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Hyperhomocysteinemia represents a pathological condition characterized by an increased concentration of homocysteine in the blood, exceeding the threshold of 15 µmol/L. Hyperhomocysteinemia can be caused by genetic defects in enzymes involved in the metabolism of homocysteine and inadequate intake of vitamin B6, folic acid, and/or vitamin B12, disturbances in kidney and thyroid function, malignant diseases, psoriasis, and diabetes, as well as the use of certain medications, alcohol, tobacco, and caffeine. Hyperhomocysteinemia leads to damage to blood vessels through the induction of the proliferation of vascular smooth muscle cells, disruption of physiological endothelial functions, accumulation of reactive oxygen and nitrogen species, i.e., induction of oxidative and nitrosative stress, increased production of collagen, and degradation of the elastic fibers of the arterial wall, disturbance in the production of nitric oxide, dysfunction in the H2S signaling pathway, cellular hypomethylation, homocysteinylation of proteins, and disturbances in lipid metabolism. These pathophysiological mechanisms lead to accelerated atherosclerosis, which ultimately results in diseases such as acute myocardial infarction, heart failure, stroke, and peripheral vascular disease. In patients with the aforementioned diseases, or with associated risk factors such as hypertension, diabetes, obesity, smoking, or a positive family history of coronary heart disease, it is of great importance to determine and monitor the concentration of homocysteine in the blood and to take measures in the form of lifestyle changes aimed at secondary prevention of the consequences that hyperhomocysteinemia brings with it.

Introduction/Objective. Pseudoexfoliation (PEX) is an age-related systemic disorder, which can affect the whole body, as well as the eye. It is characterized by abnormal production and accumulation of pseudoexfoliative material. When present in the eye, it can cause different difficulties, but most common are PEX glaucoma (XFG) and intraoperative and postoperative complications of cataract surgeries. The aim of this study was to determine an incidence of patients with PEX in two different regions of Serbia. Methods. The study included 7451 patients scheduled for cataract surgery in two regions of Serbia. It was designed as a multicentric, retrospective study with evaluation of the medical records of all patients who underwent cataract surgery. The study evaluated: incidence of PEX syndrome and PEX glaucoma, age, and sex of patients, as well as preoperative antiglaucomatous therapy and intraoperative and postoperative cataract surgery complications. Results. PEX syndrome (XFS)was recorded in 676 patients (407 females and 269 males), while 243 patients had XFS. It represented 3.26% of patients included in the study. Mean age of XFG patients was 78.1 } 2.1 years with a statistically significant difference (p < 0.05) among incidence of XFG in females compared to males. Intraoperative and postoperative complications during cataract surgery were significantly common in patients with PEX (p < 0.05) Conclusion. PEX can complicate cataract surgery, while on the other hand XFG is more difficult to treat and control than most other glaucomas. Therefore, patients with PEX require special treatment during follow-up and treatment.

Introduction/Objective This study evaluates the effects of hemodialysis (HD) on intraocular pressure (IOP) and ocular anterior chamber morphometry in end-stage renal disease (ESRD) patients. Methods In total, 32 ESRD patients (50 eyes) who were on regular HD program, underwent ocular examination. To all of them, 30 minutes before HD and 30 minutes after the end of the HD session, central corneal thickness (CCT), keratometric values (K1, K2), axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) were measured using the Lenstar 900 Haag-Streit USA device (Haag-Streit Group, Koniz, Switzerland). IOP was measured using Goldman applanation tonometry. Results IOP before HD was 15.74 ± 3,043 while after HD it was 15.14 ± 3,07 (p = 0.125); K1 and K2 values were 43.11 ± 1.68 vs. 43.13 ± 1.73 (p = 0.688) and 43.11 ± 1.60 vs. 43.11 ± 1.66 (p = 0.158); AL increase from 23.25 ± 0.68 to 23.27 ± 0.68 in postHD (p = 0.158) as well as AL from 23.25 ± 0.68 to 23.27 ± 0.68 (p = 0.264); ACD decrease insignificantly from 3.14 ± 0.40 to 3.10 ± 0.42 (p = 0.063); mean LT before HD was 4.66 ± 0.38 while after HD it was 4.67 ± 0.36 (p = 0.290) and CCT was 563.68 ± 42.02 vs. 563.34 ± 42.26 (p = 0.777). Conclusion HD has no significant influences on ocular anterior segment structures such as on CCT, ACD, LT, AL, K values as well as IOP.

Introduction/Objective. Diabetic macular oedema is the accumulation of fluid in the macular tissue leading to its thickening. The aim of the study was to evaluate the efficacy of concentrated triamcinolone acetonide 10 mg / 0.1 ml injection into the suprachoroidal space in patients with diabetic macular oedema and decreased visual acuity. Methods. In 12 eyes with diabetic macular oedema, without any prior treatment, using a small-diameter 26G needle, an injection of 10 mg / 0.1 ml triamcinolone acetonide was applied into the suprachoroidal space in the superotemporal quadrant of the eye 4 mm from the limbus. Prior to the injection, as well as one, three, six, nine, and 12 months after the injection, visual acuity and intraocular pressure were measured, and central subfield thickness was recorded using optical coherence tomography. Results. After one, three, six, and nine post-injection months there was a statistically significant reduction in central subfield thickness (315.92 μm, 257.66 μm, 281.08 μm and 295.51 μm, respectively) compared to the baseline of 447.67 μm. At the end of the 12th month an increase in central subfield thickness was observed again (392.16 μm). Visual acuity improved significantly from the baseline (0.32) during the first three months (0.61) and remained stable until the end of the nineth month (0.51), but at the end of 12 months it decreased again (0.39). No significant intraocular pressure elevation and cataract development were observed in either eye during the entire follow-up period. Conclusion. A single dose of 10 mg / 0.1 ml triamcinolone acetonide injected in suprachoroidal space can significantly stabilize diabetic macular oedema and maintain satisfactory visual acuity for up to nine months.

Background/Aim: Optimal intake of magnesium minerals is essential in maintaining the coordinated physiological functions of cells, tissues and organs. The importance of this element is reflected in the fact that it is the fourth most abundant cation in the human body, participating as a cofactor in more than three hundred enzymatic reactions. Its presence is necessary for the proper functioning of a number of vital functions, such as glycaemic control, the work of the heart and the vascular system and it can potentially play a role in the regulation of body weight. Aim of this study was to investigate the effects of subchronic intake of magnesium hydrocarbonate-rich water on changes in body weight, organ weight and cardiovascular variables in rats with streptozotocin-induced diabetes. Methods: Wistar rats (n = 28) were divided into 4 groups: two control groups, on tap water (TW-C, n = 7) and magnesium hydrocarbonate-rich water (MW-C, n = 7); and two experimental groups with streptozotocin-induced diabetes, on tap water (TW-DM, n = 7) and magnesium hydrocarbonate-rich water (MW-DM, n = 7). The values of body weight, organ weight and cardiovascular parameters were compared after 6 weeks between control groups of rats on subchronic treatment with tap water (TW-C) and magnesium hydrocarbonate-rich water (MW-C) and between groups with streptozotocin-induced diabetes on tap water (TW-DM) and with magnesium hydrocarbonate-rich water (MW-DM). Results: By comparing the values of cardiovascular parameters between groups, significant (p < 0.05) positive effects of magnesium hydrocarbonate-rich water were registered on the values of systolic and pulse blood pressure in diabetic rats fed with magnesium hydrocarbonate-rich water (MW-DM) compared to those fed with tap water (TW-DM). In contrast, no significant effect of magnesium hydrocarbonate on changes in body weight and organ weight was observed. Conclusion: Based on the results, the beneficial effects of magnesium hydrocarbonate-rich water in the regulation of blood pressure can be clearly observed. Potential effects on other cardiovascular variables and body weight and organ weight should be further investigated.

Introduction/Objective. Pseudoexfoliation syndrome is characterized by abnormal production and accumulation of fibrillar, white-gray, “dandruff-like” material in almost all ocular structures. The aim of this study was to examine effect of selective laser trabeculoplasty in pseudoexfoliation glaucoma patients. Methods. Thirty-two patients (47 eyes) with medically uncontrolled pseudoexfoliation glaucoma were enrolled. All the patients could not reach target intraocular pressure with maximal tolerated medical therapy before treatment. Selective laser trabeculoplasty was performed with about 100 non-overlapping spots. Intraocular pressure was measured one hour, seven days, four weeks, three, six, twelve, eighteen, and twenty-four months after the procedure. Results. The mean base intraocular pressure was 23.45 mmHg (SD = 3.07). Statistically significant reduction of mean intraocular pressure was observed at all follow-ups except one hour after treatment. Mean intraocular pressure after 24 months was 18.39 mmHg (SD = 1.82). Success, defined as intraocular pressure reduction from base intraocular pressure by more than 20% after 24 months, was achieved in 27 eyes (57.45%). We did not find any influence of sex and age on selective laser trabeculoplasty effects in pseudoexfoliative glaucoma patients. Baseline intraocular pressure is proved to be a reliable predictor of intraocular pressure-lowering effect, as there was a strong correlation between baseline intraocular pressure and the percentage of reduction of intraocular pressure after 24 months (r = 0.71, p < 0.01). Conclusion. Selective laser trabeculoplasty is a safe and effective method for the reduction of intraocular pressure in pseudoexfoliation glaucoma patients and should be used more often in this challenging form of glaucoma. Baseline intraocular pressure seems to be a reliable predictor of success.

Background/Aim: Hypomagnesaemia is one of the most detected electrolyte abnormalities in diabetics. Modulation of numerous cardiovascular pathophysiological processes is a potential goal for anti-diabetic therapy. Magnesium supplementation prevents subclinical tissue magnesium deficiency, thus delaying the onset of metabolic imbalance in diabetes, but long-term effects of magnesium supplementation in chronic diabetes and numerous pathophysiological processes remain unknown. Aim of this study was to determine the effects of subchronic intake of magnesium hydrocarbonate-rich mineral water on cardiometabolic markers and electrolytes in rats with streptozotocin-induced diabetes. Methods: A total of 28 Wistar, male rats, body weight 160 g at start, were divided into four groups of 7 each: two controls, group that drank tap water and received a single ip injection of saline (0.9 % NaCl) (TW-C), group that drank mineral water rich in magnesium hydrocarbonate and received a single ip injection of saline (0.9 % NaCl) (MW-C); and two experimental groups with streptozotocin-induced diabetes, group that drank tap water and received a single ip injection of streptozotocin (100 mg/kg) in saline (0.9 % NaCl, 1 mL) (TW-DM), group that drank mineral water rich in magnesium hydrocarbonate and received a single ip injection of streptozotocin (100 mg/kg) in saline (0.9 % NaCl, 1 mL) (MW-DM). Results: Regarding the biochemical parameters, a decrease was observed in the MW-C group for vitamin B12 and proteins, while triglycerides were higher compared to the TW-C group. By comparing the haemostatic biomarkers between TW-C and MW-C groups, a statistically significant decrease was found for fibrinogen, while the electrolyte analysis showed an increase in phosphates for the MW-C group. Biochemical value comparison between TW-DM and MWDM groups showed that magnesium hydrocarbonate usage in diabetic rats did not significantly reduce glycaemia although the average glycaemic values were lower in the group treated with magnesium hydrocarbonate. Regarding the electrolyte values, a statistically significant decrease was observed for sodium, potassium and phosphate in the MW-DM group. The MW-DM group also showed a significant increase in iron value compared to TW-DM group. Conclusion: Subchronic intake of magnesium hydrocarbonate-rich mineral water, as a form of magnesium supplementation, did not cause a significant improvement in glycaemia or normalisation of diabetes-induced dyslipidaemia. This study showed the reduction of fibrinogen value, thus indicating the possibility of usage of this form of magnesium supplementation in different pro-thrombogenic conditions.

Introduction: Isoprenaline or isoproterenol (1-(3,4-dihydroxyphenyl)-2-isopropylaminoethanolhydrochloride; ISO), a synthetic b-adrenergic agonist, can be used to establish myocardial ischemia, cardiotoxicity, necrosis and/or an experimental model of infarction in rats. Aim: Determination of the dynamics of myocardial injury biomarkers production of aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and high-sensitive troponin T (hsTnT), with changes on electrocardiogram (ECG) parameters during the subcutaneous aplication of ISO in male Wistar rats. Material and methods: All animals (n = 23) were divided into two groups: control group (n = 11) treated with a saline solution, during two consecutive days (0,2 ml/kg b.m. daily, sc); and the ISO group (n = 12) treated with isoprenaline, during two consecutive days (85 mg/kg b.m. daily, sc). Blood was drawn from the rat tail vein in both groups, in order to determine serum activity levels of myocardial injury biomarkers, and an ECG (n = 6) was registered prior to the application, as well as 48h following the first dose of of saline solution or isoprenaline. Results: In comparison to the control group, in which no significant enzyme activities elevation (p > 0.05) nor ECG changes were registered, ISO group presented a significant rise of two clinically significant biomarkers of acute myocardial injury/myocardial infarction (AMI), CK (p = 0.05) and hsTnT (p < 0.01), as well as an ST segment elevation, with a patognomonic ECG change. Conclusion: Obtained results support previous studies, proving that isoprenaline represents an adequate experimental model for myocardial injury/AMI induction, and a "golden standard" for evaluating potential cardioprotective effects of pharmacological and non-pharmacological therapeutic modalities, with the ultimate goal of lowering the degree of lesions and improving post-infarction myocardium function.

Introduction/Objective. The most frequent postoperative complication of a successfully performed phacoemulsification cataract surgery is the development of posterior capsule opacification (PCO). It is caused by the proliferation and migration of the remaining residual epithelial cells. The objective of this study was to investigate the influence of two different intraocular lenses and two different anti-inflammatory drugs on the development of PCO in one-year follow-up period. Methods. Investigation included 120 patients (120 eyes), equally divided into four groups. The first two groups included patients who used non-steroid anti-inflammatory drug (NSAID) postoperatively, while the other groups had corticosteroid therapy. The first and third group got hydrophilic intraocular lenses (IOL), the second and fourth group had hydrophobic IOL. Software program EPCO 2000 was used for the analysis of PCO. Student’s t-test, Wilcoxon test, and ANOVA were used for data analysis and p < 0.05 value was accepted as statistically significant. Results. After the first three postoperative months, patients from NSAID groups had mean PCO score 0.25 Ѓ} 0.03, which was statistically significant higher (p = 0.042) comparing to corticosteroid groups. At the end of the investigation, the best result in PCO preventing was seen in the group of patients with hydrophobic IOL and corticosteroid therapy, with the mean PCO score of 0.47 Ѓ} 0.08. Conclusion. This study has revealed that IOL made of acrylic hydrophobic material seemed to be the right choice when choosing intraocular lens to prevent PCO development. On the other hand, NSAID and corticosteroid therapy have showed similar results in preventing postoperative intraocular inflammation. This fact can be very useful in situations when corticosteroids must be used with great caution.

Introduction/Objective. Dry eye development after phacoemulsification is a very common complication of cataract surgery. Combined with other risk factors, such as pseudoexfoliation (PEX), this complication becomes more frequent. The aim of this study was to expose the influence of phacoemulsification associated with PEX on the development of dry eye in patients who underwent cataract surgery. Methods. The study included 160 eyes (160 patients) who underwent phacoemulsification. The patients were divided into four groups (n = 40 patients). Groups I and II involved patients without PEX. The patients from Group II were prescribed artificial tears (AT) postoperatively. The patients from Groups III and IV had a presentation of PEX. The patients from Group IV got AT postoperatively. Ocular Surface Disease Index, the tear breakup time (TBUT) test, fluorescein staining, and Schirmer’s test served as “dry eye” tests in this study. The χ2 test and paired t-test were used for data analysis. Results. Measurements were taken for every patient preoperatively, on the first and the seventh day after the surgery, one month and three months, and one year after the surgery. The tests showed postoperatively developed dry eye in all the groups, with the recovery of the tear film within three months, except for Group III. The highest statistical significance (p < 0.001) was recorded between Groups II and III, three and 12 months after the surgery. Values of TBUT (6.09 ± 1.29 seconds) and Schirmer’s test (8.91 ± 2.14 mm) in Group III strongly indicated that dry eye was still present one year after phacoemulsification. The greatest recovery of the tear film was recorded in Group II in all the measurements. Conclusion. The study showed how strongly PEX and the use of AT affect the tear film during the first postoperative year. Based on our experience, we highly recommend the use of AT after performing phacoemulsification.

Introduction/Objective. Vitreal hemorrhage (VH) is one of the possible complications of the diabetic retinopathy which is followed by intensive decrease of visual acuity. Corticosteroides are commonly used in treatment of different retinal diseases, due to their antiinflammatory and anti-angiogenetic effect. Triamcinolone acetonide applied invtravitreally remains in the eye for several months, releases its crystals and decreases the density of vitreal hemorrhage. The aim of this study was to evaluate the efficacy of 20 mg intravitreal triamcinolone acetonide for the managementof long lasting VH, occurred as a complication of proliferative diabetic retinopathy (PDR) in non-vitrectomized eyes. Methods. In prospective study, from January 1st 2015 until the January 1st 2016, 24 patients with VH who received intravitreal triamcinolone acetonide, were compared to 21 patients from the control group (patients with PDR and similar degree of VH). All patients passed ophthalmological examination at the beginning of the study, 7 days, 1, 3, 6, 9 and 12 months after intravitreal application of 20mg triamcinolone acetonide. Besides VH and visual acuity, intraocular pressure and cataract development were also analyzed. Results. Statistically significant difference was recorded 1st and 3rd month after the usage of triamacinolone, in the density of vitreal hemorrhage and visual acuity. Twenty-nine percent of patients had temporally intraocular pressure rise after the intravitreal triamacinolone application, and 4.1% of patients ended the study with the developed cataract. Conclusion. Intravitreally applied triamcinolone acetonide has moderate and temporary influence on the velocity of vitreal hemorrhage reabsorption. It can be useful treatment option when the vitrectomy in not possible.

Introduction: Methionine is an essential sulfuric amino acid, which, according to numerous studies, has a role in the reduction of inflammation, caused by changes in colon, and inhibits important pathways in the development of numerous gastrointestinal disorders. However, subchronic methionine loading leads to oxidative stress, which is a potential cause of disease of numerous organs, digestive tract being one of them. N-acetyl-L-cysteine is a natural antioxidant, which affects some of the important signaling pathways and has a potential therapeutic role in treatment of colon disorders. Aim: To examine the influence of N-acetyl-L-cysteine on histological parameters of rat colon, after subchronic methionine load. Material and methods: Experiments were conducted on 15-20 days old male (Wistar albino) rats, weighing 160 g. There were used 24 animals in the experiment, divided into 3 groups, with eight animals per group. First, control group (K), received NaCl, second group received methionine (M group), while third group received methionine + N-acetyl-L-cysteine (N group). The rats were sacrificed after 21 day and tissue samples of colon were obtained. In all of the three groups, changes of histological parameters of rat colon were analyzed. Results: Methionine load leads to statistically significant increase (p < 0.01) in crypt depth of rat colon, lamina muscularis mucosae thickness, the mucosal thickness and increase in lamina propria cell density compared to control, while N-acetyl- L-cysteine application showed statistically significant decrease (p < 0.01) of these histological parameters compared to M group. Conclusion: N-acetyl-L-cysteine has a significantly protective effect on methionine load induced changes in rat colon.