Indices for the detection of keratoconus.

Identification of keratoconus has become a step of primary importance in the preoperative evaluation for the refractive surgery. In order to decrease the secondary ectasia after refractive surgery the preoperative screening of keratoconus is very important. Corneal topography, the most useful tool in the diagnosis of keratoconus, offer us the possibility of an early diagnosis of KC by a lot of mathematical indices calculate to determine the disease with a higher specificity and sensitivity. Although useful, these indices may be difficult to understand and use.

[Compliance and ignorance in glaucoma in Romanian patients]. / Complianta si ignoranta în glaucom la pacientii români.

The compliance to treatment of glaucoma patient has a big importance on the long term vision preservation, as well as on the quality of life of our patients. Unknowing and misunderstanding of disease real implications and the importance of the treatment are present in out every day practice in our patients. We want to identify and analyze these aspects in a glaucoma group of Romanian patients, knowing the implications of socio-economic aspects.

[Ocular hypertension--follow up or treatment?]. / Hipertensiunea oculara--între urmarire si tratament.

Ocular hypertension is an increase in the pressure in the eyes that is above the range considered normal with no detectable changes in vision or damage to the structure of your eyes. The term is used to distinguish people with elevated pressure from those with glaucoma, but not all people with ocular hypertension will develop this disease. However, there is an increased risk of glaucoma among those with ocular hypertension, so regular comprehensive eye examinations are essential to the overall eye health.

[Normotensive glaucoma]. / Glaucomul normotensiv.

Normal tension glaucoma is a form of primary open angle glaucoma where the intraocular pressure remains within the normal range. In this case the main challenge is to establish the correct diagnosis. The clinical evaluation of a patient suspected of a normal tension glaucoma must answer two questions: 1) is the intraocular pressure normal and 2) is it a glaucomatous optic neuropathy or another type of optic neuropathy?

The antitoxoplasma gondii antibodies incidence to the different ocular diseases patients cases of human ocular toxoplasmosis infections in Romania.

Toxoplasmosis is an anthropo-zoonosis widely spread around the earth, whose ocular complications are very frequent and are often a first sign of infestation. This is a retrospective statistic research based on the clinical survey and periodic control of a lot of 135 patients with toxoplasmosis, out of which 90 presented ocular toxoplasmosis.

[Age related macular degeneration and C-reactive protein]. / Degenerescenta maculara legata de vârsta si Proteina C reactiva.

C-reactive protein (CRP) is a systemic inflammatory marker associated with the cardiovascular risk profile. Some of the cardiovascular risk factors are linked with the development of age related macular degeneration (AMD), but the correlation between CRP and AMD is not yet well documented. Our current study is trying to emphasize the correlation between plasma CRP levels and the risk for AMD. In our study we used two groups of subjects homogenous by age and gender--group A formed of patients diagnosed with AMD and a group B with normal subjects to whom we measured the plasma levels of C-reactive protein using standard testing with high sensitivity. Our data suggests that there is a correlation between the elevated plasma levels of CPR and the stages of age related macular degeneration possibly implicating the inflammation in the etiopathogenic mechanism.

[Cataract surgery and postoperative endophthalmitis]. / Chirurgia cataractei si endoftalmita post-operatorie.

UNLABELLED: The purpose of this paper is to evaluate the incidence of endophthalmitis after the phacoemulsification. MATERIAL AND METHODS: Retrospective clinical study that includes all the patients that have been operated and all cases of endophthalmitis survived after that in the period between 1.06.2007-31.05.2008 in the Central Military Hospital. RESULTS: There were 3 cases of exogenous endophthalmitis after the cataract surgery. In all of these cases: the inflammatory reaction was limited in the anterior chamber; phacoemulsification; there were no accidents in the cataract surgery; it was performed 2.75 mm clear corneal incision; it was no suture. CONCLUSION: There is a possibility of infections even after phacoemulsification without sutures.

[Macular involvement in glaucoma]. / Implicarea maculei în evolutia glaucomului.

PURPOSE: To assess the macular structural changes in primary open angle glaucoma (POAG) patients. METHODS: A prospective clinical study, 6 months, two groups of patients--group A--case control--healthy subjects, and group B--POAG patients, divided in B1--early glaucoma and B2--advanced glaucoma. The groups were homogeneous about age and sex distribution. In all patients we have performed Humphrey Visual Field, 24-2 Sita Standard, and macular OCT. EXCLUSION CRITERIA: other ocular or systemic conditions. RESULTS AND CONCLUSIONS: In POAG group, we found macular changes comparing to the case-control group. Macular assessment in glaucoma is an important element to consider in the future.

[TGF-beta2 involvements in open angle glaucoma]. / Implicatiile TGF-beta2 în glaucomul primitiv cu unghi deschis.

PURPOSE: To emphasize the correlation between TGF beta2 and primary open angle glaucoma (POAG). METHODS: Observational clinical study on two groups of patients: group I--17 patients with POAG who need surgical approach and group II--16 patients without glaucoma. The groups were homogeneous regarding age and sex. The exclusion criteria were any associated systemic pathology. The concentration of TGF beta2 in the aqueous humor of each patient of both groups was measured by ELISA method. RESULTS AND DISCUSSIONS: After the comparative analysis we observed that TGF beta2 was more increased in patients with POAG than in patients without the disease. The changes of trabecular extra cellular matrix are induced by many factors. TGF beta2 is a special cytokine witch is believed to increase the fibronectin concentration in the trabecular meshwork and alter the extra cellular matrix turn-over with a final profibrotic effect.

[Ocular surface disfunction in glaucoma]. / Disfunctia suprafetei oculare în glaucom.

PURPOSE: To determine the effects of travoprost 0.004% and latanoprost 0.005% treatment on ocular surface in primary open angle glaucoma (POAG) patients. METHODS: Clinical, observational prospective study, during 6 months on two groups of patients newly diagnosed with POAG. Group I (10 patients) was treated with travoprost 0.004% and group II (10 patients) was treated with latanoprost 0.005%. The groups were homogeneous about age and sex, exclusion criteria being any ocular or general associated pathology Routine ophthalmic examination was performed before and after treatment. At each examination was performed Schirmer 1 test and break up time test. Conjunctival cytology specimen was taken and goblet cells density evaluated. RESULTS: There was statistically significant difference in goblet cell density Schirmer 1 test and BUT test before and after treatment (p<0.05). For the both groups the decrease of IOP was similar (from 23.7+/-1.5 mmHg to 15.4+/-1.7 mmHg in group I and from 24.3+/-1.5 mmHg to 15.8+/-1.7 mmHg in group II). CONCLUSIONS: This study showed that travoprost 0.004% and latanoprost 0.005% treatment can have adverse effects on ocular surface and may give rise to dry eye symptoms.

[Malignant glaucoma]. / Glaucomul malign.

Malign glaucoma is an important challenge for the ophthalmologist by the incomplete knowledge of the exact etiopathological mechanisms and by the fact that represent the most difficult type of secondary glaucoma to treat, that has a reserved prognostic.

[Cataract surgery and diurnal fluctuations of IOP in non-glaucoma patients]. / Chirurgia cataractei si fluctuatiile diurne ale PIO la pacientii neglaucomatosi.

PURPOSE: To study the effect of cataract surgery on diurnal IOP fluctuations. METHODS: Three months clinical, observational, prospective study on one group of 34 patients (34 eyes) with cataract surgery (phacoemulsification technique) performed by the same surgeon. The IOP was measured, every two hours, for each patient (from 8am to 18pm) preoperative and postoperative by Goldman aplanotonometry. EXCLUSION CRITERIA: not normal open angle in gonioscopy examination and ocular or general associated diseases. The group was homogeneous about age and sex distribution. Statistic analyse was realised by t student test. RESULTS: Cataract surgery reduced IOP at all time points of measurement (p<0.05). The mean IOP was decreased from a preoperative level of 12.3+/-2.5mmHg to 11.2+/-2.2mmHg at follow-up (p<0.05). The maximum and minimum IOP also showed significant difference. There was no difference in the range of IOP before (3.0+/-1.5mmHg) and after surgery (2.75+/-1.5mmHg) (p<0.05). CONCLUSION: Cataract surgery significantly decreases IOP and has no effect on diurnal IOP fluctuation.

[Ginkgo biloba in glaucoma]. / Ginkgo biloba în glaucom--de la teorie la practica.

The two principal directions in the therapy of the primary open angle glaucoma (POAG) are lowering intraocular pressure medication and the surgical way. None of these two therapeutic modalities act on independent pressure risk-factors Thinking in this direction the neuro-protection concept should be in our minds all the time in the treatment of this disorder.

[The future started: nitric oxide in glaucoma]. / Viitorul a început: oxidul nitric în glaucom.

UNLABELLED: Nitric oxide (NO) is an important messenger intra and extra molecular implicated in vasodilatation, contractility, neurotransmission, neurotoxicity and inflammation. NO is formed from L-arginine by nitric oxide synthase (NOS). Nitric oxide synthase has three isoforms: NOS- 1 neuronal, NOS-2 inducible and NOS-3 endothelial (role in vasodilatation). Nitric oxide has a demonstrate role in many neurodegenerative diseases like: glaucoma, Alzheimer disease, multiple sclerosis and cerebral-cardio-vascular diseases. PURPOSE: To investigate the activity of the NOS by immunohistochemistry in patients with primary open angle glaucoma (POAG). METHODS: Observational, prospective, clinical study, during 9 months on one group of 9 patients with POAG that have underwent filtering surgery - trabeculectomy. The fragments of trabecular meshwork harvested during surgery were studied by immunohistochemistry for NOS. The exclusion criteria at the beginning of the study were any ocular or general pathology associated. RESULTS AND CONCLUSIONS: After laboratory analyses in patients with primary open angle glaucoma we observed the presence of the activity of NOS in trabecular meshwork. The trabecular distribution of NOS suggests an important role of nitric oxide in the future therapies for the glaucoma. The increase of nitric oxide makes vasodilatation and improves contractility in the trabecular meshwork; the final effect being the decrease of intraocular pressure and on the other hand the contra-apoptotic effect giving neuroprotection.