EDITORIAL 1/2007

 

EDITORIAL

 

 

REFERATE GENERALE

GENERAL REPORTS

 

Oana Gheorghe - Keratopatia de expunere

 

Oana Gheorghe - Lagophthalmoc keratopathy

 

 

V. Beraru, Corina Staicu - Leziuni degenerative periferice care predispun la decolare de retina

 

V. Beraru, Corina Staicu - Peripheral retinal degenerations predispose to retinal detachment

 

 

Andreea Craiu - Fluoroforii oculari

 

Andreea Craiu - Ocular fluorophores

 

 

CAZURI CLINICE

CLINICAL CASES

 

Monica Armegioiu, Andreea Craiu, V. Beraru, Corina Staicu, Camelia Constantin, Liliana Pulbere, Oana Mihalcea, Oana Epure - Metastaze coroidiene intr-un caz de adenocarcinom pulmonar

 

Monica Armegioiu, Andreea Craiu, V. Beraru, Corina Staicu, Camelia Constantin, Liliana Pulbere, Oana Mihalcea, Oana Epure - Coroidian metastasis in a patient with pulmonary adenocarcinoma

 

 

I. Stefaniu, Silvia Chiototoiu, Corina Epure, Mihaela Frasia - Disgenezie irido-corneeana, Sindromul Axenfeld Rieger

 

I. Stefaniu, Silvia Chiototoiu, Corina Epure, Mihaela Frasia 0 Irido-corneal disgenesys, Axenfeld Rieger syndrome

 

 

Mirela Preda, Carmen Damian, Rodica Manescu, Livia Davidescu, Anca Irimia, Cristi Adelina Ciuca, Mihaela Sollosy - Distrofia retiniana in fagure de miere Doyne

Mirela Preda, Carmen Damian, Rodica Manescu, Livia Davidescu, Anca Irimia, Cristi Adelina Ciuca, Mihaela Sollosy - Doyne retinal Distrophy

 

 

Georgeta Martiniuc, Anca Trifina, L. Trifina - Oedipism partial

 

Georgeta Martiniuc, Anca Trifina, L. Trifina

 

 

 

Cristi Ciuca, Anca Irimia, Mirela Preda, Carmen Damian - Oftalmia simpatica

 

Cristi Ciuca, Anca Irimia, Mirela Preda, Carmen Damian - Sympathetic ophthalmia

 

 

M. Munteanu, Ileana Zolog - Hemangiomul capilar retinian

 

M. Munteanu, Ileana Zolog -

Retinal capilar hemangioma

 

 

O. Samoila, D. Calugaru, M. Calugaru - Aspecte clinice si angiofluorografice in angiomatoza retiniana (von Hippel)

 

O. Samoila, D. Calugaru, M. Calugaru - Clinical and fluorescein angiography aspects in retinal angiomatosis

 

 

STUDII CLINICE

CLINICAL STUDIES

 

C.Stefan, Diana Melinte Dumitrica, A. Nenciu - Chirurgia cataractei si fluctuatiile diurne ale PIO la pacientii neglaucomatosi

 

C.Stefan, Diana Melinte Dumitrica, A. Nenciu - Cataract surgery and diurnal fluctuatuions of IOP in nonglaucoma patients

 

 

Miruna Tudosie - Evolutia refractiei oculare dupa chirurgia refractiva cu laser excimer prin metoda PRK si LASEK

 

Miruna Tudosie - The evolution of ocular refraction after laser excimer surgery - PRK and LASEK tehniques

 

 

Laura Macovei - Asocierea pseudoexfolierii capsulare la pacientii cu membrana epiretiniana - observatie clinica

 

Laura Macovei - Association of capsular pseudoexfoliation in patients with epiretinal membrane

 

 

D. Chiselita, Crenguta Marcu, Alina Apostol, Miruna Nitu - Influenta operatiei de cataracta asupra campului vizual la pacientii cu glaucom

 

 

D. Chiselita, Crenguta Marcu, Alina Apostol, Miruna Nitu - Effect of cataract surgery for visual field in glaucoma patients

 

 

 

D. Chiselita - Evaluarea rolului travoprostului 0,004% in tratamentul glaucomului cu unghi deschis si al hipertensiunii intraoculare

 

D. Chiselita - Evaluation of th role of travoprost 0,004% ophthalmic solution in the management of open angle glaucoma and ocular hypertensive patients

 

 

Sorin Dudea, Andreea Saceleanu, Carolina Botar-Jid, Angelica Chiorean, Carmen Mihu - Ultrasonografia Doppler in patologia tumorala oculo-orbitara

 

Sorin Dudea, Andreea Saceleanu, Carolina Botar-Jid, Angelica Chiorean, Carmen Mihu - Doppler ultrasound assessment of intraoclar and orbital tumors

 

 

Liliana Voinea, Elena Podoleanu, Daniela Ion, Sanziana Gradinaru, E. Ungureanu, Nicoleta Covaliu, Andreea Tecuceanu, Cristina Alexandrescu, Ruxandra Simionescu, Viorela Popescu, Aida Panca, Ana Maria Dascalu, Alexandra Vrapciu, Madalina Voicu - Gaura maculara - consecinta rara a infectiei toxocariozice

 

 

Liliana Voinea, Elena Podoleanu, Daniela Ion, Sanziana Gradinaru, E. Ungureanu, Nicoleta Covaliu, Andreea Tecuceanu, Cristina Alexandrescu, Ruxandra Simionescu, Viorela Popescu, Aida Panca, Ana Maria Dascalu, Alexandra Vrapciu, Madalina Voicu - Macular hole - a rare result of toxocariosis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROBLEME DE TERAPEUTICA

THERAPEUTICAL PROBLEMS

 

Aurora Nicodin - Conjunctivita alergica de la implicarea celulara la practica medicala

Aurora Nicodin -Alergical conjunctivitis from celular involvment ito medical practice

 

 

 

 

 

 

 

 

 

 

STUDII EXPERIMENTALE

EPERIMENTAL STUDY

 

Mihaela Sollosy, Mirela Preda, Cristina Simionescu, C. Margaritescu - Modificari histopatologice in sindromul exfoliativ

Mihaela Sollosy, Mirela Preda, Cristina Simionescu, C. Margaritescu - Histopathological changes in pesudoexfoliative syndrome

 

 

 

 

 

 

INFORMATII PENTRU CITITORI

INFORMATIONS FOR READERS

 

 

 

 

RECENZII

REVIEWS

 

 

 

 

 

Oftalmologia nr.2/2007

 

 

KERATOPATIA DE EXPUNERE (KERATITA PRIN INOCULZIE PALPEBRALA)

OANA GHEORGHE- SPITALUL CLINIC DE URGENTA MILITAR CENTRAL

 

 

 

REZUMAT

Keratopatia de expunere (KPE) este o keratita neinfectioasa ce rezulta in urma oricarui proces patologic care limiteaza inchiderea pleoapelor, corneea ramanand astfel neprotejata in cursul clipitului sau al somnului. Lagoftalmia este determinata cel mai frecvent de paralizia periferica de nerv facial si de exoftalmie/proptoza.

Abordarea terapeutica presupune atat tratamentul bolii cauzale, cat si tratament simptomatic ai al leziunilor corneene, atitudine ce se asociaza frecvent cu un bun prognostic functional.

 

CUVINTE CHEIE:

·        Keratopatie

·        Lagoftalmie

·        Exoftalmie

·        Film lacrimal

 

ABSTRACT

Exposure keratopathy is a non-infectious keratitis which follows any pathological process that limits eyelid closure, thus leaving the cornea unprotected during blinking or during sleep.

Lagophtalmos is most frequently determined by peripheral facial nerve palsy and by exophtalmos/proptosis. The therapeutical approach includes both etiological and symptomatic treatment, as well as the treatment of corneal lesions, an attitude often associated with a good functional prognosis.

 

KEY WORDS:

·        Keratopathy

·        Lagophtalmos

·        Exophtalmos

·        Tear film

 

 

 

 

 

LEZIUNI DEGENERATIVE RETINIENE PERIFERICE CARE PREDISPUN LA DEZLIPIRE DE RETINA

V. BERARU, CORINA STAICU – SCUMC

 

REZUMAT

Leziunile degenerative retiniene periferice reprezinta un capitol fascinant al patologiei retiniene. Ne propunem sa trecem in revista doar acele afectiuni periferice care predispun la DR.

 

CUVINTE CHEIE:

·        Lattice

·        Retinoschizis

·        Retinal tufts

 

ABSTRACT

Peripheral retinal degenerations are a fascinating chapter of retinal pathology. The authors merely try to classify those peripheral retinal lesions that predispose to RD.

 

KEY WORDS:

·        Lattice

·        Retinoschizis

·        Retinal tufts

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FLUOROFORII OCULARI

ANDREEA CRAIU – SPITALUL CLINIC DE URGENTA MIITAR CENTRAL, BUCURESTI

 

            REZUMAT

            Majoritatea mediilor si tesuturilor oculare sunt expuse radiatiilor electromagnetice pe toata durata vietii. O serie de evenimente fotochimice si fotobiologice au loc in aceste medii si in special in cristalin si retina, rezultand astfel o permananta modificare a proprietatilor lor optice si functionale; majoritatea acestor evenimente au ca rezultat formarea de agregate moleculare fluorescente din cauza alterarilor unor molecule initial non-fluorescente sau a proceselor de acumulare (acesti fluorofori se numesc endogeni; cantitatea si distributia lor in ochi este legata de varsta si de expunerea la lumina si poate fi modificata de patologie).Trasori fluorescenti pot fi, intentional sau nu, introdusi in ochi prin barierele hematoapoasa sau hematoretiniana (acestia sunt fluoroforii exogeni)

 

            CUVINTE-CHEIE:

 

 

ABSTRACT

The majority of ocular media and tissues are lifelong exposed to electromagnetic radiations. O series of photochemical and photobiological events take place in these tissues and especially in the lens and the retina, thus resulting a permanent changing of their optical and functional qualities; the result of most of these events is the appearance of fluorescent molecular aggregates due to the alterations of initially non-fluorescent molecules or to accumulations processes (these are the endogenous fluorophores; their quantity and intraocular distribution is age- and light-exposure- linked and can be altered by pathology). Willingly or not, fluorescent substances can be introduced in the eye through its hematic barriers (these are exogenous fluorophores).

 

KEY WORDS:

·        Endogenous fluorophores

·        Exogenous fluorophores

·        Free radicals

·        Antioxidants

 

 

 

 

 

 

 

 

METASTAZE COROIDIENE INTR6UN CAZ DE ADENOCARCINOM BRONHOMPULMONAR- CAZ CLINIC

MONICA ARMENGIOIU, ANDREEA CRAIU, V. BERARU, CAMELIA CONSTANTIN – SCUMC, BUCURESTI

 

 

            REZUMAT

            Autorii prezinta cazul unei paciente cu metastaze coroidiene multifocale bilaterale in contextul unui adenocarcinom bronhopulmonar T4N2M1. Diagnosticul oftalmologic al metastazelor intraoculare a dus la descoperirea afectiunii sistemice, dar, din pacate, intr-un stadiu tardiv. Scopul lucrarii este sensibilizarea medicilor de specialitate pentru a pune diagnosticul intr-un stadiu al bolii care sa permita cel putin o rata de supravietuire crescuta, daca nu si prezervarea functionalitatii.

 

            CUVINTE-CHEIE:

 

 

ABSTRACT

The authors present the case of a pacient with multifocal bilateral choroidian metastatic carcinoma in the general medium of a bronchi-pulmonary adenocarcinoma T4N2M1. The ophtalmological diagnosis of intraocular metastases led to the discovery of the systemic affliction, yet unfortunately in a late stage. The purpose of this paper is to draw the attention of the specialist in order to diagnose in an evolutionary stage that allows at least a prolonged survival rate, if not the maintenance of functionality.

 

KEY WORDS:

·        Choroidal metastases

·        A- and B-scan ultrasound

·        AFG

·        Laser photocoagulation

 

 

 

 

 

 

 

 

 

DISGENEZIE IRIDO-CORNEANA, SINDROMUL AXENFELD- RIEGER (CAZ CLINIC)

IOAN STEFANIU, SILVIA CHIOTOROIU, CORINA EPURE, MIHAELA FRASIA

CLINICA DE OFTALMOLOGIE- SPITALUL CLINIC DE URGENTA MILITAR CENTRAL

 

            REZUMAT

            Autorii prezinta cazul unui pacient cu diagnosticul de sindrom Axenfeld- Rieger, depistat la varsta de 19 ani, cu ocazia prezentarii in Clinica de Oftalmologie, in vederea precizarii situatiei medico-militare. Prezenta anomaliei si la mama tanarului demonstreaza transmiterea ereditara a acestei boli. De mentionat ca in momentul stabilirii diagnosticului, pacientul avea acuitate vizuala relativ buna (1/3 fc si nc), nu dezvoltase glaucom secundar si asocia prezenta hipoacuziei bilaterale.

 

            CUVINTE-CHEIE:

·        Sindrom Axenfeld-Rieger

·        Embriotoxon posterior

·        Corectopie

·        Ectropion uveal

 

            ABSTRACT

            The authors present the case of a patient diagnosed with the syndrome A-R, which was discovered at the age of nineteen during a medical examination at the Ophthalmology Clinic in order to establish his medico-military situation. The youngster’s mother presents the same anomaly, fact which demonstrates the hereditary transmission of this disease. It must also be mentioned the fact that when he was diagnosed, the patient presented a relatively good visual acuity, that he had not developed secondary glaucoma and besides he associated the presence of bilateral hypoacusis.

 

            KEY WORDS:

 

 

 

 

 

 

 

 

 

 

 

DISTROFIA RETINIANA “IN FAGURE DE MIERE” DOYNE – PREZENTARE DE CAZ CLINIC

MIRELA PREDA, CARMEN DAMIAN, RODICA MANESCU, LIVIA DAVIDESCU, ANCA IRIMIA, CRISTI ADELINA CIUCA, MIHAELA SOLLOSOY – CLINICA DE OFTALMOLOGIE CRAIOVA

 

      REZUMAT

      Este prezentat cazul unei paciente in varsta de 16 ani, la care examenul oftalmoscopic a evidentiat prezenta, in regiunea maculara, a unor leziuni de drusen; aspectul clinic, completat cu AFG, perimetrie, adaptometrie, ERG a pledat pentru diagnosticul de Distrofie Retiniana “in fagure de miere” Doyne.

      Afectiunea, inclusa intre formele de manifestare ale Drusenului familial, se datoreaza unei erori de metabolism la nivelul epiteliului pigmentar al retinei. Se pare ca defectul este la nivelul proteinei matrixului intracelular ceea ce determina dezvoltarea unei membrane bazale anormale.

 

      CUVINTE CHEIE:

·        Drusen

·        Distrofie retiniana “in fagure de miere”

 

ABSTRACT

We present of the case of a female patient, 16-years old, whose fundus  examination revealed the presence, in the macular region, of drusen type lesions; the clinical aspect completed with AFG, perimetery, dark adaptation, ERG pleaded for the diagnosis: Doyne’s honeycomb retinian dystrophy.

The disorder, included in the Familial drusen, is due to an inborn error of  metabolism localizated the RPE. It seems that the defect is in an intracellular matrix protein which leads to the development of abnormal basement membranes.

 

KEY WORDS:

·      Drusen

·      “honeycomb” retinian dystrophy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OEDIPISM PARTIAL- PREZENTARE DE CAZ

DR. GEORGETA MARTINIUC, DR. ANCA TRIFINA, DR. L. TRIFINA

SPITALUL JUDETEAN DE URGENTA “SF. IOAN CEL NOU”, SUCEAVA

CORESPONDENTA: ANCA.TRIFINA@YAHOO.COM

 

            REZUMAT

            Prezentam cazul unui pacient cu schizofrenia paranoida in episod de psihoza acuta, halucinatii cu tema religioasa si automutilare ce au dus la pierderea vederii la un ochi si suferinta celuilalt, si subliniem dificultatile de terapie si management, precum si importanta colaborarii interdisciplinare: oftalmolog, neurolog, psihiatru.

 

            CUVINTE CHEIE:

 

 

            ABSTRACT

            We present the case of a schizophrenic pacient in acute psychozis, with religious delusions, and autoaggressive acts, resulting amaurosis of the right eye and impairment of the other, and showing the difficulties of managing and therapy, as the crucial importance of the team work between the ophthalmologist, the neurologist and the psychiatrist.

KEY WORDS:

·        Paranoid schizophrenia

·        Automutilation

·        Optic nerve avulsion

·        Interdisciplinary work-out

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFTALMIA SIMPATICA- CAZ CLINIC

DR. CRISTI CIUCA, DR. ANCA IRIMIA, DR. MIRELA PREDA, DR. CARMEN DAMIAN – CLINICA DE OFTALMOLOGIE CRAIOVA

 

 

            REZUMAT

            Lucrarea de fata prezinta un caz clinic de Oftalmie simpatica aparuta in urma unui traumatism ocular vechi de 30 de zile, la o pacienta care a temporizat prezentarea la medic.

 

            CUVINTE CHEIE:

 

 

ABSTRACT

This paper presents a case of Sympathetic ophtalmia following a penetrating ocular injury produced 30 days ago, of a pacient who postponed the presentation to the ophthalmologist.

 

      KEY WORDS:

·         Sympathetic ophtalmia

·        Penetrating ocular injury

·        Autoimune response

·        Ocular antigen

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HEMANGIOMUL CAPILAR RETINIAN

M. MUNTEANU, ILEANA ZOLOG

CLINICA DE OFTALMOLOGIE, TIMISOARA

 

            REZUMAT

            Hemangioamele capilare retiniene sunt tumori evolutive care, solitare sau multiple, prezinta un vast tablou clinic, cuprins sub denumirea de “angiomatoze retiniene”. Este prezentat cazul unui tanar cu hemangiom capilar retinian izolat, localizat interpapiloretinian. Formatiunea tumorala exofitica s-a caracterizat printr-o dispunere particulara a retelei vasculare tumorale: superficiala (cadranul superior) si profunda (cadranul inferior).

            Dubla localizare vasculara explica aspectul patat al fluorescentei tulorale, cat si fenomenul de “adoptie” coroidiana.

 

            CUVINTE CHEIE:

·        Hemangiomul capilar retinian

·        Angiomatoza retiniana

 

 

SUMMARY

The retinal capilar hemangiomas are evolutive tumors which, solitary or multiple, present a vast clinical appearance, described under generic name of “retinal angiomatosis”.

We present the case of a young male pacient with solitary retinal capilar hemangioma, localized in the interpapilo-macular region. The exofitic tumors were characterized by a particular arrangement of the tumoral vascular network: superficial (in the superior area) and profound (in the inferior area). This double vascular localization explains the spotted aspect of the tumoral fluorescente, and also the phenomenon of “choroidal adoption”.

 

KEY WORDS:

·        Retinal capilar hemangioma

·        Retinal angiomatosis

 

 

 

 

 

 

 

 

 

 

 

 

 

ASPECTE CLINICE SI ANGIFLUOROGRAFICE IN ANGIOMATOZA RETINIANA (VON HIPPEL)

O. SAMOILA, D. CALUGARU, M. CALUGARU

CLINICA OFTALMOLOGICA, CLUJ

 

            REZUMAT

            Angiomatoza retiniana reprezinta o afectiune rara cuprinzand hamartoame izolate sau asociate unei boli sistemice (boala Von Hippel Lindau). Prezentam cazul unei paciente cu angioame retiniene multiple, cu aspect angiofluorografic atipic posibil datorita unor fenomene trombotice vasculare. Acuitatea vizuala a fost usor diminuata in conditiile unor complicatii hemoragice care au determinat dificultati in realizarea tratamentului. S-au utilizat resurse imagistice pentru excluderea unei afectari sistemice.

 

            CUVINTE CHEIE

·        Angim retinian

·        Boala Von Hippel

 

ABSTRACT

Retinal angiomas represent a rare condition consisting of hamartomas isolated or associated with a sistemic disease (Von Hippel-Lindau Disease). We present a patient with multiple retinal angiomas, with atypical fluorescein angiography possible due to vascular thrombotic phenomena. Visual acuity was slighty dimished because of hemorrhagic complications. Sistemic involvement was excluded with imagistic studies.

 

KEY WORDS:

·        Retinal angiomas

·        Von Hippel Disease

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHIRURGIA CATARACTEI SI FLUCTUATIILE DIURNE ALE PIO LA PACIENTII NEGLAUCOMATOSI

DR. C. STEFAN, DR. DIANA MELINTE DUMITRICA, DR. A. NENCIU

SPITALUL CLINIC DE URGENTA MILITAR CENTRAL BUCURESTI CLINICA DE OFTALMOLOGIE

CENTRU MEDICAL DE DIAGNOSTIC SI TRATAMENT “STEFAN MILCU”- BUCURESTI

 

            REZUMAT

           

            SCOP: Studierea efectului operatiei de cataracta asupra fluctuatiile diurne ale presiunii intraoculare (PIO).

 

            MATERIAL SI METODA: Studiu clinic observational, prospectiv, cu durata de 3 luni efectuat pe un lot de 34 de pacienti (34 de ochi) operati de cataracta prin aceeasi tehnica chirurgicala (facoemulsificare) de acelasi chirurg. Fiecarui pacient i s-a realizat masuratoarea presiunii intraoculare atat preoperator cat  si postoperator la un interval de 2 ore (intre 8 am si 18 pm) prin aplanotonometrie Goldmann. Au fost exclusi pacientii care nu au prezentat unghi deschis la examenul gonioscopic, cat si pacientii care asociau alte patologii oculare sau generale. Lotul de pacienti a fost omogen ca varsta si sex. Analiza statistica a fost realizata cu testul t student.

 

            REZULTATE: Operatia de cataracta reduce valoarea presiunii intraoculare in orice moment al masuratorilor. De la o valoare medie preoperatorie de 12,3±2,5 mmHg a presiunii intraoculare aceasta a scazut la 11,2±2,2mm Hg postoperator (p<0,05). Presiunea intraoculara maxima si minima a inregistrat modificari statistic semnificative in sensul reducerii nivelelor postoperator (p<0,05). Nu a fost inregistrata nici o diferenta semnificativa intre fluctuatiile PIO preoperator (3,0±1,5 mmHg) si postoperator (2,75±1,5) (p<0,05).

 

            CONCLUZII: Chirurgia cataractei scade semnificativ statistic presiunea intraoculara si nu are nici un efect asupra fluctuatiilor diurne ale acesteia.

 

            ABSTRACT

 

            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 realized 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±2,5 mmHg to 11,2±2,2mm Hg 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±1,5) (p<0,05).

 

            CONCLUSION: Cataract surgery significantly decreases IOP and has no effect on diurnal IOP fluctuation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EVOLUTIA REFRACTIEI OCULARE DUPA CHIRURGIA REFRACTIVA CU LASER EXCIMER PRIN METODELE PRK SI LASEK

MIRUNA TUDOSIE, CMDTR BUCURESTI

 

            REZUMAT

            Scopul chirurgiei refractive este acela de a diminua viciile de refractie si de a optine o acuitate vizuala cat mai buna fara corectie optica.

            Studiul efectuat prezinta evolutia refractiei dupa doua dintre metodele de chirurgie refractiva cu laser excimer (PRK si LASEK). Rezultatele obtinute arata ca aceste metode chirurgicale sunt sigure si predictibile in conditiile unor indicatii riguroase si a unor interventii corect efectuate.

 

            CUVINTE CHEIE:

 

 

ABSTRACT

The purpose of the refractive surgery is to diminish the refractive errors and to obtain a better visual acuity without correction.

The study presents the evolution of the refraction after two methods of excimer laser refractive surgery (PRK and LASEK). The results show that these surgical methods are safe and predictable when there are correct indications and well peformed interventions.

 

KEY WORDS:

·        Photorefractive keratectomy

·        Laser subepitelial keratomileusis

·        Evolution of the refraction

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASOCIEREA PSEUDOEXFOLIERII CAPSULARE LA PACIENTII CU MEMBRANA EPIRETINIANA – OBSERVATIE CLINICA

DR. LAURA MACOVEI

SPITALUL CLINIC DE URGENTA MILITAR CENTRAL; BUCURESTI

 

 

            REZUMAT

            Membrana epiretiniana si sinddromul pseudoexfoliativ sunt doua entitati anatomoclinice diferite a caror etiopatogenie este incomplet elucidata. Am constatat asocierea pseudoexfolierii capsulare la un procent important de pacienti diagnosticati cu membrana epiretiniana; studii viitoare ar putea stabili daca aceasta concomitenta este intamplatoare sau apare in urma unui pas patogenic comun.

 

            CUVINTE CHEIE:

 

 

ABSTRACT

The epiretinal membrane and pseudoexfoliation syndrome represent two different anatomo-clinical items whose etiopathogenesis is incompletely solved. We have noticed the capsular pseudoexfoliation at a significant percentage of patients that have been diagnosed with epiretinal membrane; further studies may demonstrate if this is a random coincidence or their emergence is caused by a common pathogenic step.

 

KEY WORDS:

·        Pseudoexfoliation syndrome

·        Epimacular membrane

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFLUENTA OPERATIEI DE CATARACTA ASUPRA CAMPULUI VIZUAL LA PACIENTII CU GLAUCOM

D. CHISELITA, CRENGUTA MARCU, ALINA APOSTOL, MIRUNA NITU

CLINICA I OFTALMOLOGIE- UNIVERSITATEA DE MEDICINA SI FARMACIE “GR. T. POPA”- IASI

 

            REZUMAT

           

            SCOPUL LUCRARII

            Influenta operatiei de cataracta asupra parametrilor cantitativi si calitativi ai campului vizual la pacientii operati de glaucom si controlati terapeutic.

 

            MATERIAL SI METODA

            Studiu retrospectiv ce include 42 ochi cu glaucom primitiv cu unghi deschis, anterior trabeculectomizati, compensati terapeutic, la care s-a practicat extractia cristalinului cataractat si implantarea de cristalin artificial.

            Pacientii au fost evaluati pre si postoperator la intervale scurte de timp pentru a se evita o eventuala progresie a bolii. Pe toata perioada urmaririi, PIO a fost sub 21 mmHg cu sau fara medicamente antiglaucomatoase.

 

            REZULTATE

            Dupa operatia de cataracta, acuitatea vizuala a crescut semnificativ (AV preoperatorie 0,22±0,15, AV postoperatorie 0,57±0,27, p<0,0001).

            Parametrii de evaluare si urmarire ai glaucomului au ramas nemodificati (PIO preoperatorie 17±6,71 mmHg, PIO postoperatorie 17,04±4,56 mmHg, p= 0,97; raportul C/D preoperator 0,59±0,26, postoperator 0,62±0,26, p=0,69).

            Parametrii cantitativi ai campului vizual nu s-au modificat semnificativ (MD preoperator -15,52±8,69, postoperator -13,33±9,97, p=0,28; PSD preoperator 5,86±3,25, postoperator 6,11±3,39, p=0,79). In aproximativ 60% din cazuri, valoarea MD s-a ameliorat, iar in 24% s-a agravat; PSD s-a ameliorat in 33% din cazuri si s-a agravat in 26% din cazuri.

 

            CONCLUZIE

            Operatia de cataracta la pacientii trabeculectomizati, controlati terapeutic, nu influenteaza semnificativ parametrii sintetici ai campului vizual.

 

            CUVINTE CHEIE:

·        Glaucom

·        Trabeculectomie

·        PIO

·        Mean deviation (MD)

·        Pattern standard deviation (PSD)

 

 

 

ABSTRACT

 

PURPOSE

To study the influence of cataract surgery on the quantitative and qualitative parameters of visual field in patients previously operated for glaucoma.

 

METHOD

Retrospective study that included 42 eyes with primary open angle glaucoma that had been previously subjected to trabeculectomy. The glaucoma was therapeutically controlled in all patients. Then they all underwent cataract extraction and artificial lens implantation.

All eyes were evaluated pre- and postoperatively at short intervals to avoid glaucoma progression. Throughout the follow-up period the IOP remained under 21 mmHg, with or without antiglaucoma drugs.

 

RESULTS

After cataract surgery the visual acuity increased significantly (preoperative VA 0,22±0,15, postoperative VA 0,57±0,27, p<0,0001).

The parameters used for glaucoma avaluation and follow-up remained unchanged (preoperative IOP 17±6,71 mmHg, postoperative IOP 17,04±4,56 mmHg, p= 0,97; preoperative C/D ratio 0,59±0,26, postoperative C/D ratio 0,62±0,26, p=0,69).

The quantitative parameters of visual field did not change significantly (preoperative MD -15,52±8,69, postoperative MD -13,33±9,97, p=0,28; preoperative PSD 5,86±3,25, postoperative PSD 6,11±3,39, p=0,79). In about 60% of cases the MD value improved and in 24% it worsened. The PSD was ameliorated in 33% of cases and aggravated in 26% of cases.

 

CONCLUSION

Cataract surgery in patients with previously operated, therapeutically controlled glaucoma does not influence significantly the synthetic parameters of visual field.

 

KEY WORDS:

·        Glaucoma

·        Trabeculectomy

·        IOP

·        Mean deviation (MD)

·        Pattern standard deviation (PSD)

 

 

 

 

 

 

 

 

 

TRAVOPROST 0.004%- EVALUAREA ROLULUI IN MANAGEMENTUL GLAUCOMULU PRIMITIV CU UNGHI DESCHIS SI HIPERTENSIUNII INTRAOCULARE

D. CHISELITA, PENTRU EASTERN EUROPEAN START STUDY GROUP

 

            SCOPUL LUCRARII

            Evaluarea efectului hipotensor ocular al solutiei de travoprost 0,004% la pacienti cu glaucom primitive cu unghi deschis (GPUD) sau hipertensiune intraoculara (HTIO), cu sau fara terapie anterioara.

           

            METODA

            Trial multicentric, open-label, cu durata de 3 luni, desfasurat in 61 de centre din Europa de Est, ce a inclus 1133 pacienti. Ptii cu GPUD sau HTIO aflati sub tratament au suferit inlocuirea medicatiei anterioare (in totalitate sau a unei parti din aceasta) cu travoprost sau aditia de travoprost la medicatia preexistenta, conform judecatii clinice a investigatorilor. La pacientii netratati s-a initiat terapia cu travoprost. In toate cazurile administrarea s-a efectuat o data pe zi, in cursul serii. Vizitele de urmarire au avut loc la 1 si 3 luni. Variabila primara urmarita a fost modificarea presiunii intraoculare (PIO) medii fata de vizita initiala.

 

            REZULTATE

            1109 pacienti au ramas in studiu pentru analiza eficacitatii; 731 au folosit travoprost ca terapie de inlocuire (665 inlocuire completa si 66 partial), 176 ca terapie adjuvanta, iar 202 ca prima terapie. PIO meide a scazut cu 19-22% in cazul inlocuirii altei terapii, cu 26-29 % in terapia adjuvanta si cu 27-30% la pcientii netratati anterior. Atunci cand monoterapia cu beta-blocant sau latanoprost a fost inlocuita cu travoprost, scaderea PIO medii a fost de 21-24%, respectiv 13-17%.

 

            CONCLUZII

            Rezultatele acestui studiu sustin ideea ca majoritatea pacientilor cu glaucom care raspund inadecvat la alte terapii antiglaucomatoase ar beneficia de trecerea la monoterapia cu travoprost sau de aditia de travoprost la terapia initiala.

 

            ABSTRACT

 

            PURPOSE

            To assess  the intraocular pressure lowering affect of travoprost 0.004% in previously treated and untreated open-angle glaucoma and ocular hypertensive patients.

 

            METHODS

            This was a 3-month, multi-centre, open-label trial involving 1133 patients, conducted at 61 sites in Eastern Europe. Previously treated open-angle glaucoma or ocular hypertensive patients either had all or part of their existing therapy replaced with travorprost or had travoprost added to existing therapy, depending on the clinical judgement of the investigator. Untreated patients were also started travoprost. In all patients travoprost was given once daily in the evening. Patients returned for follow-up visits at 1 and 3 months. The primary outcome variable was mean IOP change from baseline.

 

            RESULTS

            A total of 1109 patients were available for analysis of efficacy; 731 used travoprost as replacement therapy (665 complete and 66 partial), 176 as adjunctive therapy; and 202 had not previously been treated. Mean IOP decreased by approximately 19-22% in replacement therapy patients; 26-29% in adjunctive therapy patients; and 27-30% in previously untreated patients. Replacement of beta-blocker monotherapy and latanoprost monotherapy by travoprost was accompanied by a 21-24% and 13-17% decrease in mean IOP respectively.

 

            CONCLUSIONS

            The results from this study support the concept that the majority of glaucoma patients, who are responding inadequately to other glaucoma therapies, could benefit from a change to travoprost monotherapy or from the addition of travoprost to their existing therapy.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ULTRASONOGRAFIA DOPPLER IN PATOLOGIA TUMORALA OCULO-ORBITALA

SORIN M. DUDEA, ANDREEA SECELEANU, CAROLINA BOTAR-JID, ANGELICA CHIOREAN, CARMEN MIHU

CATEDRA DE RADIOLOGIE, CATEDRA DE ANATOMIE, CLINICA OFTALMOLOGICA, CATEDRA DE HISTOLOGIE, UNIVERSITATEA DE MEDICINA SI FARMACIE « IULIU HATIEGANU », CLUJ-NAPOCA

 

 

            REZUMAT

 

            SCOP

            Evaluarea rolului ultrasonografiei Doppler spectral si color in diagnosticul pozitiv si diferential al maselor tumorale oculo-orbitale.

 

            MATERIAL SI METODA

            Studiu clinic retrospectiv, efectuat pe 153 pacienti cu 163 mase tumorale oculare sau/si ale orbitei, examinati prin ultrasonografie Doppler spectral si color in Clinica Radiologica, Spitalul Clinic Judetean de Urgenta Cluj, in perioada 1997-2004. In cursul examinarii spectrale au fost determinati indicii de impedanta arteriala la nivelul masei. Caracterizarea prin Doppler color a constat din descrierea vascularizatiei intratumorale: prezenta, numar, traiect si aspecte particulare. Diagnosticul final a fost stabilit prin examen anatomo-patologic efectuat la 123 tumori. La 40 de tumori diagnosticul a fost stabilit prin corelarea rezultatelor examenului clinic cu cel al altor examinari imagistice.

 

            REZULTATE

            Au fost identificate si descrise aspecte imagistice particulare ale vascularizatiei maselo tumorale oculo-orbitale. Sunt descrise si ilustrate aspecte ultrasonografice Doppler intalnite in melanomul coroidian, retinoblastom, metastazele uveale, hemangiom, limfangiom, gliom al nervului optic, pseudotumori inflamatorii si tumori invadante in orbita.

 

            CONCLUZII

            Asocierea informatiei vasculare la imaginea ecografica bidimensionala permite caracterizarea ameliorata a maselor tumorale oculo-orbitale.

 

            CUVINTE CHEIE:

 

 

 

 

 

 

ABSTRACT

 

PURPOSE

To assess the role of spectral and color Doppler ultrasonography in the positive and differential diagnosis of ocular and orbital tumoral masses.

 

MATERIAL AND METHODS

Retrospective clinical study of 153 patients with 163 ocular or/and orbital masses who were examined by spectral and color Doppler ultrasonography in the Clinic of Radiology, Cluj County Emergency Hospital, between 1997 and 2004. In all patients, the arterial impedance indices were measured by pulsed Doppler examination. The color Doppler characterization of the mass consisted in the description of intratumoral vascularity: presence, vessel number and appearance and peculiar aspects. The final diagnosis was established by histopathology in 123 tumors. In 40 tumors, the diagnosis was established by correlating the clinical findings with results of other imaging modalities.

     

RESULTS

The study identifies and describes peculiar ultrasonographic aspects of the vascularity in various intraocular and orbital tumors. It describes and illustrates the Doppler ultrasonographic appearance of choroidal, melanoma, retinoblastoma, eyeball metastases, hemangioma, lymphangioma, optic nerve sheath glioma, inflammatory pseudotumors and tumors invading the orbit.

 

      CONCLUSIONS

The association of vascular information to the two-dimensional ultrasonographic image allows for an improved characterization of ocular and orbital tumoral masses.

 

      KEYWORDS:

·        Doppler ultrasonography

·        Ocular tumors

·        Orbital tumors

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GAURA MACULARA- CONSECINTA RARA A INFECTIEI TOXOCAROZICE

LILIANA VOINEA, ELENA PODOLEANU, DANIELA ION, SINZIANA GRADINARU, E. UNGUREANU, NICOLETA COVALIU, ANDREEA TECUCEANU, CRISTINA ALEXANDRESCU, RUXANDRA SIMIONESCU, VIORELA POPESCU, AIDA PANCA, ANA MARIA DASCALU, ALEXANDRA VRAPCIU, MADALINA VOICU

UMF “CAROL DAVILA”, SPITALUL UNIVERSITAR DE URGENTA BUCURESTI  

 

 

            REZUMAT

            Gaura maculara este o afectiune prezenta aproape exclusiv la paceinti adulti si mai ales in varsta, fiind rara la adolescenti si exceptionala la copii. Mecanismele etiopatogenice in cazul gaurilor maculare la tineri este frecvent idiopatic. In cazul de fata mecanismul sugerat este reprezentat de tractiuni vitreoretiniene dat de un granulom toxocarozic la o pacienta de 9 ani.

 

            CUVINTA CHEIE:

 

 

ABSTRACT

Macular hole is a condition that characterizes older patients, being rare in adolescent patients and exceptionally at children. The ethiopathogenic mechanism of most macular holes in children and adolescent is idiopathic. The suggested ethiopathogenic  mechanism is vitreoretinal traction due to a toxocara granuloma for a 9 years old girl.

 

KEYWORDS:

·        Macular hole

·        Toxocara

·        Tractional mechanism

 

 

 

 

 

 

 

 

 

 

 

CONJUNCTIVITA ALERGICA- DE LA IMPLICAREA CELULARA LA PRACTICA MEDICALA

AURORA NICODIN

MEDIC PRIMAR OFTALMOLOG- INSTITUTUL NATIONAL DE MEDICINA AERONAUTICA SI SPATIALA- BUCURESTI

 

 

            REZUMAT

            Lucrarea prezinta cateva notiuni referitoare la tipul de celularitate implicat in principalele afectiuni oculare induse prin mecanism alergic si incearca o corespondenta cu un tratament logic, tintit, cu eficienta maxima.

 

            CUVINTE CHEIE:

 

 

SUMMARY

The paper presents some notes about the type of celularity involved in principal ocular allergy determinated by an allergic mechanism and tries a corespondence with a logical and target treatment, with maximum efficiency.

 

KEY WORDS:

·        Ocular allergy

·        Type I hypersensitivity

·        Mast cells

·        Eosinophils

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MODIFICARI HISTOPATOLOGICE IN SINDROMUL EXFOLIATIV

MIHAELA SOLLOSY, MIRELA PREDA, CRISTINA SIMIONESCU, C. MARGARITESCU

CLINICA DE OFTALMOLOGIE CRAIOVA

CATEDRA DE ANATOMIE PATOLOGICA- UMF CRAIOVA

 

 

            REZUMAT

 

            SCOPUL LUCRARII

            Evidentierea modificarilor structurale ale segmentului anterior ocular in microscopie optica la globii oculari cu sindrom exfoliativ.

 

            MATERIAL SI METODA

            S-au utilizat fragmente de conjunctiva bulbara recoltate intraoperator si fragmente ale structurilor polului naterior recoltate de la globi oculari eviscerati pentru complicatii ale glaucomului exfoliativ absolut dureros.

            Pentru examenul in microsopie optica s-au folosit coloratiile cu Hematoxilina- Eozina, PAS si Rosu de Congo.

 

            REZULTATE SI DISCUTII

            Utilizarea celor trei tipuri de coloratii au permis evidentierea prezentei elementelor caracteristice sindromului exfoliativ la toate structurile oculare  cercetate (conjunctiva, cornee, iris, corp ciliar, cristalin) si excluderea prezentei amiloidului.

 

            CONCLUZII

            Toate structurile polului anterior prezinta modificari histopatologice tipice sindromului exfoliativ.

            Coloratia cu Rosu de Congo , prin excluderea amiloidului, transeaza in favoarea exfolierii leziunilor structurale constatate.

 

            CUVINTE CHEIE:

·        Sindrom exfoliativ

·        Cornee

·        Corp ciliar

·        Cristalin

 

 

ABSTRACT

 

PURPOSE

The purpose of this study was to analize the structural modifications of the anterior structures of the huma eyes with exfoliation syndrome in optic microscopy.

 

MATERIAL AND METHOD

For this we used bulbar conjunctival fragments and the anterior part of the eyes who were eviscerated for the complications of exfoliative glaucoma.

For the optic microscopy the human specimens were preserved in paraphine and stained with hematoxiline-eozine, PAS and Congo red method.

 

RESULTS

We have demonstrated in this study using this three colorations that the abnormal material is exfoliative material and not amiloid in all the ocular structures that were studies (conjunctiva, cornea, lens and cliary body).

 

CONCLUSIONS

All the anterior structures of the eyes that were examined present tipical histopathological alterations of the exfoliation syndrome.

The Congo red coloration demonstrate that the abnormal material present in all the structures that were examined is exfoliation material and not amiloid.

 

KEYWORDS:

·        Exfoliation syndrome

·        Cornea

·        Ciliary body

·        Lens