[Conjunctival tumor...more than meet the eye]. / Doar tumora conjunctivala....

The authors present the case of a patient diagnosed with a conjunctival tumor. Questions are being asked about the nature of the tumor--is there just a melanocitic conjunctival tumor or a scleral extension of a intraocular tumor (that also infiltrates the cornea). A minimally invasive surgical approach is decided, with excellent intra- and post-op results. There have been no complications during 1 year of combined ophthalmologist - oncologist surveillance.

[Tardive juvenile glaucoma]. / Glaucom juvenil tardiv.

The authors present the case of a young woman with the diagnosis of late juvenile glaucoma. The treatment began in the very moment of the diagnosis but the lack of compliance, as well as the associated risk factors, led to a evolution difficult to control only through medical therapy, which is why we also used laser and surgical treatment. At present, the anatomical and functional status is stable but the long-term prognosis is reserved.

[Intraocular foreign body]. / Corp strain vegetal intraocular.

The authors present the case of a patient who suffered a penetrating ocular trauma due to wood IOFB. An emergency surgery is initiated for the traumatic cataract, afterwards the IOFB is extracted through posterior vitrectomy. The patient seeks medical help after another 3 weeks, being diagnosed with retinal detachment, which is solved surgically.

[Acute endophthalmitis--surgical treatment or conservative therapy]. / Endoftalmita acuta--tratament chirurgical sau atitudine conservatoare?

Acute endophthalmitis is an ophthalmological emergency. Immediate therapy is recommended in order to maintain a normal anatomic and functional ocular globe, according to the most recent guidelines. Surgical therapy and intravitreal drug injection represent standard treatments.

[Kerato-mycosis--case report]. / Keratomicoza--prezentare de caz.

The authors present the case of mycotic keratitis caused by Candida spp.

[Matrix-metalloproteinases and glaucoma]. / Matrix-metaloproteinazele si glaucomul.

PURPOSE: To analyze the matrix-metalloproteinases' activity (MMP-2 and MMP-9) in primary open angle glaucoma patients with indication for filtrating surgery. METHODS: A prospective study, 8 months, in the Ophthalmology Department of the Central Military Hospital, with the collaboration of "Victor Babes" Institute. The study was conducted on 27 eyes with primary open glaucoma and that have underwent filtrating surgery. Patients with other ocular or systemic associated conditions were excluded. Patients were distributed in 3 groups, according to their topical treatment with prostaglandin analogs: Group A: 11 eyes with travoprost 0,004%. Group B: 9 eyes with latanoprost 0,005%. Group C: 7 eyes without prostaglandin analogs. The fragments collected during surgery were processed for imunohistochimical analysis for MMPs. It has used the indirect tristadial method: streptavidine-biotin-peroxidase.

[Evolution of secondary pseudoexfoliative glaucoma after cataract surgery in patients with cataract-glaucoma combination]. / Evolutia glaucomului secundar pseudoexfoliativ dupa operatia de cataracta la pacientii cu asociere cataracta-glaucom.

PURPOSE: To assess the effects of the cataract surgery on the evolution of the secondary open angle glaucoma (SOAG) in patients with pseudoexfoliative syndrome (PEX) that present the association cataract--SOAG. METHODS: A prospective study on 2 years on a group of 12 eyes with PEX syndrome presenting the association cataract-secondary open angle glaucoma, that have been operated by phacoemulsification + PC IOL, without intra-operator complications. We have monitored the effects of the cataract surgery on the evolution of the glaucomatous disease, evaluated by: monitoring of the IOP dynamics, the analysis of the visual field defects and the aspect of the FO, the evolution of the visual acuity and the morphology of the specific changes of PEX. The analysed group has been compared with a control group (5 eyes) presenting the association cataract--POAG, operated by phacoemulsification by the same surgeon. We have used the SPSS programme for statistical analysis. RESULTS: In the follow-up period we have observed almost similar evolutions of the IOP dynamic, but we obtained in PEX group statistically significant lowering of the IOP than in the control group. In PEX group the papillo-perimetric results have presented significantly different characteristics than in the control group, without having an influence on the visual acuity. CONCLUSIONS: Although the cataract extraction has produced in both groups, on a medium follow-up, an IOP decrease from the pre-operator values, the glaucomatous disease in PEX patients, probably because of other specific risk factors, continues to progress.

[IOP diurnal fluctuations in patients presenting pseudoexfoliative syndrome]. / Fluctuatiile diurne ale presiunii intraoculare la pacientii cu sindrom pseudoexfoliativ.

PURPOSE: To analyze the IOP diurnal fluctuations in patients presenting pseudoexfoliative syndrome (PEX) compared to those without PEX. METHOD: A clinical observational prospective study, one year, on 2 groups of patients: group A (13 patients)--with pseudoexfoliative syndrome (PEX) and group B, control, (11 patients)--without PEX. The groups were homogeneous about the age and sex distribution. At each visit 4 IOP measurements were taken using Goldmann aplanotonometry. RESULTS: In PEX patients the IOP had greater values during the study period compared to the control group. By comparing the two groups have been observed significant differences about the maximum IOP, the mean IOP and the diurnal fluctuations, also about the incidence of the complications. CONCLUSIONS: The IOP diurnal fluctuations in PEX patients are significantly greater than the physiological ones and therefore influence the therapeutic attitude and the prognostic. The significant fluctuations in the IOP diurnal curve are an important predictive factor for the eyes that will develop secondary glaucoma. The pseudoexfoliative syndrome is an independent risk factor for glaucoma in patients with intraocular hypertension.

[Protein C reactive and glaucoma]. / Proteina C reactiva si glaucomul.

PURPOSE: To observe the possible implications of the C reactive protein in pathogenesis of the glaucoma. METHODS: A clinical observational prospective study on 2 groups: group A 14 glaucomatous patients and group B--control (12 normal subjects) without history of ocular pathology or general pathology known to be associated with high plasma levels of CRP. The groups were homogeneous about the age and sex distribution. CRP levels were evaluated by tests with high specificity. RESULTS: The plasma CRP level reveals important differences (p < 0,0001) on the two groups: 3,87 +/- 0,8 mg/dl in the group A and 0,68 +/- 0,13 mg/dl in the control group. CONCLUSIONS: Glaucoma is associated with high plasma levels of CRP. In the complex pathogenesis of glaucoma, in which the vascular factor has his well known place, the inflammatory vascular modifications may represent an important component.

[Refractive stability of foldable intraocular lenses]. / Stabilitatea refractiva a cristalinelor artificiale foldabile.

PURPOSE: To compare the refractive stability of different kind of foldable intraocular lenses. METHOD: There was performed a two years (mean follow-up 7,4 +/- 1,2 months) prospective interventional case series study on 108 with senile cataract, without another ocular pathology which underwent cataract surgery by phacoemulsification and implantation of foldable intraocular lens (the same surgeon). Each patient had their refractive status measured at the 1-month postoperative visit, 3-months and at the 6-months follow-up visit. The results have been statistically analyzed using the Wilcoxon test. RESULTS: The postoperative refractive results were correlated with IOL design and material. The acrylic hydrophobic foldable intraocular lens with rigid haptics was more likely to move to hypermetropia and the acrylic hydrophobic foldable intraocular lens with pliable haptics showed minimal myopic movement. CONCLUSIONS: On long-term, the 1-piece acrylic hydrophobic IOL with soft acrylic loops had the most stable refractive results.

[Axial length of the ocular globe and hypotensive effect in glaucoma therapy with prostaglandin analogs]. / Lungimea axiala a globului ocular si degajarea presionala în monoterapia cu analogi de prostaglandine.

PURPOSE: To observe the possible correlations between the hypotensive effect of the prostaglandin analogs and the axial length of the ocular globe. METHOD: A prospective, observational and randomized study (one year) on 27 patients with POAG treated by prostaglandin analogs monotherapy. The patients have been divided in two groups according to the type of the prostaglandin analogs used: group A - 12 patients - travoprost 0,004 % (Travatan) and group B - 15 patients - latanoprost 0,005 % (Xalatan). The IOP and the axial length have been evaluated at the beginning of the study and at 1, 3, 6, 9, 12 months using Goldmann aplanotonometry and echo-biometry. The results have been statistically analyzed using the Wilcoxon test. RESULTS: The mean IOP reduction was similar in both groups, without statistically significant differences. Between the IOP reductions and the axial length of the ocular globe were demonstrated significant correlations according to the patients distribution on the echo-biometry results. CONCLUSIONS: The IOP reduction with prostaglandin analogs monotherapy may also depend of the axial length of the ocular globe.

[Retinal venous occlusion and intraocular pressure]. / Ocluzia venoasa retiniana si presiunea intraoculara.

PURPOSE: To highlight the etiopathogenic correlations between the changes of intraocular pressure (IOP) and the retinal venous occlusion (RVO). METHOD: A prospective clinical study for a period of 2 years (01.01.2003-12.31.2004) that included two groups of patients: group A (31 patients) with POAG and group B (14 patients) with OHT, homogeneous concerning the repartition on groups of age, sex, associated systemic conditions. We have evaluated the incidence of RVO and its characteristics and the evolution of IOP. The data have been statistically analysed using the Wilcoxon test. RESULTS: In the A group we have recorded a significantly higher incidence of RVO comparing to the B group (p=0.0031). In most of the cases, the site of OVR in both groups has been localised at the optic nerve head and accompanied by the fall of IOP comparing to the fellow eye. CONCLUSIONS: The rise of IOP represents an important risk factor for RVO, and particularly in the presence of other risk factors, the normalisation of IOP is necessary. The glaucomatous changes of optic nerve head have a major role in the apparition of this type of retinal vascular pathology. The changes of IOP can be "hidden" by the occurrence of RVO.