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Introduction. Basaloid follicular hamartoma (BFH) is a rare benign follicular malformation often clinically misdiagnosed. Patients with BFH demonstrate a variety of clinical manifestations and associated abnormalities. BFH may be a familial, congenital, or acquired condition with a localized or generalized distribution. Several clinical variants of generalized BFH are recognized, which may be associated with a diverse spectrum of abnormalities. Case report. We present two cases of solitary BFH in pediatric patients. The first patient was a 16- year-old boy with a history of autism spectrum disorder, admitted to our department for consultation due to a harmless dermal nevus on his face. The second patient was a six-year-old girl presented with a ten-month history of an asymptomatic, skin-colored papule located on the right nasolabial fold that gradually increased in size over time. Both cases were documented dermoscopically, and they were presented with a brief overview of the current literature. Conclusion. Considering the overlapping clinical, histological, and dermoscopic features of BFH with other benign and malignant lesions, its incidence in pediatric patients is probably higher than what is reported in the current literature.

Introduction/Objective. Intensive oxidative stress is proven in patients with diabetes mellitus and important in the development of a microvascular complication of type 2 diabetes mellitus. The aim of the study was to investigate the relationship between morphometric parameters of retinal blood vessels in patients with diabetic retinopathy (DR) and the levels of parameters of oxidative stress: advanced oxidation protein product (AOPP), thiobarbituric acid reactive substances (TBARS), and total sulfhydryl (SH) groups in blood samples. Methods. The patients (the group with DR and controls) were sex- and age-matched. Glycaemia, hemoglobin A1C HbA1C, total cholesterol and its fractions, and triglycerides were measured in blood samples. AOPP and total SH groups were determined in the plasma by specific methods. Modification of the thiobarbituric acid method was used for the determination of TBARS. The number and diameter of retinal blood vessels, as morphometric parameters on digital retinal photography, was determined by using the ImageJ software. Student’s t-test was used as the statistical method for the evaluation of differences between the morphometric and blood test parameters. The significance of differences in morphometric parameters of retinal blood was establish by one-way ANOVA. Results. Significantly higher levels of parameters of oxidative stress (AOPP and TBARS) were in the group of patients with DR than in the controls. This difference was also present among the patients with mild and severe forms of DR (AOPP F 77.03, p < 0.001) (TBARS F 63.28, p < 0.001). The diameter of retinal blood vessels correlated with levels of AOPP, but only in patients with mild DR. Conclusion. Parameters of oxidative stress, AOPP and TBARS, may be important for the follow-up of DR. In early stages in diabetic retinopathy, AOPP can be a valuable biomarker.

Introduction. Ankyloblepharon filiforme adnatum (AFA) is a rare congenital abnormality of the eyelids that has been reported as an isolated anomaly, but may also be associated with other anomalies or as a part of well-defined syndromes. The aim of this work was to present a case of familial AFA associated with bilateral cleft lip and palate. Case outline. A full-term female newborn (40 weeks’ GA, BM 3,700 g) had bilateral partially fused eyelids at birth, associated with a cleft lip and palate. The surgical treatment was performed five days after AFA was diagnosed. The baby’s mother also had AFA, without a cleft lip or palate. The baby girl has been followed up by a plastic surgeon, a specialist in orthodontics, as well as an ophthalmologist and a pediatrician. Conclusion. This case indicates familial clustering of AFA, whereby it assumes a more severe form in the following generation. A cleft lip and palate in our patient has required surgical treatment, oral and dental rehabilitation, as well as the need for more intensive care and regular follow-ups by multidisciplinary teams.

Background/Aim. Retinopathy of prematurity (ROP) is a vasoproliferative retinopathy which affects the blood vessels of the retina during its development. The aim of this study was to evaluate the incidence and the degree of refractive errors in premature infants with severe ROP treated with antivascular endothelial growth factor (anti-VEGF) (bevacizumab). Methods. This prospective study included 21 patients (42 eyes) nine months old who received intravitreal injection of anti-VEGF therapy. The control group consisted of 45 patients (90 eyes) who were subjected to laser treatment. In cycloplegia each patient underwent retinoscopy, keratorefractometry, and A-scan ultrasonography. Results. Myopia was present in 47.62% of the eyes in the study group and in 33.33% of the eyes in the control group, but there were no statistically significant differences between these groups. Seven (16.67%) eyes in the study group and 17 (18.89%) eyes in the control group were discovered to have high myopia (SE– spherical equivalents < -3.0 D – dioptre). Clinically significant hypermetropia was higher in the study group (47.62%) than in the control group (34.44%), but with no statistically significant difference. In addition, high hypermetropia was significantly greater in the control group (15.56%) than in the study group (11.90%) (p < 0.001). Astigmatism was more common in the control group than in the study group (81.11% vs 71.43%, respectively), especially high astigmatism (56% vs 43%, respectively). Also the more common form of astigmatism was with the rule (WTR) both in the study and the control group (42.86% vs 55.56%, respectively). Anisometropia was significantly greater in the control group (24.44%) than in the study group (9.52%) (p < 0.05). The children from the study group had significantly greater lens thickness, and a shorter anterior chamber depth than children from the control group (p < 0.01). There was no significant difference in the axial length of the eye between the groups. Conclusion. At the 9-month follow-up myopia was present in the patients with severe ROP treated with anti-VEGF, but high myopia was present to a lesser degree than in the laser treated patients. This difference is possibly related to anterior segment development. Research into the longer-term refractive outcomes is necessary with observation of the biometric components, visual acuity, and the visual field in order to monitor the real effects of this therapy.

This paper presents a strategy and action plan was implemented in the Federation of Bosnia and Herzegovina within the Ministry of Interior within 5 years. Given are the steps to achieve the strategic objectives.

Intraduction. Optic nerve aplasia is a rare developmental anomaly characterised by the congenital absence of the optic nerve, central retinal vessels and retinal ganglion cells that is seen most often in a unilaterally malformed eye. Case report. We reported a girl with a very rare anomaly of the eye, unilateral aplasia of the optic nerve and microphthalmia. We carried out a complete ophthalmological examination, A- and Bscan ultrasonography, magnetic resonance imaging (MRI) of the orbit and brain, pediatrician, neurological examinations and karyotype determination. The examined child was a third child from the third regular pregnancy, born at term (39 GS, BM 3100 g). Family ocular history was negative. The right corneal diameter was 7.5 mm and left 10 mm. On dilated fundus examination, the right eye showed the absence of optic nerve and central retinal vessels. B-scan echography showed a small right globe (axial length 13.80 mm), normal size left globe (axial length 18.30 mm) and the absence of optic nerve on the right eye. Physical and neurological findings and karyotype was normal. MRI of the orbits and brain marked asymmetry of globe size and unilateral absence of the optic nerve. The patient is under the control of a competent ophthalmologist and prosthetic. Conclusion. Further aesthetic and functional development of a young person is the primary goal in tracking this rare congenital optic nerve anomalies in the malformed eye.

Background. Idiopathic polypoidal choroidal vasculopathy (IPCV) is uncommon condition. It is considered to be a variant of neovascular age-related macular degeneration, but it can be also found in younger patients. Case report. We presented a case of otherwise healthy, 36-year-old women, with sudden unilateral visual impairment in the left eye and metamorphosia. Slit lamp biomicroscopy examination of the eye anterior segment was normal. Intraocular pressure determined by aplanation tonometry was 16 mmHg in both eyes. Indirect slit lamp biomicroscopy examination showed signs of serosanquinous detachments of the retinal pigment epithelium. Fluorescein angiography showed a subretinal vessel network through the pigment epithelial atrophy with hyperfluorescence in superior part of serohemorrhagic pigment epithelial detachment and the inferior hypofluorescence, caused by hemorrhage. Optical coherence tomography proved detachment of the retinal pigment epithelium. Conclusion. In patients with IPCV a mild, natural course with spontaneous resorption of exudations and hemorrhage and improvement in visual acuity can be observed. There is no approved treatment at present.

Background/Aim. Transforming growth factor-b1 (TGF-b1), oxidative stress and imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) may play an important role in pathogenesis of pseudoexfoliation syndrome/glaucoma (PEX Sy/Gl). The aim of the study was to measure concentrations of TGF- b1, MMP-2, TIMP-2 in the aqueous humor in the examined group, as well as to compare the biochemical findings with the following clinical parameters: degree of chamber angle pigmantation, presence of pseudoexfoliation and the value of intraocular pressure (IOP). Methods. Aqueous samples from 30 patients with cataract, 30 patients with PEX Sy, 36 patients with PEX Gl, and 42 patients with primary open-angle glaucoma (POAG) were collected during phacoemulsification cataract surgery. TGF b1, MMP-2, TIMP-2 Fluotokine Multi Analyze Profiling kits and Luminex technology were used to simultaneously measure TGF b1, MMP-2 and TIMP-2. Results. TGF- β1, MMP-2, TIMP-2 were detected in human aqueous from all the groups with the highest level in the group with PEX Gl. Statistically, a significant correlation between the levels of TGF b1, MMP-2, TIMP-2 in the aqueous humor of the patients with PEX Gl and the IOP value was confirmed (p < 0.05). In this group, the positive correlations between the TGF b1 concentration in the aqueous humor and the presence of pseudoexfoliation (p < 0.01), on the one hand, and between the TIMP-2 level and the presence of pseudoexfoliation (p < 0.05), on the other, were reported. A statistically significant positive correlation of TGF-b1 and MMP-2, and the degree of chamber angle pigmentation in the PEX Gl group was confirmed (p < 0.05). In the POAG group, TIMP-2 values were in a negative correlation with the degree of pigmentation (p < 0.05), and the IOP value (p < 0.05). Conclusion. TGF b1 and MMP-2 affect the degree of chamber angle pigmentation and the degree of pseudoexfoliation in patients with pseudoexfoliative glaucoma.

Introduction. Identical twins account for 0.2% of the world population and 8% of all twins. A “mirror image” variation can be found in 25% of identical twins. Studies of twins assume a special place in human genetics due to the possibility of comparing genetic and other factors. We present two pairs of identical male twins with mirror-image astigmatism and esotropia. Case Outline. The first was a pair of twelve-year old identical twins with “mirror image” myopic astigmatism. The Twin 1 had myopic astigmatism in the right eye, while the Twin 2 was affected by the left eye myopic astigmatism. The second was a pair of six-year old identical twins with esotropia and hypermetropic astigmatism. The Twin 1 had esotropia in the left eye, while the right eye was affected in the Twin 2. Esotropia was surgically corrected. Conclusion. In this study we pointed to the role of genetic factors in the development of refractive error, as well as the type of strabismus. Refraction anomalies (myopia, hypermetropia and astigmatism) are complex heterogeneous disorders and ideal for genetic investigation. The knowledge of genetic mechanisms involved in refractive error susceptibility may allow treatment to prevent progression or to further examine gene-environment interactions. We hope that this paper will initiate further investigation of refraction anomalies in twins and future multicentre studies, which, to our knowledge, have not been conducted in our country so far.

Background/Aim. There are studies stressing out that atherosclerosis is most common associated systemic condition in patients with retinal artery occlusion. The aim of this study was to analyze values of body mass index and lipid fractions in healthy individuals and patients with retinal artery occlusion. Methods. This study included 90 participants during a 6-year period. The population was divided into 2 groups: the group with the diagnosed retinal artery occlusion and the group without retinal artery occlusion. The observed parameters were as follows: body mass index, low and high density lipoproteins and triglycerides. Results. The study revealed no significant difference regarding body mass index and triglycerides values between the two evaluated groups, while low and high density lipoproteins values were significantly higher in the group of patients with retinal artery occlusion. Conclusions. The study demonstrated that body mass index and triglycerides have less important role in atherogenic pathogenesis of retinal artery occlusion, while low density lipoprotein is the fraction that is shown to be most potent in such etiological processes.

The influence of intensive acute hypoxia on the frequency-amplitude formant vocal O characteristics was investigated in this study. Examinees were exposed to the simulated altitudes of 5 500 m and 6 700 m in climabaro chamber and resolved Lotig’s test in the conditions of normoxia, i.e. pronounced the three-digit numbers beginning from 900, but in reversed order. Frequency and intensity values of vocal O (F1, F2, F3 and F4) extracted from the context of the pronunciation of the word eight (osam in Serbian), were measured by spectral speech signal analysis. Changes in frequency values and the intensity of the formants were examined. The obtained results showed that there were no significant changes of the formant frequencies in hypoxia condition compared to normoxia. Though significant changes of formant’s intensities were found compared to normoxia on the cited altitudes. The rise of formants intensities was found at the altitude of 5 500 m. Hypoxia at the altitude of 6 700 m caused the significant fall of the intensities in the initial period, compared to normoxia. The prolonged hypoxia exposure caused the rise of the formant intensities compared to the altitude of 5 500 m. In may be concluded that due to different altitudes, hypoxia causes different effects on the formants structure changes, compared to normoxia.