[A peculiar case of microcystic macular edema]. / Un caz particular de edem macular microchistic.

We present a case of microcytic macular oedema, in a patient 60 years old, suffering of systemic lupus erythematosus. The specific feature of the case is the presence of the microcystic macular oedema, as the only form of manifestation of the retinal lesions in the posterior pole. The diagnosis, etiopathogenicity and treatment are discussed.

[Serpiginous choroiditis - clinical study]. / Coroidita serpiginoasa--studiu clinic.

The work shows a retrospective study a period of 12 years, on a number of 34 cases of serpiginous choroiditis. The average age of the patients was 36 years (29-68). The start of the illness was juxtapapillary in 99.1% and macular on 5.9% of the cases. The bilateralism was present in all the cases (delayed start), and the visual acuity was strongly affected in macular localizations. The ophthalmoscopical and angiofluorographic aspect is specific for all the evolutive phases, and the extension of the lesions is made by means of pseudopodia. problems of differential diagnosis, pathogenesis (hereditary, inflammatory, vascular) are discussed. We have obtained satisfying results by triple association of immunosuppressants: azathioprine, cyclosporins and prednisone.

[Myelinated nerve fibers associated with juxtapapillary haemorrhages]. / Fibrele nervoase cu mielina asociate cu hemoragii juxtapapilare.

The myelinated nerve fibers (MNF) are o congenital anomaly characterized by the extension of the myelinisation process anterior from the lamina cribosa. The incidence of myelinated nerve fibers is 0.3-0.6% in patients and 0.54% in eyes from autopsies. Although these represent benign lesion, rarely are associated with retinal abnormalities: vascular abnormality (retinal telangiectasis, cranial-facial lesions, coloboma of the iris, keratoconus, myopia/strabismus, amblyopia). Myelinated nerve fibers asSociated with juxtapapillary haemorrhages was not reported in the available literature. We describe the clinical findings and diagnostic particularities of myelinated retinal nerve fibers associated with juxtapapillary haemorrhages in a personal case. An 40-year-old woman was referred for unilateral papillary abnormalities. The diagnosis was myelinated retinal nerve fibers as white striated patches with feathery edges, associated with two juxtapapillary haemorrhages. The clinical and pathogenic features are discussed. Based on the association between the myelinated nerve fibers, the juxtapapillary haemorrhages there is a possible pathogenic correlation between these elements. The action of the myelinated nerve fibers can be explained by a mechanical compression, with the disruption of the retinal artery, a structural vulnerable artery.

[A familial case of drusen of the optic disk]. / Un caz familial de drusen al discului optic.

The present abstract is about a case of drusen of the optic disc (DOD), consisting of three members, belonging to two generations: the mother (41 years) and two daughters (16 and 19 years). Their personal records showed nothing special, except case III-2 with crisis equivalent to the epileptic ones. No changes of the visual acuity and of the visual field were found. Ophthalmoscopy and angiofluorography showed: a bilateral and superficial location of the DOD; no vascular anomalies (discal and peridiscal) or other retinal changes; a trend towards flattening and getting more mat of the DOD, in older cases. It is debated upon the possibility that a single gene might be involved, responsible for an autosomal dominant or autosomal recessive transmission mode.

[Colobomatous pits of the optic nerve papilla associated with serous retinal detachment. The clinical and pathogenic aspects]. / Foseta colobomatoasa a papilei nervului optic, asociata cu decolarea seroasa a retinei. Aspecte clinice si patogenice.

The present study is about a number of 19 cases (19 eyes), the patients having a congenital pit of the optic papilla (CPP) complicated with serous retinal detachment (SRD). The cases were selected, from a group of 41 patients with CPP. Average age of the cases was 37(31-54) years. The serous retinal detachment appeared under two different clinical appearances: the detachment of the internal retinal layers (DIRL) or retinal schisis, 10 cases, located between the papillae and macula, and involving the optic disc; the detachment of the external retinal layers (DERL), 9 cases, located within the macular area, without involvement of the optic disc. A number of 8 cases (42%) developed a macular hole, located within the external retinal layers. The cases with DIRL had better visual acuity, compared to those with DERL. This study proves the bilamellate character, of the serous retinal detachment. The disease starts with DIRL (retinal schisis), due to fluid passing at the level of the CPP and then DERL develops as a complication, following the degenerescence of the retinal layers within this area.

[The clinico-evolutionary neuro-ophthalmological aspects in multiple sclerosis]. / Aspecte neuro-oftalmologice clinico-evolutive în scleroza multipla.

The paper presents the dynamic of the more important neuro-ophthalmologic signs in 112 patients with multiple sclerosis from the first attack to the second one using an interdisciplinary methodology. The existence of ocular signs at the first attack as well as the fortuitous association of the signs of the disease make doubtfully the utility of defining a neuro-ophthalmologic clinical form of the disease. The more significant dominance of the ocular signs at the first attack points out the importance of the ophthalmologic examination for the early diagnosis of the multiple sclerosis.

[The epidemiology of diabetic retinopathy]. / Epidemiologia retinopatiei diabetice.

The paper presents a statistic study of the incidence of the diabetic retinopathy in patients who have been recently taken into evidence in the Antidiabetic Centre Timisoara. These patients were diagnosed between 1994 and 1997. The incidence of the diabetic retinopathy in Romania is more significant than in other countries like USA, France, UK, Finland. The prevalence of the diabetic retinopathy is significant too being placed around the value of 0.02-0.03%. When diabetes mellitus was found, the incidence of nonproliferative diabetic retinopathy was placed around 8% while the incidence of proliferative diabetic retinopathy was placed around 1%. The diabetic retinopathy is more often diagnosed in patients insulin dependent. After 20 years of diabetes mellitus evolution, 80% of the insulin dependent patients and 60% of the noninsulin dependent patients present diabetic retinopathy with a more or less important impact on the visual function.

[Pseudophacos explant: the causes and the functional results]. / Explantul de pseudofak: cauze si rezultate functionale.

We've studied a number of 20 cases of pseudophakic explantation performed in the Eye Center Timisoara between 1991-1997 from 2605 pseudophakic implantations. The interval between implantation and the moment of explantation was between 4 days and 7 years. The causes which indicated pseudophakic explantation were: pseudophakic bullous keratopathy, IOL decentration and dislocation, uveitis, persistent secondary glaucoma. The study refers to the established treatment for avoiding the explantation and also to the functional results obtained after pseudophakic explantation. Most of the explanted artificial lens cases were anterior chamber lens--13, all of them ALCON type, also we've explanted 4 pupillary implants Fedorov type. The visual acuities obtained after explantation were between hand movement perception and 10/10. Before surgery, visual acuity was between light perception and 10/10. The best functional results were obtained in pseudophakic decentration and dislocation cases and the worst in pseudophakic bullous keratopathy, uveitis and secondary glaucoma cases.

[Difficulties in reading the optotype]. / Consideratii asupra unor dificultati de citire a optotipului.

The paper presents in its first part the actual knowledge about the literal paralexias taking into consideration that the main method to examine the visual acuity includes the literal gnosia that has a symbolic character. The literal paralexias represents a normal cerebral phenomenon at the limit of the visual acuity. The typology of the paralexias is being studied by the morphological entiry of the letter and by the degree of being aware of them. After these methods we can divide the subjects in 3 types. We conclude the utility of the construction of some charts containing letters at which we should take into consideration the degree of the morphological entiry of the letters as well as the suggestion of creating charts containing letters could be left out letters with double similitude: morphological and semiotic.

[Paranystagmic ocular dyskinesias]. / Dischineziile oculare paranistagmice.

In the paper there are described and systematised semeiologically the paranystagmic eye dyskinesias. Their neuro-ophthalmological significance and their diagnostic value are discussed. Although there is a large semiological diversity, they signify the sufferance of the cerebellum or the brainstem or of both.

[Clinical correlations between the incidence of diabetic retinopathy and diabetic nephropathy]. / Corelatii clinice între incidenta retinopatiei diabetice si nefropatiei diabetice.

In this study we included 651 patients with recently diagnosed diabetes mellitus registered at the Centre for Diabetes Care from Timisoara in 1995. All the patients were from Timisoara and the county of Timis. They had insulin-dependent and noninsulin-dependent diabetes mellitus. We studied the eye lesions ophthalmoscopically, retinophotographically and angiographically and we correlated these informations with the lesions of diabetic nephropathy. We also made an evaluation of the functional implications of the ocular lesions.

[Familial congenital aniridia]. / Aniridia congenitala familiala.

We have studied a family that has been presenting cases of congenital aniridia for three generations. A specific trace found in this family is the varied expression of the pathological gene as some members showed bilateral congenital aniridia, others showed unilateral aniridia with coloboma or just bilateral coloboma aspect. Aniridia can be found either as a "de novo" mutation in a family or as a continuous transmission between generations reproducing the dominant autosomal model. The ocular manifestations of this anomaly include: defects of the cornea, glaucoma, lens subluxations, hypoplasia of the fovea, nystagmus.

[Macular changes in patients with insulin-dependent diabetes mellitus]. / Modificari maculare la bolnavi cu diabet zaharat insulinodependent.

We have studied, ophthalmoscopically and angiographically the macular modifications arisen within diabetic retinopathy in 79 individuals with insulin-dependent diabetes (IDD). The 79 patients presented an unbalanced diabetes, suffering from the disease for 5-8 years. The age of these patients ranged between 29 and 41. In all these cases we have noticed the predominance of the macular form of the diabetic retinopathy. Often the disease showed non-typical modifications. It is important to mention that in 213 of the cases we have found incipient lesions of diabetic retinopathy in the ocular fundus: the lesions were few in many cases.

[Ophthalmodynamometry. Current aspects]. / Oftalmodinamometria. Aspecte actuale.

In the paper we have pointed out the importance of ocular pressure in diagnosis of vascular-cerebral diseases. We have insisted upon the difficulties of interpreting the values of ocular pressure. The correlations between the maximum, medium and minimum values of ocular pressure are presented. We have also carried out a systematization of the four possibilities of altering the arteries resistance in the carotid system and pointed out the pathological situations which can determine changes of the ocular pressure. Presenting the method limitations we have emphasized the importance of the method in clinical practice.

[Anesthesia in interventions for diabetic cataract]. / Anestezia în interventiile pentru cataracta diabetica.

It presents the indications and contraindications of general and local anesthesia in the patients with diabetic cataract. It insists about the criterion of preoperative clinical evaluation of the patients, about the different schemes used in those two type fact that every case must be individualised as for the indication for anesthesia. Also, it insists about the fact that it is necessary the collaboration between the ophthalmologist with diabetologist and anaesthesist, with a view to ensuring one operator gesture that establish the best, functional outcome.

[Screening for diabetic retinopathy in Romania]. / Screeningul retinopatiei diabetice în România.

The survey proposes the analysis of the Romanian implementation of the action: "Protocol for screening of diabetic retinopathy in Europe" (London, 1990). Based on the answers obtained after spreading a typical questionnaire, it was constated that the protocol's implementation was done in 9 sanitary profilated units and implied a percentage of patients less then 4%. Some of the difficulties mentioned were the insufficiency of (photocoagulation) devices, of funds and adequate (qualified) staff, and also the inertia of the old evidencing system.

[The macular vascular changes in diabetic retinopathy]. / Modificarile vasculare maculare în retinopatia diabetica.

The angiofluorographic surveys done on 46 patients with diabetes shows some particular modifications of the retinal vessels, from the foveolar, perifoveolar and parafoveolar areas. These modifications influence the values of the visual acuity; they are not connected in all cases with all the retinal vascular modifications.

[Psychiatric aspects in eye surgery]. / Aspecte psihiatrice în chirurgia oculara.

The psychic ill man, no matter the gravity of the syndrome presented, is not undesirable and does not constitute a contraindication in ocular surgery. But in these situations a correct evaluation of the general and ocular state must be done, and also a correct premedication, a local or general on case good-conducted anesthesia and a close cooperation with the psychiatrist. Are discussed the problems of the little psychiatry which appear in the ocular interventions: senile psychosis, unorganical psychoses like ambulatory schizophrenia, maniacal-depress psychosis and paranoia decompensated by surgical act.

[The characteristics of general anesthesia in ocular surgery]. / Particularitati ale anesteziei generale în chirurgia oculara.

The general anesthesia is recommended in ocular surgical interventions on children or patients with psychical lability, anxiety and in general intervention on open globe. Before the intervention, a permanent contact between the ophthalmologist and the anesthesiologist is necessary, in order to manage the complexity of the case and to adopt a common attitude. The attitude which has to be taken to avoid the pre- and post-operational incidents is put into light.