Retinal Perfusion Analysis of Children with Diabetes Mellitus Type 1 Using Optical Coherence Tomography Angiography.

(1) Background: This study aims to evaluate retinal perfusion by optical coherence tomography angiography (OCTA) in pediatric patients with type 1 diabetes mellitus (T1D) without diabetic retinopathy (DR). (2) Methods: Thirty-one patients affected by T1D were enrolled. All participants were evaluated using OCTA. The foveal avascular zone (FAZ) and superficial and deep macular vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as body mass index (BMI), glycated hemoglobin (HbA1c), and the type of insulin therapy (multiple daily injections, MDI vs. continuous subcutaneous insulin infusion, CSII) was determined. (3) Results: None of the OCTA parameters were significantly different between the groups. The patients' HbA1C level did not influence any of the OCTA parameters. The use of MDI tended to reduce the parafoveal and perifoveal deep VD (p = 0.048 and p = 0.021, respectively) compared to CSII. An elevated BMI tended to increase the deep macular (p = 0.005) and perifoveal VD (p = 0.006). (4) Conclusion: VD and FAZ are normal in pubescent children with T1D without signs of DR. Treatment with CSII may be a better choice compared to MDI, as CSII may be protective against retinal microvascular damage. Our results indicate the need for new clinical parameters of glycemic control in addition to HbA1c which could assess the risk of DR.

Evaluation of dry eye symptoms and risk factors among medical students in Serbia.

BACKGROUND: Dry eye is a multifactorial disease defined less than 30 years ago. It is a relatively common disorder, affected by a number of well-known risk factors. Dry eye can be challenging to diagnose because of the possible discrepancy between patients' symptoms and clinical signs, and its overlap with other ocular surface diseases. Literature-wise, dry eye is usually associated with age and therefore investigated within older populations. Recently, studies focusing on young adult and student populations have demonstrated a higher prevalence of dry eye than previously expected. AIM: The study aims to determine the frequency of dry eye symptoms in the student population, and the impact of students' activities and habits as potential risk factors. METHODOLOGY: Our study involved 397 students from the medical school at the University of Belgrade, Serbia. Students were asked to complete an online survey that addressed general information, health, habits, and routine in everyday use of electronic devices. In addition, students completed a standard Ocular Surface Disease Index questionnaire. RESULTS: The prevalence of dry eye was 60.5% (240/397) in our study population. Contact lens wear (p<0.001), allergies (p = 0.049) and increased number of hours per day using VD devices for studying purposes (p = 0.014) were associtated with a higher risk of dry eye disease. Risk factors that did not significantly impact dry eye were the use of oral contraceptives, smoking, systemic diseases, year of study and sex. CONCLUSION: In our study, the prevalence of dry eye disease was similar or slightly higher than in previous studies among young adults. In addition, contact lenses, allergies and visual display devices were associated with the development of the dry eye.

Determination of olopatadine in human tears by hydrophilic interaction liquid chromatography-MS/MS method.

AIM: The objective of the study was development of hydrophilic interaction liquid chromatography-ESI/MS/MS method for the determination of olopatadine in tear matrix. MATERIALS & METHODS: Separation was performed on Acquity BEH amide column (2.1 × 100 mm, 1.7 µm). The mobile phase was consisted of 0.1% formic acid in water and acetonitrile. Mianserin hydrochloride was implemented as an internal standard. The artificial tear fluid was used as matrix. The tear samples were collected using Schirmer test strips. For the optimization of ultra pressure liquid chromatography conditions, Box-Benhken design was utilized. RESULTS: The optimal values of the ion source and collision cell parameters were found. Quantification was performed in multiple reaction monitoring mode. The optimized method was fully validated. CONCLUSION: The proposed method was utilized for monitoring of olopatadine in human tear.

[Ultrasound biomicroscopy in diagnosis of anterior segment pathology].

INTRODUCTION: Ultrasound biomicroscopy (UBM) is a non-invasive diagnostic procedure, developed in order to achieve better visualization of the anterior segment of the eye. The first clinical images were made in March 1990. The use of UBM at the Institute for Eye Diseases, Clinical Centre of Serbia, began in February 2007. OUTLINE OF CASES: Due to a drop in visual acuity, the first patient was sent to the Institute for Eye Diseases, Clinical Centre of Serbia. The existence of the ciliary body tumour was suspected, so she underwent a UBM diagnostic procedure. UBM showed fibrin in the anterior chamber of the eye, occlusion of the pupil, and the absence of tumour. The second patient had a part of the chamber angle filled with solid lesion. UBM showed a solid tumour lesion filling the chamber angle in the lower part of the anterior chamber. The origin of the tumour was the ciliary body rather than the choroid which was shown by the B scan ultrasound. Lipodermoid was found by clinical examination of the third patient. He underwent UBM in order to exclude the involvement of the sclera under the lesion. UBM visualized a subconjunctival lesion lying on the sclera, reaching the limbus of the cornea.The difference in ultrasound reflection of the two tissues helped us to confirm that the sclera was not involved. Our fourth patient underwent an antiglaucomatous procedure, and the assessment of the chamber angle opening was the reason for the UBM examination. Parameters measured in the lower quadrants (6 o'clock) that we managed to obtain were the following: AOD (250 microm)--180 microm, AOD (500 microm)--400 microm, TIA--34.39 deg., ARA--0.25 mm2. Comparing them to normal values, we came to the conclusion that the chamber angle was open in the lower part of the anterior chamber. CONCLUSION: Ultrasound biomicroscopy gives us plenty of useful information when it comes to diagnosing the anterior chamber pathology.