Macular Parameters Change during Silicon Oil Tamponade for Retinal Detachment Surgery.

Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant compared to preoperative values. The average span of silicon oil tamponade was 162 +/- 23 days. Conclusions: Silicon oil tamponade during 23-gauge rhegmatogenous retinal detachment surgery leads to a transitory reduction of central macular thickness, central macular volume cube and average macular thickness cube in eyes that underwent retinal surgery. After silicon oil removal, macular parameters returned to preoperative values in most of the patients.

Hypomagnesemia in adults of northern Serbia: prevalence, nutritional risk factors, and associated comorbidities.

INTRODUCTION: Magnesium (Mg) deficiency is associated with numerous non-communicable diseases. The aim of the study was to estimate the prevalence of hypomagnesemia in the general adult population of Northern Serbia (NS), and to determine the level of Mg in drinking water. METHODS: This is a cross-sectional study with 5,122 adults from the general population. Serum level of Mg was determined by spectrophotometry, while the level of Mg in the drinking water was done by atomic absorption spectrophotometry. Standard laboratory methods were used to determine individual's blood lipid status and complete blood count. RESULTS: The prevalence of hypomagnesemia (Mg < 0.75 mmol/L) in the general population was 2.7%, while the prevalence of the subjects with high risk for the Mg deficiency (Mg 0.75-0.85 mmol/L) was 20.1%. The public water supply showed variable values between 17.3-35.3 mg/L. Age, systolic blood pressure, duration of diabetes mellitus, and glycemia increase with the decrease of Mg level. In addition, increased level of Mg was associated with higher red blood cell count and hemoglobin levels. CONCLUSIONS: The prevalence of hypomagnesemia in Northern Serbia is low (2.7%) and level of Mg in drinking water is not satisfactory. Serum level of Mg in the range 0.75-0.85 mmol/L is present in about 1/5 of the population. Glycemia, advanced age, gender, and smoking have a predictive role in hypomagnesemia occurrence. There is a significant correlation between serum level of Mg and lifestyle and dietary habits.

PROGNOSTIC FACTORS FOR POSTOPERATIVE VISUAL OUTCOME IN SURGICALLY TREATED SUPRASELLAR MENINGIOMAS.

INTRODUCTION: The prognosis of postoperative visual acuity in patients with surgically treated suprasellar meningiomas is influenced not only by the size and precise localization of meningiomas in the optochiasmatic region and their compressive effect, but also by certain parameters, such as the age of patient, duration of symptoms, and preoperative visual acuity. The purpose of this study was to analyze the influence of these factors on postoperative visual acuity in the patients with surgically treated optochiasmatic meningioma as well as to determine their prognostic value in the recovery of visual function after surgery. MATERIAL AND METHODS: The study sample consisted of 43 pati- ents operated for suprasellar meningioma. All tumors were dia- gnosed by computed tomography or nuclear magnetic resonance scans. Visual acuity was analyzed both before surgery and six months after surgery. The effects of age, preoperative Visual loss, duration of visual symptoms and tumor size on visual outcome were analyzed. RESULTS: Postoperative improvement of visual acuity was observed in 50% of eyes (68.4% of patients). Visual outcome was better in the younger patients. The patients with better preoperative visual acuity had better postoperative visual acuity outcome. Chances of achieving better postoperative visual function and favorable tumor resection outcome were inversely proportional to the increased length of history of disease and tumor size. CONCLUSION: Postoperative visual acuity prognosis in suprasellar meningioma surgery was favorably affected by the mean duration of symptoms of less than 24 months, tumor size less than 30 mm. and preoperative visual acuity loss below 0.1.

Changes of serum VEGF concentration after intravitreal injection of Avastin in treatment of diabetic retinopathy.

PURPOSE: Avastin (bevacizumab) intravitreal injections are widely used for treatment of diabetic retinopathy. The aim of our study was to analyze effect of 1.25 mg of intravitreal Avastin on serum concentration of vascular endothelial growth factor (VEGF) in diabetic patients. METHODS: Participants were 10 diabetic patients on insulin therapy, without any other eye or systemic disease, and no kidney disfunction. Both eyes of diabetic patients were injected simultaneously with 1.25 mg of intravitreal Avastin, as a first step in treatment of nonproliferative diabetic retinopathy with clinically significant macular edema (4 patients), and of proliferative diabetic retinopathy (6 patients). Fluorescein angiography was performed prior to and laser therapy followed 1 month after Avastin treatment. VEGF concentration in patients serum was measured by ELISA technique: on the day of the Avastin administration, and 1, 7, and 28 days after intravitreal injection. RESULTS: In all analyzed participants, 24 hours after Avastin treatment, serum levels of VEGF were lower then basal (preinjection value). Maximal reduction of serum VEGF was noted on the 7th postoperative day. Twenty-eight days after, VEGF level in serum was raised, without completely reaching basal preoperative concentrations in most patients. CONCLUSIONS: Intravitreal injections of anti-VEGF drugs have an effect on decreasing systemic VEGF values. Rhythm of changes in serum VEGF concentrations and lowest detected concentration on the seventh postinjection day are according to pharmacokinetics of Avastin in serum and vitreous, reported by similar studies. The small number of patients involved in this pilot study implicates the need for further studies.

Long-term effect of 1-piece and 3-piece hydrophobic acrylic intraocular lens on posterior capsule opacification: a randomized trial.

PURPOSE: To compare the intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece haptic designs of the foldable hydrophobic acrylic AcrySof intraocular lens (IOL) over a 5-year period. DESIGN: Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison. PARTICIPANTS: Fifty-two patients with bilateral age-related cataract (104 eyes). METHODS: Each study patient had cataract surgery in both eyes and received a 1-piece AcrySof IOL in 1 eye and a 3-piece AcrySof IOL in the other eye. Follow-up examinations were performed at 1 week, 1 month, 6 months, and 1, 2, and 5 years. Digital retroillumination images were obtained of each eye. The amount of posterior capsule opacification (score range, 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software 1, 2, and 5 years after surgery. MAIN OUTCOME MEASURE: Posterior capsule opacification score (scale, 0-10). RESULTS: There was no significant difference between the 1-piece and 3-piece AcrySof IOL in best-corrected visual acuity, overlap of rhexis and IOL, capsular folds, anterior capsule opacification, and posterior capsule opacification (1-piece AcrySof PCO score, 1.7+/-1.7; 3-piece AcrySof PCO score, 1.3+/-1.4; P = 0.30). CONCLUSIONS: Modification of the IOL haptic design of the sharp optic edged AcrySof IOL from a 3-piece to a 1-piece haptic design caused no significant change in PCO intensity and neodymium:yttrium-aluminium-garnet laser treatment rate 5 years after surgery.

[Vision related quality of life--a cataract study].

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.