases, herpetic keratitis in 11 cases, anterior uveitis in 16 cases, corneal ulcus in 24 cases, total uveitis in 6 cases. In 17% of the cases, the patients were not previously aware about the diabetes affection. CONCLUSIONS: The very severe infectious complications of the eye in diabetes, determine the doubling of the ocular and general treatment, for normalisation of the blood glucose and a good evolution of the diabetes.

[Oculo-orbital manifestations of paranasal sinus diseases]. / Manifestari oculo-orbitare în afectiuni sinusale.

PURPOSE: The paper is a study of the oculo-orbital affections established by the sinusal lesions. METHODS: The study is retrospective for five years and it is affected by the patients with ocular and orbital affections hospitalized in Ophthalmological Clinic. Were used the sheets of the patients and a collaboration with ORL Clinica, where the sinusal affections were surgical cured. RESULTS: The ocular lesions caused by the sinusal inflammations were: acute uveitis, orbital cellulitis, unilateral exophthalmia without obvious inflammatory signs. The oculo-orbital signs were missing with oculo/sinusal treatment. CONCLUSIONS: Without treatment, the inflammatory or tumoral affections of the paranasal sinus, established oculo-orbital complications and the patients request the first time the oculist. It is necessary a collaboration between the ORL--ist and the oculist physician for of these cases.

[Inflammatory ocular diseases associated with oro-dental pathology]. / Afectiuni inflamatorii oculare asociate patologiei buco-dentare.

PAPER AIM: It is presented the correlation between the uveitis and the focal dental disease with infection, irritation or allergic pathogenicity. MATERIAL AND METHOD: This study was performed on a set of 54 patients with uveitis and dental diseases patients hospitalized in the Clinic of Ophthalmology of Craiova, during 1998-1999. This correlation was observed in 38-40% of uveitis. There were also mentioned some dental damages associated with uveitis: radicular focal infections, periodontitis under prosthetic works, fights cavities, inclusions dental chronic maxillary osteitis. RESULTS: The correlation uveitis-dental diseases was noticed in 1.2-1.8% of the hospitalized patients, comparing with 3-5% in literature (including the ocular adnexa diseases). CONCLUSIONS: This study shows the reality of the correlations between uveitis and dental diseases. It was relieved the importance of correlation ophthalmologist-stomatologist.

[Changes in the vascular wall in the conjunctiva of patients with diabetes mellitus]. / Modificari ale peretelui vascular în conjunctiva bolnavilor cu diabet zaharat.

Venous capillary wall in type II diabetic patients' conjunctiva was examined. The study was performed on conjunctiva fragments removed from diabetic patients during the operation of senile cataract. The fragments were fixed in Lillie's solution then studied by using optical microscopy with usual but histochemical stainings, too. Conjunctiva fragments removed from patients of the same age, being operated by senile cataract and one conjunctiva from ten years old patient were examined by using the same techniques as they could be compared. Computer determinations of the external and internal diameter of the same capillary in all three groups were performed. Venous capillary wall thickening by type IV collagen hyperproduction in all the aged patients was noted. This kind of thickening is more revealed in aged diabetic person. Type I-III collagen presence in the capillary wall of the diabetic patients was noted, too. The average value of the differential between the external and internal diameter was increased in the diabetic patients with diabetic retinopathy. Venous capillary wall thickening in the diabetic patients is due to the basal membrana both by means of the type IV collagen hyperproduction and presence of the I-III collagen, too.

[The incidence of ocular complications in 10,000 diabetes mellitus patients hospitalized at Dolj County Clinical Hospital]. / Incidenta complicatiilor oculare la 10.000 de pacienti cu diabet zaharat dispensarizati la Spitalul Clinic Judetean Dolj.

The paper surveys the statistical results of retrospective analysis for observation sheets of patients having mellitus diabetes, type I and II, hospitalized during the last 10 years at the Ophthalmological Clinic in Craiova. The accent was made on the ocular complications related to the type of mellitus diabetes, the age of its debut, the evolution length, the treatment made, glycemia compensation, which make this affection to be the first cause of cecity at adult age.

[The ocular changes in patients on chronic dialysis]. / Modificari oculare la bolnavii dializati cronic.

The paper propose the study of lacrimal secretion alterations, the lacrimal level of the urea and the fundus optic alterations at the patients with chronic renal failure, during the hemodialysis. For the study we used the general ophthalmologic examination, the fundus optic examination before and after the hemodialysis, the lacrimal secretion examination by Schirmer l-test and the measure of lacrimal urea by the Berthelot modified method. The study was done on a member of 30 patients, with chronic renal failure, having a age of the dialysis between one and 80 months. The results of the study showed lacrimal hyposecretion, the urea lacrimal level being lower than the urea blood level and a concordance between the lacrymal and sanguine clearance of the urea. The fundus optic examination during the hemodialysis showed a pale aspect of the fundus the pallidity being more pronounced before the dialysis with filiforme arterioles, apparently without content, significant for decreasing of the circulatory debit.

[The exacerbating role of the vascular factor in the evolution of open-angle glaucoma]. / Rolul agravant al factorului vascular în evolutia glaucomului cu unghi deschis.

UNLABELLED: The paper proposes to study the ophthalmic and carotid circulation of patients with primary open-angle glaucoma in varied stages of evolution. MATERIAL AND METHOD: The lot is formed by 8 patients with primary open-angle glaucoma, selected such that one eye to be absolute or quasiabsolute and the congener eye in incipient stage. The average (medium) age is 64 years, the patients having blood pressure within normal limits. The study of ophthalmic and carotid circulation was made by echo-Doppler and the calcul of velocimetric indices. RESULTS: The resistance index is increased in concordance with the stage of glaucoma. The diastolic flux is the most serious affected. There is no parallelism between the blood pressure value and the grade affectation of velocimetric indices. CONCLUSIONS: The local vascular diseases, ophthalmic and carotid, influence unsatisfactory the evolution of primary open-angle glaucoma.

[Syphilitic parenchymatous keratitis]. / Cheratita parenchimatoasa sifilitica.

It shows a clinical observation about luetic bilateral keratitis at a young man 17 years old. The high-positive VDRL, the presence of the AT antigen, the bilateral low hearing perception and the left low hearing transmission associated with minimal dental malformations suggest the luetic congenital etiology of the disease. The AT positive-test at the patient's mother (which VDRL is negative) shows a tardive luetic infection during the pregnancy, that has determined the apparition at the fetus of congenital lately lues. The specific antiluetic treatment with Benzylpenicillinum kalicum and Prednisonums the evolution of the disease is spectacularly good. Six weeks after the beginning of the treatment V.A. is 1 at the both eyes and the neoformation vessels are completely obturated. The paper insists on the medical and social implications of the ignored complications of late lues.

[Sympathetic ophthalmia in a case of neurilemmoma of the ciliary body]. / Oftalmie simpatica într-un caz de neurilemom de corp ciliar.

The paper presents the case of a 62-year-old male patient, which has been hospitalized with the symptomatology of a acute glaucoma through intumescent lens. After the lens extraction, the globe evolution was to atrophy with chronic irrigation, starting a hypertensive cyclitis at the other eye, assumed to be a sympathetic ophthalmia. After several acute evolutive episodes at both eyes, the enucleation of the primal eye was made and a ciliary body tumour (neurinoma) was discovered. After enucleation under general and local cortisone treatment, the inflammatory phenomena at the sympathetic eye were entering in remission; but the hypertony, which was considered to be an open-angle pre-existent glaucoma, was persistent. The paper also discusses the sympathetic ophthalmia producing mechanism the characteristics of the ciliary body tumour and the diagnosis problems raised by this case.

[Dacryocystorhinostomy in children]. / Dacriocistorinostomia la copil.

During the last ten years 218 dacryocystorhinostomies were done, 8 of them on under 10-years-old children (3.7%). Dacryocystorhinostomy remains the only curative intervention which may be done on children even when the lacrimal ways sounding is inefficient. The surgical technique was the same as the one used for the adults, with some characteristic features imposed by the age of the patient. The intervention was some especially on children with congenital imperforations of the lacrimo-nasal channel, when the repermeability of the lacrimal ways could not be obtained by repeated soundings, but also in traumatic and congenital malformed dacryocystitis. The operation was made with good results even after the extirpation of the lacrimal sac, followed by the formation of a neosac. In the observations we presented the underlimit of the intervention has been 2 years and 4 months.

[Corneal rodent ulcer]. / Ulcus rodens cornean.

It is presented the observation of a 67-years-old female patient with relapsed ulcus rodens at the right eye. Are also discussed the etiopathogenic mechanisms of the affection and the actual treatment principles, based on the mechanism of self immunity which stays at the basis of the disease's pathogeny.

[The role of accommodation in functional strabismus]. / Rolul acomodatiei în strabismul functional.

The accommodative reflex unleash is produced by many stimuli, of which the most important are the lack of clarity of the retinal image and the convergence. The ciliary muscles, although innervated by vegetative fibres, behave like striated fibres. It is also discussed the role of accommodation in the appearance of functional strabismus.

[The late results of protected goniotrepanation]. / Résultats tardifs de la goniotrépanation protégée.

The analysis of 737 goniotrepanation with scleral protection shows the higher efficacy of this operation in comparison with other protected fistulizing operations. The normalization of the intraocular pressure persisted in 97% of cases a year after the operation and in 80% five years. According to the evolutive stage of the disease, 50% of the operations were performed in the second stage of glaucoma, 13% in the advanced and quasi-absolute glaucoma stage and only 17% in the initial stage of the disease. The normalization of the intraocular pressure was directly proportional to the evolutive stage of glaucoma. The intraoperative incidents were minimal and the reduced postoperative complications did not influence the visual function. Owing to the simplicity of the technique and to the better results over time, authors prefer protected goniotrepanation to other fistulizing operations.

[Ocular manifestations in Stevens-Johnson syndrome]. / Manifestari oculare in sindromul Stevens-Johnson.

A patient woman, 45 years old, showed bilateral corneal ulcers, symblepharon, milkish-white scars, cicatricial entropion, trichiasis, lacrimal hyposecretion within a Stevens-Johnson syndrome. Histological examination of the conjunctiva shows a necrosis process of epithelium with phlyctenular cavities and abundant subepithelial inflammatory infiltrate. The affection etiopathogenesis is discussed.

[Pathologic cataract due to ovarian failure]. / Cataracta patologica din insuficienta ovariana.

The analysis of a group of 289 presenile cataracts, in patients between 31 and 60 years old showed that 33 cases were due to ovarian insufficiency, 9 of them appeared after ovariectomies for ovarian cyst, 9 after hysterectomies, 4 after other obstetrical and gynecological surgeries, 2 after ovarian inflammatory processes and 9 were generated by central ovarian insufficiency with precocious menopause. The low secretion of ovarian hormones and mainly of estrogenic hormones induces--at the level of sensitive receptors--involutive modifications such as the lens opacification.