[Ophthalmological involvement in rheumatic disease]. / Aspecte ale afectarii oftalmologice in bolile reumatice.

PURPOSE: The main objective of this study was to identify the prevalence of ocular manifestations in rheumatic patients admitted in a specialized clinic. METHODS: Information regarding rheumatic and ocular diseases was extracted from medical records system available in "Dr. I. Cantacuzino" Clinical Hospital from Bucharest. The prevalence of ocular involvement reported passively by rheumatologists (retrospective descriptive study of 375 different cases of rheumatic patients) was compared with the literature data. RESULTS: There were 45 cases of ocular manifestations. Keratoconjunctivitis sicca was noted in 16 patients with rheumatoid arthritis, two patients with systemic lupus erythematosus and one patient with scleroderma. Anterior uveitis was found in seven patients with ankylosing spondylitis, one patient with reactive arthritis, two patients with psoriatic arthritis and one patient with LES. Conjunctivitis was present in two patients with reactive arthritis. In LES ocular involvement also included four cases of retinal vasculitis. Complications clearly related to steroid therapy were nine cases of cataracts. One case with typical "bull's eye" maculopathy due to Hydroxychloroquine treatment was detected. CONCLUSIONS: The main conclusion of our study is that the rheumatic patients need to be referred to an ophthalmologist for the diagnosis and the optimal treatment of ocular involvement.

[Functional recovery in strabismus]. / Recuperarea functionala în strabism.

The paper enumerates the objectives of functional recovery in strabismus and the approaches to the achievement of these objectives. The goal in the treatment of the strabismus is obtaining a binocular sight with the remake of the divergence-convergence synergism. A three stage scheme for the treatment is made: 1st stage--the treatment of the amblyopia; 2nd stage--the correction of the strabismus deviation; 3rd stage--the recovery of the binocular sight. The conclusion is that the healing of the strabismus with "restitutio ad integrum" is a distant desire.

[Pathology of posterior capsule, a literature review]. / Patologia sacului cristalinian o trecere în revista a literaturii.

The posterior capsule opacification (PCO) is a frequent complication in the modern cataract surgery, uncomfortable for the patient and expensive for the health care system. According to prof. Apple, the main health care expenditure in U.S. is represented by cataract surgery, laser capsulotomy for PCO ranking next. Under these circumstances, it is not surprising that the lens bag pathology and the prevention of aftercataract hold the attention of many research groups all over the world. This paper is a literature review of the last 15 years, presenting the data we have considered to be the most significant.

[Pigmentary tumors of the conjunctiva in children: analysis of surgical decision]. / Tumorile pigmentare ale conjunctivei la copii: o analiza a deciziei chirurgicale.

Pigmentary tumors of the conjunctiva are rare in children, but they deserve special attention as, under some circumstances, they can question the quo ad vitam prognosis. The management of these tumors is controversial because the clinical diagnosis is uncertain, not reliable for a long term evolution prognosis. In this study, after a short review of the literature, the authors present their own experience in the field (47 cases during the last 10 years, out of which 18 underwent surgery) and they try to develop an algorithm of surgical decision based on age-related factors, clinical appearance, aesthetic factors and on the possibility of establishing a good relationship with the patient and the family.

[Yag-Nd posterior capsulotomy.When? Where? How?]. / Capsulotomia posterioara Yag:Nd. Când? Unde? Cum?

PURPOSE: To answer a few elementary questions raised when confronted with the patient with aftercataract: Which are the indications and counter indications of the posterior capsulotomy? How can be evaluated the degree of PCO (posterior capsule opacification)? Which are the ideal size and location of the capsular opening? Is it mandatory to dilate the pupil? What energies are to be used? Which would be the recommended follow-up pattern? METHOD: This paper is a retrospective analysis of the 956 posterior capsulotomies performed between January 2001 and December 2002 at Bucharest Eye Hospital, Ophthalmology III Clinic, Nd:Yag laser surgery department. RESULTS: The best outcome is obtained with the fewest complications when the following conditions are met: the capsulotomy is performed no sooner than 6 months postoperatively; the capsular opening is small--2 mm în diameter--but perfectly aligned relative to the pupil and the IOL (sometimes this is difficult to achieve and the surgeon must always bare în mind the geometry of the posterior chamber and the parallax effect); laser pulses have low energy and are posteriorly defocused; when energy higher than 2 mJ is employed, the capsulotomy is performed by applying punctures în a circular pattern instead of a crosslike rectilinear pattern (in the case of IOL pitting, the visual axis is spared). CONCLUSION: The Nd:Yag photodisruptive laser offers a swift, safe and elegant method for dealing with a common and disturbing complication of the modern cataract surgery, the posterior capsule opacification. The results are often spectacular from the patient's point of view, but one should not neglect the risks related to the posterior capsulotomy.

Simultaneous ERG and VEP investigation in ophthalmic diseases: I. The retinopathies.

Simultaneous ERG and VEP investigations were performed in 42 patients presenting reduced visual acuity and characteristic signs of retinopathy on direct ophthalmoscopic inspection: 1) primary retinal pigmentary degeneration - 15 cases; 2) secondary retinopathy - 11 cases; 3) infantile retinal degeneration - 16 cases. Reciprocal relations of ERG--VEP component latency/amplitude in the three types of retinal disorder are described.

Pseudotumor cerebri: risk factors, clinical course, prognostic criteria.

UNLABELLED: Eighty-five patients with the diagnosis of pseudotumor cerebri were retro- and prospectively studied. For clinical evaluation, the following criteria were used: neurological--headache, ophthalmological--visual acuity, visual field, ophthalmoscopy and psychic--memory. Each patient was assigned 2 categories of results expressed by: neuropsychic and ophthalmological scores which were statistically processed. The following conclusions related to the aim of our paper can be drawn: I. RISK FACTORS: pregnancy (8% of cases), obesity (15%), generalized infections or located in the pelvic region+operated on (6%), hormonal treatment (cortisol (12%), estrogens (6%)); II. The clinical course was significantly favourable for: headache (51% of cases), defects of visual acuity (54%) and papilledema (63%). The long-lasting effects of the treatment applied showed: recovery (for the 2 parameters) in 27% of patients and improvement with sequelae for one and/or the other parameter in 73% of the cases; III. Among the more significant prognostic criteria were the ophthalmological symptoms and signs at onset of the disease. The ophthalmological sequelae (visual acuity, visual field defects, chronic papilledema and optic atrophy) are important factors in the prognosis of the disease and represent predictors for the surgical management.