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Background/Aim: Due to the numerous beneficial effects of pomegranate that can be explained through its antioxidative effects, the aim of this study was to determine the antioxidant potential of pomegranate peel extract (PoPEx) prepared from pomegranate that was harvested in the southeast region of Herze-govina (Bosnia and Herzegovina), through in vitro and in vivo studies. Methods: In PoPEx total phenols, flavonoids, flavonols, flavan-3-ols and antho-cyanins content was determined, as well as several antioxidative assays, including 2,2 diphenyl-1-picrylhydrazyl assay (DPPH), 2,2'-azino bis(3-ethylbenzothi-azoline-6-sulphonic acid) assay (ABTS), iron (III)-2,4,6-tripyridyl-S-triazine complex assay (FRAP), reduction of copper(II) ions (CUPRAC) assay, Briggs-Rauscher oscillatory reactions, neutralisation of OH radicals and lipid peroxidation assay. In vivo studies were performed by administrating 100 mg/ kg of body weight of PoPEx to the rats by gavage for 7 days, after which the rats were euthanised and prooxidative parameters (thiobabrituric acid reactive substances-TBARS as an index of lipid peroxidation, nitrites-NO 2 , hydrogen peroxide-H 2 O 2 and superoxide anion radical O 2-) were determined in plasma, as well as antioxidative parameters (superoxide dismutase-SOD, reduced gluta-thione-GSH and catalase-CAT) in erythrocyte lysates. Results: High content of phenolic compounds was found in PoPEx, which resulted in high antioxidative potential in all in vitro tests performed. In vivo study showed that PoPEx administration caused a significant decrease in TBARS, NO 2-, as well as an increase in reduced glutathione (p < 0.05) in comparison to the control group, while H 2 O 2 and O 2 * showed a lowering trend and SOD and CAT showed an increasing trend in PoPEx group, but without statistical significance. Conclusion: PoPEx demonstrated high antioxidative capacity measured in vitro and in vivo and can be potentially used as a supplement treatment in the prevention of various inflammatory conditions.

Background/Aim. Age-related cataract is a common disease among senior population. Vitamin C is the most effective reducing hydrosoluble antioxidant causing reduction in the levels of free radicals in crystaline lens. The aim of this study was to evaluate the age-related change of vitamin C (L-ascorbic acid) level in the aqueous humor of patients with senile cataract. Methods. This prospective study included 74 patients, divided into 3 age groups, with age-related cataract, underwent routine phaco cataract surgery with intraocular lens implantation. Aqueous humor was aspirated from 74 eyes at the beginning of phacoemulsification. The levels of vitamin C (L-ascorbic acid) in aqueous humor were determined with high-performance liquid chromatography (HPLC). Results. The average age of patients included in the study was 65 ± 9.85 years (54-87 years). The level of vitamin C in aqueous humor was 152.78 ± 7.0125 μg/mL in the group A (50-59 years), 134.15 ± 5.1569 μg/mL in the group B (60-69 years) and 106.51 ± 5.44 μg/mL in the group C (over 70 years). Conclusion. The amount of vitamin C in aqueous humor of patients with age-related cataract is decreasing with age. There was a statistically significant change (p < 0.001) of vitamin C aqueous concentration in the patients of different age. This decrease could play a role in susceptibility to cataract formation in older population.

Background: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe., Methods: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries., Results: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease., Conclusions: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Since 1996, advanced methods and new instruments for the assessment of vision quality of life (VisQoL) index (37 and 15) have been developed and applied at the University Eye Clinic in Novi Sad. Many researches assume that postoperative results should not be evaluated only by postoperative visual acuity, but also by subjective perception of visual function and the patients ability to perform everyday activities, i.e. by quality of life. Therefore, our clinical results were based on both parameters of visual function, as the most objective attributes for assessing outcomes of certain types of cataract surgery., Material and Methods: Based on the results of the Cataract Study in Vojvodina in 2004, 5.7% of patients waiting for cataract surgery were already blind, 16.5% had low vision with cataract on both eyes, and 57% of patients had monocular blindness., Results and Discussion: With improvement of visual acuity to 0.5 or higher, after cataract surgery in 96.5% of patients, the cumulative VisQoL 15-index changed from 59.3 to 95.5. Intraocular lens implantation contributed most to the significant improvement in the vision related quality of life. Our study showed that pseudophakic patients had better qualitiy of life than aphakic patients, who had the same visual acuity and refractive correction. Difficulties in performing everyday activities, such as shopping, using the telephone and reading, were found in 12.7% of aphakic, but only in 3% of pseudophakic patients., Conclusion: Advanced phacoemulsification techniques enable operated cataract patients immediate vision recovery, better quality of life, and personal satisfaction with visual function in everyday activities.

Introduction: Visual impairment and blindness are serious social and health problems in the world. 1992 classification of visual disorders by World Health Organization has recently been implemented. The goal of this study was to determine common causes of visual impairment and blindness in the region of Eastern Herzegovina., Material and Methods: In this population based study we have analyzed medical records stored in the regional Association of Visually Impaired and Blind Persons of the Republic of Srpska (Trebinje, Bileća, Foca, Eastern Sarajevo). The analysis included sex and age distribution of registered population, classification and leading causes of visual disability and blindness. RESULTS There are 298 registered persons with visual disability and blindness in the region of Eastern Herzegovina and Eastern Sarajevo. The prevalence of visual impairment and blindness in the aforementioned region is 0.1%. Among the studied population, there are more males than females with visual disability or blindness (56% versus 44%). Most (78%) of registered persons are blind, and only 22% are visualy impaired. 43% of registered population are in the IV category and only 8.38% are registered in the II category. Only 2% of registered population are children. Common causes of visual disability and blindness in the region of Eastern Herzegovina are: glaucoma (22%), cataract (17%), myopia alta (13%), diabetic retinopathy (12%) and ocular trauma (11). Common causes of children's visual impairment include. optic nerve anomalies, congenital cataract and premature retinopathy., Discussion and Conclusion: Compared with literature data, common causes of blindness and visual impairment in the region of Eastern Herzegovina do not differ significantly from those in other regions. Registration is based on the WHO model, but it is possible only by performing active epidemiological studies.

Introduction: Cataract is the second leading cause of blindness and visual disability in the region of Eastern Herzegovina and Eastern Sarajevo. It is a curable and preventable cause of blindness, because visual function can be surgically recovered. The aim of our study was to determine the frequency of cataract among registered blind population., Material and Methods: We used data stored in the Regional Association of Blind Persons from municipalities of Eastern Herzegovina (Trebinje, Bileća, Foca) and Eastern Sarajevo. In this population-based study data were analyzed using standard statistical methods. We have investigated sex and age distribution, visual acuity and type of cataract in the registered population. Among 298 registered blind persons and persons with visual disability, 17% are persons with cataract. Males are more frequent than women. Most people with cataract are older than 60 and are with age-related cataract., Discussion and Conclusion: Literature data show that cataract is one of the leading causes of blindness and visual disability in the world. Cataract is the second leading cause of visual disability and blindness in the registered population of Eastern Herzegovina. The total number of people with visual disability caused by cataract would decrease by increasing the number of surgeries, which correlates with improving the quality and training of ophthalmologists.

On the basis of obtained results on the University Eye Clinic of Novi Sad, the modern aspects of the most frequent microsurgical operations in ophthalmology are presented. Cataract operations with endocapsular implantation of IOL result in improvement of visual function and daily activities in 98% of patients. Vitreoretinal surgery leads anatomical and functional improvement in 50% to 85% of all cases in correlation with pathology. Different laser microsurgical techniques are used in vascular retinal diseases, corneal refractive surgery, prevention and treatment of glaucoma, secondary cataract treatment, and treatment of diabetic retinopathy.

In order to study refractive changes caused by a intravitreal silicone oil injection we retrospectively analyzed 25 eyes after vitreoretinal surgery combined with silicone oil tamponade. In all cases the postoperative visual acuity was 0.1 or better. Mean difference in refraction after silicone oil tamponade in phakic eyes was +5.07 Dsph (+2.0 to +8.0 Dsph). Mean refractive change in the aphakic silicone oil filled eyes was - 6.63 Dsph (-4.0 to -9.0 Dsph). Silicone oil extraction induced a greater refractive change (myopic shift, mean -5.57 Dsph) than silicone oil injection. After silicone oil extraction from the aphakic eyes refractive changes (shift towards hypermetropia, mean +5.86 Dsph) were less manifest than after silicone oil injection. The disparity could be explained by eye elongation after cerclage performed during primary vitreoretinal surgery.

Effects of substitution therapy was investigated in 42 patients having the dry eye syndrome associated with systemic diseases of connective tissues (systemic lupus, Sjögren's syndrome, etc). Artificial tears were applied: Liquifilm sol, Hydroxypropyl methylcellulose 0.3% (HPMC) and Ocutal sol. After the one-month application of each preparation, mean values of Schirmer's test were approximately identical and the differences were not statistically significant (4.5 +/- 3.5; 4.95 +/- 4.4; 4.01 +/- 3.6), differing slightly from mean values of Schirmer's test prior to the treatment (4.4 +/- 3.4; 3.9 +/- 2.5). The lacrimal secretion did not increase after the administration of the above therapy. The therapy with artificial tears resulted in the improvement of subjective complaints (scratching, dryness and burning sensation) in 65% of cases treated with Liquifilm sol, in 69% upon the administration of HMPC 0.3% and in 60% after the application of Ocutal sol.

A series of 46 eyes with idiopathic rhegmatogenous retinal detachment, treated by pneumatic retinopexy has been reviewed. Of 46 eyes 8 were aphakic and 3 pseudophakic. In 4 eyes proliferative vitreoretinopathy was preoperatively present. Anatomic success was achieved in 59% of cases after follow-up of 6-26 months. With additional operations (conventional and/or vitrectomy) anatomical success rate was increased to 98%.

The paper reviews the results of a ten-year follow up conducted in 140 diabetic patients at the Ophthalmology Clinic in Novi Sad. We analysed the number of the cases and ratios between diabetic retinopathy and other complications in eyes and other organs. Apart from retinopathy among eye diseases the most frequent was hypertonic fundus in 20%, cataract in 17% of the eyes and occlusive conditions in the retinal blood vessels in 2.6%. In the whole group only 8% of the examined eyes had no changes. Complications develop in 70% of diabetics with retinopathy and 48% of those without retinopathy. Nephropathy was found in 18% of diabetics with retinopathy and 13% of those without it. Macroangiopathy of the brain, heart and peripheral blood vessels was found in lower percentage but more frequently in diabetics with retinopathy.

The relationship between vasomotoric activity and blood vessel permeability was studied in the course of discovering the ocular hypotonising mechanism of cholinergic drug activity (pilocarpin and carbamylcholin). The authors found, in experimental conditions, that the vasomotoric activity (vasodilatation) of the two cholinergic drugs is expressed in the increased permeability of the blood-aqueour barrier. In the presence of an elevated extracirculatory pressure (IOP), as in glaucoma, vasodilatation under the influence of cholinergic drugs, is converted to passive vasoconstriction which leads to reduced aqueous humor production. Carbamilcholin reduces aqueous humor production in a greater extent than pilocarpin.