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PURPOSE: To report the prevalence of undiagnosed glaucoma, as well as demographic characteristics and risk factors among glaucoma suspects who were detected in a publicly promoted intraocular pressure (IOP) based glaucoma screening event. METHODS: A total of 2468 subjects older than 18 years participated in the glaucoma screening event in Zagreb, in 2014, which included a medical interview and IOP measurement using Icare tonometer. 256 subjects (10.37%) were identified as glaucoma suspects, out of which 125 (5.06%) subjects underwent further detailed ophthalmic examination and were classified into five diagnostic groups. RESULTS: The prevalence of all types of newly diagnosed glaucoma was 1.175%, while the prevalence of ocular hypertension (OH), primary open-angle glaucoma (POAG), primary angle closure (PAC) and secondary glaucoma (SG) was 0.16%, 0.89%, 0.16% and 0.12%, respectively. The prevalence of newly diagnosed glaucoma in glaucoma suspects was 23.2%. 17.60% of glaucoma suspects were diagnosed as POAG. Older age was statistically significantly associated with POAG (p = 0.001) and PAC (p = 0.029). At the univariate level, refractive errors were a statistically significant predictor of POAG, and those with hyperopia had more than three times larger odds for POAG. At the multivariate level, none of the predictors reached statistical significance. CONCLUSION: Successful cooperation between healthcare institutions and media can be a useful way of increasing awareness and detection of individuals at an increased risk for developing glaucoma.

SUMMARY The XEN gel stent is one of the available minimally invasive glaucoma surgery devices, a new generation implant, which is designed to reduce intraocular pressure in patients with primary open angle glaucoma if past medical treatments have failed. This report presents a case of subconjunctival fragmentation of the XEN gel stent after a three-month follow-up of successful XEN gel implantation. A 70-year-old male patient was treated for primary open angle glaucoma. He underwent successful phacoemulsification and intraocular lens implantation two years before. Due to medical therapy failure in controlling glaucoma, XEN gel stent implantation was suggested to the patient. The implant was successfully placed in both eyes, and extended bleb and drainage aqueous humor from the anterior chamber to the subconjunctival space was obtained. Three months after the surgery, at a regular follow-up visit, three fragments of the subconjunctival part of the XEN gel implant were found in his left eye. Neither serious complications nor intraocular pressure increase were detected. A new potential complication of the XEN gel implant is described.

The progressive nature of glaucoma suggests it should be possible to detect structural changes such as retinal nerve fiber layer (RNFL) thickness loss before the condition becomes clinically apparent with visual field (VF) impairment. Therefore, the aim was to analyze RNFL thickness and VF changes in study groups with unilateral exfoliation syndrome (XFS), bilateral XFS and bilateral exfoliative glaucoma (XFG), and compare it with controls. The study included 114 subjects (228 eyes) divided into 4 groups according to the presence of exfoliation: 30 subjects with unilateral XFS (30 with clinically visible XFS and 30 fellow eyes), 24 subjects (48 eyes) with bilateral XFS, 28 (56 eyes) subjects with bilateral XFG, and control group (32 subjects). All subjects underwent VF and RNFL measurements after ophthalmologic examination. Both eyes of unilateral XFS (clinically ­visible and fellow eye) showed positive correlation between Mean Defect (MD) and square root of Loss of Variance (sLV) and between MD and inferior quadrant RNFL thickness. In bilateral XFS and XFG, there was negative correlation between MD and inferior quadrant RNFL thickness. Inferior, superior and nasal quadrant RNFL thickness was lower in XFG group than in other groups. In bilateral XFS group, the inferior quadrant RNFL thickness was lower as compared with unilateral XFS group (in both eyes). The mean RNFL thickness negatively correlated with MD in bilateral XFS and XFG groups. In conclusion, structural changes before VF impairment have an important role in early detection of glaucoma in subjects at risk.

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non- arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.

The XEN gel stent is one of the available minimally invasive glaucoma surgery devices, a new generation implant, which is designed to reduce intraocular pressure in patients with primary open angle glaucoma if past medical treatments have failed. This report presents a case of subconjunctival fragmentation of the XEN gel stent after a three-month follow-up of successful XEN gel implantation. A 70-year-old male patient was treated for primary open angle glaucoma. He underwent successful phacoemulsification and intraocular lens implantation two years before. Due to medical therapy failure in controlling glaucoma, XEN gel stent implantation was suggested to the patient. The implant was successfully placed in both eyes, and extended bleb and drainage aqueous humor from the anterior chamber to the subconjunctival space was obtained. Three months after the surgery, at a regular follow-up visit, three fragments of the subconjunctival part of the XEN gel implant were found in his left eye. Neither serious complications nor intraocular pressure increase were detected. A new potential complication of the XEN gel implant is described., XEN gel stent je implantat nove generacije koji se rabi u minimalno invazivnoj kirurgiji glaukoma, namijenjen za snižavanje intraokularnog tlaka u bolesnika s glaukomom primarno otvorenog kuta kada prethodno liječenje nije dovelo do željenog rezultata. Prikazan je slučaj bolesnika kod kojega je nakon tri mjeseca praćenja uspješno implantiranog XEN gel stenta došlo do njegove subkonjunktivne fragmentacije. Muškarac u dobi od 70 godina liječen je zbog glaukoma otvorenog kuta. Dvije godine ranije imao je uspješnu operaciju katarakte s ugradnjom intraokularne leće. Zbog neuspješne kontrole glaukoma medikamentnom terapijom bolesniku je predložena implantacija XEN gel stenta. Implantat je uspješno implantiran u oba oka te je omogućen protok očne vodice iz prednje očne sobice u subkonjunktivni prostor uz formiranje filtracijskog jastučića. Tri mjeseca nakon operacije lijevoga oka, na redovnoj kontroli vizualizirana su tri fragmenta subkonjunktivnog dijela XEN gel stenta, bez da je prethodno bilo ozbiljnijih komplikacija ili porasta intraokularnoga tlaka. Opisana je nova moguća komplikacija XEN gela implantata.

The aim of this study was to assess the eff ect of diff erent visual impairment levels on diff erence in the subjective quality of life estimation. We included 150 patients with glaucoma whose best-corrected visual acuity in the better-seeing eye was 0.5 and less. All of them were in advanced stage of the disease, with visual fi eld defect worse than 12 dB in mean defect, when measured with the Octopus Visual Field Analyzer. In order to assess the quality of life, we used the Impact of Vision Impairment questionnaire. Additionally, we used General Information Questionnaire, which was developed for the purpose of this study. The information obtained from the questionnaires was analyzed using the Robust Discriminant Analysis program. Diff erence analysis was performed for each of the three areas of the questionnaire (reading and accessing information, mobility and independence, and emotional well-being). Results of this study confi rmed the diff erence between the groups of patients with diff erent levels of visual impairment, varying from total visual loss up to visual acuity 0.5 on the better-seeing eye in the eff ects of visual impairment on the quality of life. All levels of visual impairment had the largest eff ect in the area of reading and accessing information, slightly less in the area of mobility and independence, and the least eff ect was in the area of emotional well-being. Based on the results, it is concluded that all levels of visual impairment have negative eff ect on the quality of life in glaucoma patients.

The aim of this study was to assess the eff ect of diff erent visual impairment levels on diff erence in the subjective quality of life estimation. We included 150 patients with glaucoma whose best-corrected visual acuity in the better-seeing eye was 0.5 and less. All of them were in advanced stage of the disease, with visual fi eld defect worse than 12 dB in mean defect, when measured with the Octopus Visual Field Analyzer. In order to assess the quality of life, we used the Impact of Vision Impairment questionnaire. Additionally, we used General Information Questionnaire, which was developed for the purpose of this study. The information obtained from the questionnaires was analyzed using the Robust Discriminant Analysis program. Diff erence analysis was performed for each of the three areas of the questionnaire (reading and accessing information, mobility and independence, and emotional well-being). Results of this study confi rmed the diff erence between the groups of patients with diff erent levels of visual impairment, varying from total visual loss up to visual acuity 0.5 on the better-seeing eye in the eff ects of visual impairment on the quality of life. All levels of visual impairment had the largest eff ect in the area of reading and accessing information, slightly less in the area of mobility and independence, and the least eff ect was in the area of emotional well-being. Based on the results, it is concluded that all levels of visual impairment have negative eff ect on the quality of life in glaucoma patients., Cilj istraživanja bio je utvrditi utjecaj oštećenja vida na kvalitetu života bolesnika s glaukomom. Istraživanjem je obuhvaćeno 150 bolesnika s glaukomom, s ostatkom vida od 50% i manje na boljem oku (vidna oštrina ≤0,5). Svi su bili u terminalnoj fazi bolesti, s oštećenjem vidnoga polja većim od 12 dB u Mean Defects (MD) mjerenim analizatorom vidnog polja Octopus. Za mjerenje utjecaja oštećenja vida na kvalitetu života primijenjen je upitnik Th e Impact of Vision Impairment (IVI), a dodatno je primijenjen upitnik vlastite izrade General Information Questionnaire. Prikupljeni podaci su obrađeni modelom robustne diskriminacijske analize (ROBDIS). Utvrđena je razlika između skupina ispitanika s različitim stupnjem oštećenja vida, od potpunog gubitka vida do ostatka vida na boljem oku od 50%. Za svako od tri područja (čitanje i pristup informacijama, kretanje i samostalnost te emocionalno blagostanje) učinjena je razlikovna analiza. Rezultati istraživanja potvrdili su da oštećenje vida utječe na kvalitetu života bolesnika s glaukomom. Najveći utjecaj različitih stupnjeva oštećenja vida bio je očit u području čitanja i pristupa informacijama, nešto manji u području orijentacije i kretanja, a najmanji u području emocionalnog blagostanja.

The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of IOP below 23 mm Hg (with or without antiglaucoma medications) and changes in visual acuity. Complications were recorded. After AGV implantation, IOP values ranged from 18 mm Hg to 23 mm Hg (except for one eye with postoperative hypotonia due to suprachoroid hemorrhage, where the postoperative IOP value was 4 mm Hg). The number of antiglaucoma medications was reduced, i.e. four patients had two medications, one patient had one medication, and the others did not need antiglaucoma medication on the last follow-up visit. One eye had suprachoroid hemorrhage, one eye had long-term persistent uveitic membrane, and two eyes had tube-cornea touch. In conclusion, AGV implantation appears to be a viable option for the management of refractory pediatric glaucoma and shows success in IOP control. However, there was a relatively high complication rate limiting the overall success rate.

The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL.

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group., Svrha ovoga rada bila je utvrditi oštećenje ganglijskih stanica mrežnice i morfološke promjene glave vidnoga živca u ispitanika s primarnim glaukomom otvorenog kuta (POAG) i nearteritičkom prednjom ishemijskom optičkom neuropatijom (NAION). Prva skupina ispitanika sastojala se od 40 očiju s POAG, druga skupina od 40 očiju s NAION i treća skupina od 40 očiju s refrakcijskom anomalijom (kontrolna skupina).Svim ispitanicima napravljena je automatizirana perimetrija i analiza topografije glave vidnoga živca pomoću konfokalne skenirajuće laserske oftalmoskopije (CSLO)-HRT II. Smanjena mrežnična osjetljivost prevladavala je u bolesnika s POAG, dok su se u bolesnika s NAION defekti očitovali u obliku koncentrično suženog vidnog polja i kvadrantnih ispada. Topografske promjene glave vidnoga živca ispitivane pomoću HRT II ukazale su na to da je u bolesnika s POAG i NAION oštećen jednak broj sektora. Veći broj sektora u gornjem dijelu glave vidnoga živca bio je oštećen u bolesnika s NAION. Morfologija glave vidnoga živca značajno se razlikovala između bolesnika s POAG i NAION, pokazujući veće stanjenje neuroretinalnog ruba i veću dubinu ekskavacije u bolesnika s POAG.

The progressive nature of glaucoma suggests it should be possible to detect structural changes such as retinal nerve fiber layer (RNFL) thickness loss before the condition becomes clinically apparent with visual field (VF) impairment. Therefore, the aim was to analyze RNFL thickness and VF changes in study groups with unilateral exfoliation syndrome (XFS), bilateral XFS and bilateral exfoliative glaucoma (XFG), and compare it with controls. The study included 114 subjects (228 eyes) divided into 4 groups according to the presence of exfoliation: 30 subjects with unilateral XFS (30 with clinically visible XFS and 30 fellow eyes), 24 subjects (48 eyes) with bilateral XFS, 28 (56 eyes) subjects with bilateral XFG, and control group (32 subjects). All subjects underwent VF and RNFL measurements after ophthalmologic examination. Both eyes of unilateral XFS (clinically ­visible and fellow eye) showed positive correlation between Mean Defect (MD) and square root of Loss of Variance (sLV) and between MD and inferior quadrant RNFL thickness. In bilateral XFS and XFG, there was negative correlation between MD and inferior quadrant RNFL thickness. Inferior, superior and nasal quadrant RNFL thickness was lower in XFG group than in other groups. In bilateral XFS group, the inferior quadrant RNFL thickness was lower as compared with unilateral XFS group (in both eyes). The mean RNFL thickness negatively correlated with MD in bilateral XFS and XFG groups. In conclusion, structural changes before VF impairment have an important role in early detection of glaucoma in subjects at risk., Progresija glaukoma upućuje na to da se strukturne promjene kao što je gubitak mrežničnog sloja živčanih vlakana mogu otkriti prije nego što nastupi oštećenje vidnog polja. Cilj rada je bio analizirati debljinu sloja živčanih niti i promjene u vidnom polju u skupinama ispitanika s jednostranim i obostranim eksfolijativnim sindromom i obostranim eksfolijativnim glaukomom te ih usporediti s kontrolnom skupinom. Kod 114 ispitanika (228 očiju) podijeljenih u 4 skupine prema prisutnosti eksfolijacije: 30 ispitanika s jednostranim sindromom (30 s klinički vidljivim sindromom i 30 pratećih očiju), 24 ispitanika (48 očiju) s obostranim eksfolijativnim sindromom, 28 (56 očiju) ispitanika s obostranim glaukomom i 32 ispitanika u kontrolnoj skupini učinjeno je vidno polje i mjerenje debljine živčanog sloja mrežnice nakon oftalmološkog pregleda. Oba su oka jednostranog eksfolijativnog sindroma (klinički vidljivog i kod pratećih očiju) pokazala pozitivnu korelaciju između srednjeg defekta i pokazatelja lokaliziranog defekta vidnog polja te srednjeg defekta i donjeg kvadranta debljine mrežničnog sloja živčanih niti. U obostranom eksfolijativnom sindromu i obostranom glaukomu postojala je negativna korelacija između srednjeg defekta vidnog polja i debljine živčanih niti donjeg kvadranta. U obostranom eksfolijativnom sindromu postojalo je stanjenje mrežničnog sloja živčanih stanica donjeg kvadranta u odnosu na ispitanike s jednostranim eksfolijativnim sindromom (u oba oka). Prosječna debljina živčanog sloja mrežnice bila je u negativnoj korelaciji s prosječnim defektom vidnog polja u obostranom eksfolijativnom glaukomu i obostranom sindromu. U zaključku, strukturne promjene prije pojave oštećenja vidnog polja imaju značajnu ulogu u ranom otkrivanju glaukoma kod osoba koje spadaju u rizičnu skupinu.

The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL., Cilj je bio usporediti debljinu sloja živčanih vlakana mrežnice (RNFL) i kompleksa ganglijskih stanica (GCC) u bolesnika s primarnim glaukomom otvorenog kuta (POAG), okularnom hipertenzijom (OH) i u zdravih ispitanika te istražiti ulogu parametara GCC u dijagnostici glaukoma. Ispitanici su bili podijeljeni u četiri skupine prema Hodapp-Parrish-Andersonovoj klasifi kaciji: 26 ispitanika s OH, 22 s ranim POAG-om, 10 s umjerenim do uznapredovalim POAG-om i 23 zdrava ispitanika. Svim ispitanicima je izmjerena debljina RNFL-a i GCC-a primjenom SOCT Copernicus HR. Ispitanici s POAG-om imali su značajno niže vrijednosti debljine GCC i RNFL nego ispitanici s OH i zdravi ispitanici, osobito vrijednosti prosječnog RNFL-a te RNFL-a u gornjem i donjem kvadrantu. Od svih parametara RNFL najveće područje ispod krivulje (AUC) pripadalo je prosječnom RNFL-u, 0,906. Prosječni GCC te GCC u gornjem i donjem kvadrantu imali su ukupno najveće vrijednosti AUC-a sa 100% specifičnošću. Glavni prediktori za razvoj glaukoma su bili prosječni RNFL, RNFL u donjem kvadrantu, prosječni GCC te GCC u gornjem i donjem kvadrantu (p1=0,015 i p2=0,014 prema p3=0,002, p4=0,002 i p5=0,003). U zaključku, parametri GCC su bolje razlikovali glaukomske od neglaukomskih bolesnika te su se pokazali kao bolji prediktori razvoja glaukoma u odnosu na parametre RNFL.

The aim of the study was to evaluate macular thickness and macular volume in unilateral and bilateral exfoliation syndrome and to compare them with exfoliative glaucoma and control eyes using optical coherence tomography. This prospective study included 114 subjects (228 eyes) divided into 4 groups according to the presence of exfoliation: 30 patients with unilateral syndrome, 24 patients with bilateral syndrome, 28 patients with bilateral glaucoma and control group without glaucoma or exfoliation syndrome (32 subjects). All subjects were older than 50 years. Patients with visual acuity under 0.6 according to Snellen were excluded, as well as those with refraction errors, i.e. hypermetropia over +3 spherical diopters, myopia over -5 spherical diopters, astigmatism over 2 cylindrical diopters, patients with affections that might affect the macula or the optic nerve, such as diabetic retinopathy, macular degeneration, macular edema, epiretinal membrane, vascular occlusions, neuropathies, and patients having undergone eye surgery except for pseudophakic patients with visual acuity within the set limits. Study results confirmed the hypothesis on the existence of structural changes of macular parameters before the functional ones, thus representing an early sign of glaucomatous damage in risk groups such as unilateral and bilateral exfoliation syndrome. If the glaucoma had already manifested (exfoliative glaucoma in this study) with changes in optic disc and visual field, structural changes confirmed the clinical findings and warned of the disease severity.

The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of IOP below 23 mm Hg (with or without antiglaucoma medications) and changes in visual acuity. Complications were recorded. After AGV implantation, IOP values ranged from 18 mm Hg to 23 mm Hg (except for one eye with postoperative hypotonia due to suprachoroid hemorrhage, where the postoperative IOP value was 4 mm Hg). The number of antiglaucoma medications was reduced, i.e. four patients had two medications, one patient had one medication, and the others did not need antiglaucoma medication on the last follow-up visit. One eye had suprachoroid hemorrhage, one eye had long-term persistent uveitic membrane, and two eyes had tube-cornea touch. In conclusion, AGV implantation appears to be a viable option for the management of refractory pediatric glaucoma and shows success in IOP control. However, there was a relatively high complication rate limiting the overall success rate., Svrha rada je prikazati sigurnost i učinkovitost implantacije Ahmedove glaukomske valvule (AGV, New World Medical, Inc., Rancho Cucamonga, CA, SAD) kod refraktornog glaukoma dječje dobi tijekom jednogodišnjeg praćenja. Proveden je retrospektivni pregled nalaza 10 očiju u djece mlađe od 11 godina u kojih je ugrađena AGV zbog medikamentima nekontroliranog glaukoma u razdoblju od 2010. do 2014. godine. Pratila se visina intraokularnog tlaka (IOT) i vidna oštrina, a također su bilježene komplikacije. Rezultati su pokazali da su nakon implantacije AGV vrijednosti IOT-a bile od 18 mm Hg do 23 mm Hg (osim kod jednog oka s poslijeoperacijskom hipotonijom zbog suprakoroidnog krvarenja, gdje je poslijeoperacijski IOT bio 4 mm Hg). Broj antiglaukomskih lijekova bio je smanjen: četvoro bolesnika su imali po dva lijeka, jedan je imao jedan lijek, a svi ostali nisu trebali dodatne lijekove na posljednjem pregledu. Kod jednog oka se pojavilo suprakoroidno krvarenje, kod jednog dugotrajna upalna membrana, a kod dva oka kontakt cjevčice s rožnicom. Zaključuje se da implantacija AGV predstavlja izbor u liječenju refraktornog glaukoma dječje dobi i ima uspjeha u kontroli IOT-a. Međutim, relativno velik broj komplikacija ograničava konačan uspjeh.

The purpose of this study was to assess the prevalence of pseudoexfoliation syndrome and pseudoexfoliation glaucoma and to evaluate its association with open-angle glaucoma in patients attending the Department of Ophthalmology, Dr Tomislav Bardek General Hospital in Koprivnica, northwestern Croatia. This prospective study was conducted at Dr Tomislav Bardek General Hospital between December 2012 and October 2013. A total of 5349 subjects aged 40 or above presenting for general ophthalmic examination were screened for pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Each patient underwent complete ophthalmologic examination including ocular history, visual acuity testing, slit-lamp examination, applanation tonometry, optic disc evaluation, visual field analysis, and gonioscopy if glaucoma was suspected. Exclusion criteria were pseudophakic and/or aphakic patients of any age, patients with concomitant congenital eye disease, and patients with very dense ocular media opacities. Out of 5349 patients examined, there were 1994 (38.38%) males and 3201 (61.61%) females. The prevalence of pseudoexfoliation syndrome was 3.6% and primary open angle glaucoma 9.4%, out of which 23.6% with pseudoexfoliation glaucoma. The findings of this study improve our knowledge of pseudoexfoliation syndrome and pseudoexfoliation glaucoma in Croatia, particularly in the northwest region., Svrha ovoga istraživanja bila je procijeniti učestalost pseudoeksfolijativnog sindroma i pseudoeksfolijativnog glaukoma te njihovu povezanost s glaukomom otvorenog kuta kod bolesnika Očne poliklinike Opće bolnice “Dr. Tomislav Bardek” u Koprivnici, sjeverozapadna Hrvatska. Ovo prospektivno istraživanje provedeno je od prosinca 2012. do listopada 2013. godine. Ukupno je pregledano 5349 ispitanika u dobi od 40 godina i više. Kod svakog je učinjen kompletan oftalmološki pregled uključujući anamnezu, ispitivanje vidne oštrine, pregled na biomikroskopu, aplanacijsku tonometriju, pregled očnoga živca i pozadine oka te vidno polje i gonioskopiju kod onih sa sumnjom na glaukom. Kriteriji za isključenje bili su bolesnici s pseudofakijom/afakijom, bolesnici s prirođenim očnim bolestima te oni s vrlo gustim zamućenjem očnih medija. Od 5349 bolesnika bilo je 1994 (38,38%) muškaraca i 3201 (61,61%) žena. Učestalost pseudoeksfolijativnog sindroma bila je 3,6%, a primarnog glaukoma otvorenog kuta 9,4%, od čega 23,6% spada u skupinu pseudoeksfolijativnog glaukoma. Rezultati ove studije proširuju naše spoznaje o pseudoeksfolijativnom sindromu i pseudoeksfolijativnom glaukomu u Hrvatskoj, osobito u sjeverozapadnoj regiji.

Limbal stem cell transplantation (LSCT) and amniotic membrane transplantation may improve corneal recovery after a chemical burn. Amniotic membrane was applied as a patch in 5 eyes; LSCT from healthy contralateral eye was performed in 6 eyes, and a combination of these techniques was performed in 4 eyes. There were no complications during surgical procedure. Epithelization was completed after 2 weeks in patients with LSCT, and after 3 weeks in the amniotic membrane transplantation group. Visual acuity improved in all patients. No complication was observed on either the donor or the recipient eye during a follow-up period of >13 months in all groups. Amniotic membrane is effective in promoting re-epithelization and reducing inflammation when applied alone in patients with 3- to 6-hour limbal involvement, as well as combined with LSCT in patients with >6-hour limbal ischemia. LSCT is an effective procedure for rehabilitation after severe chemical trauma of the eye with more than 50% limbal involvement.

Cilj rada bio je ispitati prognostičku vrijednost, tj. ulogu hemodinamske promjene u arteriji oftalmici (AO) ultrazvučnim obojenim doplerom (CDI) kod bolesnika s vitiligom za nastanak primarnog glaukoma otvorenog kuta (PGOK), te skrenuti pažnju kliničarima dermatolozima i oftalmolozima na važnost ispitivanja i vaskularne komponente u rutinskoj obradi bolesnika zbog moguće povezanosti vitiliga i očnih promjena suspektnih za PGOK. Naše kliničko zapažanje i istraživanje da se kod bolesnika koji se liječe od vitiliga relativno često dijagnosticira ili uoči već ranije dijagnosticirani PGOK potaknulo nas je i na ispitivanje vaskularne komponente kao eventualne moguće poveznice vitiliga i PGOK. Vaskularna komponenta kod PGOK i njezina uloga u dinamici nastanka bolesti nije dovoljno razjašnjena i još je kontraverzna, a posljedična ishemijska događanja vezana su primarno za oštećenje vidnog živca (NO). U našem kontinuiranom dvogodišnjem istraživanju od ožujka 2008. do ožujka 2010. godine u specijalističkoj dermatovenerološkoj ambulanti Klinike za kožne i spolne bolesti pregledano je 42 bolesnika s vitiligom. Nakon kliničkog pregleda i uz pomoć Woodove lampe, zbog sumnje na glaukom upućeni su u ambulantu za glaukom Klinike za očne bolesti zbog detekcije ili kontrole primarnog glaukoma otvorenog kuta (PGOK). Svim se bolesnicima učinilo ultrazvuk arterije oftalmike oba oka na Klinici za unutarnje bolesti KBC-a Split u svrhu ispitivanja hemodinamike. Svim ispitanicima učini se kompletan oftalmološki pregled: vidna oštrina, pregled fundusa oka, mjerenje očnog tlaka, biomikroskopija prednjeg segmenta oka s gonioskopijom i vidno polje (VP). Naša studija pokazuje da se ultrazvučnim ispitivanjem i praćenjem vaskularnih parametara u arteriji oftalmici obojenim doplerom može bolje spoznati vaskularna uloga u diferencijalnoj dijagnozi i isključiti je kao poveznicu ili potencijalnog čimbenika rizika povezanog s vitiligom i PGOK. Dakle, bolesnici koji se liječe od vitiliga bez obzira na dob, spol, zahvaćenost, lokalizaciju i trajanje bolesti trebali bi se prema našem mišljenju redovito podvrgavati kompletnom oftalmološkom pregledu s posebnim osvrtom na dijagnosticiranje POAG. S obzirom na relativno mali uzorak i razdoblje ispitivanja može se već sada gotovo argumentirano potvrditi da ta povezanost nije slučajna. Buduća istraživanja na većem broju bolesnika s vitiligom i PGOK trebalo bi dati definitivan odgovor o povezanosti tih dviju bolesti i polučiti definitivni zaključak uz ispitivanje i drugih hematoloških faktora vezano za hiperkoagubilnost krvi kako bi se mogla bolje spoznati uloga vaskularne komponente., The aim of this study was to assess the prognostic value, i.e. the role of hemodynamic changes in the ophthalmic artery determined by color Doppler imaging in patients with vitiligo in relation to the occurrence of primary open-angle glaucoma (POAG), and to call attention to the importance of examination of the vascular component in routine examinations of patients by clinical dermatologists and ophthalmologists, due to the possible correlation of vitiligo and ophthalmologic changes indicating POAG. Clinical observations and research have shown that patients treated for vitiligo are often diagnosed with POAG or have confirmed diagnosis in their medical history. These findings motivated the research of the vascular component as a possible correlation between vitiligo and POAG. The vascular component of POAG and its role in the dynamics of glaucoma progression has not been fully explained and is still somewhat controversial, and the resulting ischemic disorders are primarily related to optical nerve damage. During the course of a continuous two-year research started in March 2008 and completed in March 2010, a total of 42 patients with vitiligo were examined in the specialist dermatovenereology unit of the Department of Skin Diseases and Sexually Transmitted Diseases. Following clinical examination and Wood’s lamp examination, patients with suspected glaucoma were referred to the glaucoma unit of the Department of Ophthalmology to detect or check the progression of POAG. At the Department of Internal Medicine, Split University Hospital Center, color Doppler imaging of ophthalmic artery was performed in all patients on both eyes to examine its hemodynamics. All study participants underwent complete ophthalmologic examination: visual acuity, fundus of the eye, eye pressure measurement, anterior eye segment biomicroscopy with gonioscopy and visual field. In conclusion, our study showed color Doppler imaging and investigation of vascular parameters in ophthalmic artery to provide an insight into the vascular function in differential analysis and can be determined as a correlation or potential risk factor related to vitiligo and POAG. For this reason, we suggest that patients treated for vitiligo, irrespective of their age, sex, affected area, localization and duration of the disease, should regularly undergo complete ophthalmologic examination with special emphasis on POAG diagnosis. Considering the relatively limited sample and trial period, we can already substantiate and confirm that the correlation is not random. Future research in a larger number of vitiligo and POAG patients should provide definitive answer concerning correlation between the two diseases and lead to final conclusion, along with investigation of other hematologic factors related to blood hypercoagulability in order to reach better understanding of the vascular component function.

Astigmatism represents an inability of the cornea and lens to provide a sharp image onto the retina. Correcting astigmatic errors, whether congenital, contact lens induced or surgically induced, is now an integral part of modern cataract and refractive procedures. Development of modern technology has enabled accurate diagnosis and perfect opportunities for correction; however, while cataract and keratorefractive surgery have come a long way in the last decade, the treatment and diagnosis of astigmatism continue to challenge ophthalmologists. There are several diagnostic procedures and tools available today, some standard and some contemporary that include keratometry, corneal topography, apparatus using wavefront or Scheimpflug analysis like Orbscan, Pentacam, Wavescan, etc. With the introduction of several new diagnostic tools, measurements of astigmatism have become less of an issue, but in some cases it is still difficult to obtain consistent results. What remains still unanswered is the question of the best diagnostic tool on the market. Further research is needed to evaluate both tools as well as their clinical application for optimal use., Astigmatizam predstavlja svojevrsnu nemogućnost rožnice i leće da stvore jasnu i oštru sliku na mrežnici. Korekcija astigmatizma dio je moderne refraktivne i kirurgije katarakte, bilo da se radi o kongenitalnom, uzrokovanom kontaktnim lećama ili kirurški uzrokovanom astigmatizmu. Razvoj moderne tehnologije omogućio je lakše otkrivanje i postavljanje dijagnoze, no unatoč velikom napretku kirurgije terapija i dijagnostika astigmatizma i dalje predstavlja velik izazov. Nekoliko je dijagnostičkih postupaka odnosno uređaja danas dostupno, pa se tako razlikuje keratometrija, kornealna topografija, uređaji za wavefront i Scheimpflug analizu kao Orbscan, Pentacam, Wavescan itd. S uvođenjem novih uređaja mjerenje i dijagnostika astigmatizma je pojednostavljena, no i dalje postoje slučajevi s nezadovoljavajućim rezultatima. Nerazjašnjeno ostaje i dalje pitanje univerzalnog dijagnostičkog postupka i uređaja, pa stoga valja naglasiti i potrebu budućih studija, odnosno daljnjih istraživanja glede evaluacije uređaja i njihove optimalne kliničke primjene.

The aim of this study was to evaluate macular thickness parameters in glaucoma patients and to compare them to normal subjects using Optical Coherence Tomography (OCT). This prospective, observational study included 20 primary open angle glaucoma patients (POAG) and 20 healthy subjects in control group. Exclusion criteria were diabetes and other macular pathology, like age-related macular degeneration, macular oedema, central serous retinopathy and high myopia >4.00 dsph. OCT imaging of peripapillar retina and macular area were performed using Cirrus HD OCT. In these two groups of patients we analyzed changes of macular thickness parameters (central subfield thickness, macular volume, and average macular thickness). The group of glaucoma patients had decreased values of the two macular thickness parameters: macular volume and average macular thickness, compared to control group. There was no difference in central macular thickness, presumably because of the absence of the ganglion cells in this layer. Macular imaging can be a useful additional method to determine glaucoma status and has a potential for tracking glaucoma progression.

Purpose: To assess the safety and efficacy of changing antiglaucoma therapy to the travoprost 0,004%/timolol 0,5% (TTF C) fixed combination from previous monotherapies. Methods: Prospective, open-label, observational, multicenter cohort. A change was done from prior monotherapy at day 0 to TTF C dosed once a day, regardless in the evening or in the morning, without washout period. Active evaluation of systemic and local tolerability (adverse events), and efficacy ie. intraocular pressure (IOP) lowering was done at control 1 (day 30), control 2 (day 90) and control 3 (day 120). Results: 40/155/170 patients (79/309/339 eyes) completed the study (120 days/ 90 days/baseline, respectfully). At control 1 excluded were patients with low tolerability (severe hyperemia (6 patients), discomfort (4), chest pain (1)) and non responders (IOP lowering less than 15% from baseline IOP or target IOP >18 mmHg (4 patients)). Mean IOP at control 1 was 15,92±1,85 mm Hg (21,66% reduction) for 155 patients (non responders excluded), at control 2 was for 155 patients 15,67±2,17 mm Hg (21,14% reduction), and at control 3 for 40 patients 16,28±1,59 mm Hg (19,86% reduction). At control 2 analysis of IOP reduction by 4 groups of previous monotherapy (timolol 0,5% (N=33/66), latanoprost 0,005% (N=49/98), betaxolol 0,5% (N=30/60), and travoprost 0,004% (N=43/85) was performed. 40 patients/79 eyes endured to control 3 (after day 90 free samples were not available for all patients). Analysis of IOP reduction by 4 groups of previous monotherapy medications was performed (timolol 0,5%(N=7/14), latanoprost 0,005% (N=14/28), betaxolol 0,5% (N=7/14), travoprost 0,004% (N=12/23)). Conclusions: Changing patients from prior monotherapy to TTF C can provide on average a further reduction in IOP, while demonstrating a favorable safety profile., CILJ: Zabilježiti sigurnost i učinkovitost promjene antiglaukomske terapije u travoprost 0,004%/timolol 0,5% (TTF C) fiksnu kombinaciju s prethodnih monoterapija. METODE: Prospektivna, otvorena, opservacijska, multicentrična populacija. Promjena s prethodne monoterapije na dan 0 u TTF C, doziran jednom dnevno, ili ujutro ili navečer, bez perioda ispiranja. Aktivno je ocijenjena sistemska i lokalna podnošljivost (popratne pojave), i učinkovitost tj.sniženje intraokularnog tlaka (IOT) na prvoj kontroli (dan 30), drugoj kontroli (dan 90) i trećoj kontroli (dan 120). REZULTATI: 40/155/170 bolesnika (79/309/339 očiju) završilo je studiju (120 dana/ 90 dana/početak). Na prvoj kontroli isključeni su svi bolesnici koji su slabo podnosili lijek: ozbiljna hiperemija (6 bolesnika), neugoda (4), bol u prsištu (1) i ne- responderi tj. sniženje IOT-a manje od 15% od početnog IOT ili ciljnog IOT >18 mmHg (4 bolesnika). Prosječni IOT na prvoj kontroli je bio 15,92±1,85 mm Hg (21,66% sniženja) kod 155 bolesnika (isključeni ne-responderi), na drugoj kontroli je kod 155 bolesnika bio 15,67±2,17 mm Hg (21,14% sniženja), i na trećoj kontroli kod 40 bolesnika 16,28±1,59 mm Hg (19,86% sniženja). Na drugoj kontroli je učinjena analiza sniženja IOT-a u 4 grupe prethodno korištene monoterapije: timolol 0,5% (N=33/66), latanoprost 0,005% (N=49/98), betaxolol 0,5% (N=30/60), i travoprost 0,004% (N=43/85). 40 bolesnika/79 očiju praćeno je do treće kontrole. Učinjena je analiza sniženja IOT-a u 4 grupe prethodno korištene monoterapije: timolol 0,5% (N=7/14), latanoprost 0,005% (N=14/28), betaxolol 0,5% (N=7/14), travoprost 0,004% (N=12/23). Zaključak: Promjena terapije s prethodne monoterapije u TTF C može u prosjeku omogućiti dodatno sniženje IOT-a, uz zadovoljavajući profil sigurnosti.

To study the efficacy and safety of subcutaneous botulinum toxin A injections in the treatment of primary and recurrent chalazia. Prospective, placebo-controlled consecutive case-series trial. Sixty three patients were divided into two groups: group 1 consisting of 32 patients previously diagnosed with and treated for primary or recurrent chalazia with 2–5 international units (IU) in 0.2–0.5 ml of preserved saline solution of botulinum toxin injection, and group 2 consisting of 31 patients receiving placebo. The main outcome measures were localization and duration of the disease, size of chalazion before and after treatment, clinical resolution of chalazion, time to resolution, and complications of treatment. There was a clinically and statistically significant between-group difference in the rate of therapeutic success and post-therapeutic chalazion regression, but not in the rate of complications. Botulinum toxin A injection is effective and safe treatment for primary and recurrent chalazia. Lesion regression that did not respond to the average of two injections would benefit more from surgical excision or systemic antibiotic therapy.

Syphilis, a disease which used to be terminal up to the 1950s, has become curable with the discovery of penicillin. In the last few years, an increase in its incidence has been recorded in the world as well as in Croatia, primarily with the human immunodeficiency virus (HIV) co-infection. We present a 40-year-old male patient who complained of a sudden decrease of visual acuity on both eyes, accompanied by dizziness. Clinical examination revealed low visual acuity and blurred edges of the optical nerve head without prominence. Pulse corticosteroid therapy failed to produce any recovery of visual acuity. Additional tests were done including Treponema pallidum hemagglutination assay (TPHA), which confirmed the infection with Treponema pallidum. The patient was administered Extencillin therapy. As a reaction to therapy administered, the patient.s visual acuity gradually fully recovered. In the medical literature available, there is no report of optical neuritis as the first and only manifestation of HIV and syphilis co-infection., Sifilis, bolest koja je do pedesetih godina prošloga stoljeća bila smrtonosna, otkrićem penicilina postala je izlječivom. U posljednjih nekoliko godina bilježi se porast incidencije kako u svijetu tako i kod nas, osobito uz suinfekciju virusom humane imunodeficijencije (HIV). Prikazujemo slučaj 40-godišnjeg muškarca koji se javio zbog naglog pada vidne oštrine na oba oka praćenog vrtoglavicom. Pri kliničkom pregledu utvrđena je niska vidna oštrina te glava vidnog živca nejasnih brisanih granica bez prominencije. Propisana pulsna kortikosteroidna terapija nije dovela do očekivanog oporavka vidne oštrine, pa su učinjene dodatne pretrage, među kojima i test hemaglutinacijske reaktivnosti Treponema pallidum (TPHA), kojim se dokazala infekcija bakterijom Treponema pallidum. Bolesniku je propisana terapija Extencillinom. Ova terapija je dovela do potpunog oporavka vidne oštrine. U dostupnoj medicinskoj literaturi, prema našim saznanjima, dosad nije opisan slučaj optičkog neuritisa kao prve i jedine manifestacije suinfekcije HIV i sifilisa.

Cilj rada je prikazati učinkovitost transplantacije limbalnih stanica (LSCT) kao načina liječenja recidivirajućih pterigija. Ukupno je 18 očiju s recidivirajućim pterigijem operirano tehnikom LSCT; 12 bolesnika je primarno bilo operirano tehnikom "bare sclera", 3 rotacijom konjunktive i 3 transplantacijom amnijske membrane. Nije bilo značajnijih intraoperacijskih komplikacija osim reverzibilnog edema konjunktivnog grafta kod 2 bolesnika, Tenonovog granuloma kod jednog bolesnika te hematoma također kod jednog bolesnika. Kod 16 bolesnika nije bilo recidiva pterigija tijekom vremena praćenja, dok se kod 2 bolesnika recidiv javio unutar 18 mjeseci. Zaključak rada je da je LSCT uspješna i sigurna metoda u liječenju recidivirajućih pterigija, iako je tehnički i vremenski dosta zahtjevna., The aim of the study was to assess the efficacy of limbal stem cell transplantation (LSCT) as a treatment for recurrent pterygium. Eighteen eyes with recurrent pterygium underwent LSCT. Twelve eyes had been previously operated by the "bare-sclera" technique, 3 by conjunctival rotation and 3 by amnion membrane transplantation. No serious intraoperative complications occurred, except for reversible conjunctival graft edema in 2 eyes, Tenon's granuloma in one case, and hematoma under the graft in one case. In 16 eyes no pterygium recurrence was recorded during the follow up period. Two recurrences were recorded during 18 months after surgery. It is concluded that LSCT is a successful and safe yet time-consuming and technically demanding method in the management of recurrent pterygium.

The aim of the study was to assess short-term efficacy of intravitreal bevacizumab in a series of patients with neovascular glaucoma. Eleven patients with neovascular glaucoma and symptomatic elevation of intraocular pressure were treated with 1.25 mg/0.1 mL of bevacizumab. In three patients, intravitreal bevacizumab was administered preoperatively, one day before pars plana vitrectomy. Additional therapy was only performed if topical medication failed to result in satisfactory control of intraocular pressure. Patients were followed-up for a minimum of 8 weeks. In all study patients, intravitreal application of bevacizumab resulted in marked regression of iris neovascularization within the first three postoperative days. Appropriate control of intraocular pressure was achieved in seven patients, whereas four patients required additional therapy for intraocular pressure regulation. No side effects of intravitreal bevacizumab were recorded. Thus, intravitreal bevacizumab seems to be a potent adjunct in the management of neovascular glaucoma. Additional studies of bevacizumab long-term safety and efficacy are warranted., Cilj ove studije bio je procijeniti kratkotrajni učinak intravitrealne primjene bevacizumaba u skupini bolesnika s neovaskularnim glaukomom. U studiju je bilo uključeno jedanaestoro bolesnika s neovaskularnim glaukomom i simptomatskim povišenjem očnog tlaka. Kod svih bolesnika primijenjen je bevacizumab u dozi od 1,25/0,1 mL intravitrealno. Kod troje bolesnika je bevacizumab primijenjen jedan dan prije pars plana vitrektomije. Dodatna antiglaukomska terapija primijenjena je samo kod onih bolesnika u kojih očni tlak nije bio dobro kontroliran lokalnom antiglaukomskom terapijom. Najkraće razdoblje praćenja bolesnika bilo je 8 tjedana. Intravitrealna primjena bevacizumaba dovela je kod svih bolesnika do značajne regresije neovaskularizacije šarenice, što je trećega dana od primjene bevacizumaba potvrđeno biomikroskopski te fluoresceinskom angiografijom. U sedmoro bolesnika je očni tlak bio dobro kontroliran samo lokalnom antiglaukomskom terapijom. Kod četvoro bolesnika bilo je potrebno daljnje kirurško antiglaukomsko liječenje. Nisu zabilježene nuspojave kao niti komplikacije za vrijeme ili poslije intravitrealne injekcije bevacizumaba. Zaključuje se kako se intravitrealna primjena bevacizumaba čini dobrom dodatnom metodom u kombinaciji s ostalim terapijskim modalitetima liječenja neovaskularnog glaukoma. Dodatne studije kojima se ispituje dugotrajniji učinak i sigurnost intravitrealne primjene bevacizumaba su u tijeku i one će doprinijeti boljem razumijevanju farmakokinetike, toksičnosti i putova primjene bevacizumaba u liječenju neovaskularnog glaukoma.

Cilj ove studije bio je procijeniti izgled glave vidnoga živca i debljinu retinalnog nervnog sloja (RNFL) u zdravim očima, očima s očnom hipertenzijom i glaukomskim očima pomoću optičke koherentne tomografije (OCT). U ovoj usporedbenoj analizi bila su uključena 62 oka i to 24 zdrava oka, 16 očiju s očnom hipertenzijom i 22 glaukomska oka. Topografski parametri OCT kao promjer ekskavacije, područje ekskavacije, područje ruba i omjer promjera ekskavacije u odnosu na promjer papile bili su značajno veći u očima s očnom hipertenzijom u odnosu na zdrave oči. Parametri su također bili značajno veći u glaukomskim očima u odnosu na zdrave oči i one s očnom hipertenzijom. Retinalni nervni sloj je bio značajno tanji u donjem kvadrantu u očima s očnom hipertenzijom u odnosu na zdrave oči, te značajno tanji u glaukomskim očima u odnosu na zdrave oči i one s očnom hipertenzijom u prosjeku i u sva četiri kvadranta. Optička koherentna tomografija je osjetljiva metoda za otkrivanje ranih organskih oštećenja u glaukomu, dok su parametri glave vidnoga živca i debljina retinalnog nervnog sloja dobiveni tom metodom isto tako korisni u kliničkoj procjeni glaukoma., The aim of the study was to evaluate optic disk appearance and retinal nerve fiber layer (RNFL) thickness in normal, ocular hypertensive (OHT) and glaucomatous eyes using optical coherence tomography (OCT). This comparative analysis included 62 eyes: 24 normal, 16 OHT and 22 glaucomatous. OCT topographic parameters of cup diameter, cup area, rim area and cup/disk area ratio were significantly greater in OHT eyes than in normal eyes, and significantly greater in glaucomatous eyes than in normal and OHT eyes. RNFL was significantly thinner in OHT eyes than in normal eyes in the inferior quadrant, and in glaucomatous eyes as compared with OHT and normal eyes on an average and in all four quadrants. OCT is a sensitive method for detection of the earliest organic damage in glaucoma, while optic disk parameters and RNFL by use of OCT may prove useful on clinical assessment of glaucoma.

The aim of the study was to retrospectively analyze changes in the results of automated perimetry in open angle glaucoma patients, including Mean Defect (MD), Loss Variance (LV) and Corrected Loss Variance (CLV) before and after cataract surgery, and also to note how the presence of dense scotoma preoperatively could influence postoperative results. MD is a mean of all local visual field defects. LV and CLV are indexes of localized field damages. Increased values of these indicators are even more specific for glaucomatous damage than MD. We investigated 18 eyes of 14 patients with open angle glaucoma who were scheduled for cataract extraction with intraocular lens implantation. The diagnosis of open angle glaucoma was based on the presence of glaucomatous optic disk cupping and abnormal results on glaucoma field testing. The intraocular pressure (IOP) criterion was IOP higher than 21 mm Hg. On gonioscopy, all angles of the anterior chamber were open. All patients underwent Octopus Field Analyzer dG2 testing within two months before and three months after cataract surgery. The eyes were divided into two groups based on the presence of absolute or near absolute (dense) scotomata before surgery. Dense (absolute or near absolute) scotomata noted on automated perimetry were found not to be caused by the cataract. Their existence before surgery could be explained by glaucomatous visual field defects. Cataract can induce various degrees of relative scotoma, which can induce worsening of local field defects (LV and CLV) after surgery. This implies that the real size of glaucomatous damage (expressed as difference between LV and CLV before and after cataract surgery) can only be seen and properly measured after cataract extraction. Therefore, it is concluded that LV and CLV can be used as reliable indicators in distinguishing the role of coexisting cataract in glaucomatous damage, however, additional studies in the area are needed., Cilj ove studije bio je retrospektivno istražiti promjene u rezultatima kompjutorizirane automatske perimetrije bolesnika s glaukomom otvorenog kuta, uključujući pokazatelje glaukomskog oštećenja: MD (Mean Defect), LV (Loss Variance) i CLV (Corrected Loss Variance) prije i poslije operacije katarakte te ocijeniti kako prisutnost apsolutnog skotoma preoperacijski utječe na poslijeoperacijske rezultate. MD je prosječna vrijednost svih lokalnih oštećenja vidnog polja, dok su LV i CLV pokazatelji lokalnog oštećenja vidnog polja. Povišene vrijednosti ovih pokazatelja još specifičnije ukazuju na glaukomsko oštećenje u odnosu na vrijednosti MD. Ispitivali smo 18 očiju u 14 bolesnika s glaukomom otvorenog kuta koji su bili predviđeni za ekstrakciju katarakte s implantacijom intraokularne leće. Dijagnoza glaukoma je bila postavljena na osnovi kliničkog nalaza ekskavacije glave vidnog živca i patološkim nalazom vidnog polja. Intraokularni tlak je morao biti veći od 21 mm Hg te gonioskopski utvrđen otvoren kut prednje očne sobice. Svi bolesnici su testirani pomoću kompjutoriziranog perimetra Octopus, program dG2, dva mjeseca prije i tri mjeseca poslije operacije katarakte. Oči su podijeljene u dvije skupine prema prisutnosti apsolutnog skotoma prije operacije. Utvrđeno je kako apsolutni skotom, potvrđen kompjutoriziranom perimetrijom prije operacije, nije uzrokovan kataraktom te da je posljedica stvarnog glaukomskog oštećenja. U skupini bolesnika s apsolutnim skotomom pokazatelji lokalnog oštećenja vidnog polja (LV i CLV ) pogoršali su se poslijeoperacijski, što ukazuje na to da se uklanjanjem relativnih skotoma uzrokovanih kataraktom dobiva stvarna veličina glaukomskog oštećenja koje može donekle biti skriveno kataraktom (izraženo u razlici vrijednosti parametara LV i CLV prije i poslije operacije katarakte). Stoga se zaključuje da LV i CLV mogu biti pouzdani pokazatelji u razlikovanju oštećenja vidnog polja uzrokovanih glaukomom i pratećom kataraktom, no potrebne su daljnje studije u tom smjeru.

The aim of the study was to determine whether amniotic membrane could be used to treat neuroparalytic keratopathy. Amniotic membrane transplantation was performed in 19 patients with neuroparalytic ulcer. All patients were younger than 61 and all developed corneal problems due to interruption of the sensory afferent fiber innervating the cornea. In all patients, the follow up period was longer than 18 months. Postoperatively, all patients underwent fluorescein test and biomicroscope examination as well as subjective pain evaluation. Postoperatively, the pain was reduced in study patients. In one patient, retransplantation for disease recurrence was performed two months after the first operation. After the second operation, the pain was minimized for more than 18 months. Amniotic membrane transplantation appears to be a good method for pain reduction and better epithelial healing in patients with neuroparalytic keratopathy., Cilj rada bio je utvrditi može li se amnijska membrana rabiti u liječenju neuroparalitične keratopatije. Transplantacija amnijske membrane je učinjena kod 19 bolesnika s neuroparalitičnim ulkusom. Svi bolesnici bili su mlađi od 61 godine i kod svih su se problemi s rožnicom razvili kao rezultat prekida senzornih aferentnih vlakana koja inerviraju rožnicu. Razdoblje praćenja je kod svih bolesnika bio duži od 18 mjeseci. Poslijeoperacijski je kod svih bolesnika učinjen fluoresceinski test i biomikroskopski pregled, kao i subjektivna procjena boli. Nakon operacije bol je bila smanjena kod svih bolesnika. Kod jednog bolesnika učinjena je druga transplantacija, dva mjeseca nakon prve, zbog recidiva. Nakon druge operacije bol je bila smanjena više od 18 mjeseci. Transplantacija amnijske membrane čini se kao dobra metoda smanjenja boli i postizanja boljeg epitelijalnog cijeljenja kod bolesnika s neuroparalitičnom keratopatijom.

Head Doctor Jelka Spevec nee Gutchy, MD, PhD Head Doctor Neven Čosić, MD

The primary open-angle glaucomas are a group of diseases that have in common characteristic morphological changes at the optic nerve head and retinal nerve fiber layer, progressive retinal ganglion cells death and characteristic visual field loss. The risk for primary open angle glaucoma rises continuously with the level of the intraocular pressure. The disease advances slowly and there are no symptoms. Primary open angle glaucoma is caused by abnormal aqueous humour outflow in the trabecular meshwork in the open angle. Etiopathogenesis of primary open angle glaucoma is unclear. The increased risk of glaucoma in relatives has long been recognized. Frequency for manifestation of the disease is 10–30% in family members. The discovery of the specific gene loci responsible for the manifestation of glaucoma has helped us to understand its mechanism of origin and definitely confirmed the hereditary nature of this disease. Digito- -palmar dermatoglyphs were already used to determine hereditary base of many diseases and it was the reason for investigation of their qualitative patterns in patients with glaucoma (22 males and 23 females), their immediate relatives (19 males and 23 females) in comparison to a group of phenotypically healthy population (52 males and 56 females). The results pointed a connection with the dermatoglyphic traits of the digito-palmar complex between patients with glaucoma and their immediate relatives. There is a possible discrimination of patients and their immediate relatives from phenotypically healthy population, too.

AIM:5-flurouracil, an antimetabolic agent, improves the success rate of trabeculectoies by inhibiting subconjuctival fibrosis. The study was performed to evaluate efficasy and safety of subconjctival 5-flurouracil(5-FU) with ocular massage(OM) after trabeculectomy in patients with medically uncontrolled primary open angle glaucoma(POAG). PATIENTS AND METHODS:The study included patients with medically uncontrolled primary open angle glaucoma. We reviewed retrospectively 24 eyes that had undergone needling revision for failed trabeculectomy.. The needling revisions were performed with 5-FU. All patients were needling under an operating microscope. The main outcome mesaures were IOP and the number of medications used. . The mean follow up time was 10.5+ 7.3 months.RESULTS:The ten eyes achived success, defined as IOP 18mmHg without medication, eight eyes achived qualiffied sucess, defined as IOP 18mmHg with medication, and six eyes were classified as failure, defined as IOP more than 18mmHg with medication. Complications were minor.CONCLUSION: This stuy suggest that bleb needling with 5-FU is safe and effective procedure for managing failing filtering bleibs following a trabeculectomy.

To assess inapparent visual field defects in patients with multiple sclerosis free from optic neuritis. During 5 years period 120 patients with multiple sclerosis were examined at the University Department of Ophthalmology, Zagreb University Hospital Center. They were divided into three groups with 40 patients each: patients with acute unilateral optic neuritis, referred to ophthalmologist and treated with pulsed steroid therapy ; patients with subjective feeling of blurred vision, normal visual acuity and no signs of acute optic neuritis ; and patients free from subjective signs of visual impairment. Study patients underwent standard ophthalmologic examination and visual field testing in photopia by use of quantitative kinetic Goldmann perimetry. The initial and control examination by visual field testing were performed at least 6 months apart. Study results showed 65% of multiple sclerosis patients to have visual field defects without subjective signs of impaired vision. The most common defects were mild to moderate visual field narrowing with blind spot enlargement and depression from above. The following results were recorded: acute optic neuritis group: normal in 13/40 (32.5%) for the affected eyes and 27/40 (67.5%) for fellow eyes ; mild visual field narrowing in 4/40 (10%) for the affected eyes and 10/40 (25%) for fellow eyes ; moderate visual field narrowing with blind spot enlargement in 14/40 (35%) for the affected eyes and 1/40 (2.5%) for fellow eyes ; and paracentral and arcuate scotomata in 9/40 (22.5%) for the affected eyes and 2/40 (5%) for fellow eyes ; subjective symptom group: normal in 8/40 (20%) for the affected eyes and 11/40 (27.5%) for fellow eyes ; mild visual field narrowing in 11/40 (27.5%) for the affected eyes and 16/40 (40%) for fellow eyes ; moderate visual field narrowing with blind spot enlargement in 18/40 (45%) for the affected eyes and 10/40 (25%) ; andparacentral and arcuate scotomata in 3/40 (7.5%) for both affected and fellow eyes ; and subjective symptom-free group: normal in 24/80 (30%), mild visual field narrowing in 22/80 (27.5%) moderate visual field narrowing with blind spot enlargement in 24/80 (30%) ; and paracentral and arcuate scotomata in 10/80 (12.5%). The presence of subclinical form of optic nerve involvement could be demonstrated in a very early stage of multiple sclerosis by the introduction of visual field testing in the standard examination protocol.

Glaucoma is associated with an increased incidence of cardiovascular disease and risk factors. The aim of the study was to assess the left ventricular (LV) function in patients with pseudoexfoliation (PEX) glaucoma using doppler-echocardiographic examinations. Two-dimensional and pulsed Doppler echocardiography of transmitral flow was performed in 21 patients with (PEX) glaucoma and 24 controls. LV systolic contraction and ejection were assessed using the LV ejection fraction (EF) and fractional shortening (FS). LV diastolic filling assessed parameters were: early, fast diastolic filling (E wave), late diastolic filling (A wave), ratio E/A, velocity time integral E wave (VTIE) and A wave (VTIA), their ratio (VTIE /VTIA), pressure at the end of filling (LVEDP) and a pulmonary capillary wedge pressure (PCWP). A significant difference was found concerning LV filling flow parameters in E, E/A, VTIA and ratio VTIA/ VTIE. No significant difference was found in EF, FS, A, VTIE, LVEDP and PCWP tested parameters. Our study indicates the possibility of slightly impaired diastolic function of LV in patients with PEX glaucoma assessed by Doppler-echocardiographic examinations.

A chief morbidity of Graves eye disease is eyelid retraction and exophthalmus. Transpalpebral orbital fat removal accomplished with full thickness anterior blepharotomy was performed in 4 patients (5 orbits). Preoperative and postoperative ocular exposure symptoms, visual acuity, upper eyelid retraction and proptosis were evaluated. In all 5 operated orbits preoperative symptoms resolved; good results were achieved from the functional and cosmetic point of view. Full-thickness anterior blepharotomy combined with fat decompression is a safe and effective surgery for patients with upper eyelid retraction and exophthalmus due to enlarged orbital fat compartment.

The aim of this study was to examine whether any correlation exists between long term use of high doses of inhaled corticosteroids and the occurrence of intraocular hypertension or open angle glaucoma. The study included 30 patients with bronchial asthma, treated with long term high doses of inhaled corticosteroids, and a control group of 30 age-matched healthy subjects. Apart from family history, the clinical examination included ophthalmologic examination, measurement of intraocular pressure, automated perimetry and photography of the optic nerve head. At least two of the following parameters were required for the diagnosis of glaucoma: intraocular pressure level, visual field defects, and characteristic appearance of the optic nerve head. The level of intraocular pressure (without therapy from 22 to 30 mmHg, daily pressure curve) was a criterion for the diagnosis of intraocular hypertension. In glaucoma free subjects, all parameters were within the normal limits. The study pointed to a correlation between long term use of high doses of inhaled corticosteroids and the occurrence of intraocular hypertension in patients with a positive family history of glaucoma., Cilj ovoga rada bio je ispitati postoji li veza između dugotrajne upotrebe visokih doza inhalacijskih kortikosteroida i pojave intraokularne hipertenzije ili glaukoma otvorenog kuta. Ispitivanjem je obuhvaćeno 30 bolesnika s bronhalnom astmom koji su bili na dugotrajnoj terapiji visokim dozama inhalacijskih kortikosteroida, a kontrolnu skupinu je činilo 30 dobno prispodobivih zdravih ispitanika. Uz detaljnu obiteljsku anamnezu, kliničko ispitivanje obuhvatilo je oftalmološki pregled, mjerenje intraokularnog tlaka, automatiziranu perimetriju i fotografiju glave vidnoga živca. Za dijagnozu glaukoma potrebna su najmanje dva od slijedećih parametara: visina intraokularnog tlaka, ispadi u vidnom polju, te znakovit izgled glave vidnoga živca. Kriterij za dijagnozu intraokularne hipertenzije je visina intraokularnog tlaka (bez terapije od 22 do 30 mm Hg, dnevna krivulja tlaka). Ispitanici bez glaukoma su imali sve parametre u granicama normale. Istraživanje je pokazalo povezanost između dugotrajne upotrebe visokih doza inhalacijskih kortikosteroida i pojave intraokularne hipertenzije u bolesnika s pozitivnom obiteljskom anamnezom za glaukom.

The aim of the study was to assess the intraocular hypotensive effect of 1.0% brinzolamide (b.i.d.) as monotherapy in patients with primary and secondary glaucoma. The six-month study included 2 patients of which 19 completed the study (one patient was excluded due to allergic drug reaction). All patients had previously received local antiglaucoma therapy. Because of local undesired side effects and inadequate control of intraocular pressure they were switched to treatment with 1.0% brinzolamide as monotherapy. Intraocular pressure was measured on the day of therapy introduction, and then at 15 days, one month, three months and six months of therapy. Nineteen patients successfully completed the six-month study. A clinically significant decrease in the intraocular pressure was recorded. The difference in intraocular pressure between the baseline (23.8 ± 2.4), and 15-day (18.2 ± 2.8), one-month (18.2 ± 2.7), three-month (18.5 ± 2.9) and six-month (18.8 ± 3.2) levels was statistically significant (p, Cilj rada bio je utvrditi intraokularni hipotenzivni učinak brinzolamida 1,0% % b.i d.) kao monoterapije u bolesnika s primarnim i sekundarnim glaukomom. Šestomjesečno ispitivanje uključilo je 20 bolesnika od kojih je ispitivanje završilo njih 19 (jedan je bolesnik isključen zbog alergijske reakcije na lijek). Svi bolesnici su do tada bili na lokalnoj antiglaukomskoj terapiji. Zbog lokalnih neželjenih popratnih pojava te neodgovarajuće kontrole intraokularnog tlaka prebačeni su na liječenje brinzolamidom 1,0% kao monoterapijom. Intraokularni tlak je mjeren na dan zamjene, te 15 dana, 1 mjesec, 3 mjeseca i 6 mjeseci od zamjene terapije. Nakon 6 mjeseci 19 bolesnika uspješno je završilo ispitivanje. Došlo je do klinički značajnog sniženja intraokularnog tlaka. Razlika tlaka prije (23,8 ± 2,4) i 15 dana (18,2±2,8), 1 mjesec (18,2±2,7), 3 mjeseca (18,5±2,9) i 6 mjeseci (18,8±3,2) od promjene terapije bila je statistički značajna (p

The aim of the study was to determine whether patients suffering from bronchial asthma constitute a special group of patients regarding their attitude to two groups of etiologic factors and their interaction: 1) ecologic factors and 2) sets of their own habits and behavior. Control group consisted of patients with coronary disease, where the influence of these factors on the disease development is well known. The study did not include objective measurement of ecologic factors but the information on their presence in the patients. environment was obtained through a questionnaire structured especially for this study, based on known scales and verified in our circumstances. The study included 50 patients with bronchial asthma and a control group of 51 patients with coronary disease. χ2-test was used to define the significance of differences in the analyzed variables, with a risk level up to 5%. Results showed statistically significant differences between asthmatic and coronary patients in their attitude to health. All patients lived in the same city, in a similar ecologic milieu, yet the asthmatic patients perceived ecologic factors in their environment much more often. Coronary patients more frequently blamed life struggle and stresses as well as their own habits and behavior for the occurrence of their disease., Cilj istraživanja bio je ispitati predstavljaju li bolesnici s bronhijalnom astmom posebnu skupinu bolesnika prema njihovim stavovima o dvjema skupinama etioloških čimbenika i njihovih interakcija: 1. ekološkim čimbenicima, te 2. njihovim navikama i ponašanju. Kontrolnu skupinu činili su bolesnici od koronarne bolesti kod kojih je dobro poznat utjecaj ovih čimbenika na nastanak njihove bolesti. Istraživanje nije uključivalo objektivno mjerenje ekoloških čimbenika, a saznanja o njihovoj prisutnosti u bolesnikovu okolišu dobivena su pomoću upitnika posebno sastavljenog za ovo istraživanje koji je prilagođen našim uvjetima. Ispitivanjem je obuhvaćeno 50 bolesnika s bronhijalnom astmom i 51 bolesnik s koronarnom bolešću. Razlike među skupinama određene su c2-testom s koeficijentom rizika od 5%. Rezultati su pokazali statistički značajnu razliku između astmatičnih i koronarnih bolesnika u stavovima o nizu rizičnih čimbenika. Ispitanici su živjeli podjednako u selu odnosno gradu, u sličnom ekološkom okruženju, ali su astmatični bolesnici držali da su štetni ekološki čimbenici više prisutni u njihovu okolišu i da su važni za nastanak njihove bolesti. Koronarni bolesnici smatrali su svoje loše životne navike i stresove važnima za nastanak bolesti.

The aim of the study was to point out the role of inheritage of primary open angle glaucoma (POAG) and frequency of POAG among other glaucoma diseases. The study included 52 relatives from 12 families with family history of POAG through 3 generations. The examination consisted of complete ophthalmologic status, automated perimetry and optic nerve photography. A detailed anamnesis and family trees were taken. Individuals were diagnosed with POAG if they fulfilled two or three of the criteria for making a diagnosis: the level of intraocular pressure visual field loss or characteristic disc appearance. Subjects were considered "suspected POAG" if they fulfilled only one of the preceding three criteria. All three parameters had to be normal for an individual to be considered unaffected. Seven relatives (l2%) were diagnosed with POAG; fifteen (29%) relatives were classified as glaucoma suspects. Siblings of POAG patients had the highest risk of POAG developing compared with children or other blood relatives. The study presented results of investigation the frequency of POAG among other glaucoma diseases and 16% patients had a family history of POAG at least in 3 generations. Detailed anamnesis confirms familial appearance of POAG and examination of all available members enables the discovery of new cases (12%)., Cilj istraživanja bio je naglasiti ulogu nasljeđa kod primarnog glaukoma otvorenog kuta te ukazati na njegovu učestalost među drugim glaukomskim oboljenjima. Ukupno je 52 elana iz 12 obitelji kod kojih se primarni glaukom otvorenog kuta pojavljuje kroz najmanje 3 generacije, obuhvaćeno je ispitivanjem. Pored detaljne obiteljske anamneze i izrade obiteljskog stabla, kliničko ispitivanje obuhvaćalo je: sveukupni oftalmološki pregled, automatiziranu perimetriju i fotografiju glave vidnog živca. Ispitanici su utvrđeni kao glaukomski bolesnici ako su ispunjavali 2 ili 3 uvjeta koji čine dijagnozu: visina intraokularnog tlaka, ispadi u vidnom polju te karakterističan izgled glave vidnog živca. Granični slučajevi ispunjavali su samo jedan postavljeni uvjet, a zdravi ispitanici su imali sve parametre u granici normale. Sedam rođaka (12%) dijagnosticirano je kao primarni glaukom otvorenog kuta a 15 (29%) kao granični slučajevi. Braća i sestre pacijenata s primarnim glaukomom otvorenog kuta imaju veći rizik pojave oboljenja u usporedbi s djecom ili ostalim rođacima. Studija pokazuje da je među glaukomskim pacijentima 16% onih s pozitivnom obiteljskom anamnezom za primarni glaukom otvorenog kuta kroz najmanje 3 generacije. Detaljna obiteljska anamneza potvrđuje obiteljsku pojavu primarnog glaukoma otvorenog kuta, a ispitivanje svih dostupnih članova omogućuje otkrivanje novih, dotad neregistriranih slučajeva - l2%.

The aim of this study was to establish the value of trabeculectomy throughout a longer period of time, 5-10 years after the operation. Success of the operations was evaluated by setting the following criteria: postoperative values of IOP < 21 mmHg with or without topical medications, preserved function of the optic nerve checked through the findings of the optic disc and the visual field. Filtering blebs were also examined and visual acuity was analyzed. Between 1990 and 1995, 359 were operated using the method of trabeculectomy at the Department of Ophthalmology, Sestre milosrdnice University Hospital. We were able to examine only 186 eyes thoroughly. Five years after the operation the IOP was < 21 mmHg in 90% of eyes with or without therapy and ten years after the IOP remained regulated in 75% of eyes. We found progression of optic disc atrophy in 17% of the cases, and deterioration of the visual fields in 18% of eyes. Visual acuity was reduced in 62% of the cases and 49% of them was due to cataract. After cataract operation, sight improved in 73 % of the cases. The size or the cystic alterations of the filtering bleb did not have the most significant influence on the value of IOP whereas its healing was directly responsible for failure of the operation. Therefore we consider trabeculectomy to be the method of choice among antiglaucoma operations for now., Svrha ove studije bila je utvrditi vrijednost trabekulektomije kroz dulji vremenski period od 5 do 10 godina iza operacije. Za uspjeh operacije postavili smo kriterije da postoperacijske vrijednosti očnog tlaka iznose ? 21 mmHg bez ili s lokalnom terapijom, da ostane sačuvana funkcija vidnog živca, što smo provjeravali nalazom papile n. optici i vidnim poljem. Pregledavani su i filtracijski jastučići, te analizirana vidna oštrina. Od 1990.do 1995.g. na Klinici za očne bolesti KB. Sestre milosrdnice. u Zagrebu operirano je 359 oeiju metodom trabekulektomije. Bili smo u mogućnosti detaljno analizirati samo 186 očiju. Pet godina iza operacije IOT je bez ili s terapijom bio ? 21 mmHg u 90 % očiju, dok je nakon 10 godina IOT bio reguliran jo. uvijek u 75% očiju. Progresiju atrofije papillae n. optici našli smo u 17% slučajeva, a pogoršanje vidnog polja u 18% očiju.Vidna oštrina je smanjena u 62% od toga zbog katarakte u 49% očiju. Iza operacije katarakte vid se popravio u 73%. Veličina ili cistična promjena filtracijskog jastučića nisu presudni za visinu IOT, dok je njegovo zarastanje direktno odgovorno za neuspjeh operacije. Držimo da je trabekulektomija do daljnjega metoda izbora među antiglaukomskim operacijama.

According to records of the Croatian Association of the Blind and Impaired Vision Persons, 5,360 blind and impaired vision persons were registered in 2001, with an incidence of 1.3‰. The records contain familial and personal data, data on the underlying disease and ophthalmologic examination findings, including visual acuity of both eyes, fundus examination, biomicroscopic examination and field of vision according to Goldman. Adaptometry, electroretinogram and color perception were rarely performed. Patients were classified according to residual visual acuity, which was converted into percentage of residual vision. During the study, tapetoretinal dystrophies were detected in 328 (6.11%) subjects, 177 (53.9%) male and 151 (46.1%) female. In the Republic of Croatia, tapetoretinal dystrophies as the cause of blindness and impaired vision were recorded in 0.007% (1:14,285) of cases. Over the last 30 years, the number of registered blind and impaired vision persons with this disease increased by 4.3% in large cities in Croatia, whereas its distribution in other areas remained uniform. Clinical manifestations of the disease occurred under the age of 40 in 84.4%, under the age of 50 in 95.2%, and after birth or under the age of 10 in 11.6% of subjects, pointing to the malignancy of the gene for dystrophy of retina pigmentosa. Of all blind subjects, 15.3% belonged to this group. During the study, 40 heredograms were completed, which confirmed the disease to be inherited as an autosomal recessive trait in 40% and autosomal dominant trait in 22.5%, whereas a fresh mutation was probably involved in 37.0% of cases., Prema registarskim podacima Saveza slijepih i slabovidnih u Republici Hrvatskoj 2001. godine bilo je registrirano 5.360 slijepih i slabovidnih osoba uz incidenciju od 1,3‰. Registarski kartoni sadrže obiteljske i osobne anamnestičke podatke vezane za osnovnu bolest i nalaze oftalmološkog pregleda koji obuhvaća vidnu oštrinu oba oka, pregled očne pozadine, pregled procjepnom svjetiljkom te vidnog polja po Goldmanu. Ispitivanje adaptacije, elektroretinogram te ispitivanje osjeta za boje rjeđe su se izvodili. Bolesnici su razvrstavani prema ostatku vidne oštrine koja se preračunala u postotak ostatka vida. U okviru ovoga istraživanja pronađeno je 328 ili 6,11% osoba s tapetoretinskim distrofijama. Od toga je bilo 177 (53,9%) osoba muškog spola i 151 (46,1%) osoba ženskog spola. Učestalost tapetoretinske distrofije kao uzroka sljepoće i slabovidnosti u Republici Hrvatskoj iznosila je 0,007% (1:14.285). U zadnja tri desetljeća veći centri u Hrvatskoj bilježe porast registriranih slijepih i slabovidnih od ove bolesti za 4,3%, dok je u ostalim krajevima Hrvatske rasprostranjenost ravnomjerna. Bolest se klinički manifestirala do 40. godine života u 84,4%, do 50. godine života u 95,2%, a rano nakon rođenja ili do 10. godine života u 11,6% ispitanika, što ukazuje na malignitet gena za distrofiju mrežnice, pigmentozu. U ovoj se dobnoj skupini nalazi 15,3% svih ispitanika koji su slijepi. U ovom je istraživanju izrađeno 40 heredograma na temelju kojih je utvrđeno da se bolest autosomno recesivno nasljeđuje u 40% i autosomno dominantno u 22,5% slučajeva, dok se u 37,0% slučajeva najvjerojatnije radilo o svježoj mutaciji.