Classical Therapies Versus Combined Therapies in Diabetic Neuropathy.

The aim of our study was to evaluate the classical therapies represented by adequate glycemic control and lifestyle changes versus classical therapies combined with new antioxidant therapies in patients with diabetic neuropathy. We conducted an observational, prospective study, between October 2017 and December 2019, which included a number of 188 patients suffering from diabetic neuropathy. In order to evaluate the response to the therapeutic protocol, we used the MNSI (Michigan neuropathy screening instrument). Responder group was defined as a decrease in MNSI (<7) from baseline to one year. According to this 34.04% (n=64) of patients were responders to classical therapy while a higher number of patients responded to combined therapy (n=73, representing 38.83%). In the group of responders, the subgroups that predicted the prevention of MNSI increase (decrease in the impact of diabetic neuropathy) in the group treated with combined therapy compared to classical therapy, related to clinicopathological features, after one year included: gender female (p=0.0415), body mass index <30kg/m2 (p=0.0335), absence of cardiovascular disease (p=0.0006) and absence of dyslipidemia (p=0.0288). In conclusion, we demonstrated an increased response to combined therapy after one year of treatment. Thus, combined therapy is an alternative for reducing side effects and for increasing efficiency.

The Neuroprotective Role of Alpha Thioctic Acid and Vitamin B Complex in Diabetic Neuropathy - an Experimental Study.

Worldwide, approximately 463 million people are estimated to suffer from a form of diabetes mellitus, with diabetic neuropathy being one of its most common complication. Using streptozotocin to induce diabetes in C57BL/6J mice, we assess the neuroprotective role of alpha thioctic acid and vitamin B complex in diabetic neuropathy. In order to highlight the peripheral nerve changes produced by diabetes, we performed an electroneurographic recording of the animals and compared the amplitude of the compound muscle action potential (CMAP). Treatment with alpha thioctic acid (A), or vitamin B complex (B), or A+B caused a smaller decrease in CMAP amplitude than if these therapies had not been applied. On the other hand, we found that in group A+B a smaller decrease of CMAP amplitude was observed compared to the control group (6 weeks after the onset of diabetes p<0.0001). Also, separate treatment with alpha thioctic acid alone caused a smaller decrease in CMAP amplitude compared to the control group (6 weeks after the onset of diabetes mellitus p<0.0436), but also separate treatment with vitamin B complex alone resulted in a smaller decrease of CMAP amplitude compared to the Control group (6 weeks after the onset of diabetes p<0.0070). The combined therapy with alpha thioctic acid and vitamin B complex has a greater effect in preventing axonal degeneration in diabetic neuropathy than the single therapy only with alpha thioctic acid or only with vitamin B complex.

A morpho-functional study using PEP/LVET ratio and global longitudinal strain in patients with dilated cardiomyopathy.

AIM: To assess left ventricular (LV) systolic function and morphology in patients with severe dilated cardiomyopathy (DCM), using both conventional and a complex technique, speckle-tracking echocardiography, and evaluate the correlation between pre-ejection period and left ventricular ejection period (PEP/LVET) ratio, global longitudinal strain (GLS), and severity of the condition. PATIENTS, MATERIALS AND METHODS: Seventeen patients were enrolled after rigorous criteria. Echocardiography was performed in conventional and speckle-tracking mode, in all patients with DCM, in sinus rhythm. LV dimensions, volumes and ejection fraction (LVEF) were measured. PEP/LVET ratio was obtained from apical 5-chamber axis and was defined as the time between QRS onset and LV ejection reported to LV ejection period. Speckle-tracking imaging was performed in offline mode and GLS was obtained from parasternal 4-, 3-, 2-chamber apical view, by averaging longitudinal peak systolic strain of all 17 LV-segments. RESULTS: New York Heart Association (NYHA) functional class correlated significantly with LVEF (-0.82; p=0.0006), PEP/LVET (0.86; p=0.001) or GLS (0.85; p=0.0002). Considerable correlations were between mitral regurgitation (MR) severity and LVEF (-0.65; p=0.01) or PEP/LVET (0.69; p=0.0059), but higher were between MR severity and GLS (0.76; p=0.0018). Tricuspid regurgitation (TR) grading correlated statistically with LVEF (-0.62; p=0.01), PEP/LVET and GLS (0.6; p=0.018; and 0.62; p=0.014, respectively). As opposed to the parameters in conventional echocardiography, GLS correlated with DCM etiology (p=0.0046) and with the gender (p=0.048). CONCLUSIONS: This study demonstrates that, in patients with DCM, assessment of cardiac dyssynchrony can be accurately accomplished by combining parameters in conventional and in speckle-tracking echocardiography.

Left and right ventricular morphology and function in athletes with elevated pulmonary systolic arterial pressure.

OBJECTIVES: The objective of the study was to evaluate the prevalence and potential impact of elevated pulmonary arterial systolic pressure (PASP) on left and right cardiac morphology and function in young elite athletes. METHODS: In total, 85 professional athletes (40 endurance, 20 strength, and 25 mixed training, mean age 17.8 ± 4.0) and 50 sedentary controls (mean age 18.6 ± 3.3) underwent transthoracic echocardiographic examination. Two-dimensional measurements of the right (RV) and left ventricle (LV) were obtained. PASP was estimated from the peak tricuspid regurgitant velocity (TRV). Speckle tracking-derived longitudinal LV and RV strain measurements (RV_LS) were calculated for function estimation. RESULTS: Maximum TRV (2.2 ± 0.3 vs 2.0 ± 0.2 m/s, P < .01) and PASP (26 ± 5 vs 22 ± 5 mm Hg, P < .01) were higher in athletes compared to controls. PAPS above 30 mm Hg (35 ± 3 mm Hg, range 31-40 mm Hg) was identified in 11 athletes (12.9%). Athletes with elevated PASP demonstrated higher LV mass (P < .01), LV stroke volume indexed (P < .01), larger RV-end-systolic area (ESAi), RV-end-diastolic area (EDAi), right atrium ES volume and ED volume, and decreased RV fractional area change (FAC) (P < .01) when compared to matched controls and higher RV-EDAi (13.0 ± 1.6 vs 11.1 ± 1.5, P < .01), RV-ESAi (8.2 ± 1.5 vs 6.1 ± 0.9, P < .01), and significantly reduced RV FAC (38.1 ± 5.8 vs 44.6 ± 2.5, P < .01) when compared to matched athletes. LV global longitudinal strain and RV_LS showed no differences between the groups. CONCLUSIONS: Pulmonary arterial systolic pressure elevation in young athletes is associated with pronounced right ventricular enlargement, even when compared to matched athletes. Conventional and speckle tracking echocardiography showed preserved right ventricular function.

Implications of inflammation and remodeling of the enteric glial cells in colorectal adenocarcinoma.

AIM: The aim of our study was to assess glial fibrillary acidic protein (GFAP) glial cell phenotype in the enteric nervous system (ENS) in colorectal adenocarcinoma of different tumor grading and, also, to establish correlations between these changes and the tumor proliferative activity and the tumor-infiltrating leukocytes. PATIENTS, MATERIALS AND METHODS: We ran an observational, prospective study on a group of 52 patients diagnosed with colorectal adenocarcinoma. They were surgically treated in the 1st Surgery Clinic of the Emergency County Hospital of Craiova, Romania. From the surgically resected pieces, after pathological confirmation and tumor grading, 3-µm thick seriate sections were cut and processed for immunohistochemistry for detecting GFAP, S100, CD45 and Ki-67. RESULTS: Evaluation of GFAP glial cell type in the ENS of colorectal cancer with different stages of differentiation showed that the density of these nervous elements is higher in well-differentiated (G1) colorectal tumors compared to moderately differentiated (G2) and poorly differentiated (G3) colorectal tumors. For well-differentiated colorectal adenocarcinoma, we did not find any correlations between GFAP glial cell type in the ENS and the tumor proliferative activity or with tumor-infiltrating leukocytes. In what the moderately and poorly differentiated adenocarcinoma are concerned, we found a high inverse variation between GFAP glial cell type in the ENS and the proliferative activity, on one hand, and, between GFAP glial cell type in the ENS and the tumor-infiltrating leukocytes, on the other hand. CONCLUSIONS: The decrease in the density of GFAP glial cell type in the ENS with tumor grading of colorectal cancer and the inverse variation with the tumor proliferative activity and with the tumor-infiltrating leukocytes might serve as putative prognostic factors in colorectal cancer.

Assessment of T- and B-lymphocytes and VEGF-A in acute pancreatitis.

AIM: Highlighting certain characteristics of T- and B-lymphocytes, as well as of vascular endothelial growth factor-A (VEGF-A) as a prognosis factors for patients suffering from acute pancreatitis, with the scope of establishing diagnosis and therapy. MATERIALS AND METHODS: Pancreatic tissue samples were analyzed, originating from 21 patients deceased due to acute pancreatitis, between the years 2015 and 2016. The study group was subdivided into two subgroups by pathology duration. As control group, pancreatic tissue fragments were sampled from eight patients, deceased due to non-pancreatic acute surgical abdomen (NPASA). RESULTS: By analyzing the immunohistochemical expression of T-lymphocytes (immunomarked with the anti-CD3 antibody) and of B-lymphocytes (immunomarked with the anti-CD20 antibody), both on the tissue sections originating from the study patients, as well as the control group patients, we established that these were mostly present in the interstitium, following which the acini, less frequently in the islets, in general with B-lymphocytes being less present than T-lymphocytes. VEGF-A also tends to emerge in the acini periphery, at the border with the stromal connective tissue, while the islets are almost negative for VEGF-A. CONCLUSIONS: We can state that the decreased expression of T- and B-lymphocytes in normal pancreatic tissue, surrounding the necrosis areas, can be used as an aggravated prognosis factor for patients diagnosed with acute pancreatitis. Moreover, the increased immunohistochemical expression of VEGF-A can play an important role in tracking the evolution and pathology of acute pancreatitis.

Assessing the Degree of Severity of Acute Pancreatitis by Using Multiparameter Scores.

AIM: To establish a clinical severity diagnosis and a therapeutical strategy in acute pancreatitis (A.P.) by using multiparameter bioclinical and morphological scores. MATERIAL AND METHOD: 71 patients, diagnosed with A.P., between 2012-2016, admitted to the surgical clinics of the Military Emergency Hospital "Dr. Stefan Odobleja" and the Clinical County Emergency Hospital of Craiova, were investigated, following the severity diagnosis, both at admission and in evolution, with the aim of obtaining an optimal therapeutic approach. The Ranson, Imre, Marshall, Balthazar and EPIC scores were used. RESULTS: By analyzing specially the values of the computer tomography severity index of the study group patients, 14.29% of patients were classified as light severity AP with favorable prognosis, 37.14% of patients moderate severity AP, and 48.57% severe AP. The examination of the CT, one of the most important diagnosis tests for AP, established that 34.29% of patients suffered from AP in Balthazar grade B and 22.85% Balthazar grade C, the severity forms we encountered most in our study. The correlation between HCT (hematocrit) value and Ranson score presents a Pearson correlation coefficient r of-0.339, which indicates the existence of a statistically significant inversely proportional relation. CONCLUSION: Corroboration of the bioclinical and imagistic data, summed as multiparameter scores, allowed us to classify AP into different severity forms: moderate severity AP (14.29%), moderate-severe AP (37.14%) and severe AP (48.57%), which will then facilitate choosing the right therapeutic approach.

Cardiac Arrhythmias in Patient with Isolated Persistent Left Superior Vena Cava.

We report here the case of a 47-year-old male presented with atypical chest pain, fatigue and arrhythmias that was found to have persistent left superior vena cava. The clinical exam was normal. Twelve leads ECG showed sinus rhythm of 70 beats/min, QRS axis of 90 degree and right bundle branch block. Transthoracic echocardiography revealed left ventricular hypertrophy, a large coronary sinus and mild pulmonary hypertension. Saline contrast echocardiography was performed and micro-bubbles were visible first into the coronary sinus and then passed through the right atrium. Multislice computed tomography confirmed the presence of persistent left superior vein cava and the site of drainage into the right atrium via a large coronary sinus. Right superior vein cava was absent. In this case report, we emphasize the importance of full assessment in patient with persistent left superior vena cava.

Utilizing Multiparameter Scores and Procalcitonin as Prognosis Markers for the Degree of Severity of Acute Pancreatitis.

AIM: Corroborating the Ranson, Marshall, computer tomography severity index (EPIC score) multiparameter tests with the biological marker procalcitonin in order to establish the degree of severity of acute pancreatitis for therapeutic management and rate of complications. MATERIAL AND METHOD: 20 patients were surveyed, diagnosed with acute pancreatitis in the surgery clinic of the Military Emergency Hospital Dr. Ștefan Odobleja, between 2016-2017, with the aim of determining the clinical, etiological and severity diagnosis by corroborating the multiparameter scores with the plasma level of procalcitonin. RESULTS: Following the use of multiparameter scores to identify the degree of severity of acute pancreatitis, we established that the best prediction is achieved by the Ranson score and the computer tomography severity index (EPIC score), with an accuracy of 90% . As for the values of the correlation coefficient, this was highly significant when correlating Ranson score and procalcitonin (r = 0.918). Other correlations were also highly significant, with values of r = 0.797 when correlating EPIC score and procalcitonin, and r = 0.736 when correlating Marshall score with procalcitonin. CONCLUSION: Our study achieved an early identification of the severe form of acute pancreatitis, by using the multiparameter tests and the biologic marker procalcitonin, allowing for the appropriate therapy to be implemented and thus decreasing the complication rate of this pathological entity. Levels of serum procalcitonin exceeded the normal limit of 2 ng/ml for 37.5% of the intermediate - severe form patients, and for 100% of the severe form patients. The levels of procalcitonin were highly correlated with the Ranson score, with a slightly lower correlation for the Marshall and EPIC scores.

Posterior vitreous detachment and macular anatomical changes - a tomographic-electroretinographic study.

AIM: Posterior vitreous detachment (PVD) is a physiological phenomenon due to aging characterized by separation of the vitreous cortex from the retina and may induce a variety of pathological events at the vitreoretinal junction. The aim of this study is to highlight in vivo anatomical and functional changes in early stages of PVD allowing the correct treatment. MATERIAL AND METHODS: Non-consecutive case series; optical coherence tomography (OCT) relies on analyzing the reflectivity of coherent light from different anatomical interfaces within posterior vitreous and retinal histological layers, thus acquiring transverse sections through vitreoretinal interface, sensory retina, retinal pigment epithelium and choroid. Modern techniques using Fourier spectral analysis of the reflected light enhance axial resolution to 5-10 µm, almost matching classic histological sections. Integrating these sections, OCT can reconstruct three-dimensional tissue anatomy. Full-field electroretinogram (ERG) evaluates the function of the entire retina evoked by a flash light. RESULTS: Imaging of the vitreoretinal interface with OCT allowed staging PVD and correctly diagnosing its secondary pathologies: cystoid macular edema, vitreomacular traction syndrome, epiretinal membrane, macular pucker, macular hole, macular pseudohole, lamellar macular hole. The cone response of full-field ERG is a marker of retinal damage in macular pathology due to PVD. CONCLUSIONS: Correct understanding of vitreoretinal anatomic and functional changes due to posterior vitreous detachment is essential for a proper diagnosis and treatment.

Microglial voltage-gated sodium channels modulate cellular response in Alzheimer's disease--a new perspective on an old problem.

Alzheimer's disease (AD) determines gradual loss of cognition and memory function, eventually leading to clinical manifest dementia. The pathogenic mechanisms of AD remain elusive and treatment options unsatisfactory, targeting only symptoms like memory loss, behavior changes, sleep disorders and seizures. These therapies are not stopping the disease's progression, at their best they can only delay it. Accumulating evidence suggests that AD is associated with a microglial dysfunction. Microglia are resident immune cells that provide continuous surveillance within the brain. When excessively activated, microglial response can also have detrimental effects via the exacerbation of inflammatory processes and release of neurotoxic substances. Recently, it was recognized that microglia express voltage-gated ion channels, in particularly voltage-gated sodium channels (VGSC). Pharmacological block of VGSC has been attempted symptomatically in AD to control the epileptic features often associated with AD, as well as to relieve detrimental behavioral and psychological symptoms of dementia. The success of VGSC treatment in AD was unexpectedly variable, ranging from very beneficial to plain detrimental. This variability could not be satisfactorily explained solely by the neuronal effects. This article will try to discuss possible implication of microglial VGSC dysfunction in AD according to available data, own personal experience of the authors and propose a new way to investigate its possible implications.

Optical coherence tomography investigation of ischemic stroke inside a rodent model.

Although already in use in several medical domains, only recently optical coherence tomography (OCT) has been applied in the study of ischemic events. In this paper, we will focus on characterizing ischemic stroke, in a rat model, by OCT. Investigations were carried on a set of 25 rats, on which ischemic stroke was inflicted by a transient occlusion of the middle cerebral artery (tMCAO). Animals were sacrificed 1, 3, 7 and 28 days after occlusion. We tested the OCT's power of detection and discrimination of stroke area compared to both normal, contralateral hemisphere and non-affected brain tissue, together with the aid of histochemical and pathological examination. Our results show a great potential of OCT to be used as a detection tool in acute and chronic phases of stroke.

Microglia: first responders in the central nervous system.

Microglia has emerged not only as an essential inflammatory cell but also as a major player in the development of the adult brain. Microglia phagocytize extra-numerical synapses during postnatal development, maintain and strengthen the remaining subset of synapses, remodel synaptic circuits and clearing apoptotic newborn neurons. Thereby, microglia plays a crucial role for the establishment, plasticity and function of adult neural circuits. In addition to the key role in normal brain function, any imbalance in microglia activity has been associated with neurodegenerative diseases. Microglial cells respond rapidly to smallest pathological changes, this being a vital aspect in many tissue scaring and the local confinement of focal lesions. It is assumed that the high motility of microglial cells represents an important requirement to fulfill the numerous functions. In this review will highlight the role of microglial motility in the healthy and the injured brain, and discuss how impairment of microglia motility can affect normal brain function.

Comparative aspects of microglia reaction in white and gray matter.

OBJECTIVES: Microglia are considered as the primary immune effector cells in the brain and have a critical role in all brain lesions. We wanted to find out if there is any difference in the way that white and gray matter microglia react to the same type of lesion. MATERIAL AND METHOD: We used 14-16 weeks old single transgenic CX3CR1-EGFP mice, whereon microglia were labeled by expression of the green fluorescent protein EGFP and the L1-L2 dorsal spinal columns were exposed. After 10 min of continuous base line image acquisition, we made a micro-lesion by focusing and raising the power of the laser and, than, we monitored it for an additional hour. Laser-lesion and image recording were also made in the right somato-sensory cortex. We quantified microglial response and compared white vs. grey matter. RESULTS: 5-10 min after the lesion, microglia already showed signs of polarization by extending their processes both in white and gray matter. Processes were sent by the microglial bodies situated at a distance of 50 to 100 µm, depending on the lesion size. Microglial processes did not display a preferred target site from the lesion; in contrast, they formed a uniform "shielding" ring around the lesion. CONCLUSIONS: Microglia showed targeted responses to acute injuries in grey and white matter also; no major differences were observed besides the speed of the process, due probably to particular cortex and spine architecture.

Morphofunctional aspects of lower limb in multiple sclerosis.

Gait, as an expression of the locomotive system, needs a complex biomechanical analysis, which allows the description of multiple sclerosis (MS) specific patterns, MS patients having a polymorphism of motion patterns. The studied group consisted of 13 MS patients with gait disorders, average age of the group was of 36 years. The evaluation of the subjects comprises: clinical evaluation (anamnesis, neurological examination), paraclinical evaluation (MRI), functional evaluation, neuro-physiologic evaluation and biomechanical evaluation. Biomechanical examination was completed using the force and pressure-measuring platform of plantar pressure distribution Footscan Scientific Version, RSscan. The studied parameters were: contact area, active contact area, heel rotation, foot balance, foot angle. The evaluated zones during a gait cycle were: the heel, medial foot, antefoot. Although the analysis of contact area in the lateral foot did not show any significant differences between the right and the left foot, it nonetheless underlined a major difference in the expression of maximum and minimum values, which meant that MS patients with clinically detectable gait disorders had a tendency to increase contact area to maintain balance. Examining the foot positions in relation to the movement direction and to the foot vertical axis, we noticed the existence of certain elements indicating an orientation tendency of the foot. This tendency had to be related to neutral position (corresponding to anatomical position) of the foot. We also noticed a foot deviation in abduction, associated with visible pronation and decrease of the contact area corresponding to medial plantar zone.

Neuromuscular assessment in the study of structural changes of striated muscle in multiple sclerosis.

UNLABELLED: The aim of this research is to present the results of neuromuscular assessment using tensiomyography (TMG) in multiple sclerosis for prediction the muscle changes. This study consists of 20 patients, selected conform to certain criteria. Thus, according to diagnosis and MS level, the studied group was divided into two subgroups: subgroup A, consisting of 13 MS patients with clinically detectable gait disorders, and subgroup B, made up of seven MS patients without clinically detectable gait disorders. TMG determines the diagnosis of a certain muscular type and muscular status÷condition (fatigue, stress influence on the body, etc.), the diagnosis of a functional muscular symmetry. The investigation has been performed on the shank muscles. The parameters evaluated through TMG were: contraction time (Tc) and the amplitude of muscular displacement in transverse direction - Dm (mm) a parameter which is also correlated with Tc values and depends on the flexibility of muscular tissue. RESULTS: Dm in the case of gastrocnemius muscles (mG) data analysis shows an evolution of functional bilateral right-left asymmetry, which is more pronounced in subgroup A. At the level of posterior shank, Dm values in subgroup A are lower, which means that patients in subgroup A have a higher muscular tone and a maximum response to stimulation. Concerning Tc values, this parameter indicates muscular fatigue at the level of anterior tibialis. CONCLUSIONS: TMG, besides classical methods of paraclinical investigation, improves data generation, standardization, identifies correlations, which may facilitate a precocious diagnosis in morphofunctional changes evolution at muscular level at MS patients.

[Visual evoked potentials in the in evaluation of the safety profile of levocetirizine]. / Potentiale evocate vizual în evaluarea profilului de siguranta al levocetirizinei.

UNLABELLED: Because human histamine H1 receptors were visualized at different brain levels, we evaluated the effects of levocetirizine (LCZ) on the visual evoked potentials (VEP). MATERIAL AND METHOD: Eighteen volunteer subjects were included in a placebo-controlled study, VEP recordings (pattern-reversal technique) were performed at baseline and 240 min. post-medication, and the N75-P100-N135 complex parameters (latency, duration, amplitude and surface of the components) were measured in the leads FzOL5, FzOz and FzOR5. RESULTS: LCZ 5 mg p.o. induced no statistically significant changes, neither in the mean values of all P100 parameters, nor in the mean latency of N75 and N135 components. No unilateral or bilateral alterations of VEP parameters were detected, suggesting that LCZ has no influence on the functional integrity of visual sensorial pathway. CONCLUSION: Our study may initiate a novel approach in the neurological safety profile evaluation of new H, antihistamines using VEP, with the advantage of no radiological exposure.

[The visual evoked potentials in diabetic retinopathy]. / Potentiale evocate vizual în retinopatia diabetica.

PURPOSE: The recording of Visual Evoked Potential alterations at the patients with diabetic retinopathy. MATERIAL AND METHODS: It was performed the Visual Evoked Potential recordings at 24 patients with diabetic retinopathy in different stages of evolution, with or without complications. The type of Visual Evoked Potential recording was pattern reversal with vertical bars. We followed the diagram alterations in correlation with the evolution stages of diabetic retinopathy and the visual parameter alterations. RESULTS: In all cases we recorded alteration of the Visual Evoked Potential. In nonproliferative diabetic retinopathy was noticed the delay of P100 wave with inconstant presence of the N75 and N135 waves. In proliferative diabetic retinopathy and its complications the alterations of the tract were important. CONCLUSIONS: The gradual alteration of the Visual Evoked Potential tract at the patients with diabetic retinopathy represents a prognosis of the disease.

[The visual evoked potentials in open angle glaucoma]. / Potentiale evocate vizual în glaucomul primitiv cu unghi deschis.

PURPOSE: The study purpose to analyse the variations of Visual Evoked Potentials on a group of patients with Open Angle Glaucoma. MATERIAL AND METHOD: It was performed the Visual Evoked Potential recordings on a number of patients with Open Angle Glaucoma in different stages of evolutions. Some of the patients were monitored by the Visual Evoked Potentials recordings in a dynamic way, before and after the law pressure treatment. The type of Visual Evoked Potentials recording was pattern reversal with vertical bars. RESULTS: In incipient stage of Open Angle Glaucoma the alteration of the tract was minimal with inconstant presence of the N75 and N135 waves and just a few variation of the delay of P100. In advanced stages of Open Angle Glaucoma the alterations of the tract were important: the delay of P100 wave. In absolute stage the tract was null. CONCLUSIONS: The alterations of Visual Evoked Potentials tract was influenced by the different stages of evolution of Open Angle Glaucoma. The gradual alteration of the Visual Evoked Potential tract represents a prognosis of the disease.