EDITORIAL 3/2007	EDITORIAL
REFERATE GENERALE	GENERAL REPORTS
Diana Melinte Dumitrica, C. Stefan - Glaucomul malign	Diana Melinte Dumitrica, C. Stefan - Malignant glaucoma
Mihaela Coroi, Ecaterina Bontas, Rodica Visan, Mladen Defranceschi, Cristiana Daniela Cioranu - Ocular migraine and antiphospholipid antibodies where we stand?	Mihaela Coroi, Ecaterina Bontas, Rodica Visan, Mladen Defranceschi, Cristiana Daniela Cioranu - Migran oftalmica si anticorpii antifosfolipidici
Mihaela Coroi, Ecaterina Bontas, Rodica Visan, Mladen Defranceschi, Daniela Bartos, Maria Dorobantu - Ocular manifestation of antiphospholipid (Hughes) syndrome - minor feature	Mihaela Coroi, Ecaterina Bontas, Rodica Visan, Mladen Defranceschi, Daniela Bartos, Maria Dorobantu - Manifestari oculare ale sindromului antifosfolipidic
Ruxandra Angela Pascu - Efectele radiatiei optice asupra structurilor oculare	Ruxandra Angela Pascu - Effects of optical radiation in ocular structures
CAZURI CLINICE	CLINICAL CASES
Irina Nae, C. Stefan - Glaucom, hidrocefalie, cvadranopsie	Irina Nae, C. Stefan - Glaucoma, Hydrocephaly and cvadranopsia
Anca Irimia, Mirela Preda, Cristi Adelina Ciuca, Carmen Damian, I. Gavrila - Sindrom Sturge Weber in asociere cu melanoza oculo-dermala	Anca Irimia, Mirela Preda, Cristi Adelina Ciuca, Carmen Damian, I. Gavrila - Sturge Weber syndrome in association with oculo-dermal melanosis
C. Stefan, Eliza Tebeanu, A. Nenciu - Glaucom pseudoexfoliativ	C. Stefan, Eliza Tebeanu, A. Nenciu - Pseudoexfoliative glaucoma
D. Cioroianu - Interrelatii neurooftalmologice in sindromul cervical	D. Cioroianu - Neuroophthalmological relations in cervical syndromme
Mirela Preda, Carmen Damian, Rodica Manescu, Livia Davidescu, Anca Irimia, Mihaela Sollosy - Uveita anterioara la un adolescent cu artrita cronica juvenila, forma oligoarticulara	Mirela Preda, Carmen Damian, Rodica Manescu, Livia Davidescu, Anca Irimia, Mihaela Sollosy - Anterior uveitis in a juvenile cronic artritis, oligoarticular form
Carmen Damian, Anca Irimia, Mirela Preda, Stefania Craitoiu, Livia Davidescu, Florentina Marinescu - Leziuni retiniene in anemia aplastica constitutionala ereditara	Carmen Damian, Anca Irimia, Mirela Preda, Stefania Craitoiu, Livia Davidescu, Florentina Marinescu - Retinal lesions in hereditary aplastic anemia
S. Macarie, Simona Sevan, Emese Kaucsar, Sorina Demea, H. Demea - Distrofia conurilor	S. Macarie, Simona Sevan, Emese Kaucsar, Sorina Demea, H. Demea - Cone distrophy
Gh. Munteanu, Stela Giuri, M. Munteanu - Sindromul Wyburn - Mason	Gh. Munteanu, Stela Giuri, M. Munteanu - Wyburn - Mason Syndromme
Carmen Damian, Mirela Preda, Rodica Manescu, Anca Irimia, C. Bataiosu - Boala Takayasu - consideratii asupra unui caz clinic	Carmen Damian, Mirela Preda, Rodica Manescu, Anca Irimia, C. Bataiosu - Takayasu disease - case report
STUDII CLINICE	CLINICAL STUDIES
O. Samoila, Cristina Stan, Oana Visan, Alexandra Craciun, Lucia Dican, Mihaela Mera - Influenta interventiilor pe glob deschis asupra secretiei lacrimale	O. Samoila, Cristina Stan, Oana Visan, Alexandra Craciun, Lucia Dican, Mihaela Mera - The influence of ocular surgery for lacrimal secretion
Cristina Stan, Mihaela Mera, O. Samoila, Simona Bedeoan - Ochiul uscat - corelatii etiopatogenice si histopatologice	Cristina Stan, Mihaela Mera, O. Samoila, Simona Bedeoan - Dry eye - etiopathogenic and histopathological correlations
Rodica Manescu, Mihaela Niculescu, Doina Barascu, Carmen Mocanu, I. Mandrila - Amprenta conjunctivala la bolnavii diabetici	Rodica Manescu, Mihaela Niculescu, Doina Barascu, Carmen Mocanu, I. Mandrila - Conjunctival stamp in diabetic patients
Adriana Neckell - Adaptarea la intuneric la pacientii diabetici	Adriana Neckell - Adaptometry in diabetic patients
D. Chiselita, C. Danielescu, Oana Gagos - Zaharia, C. Gherman - Grosimea centrala a corneei in hipertensiunea intraoculara si glaucomul primitiv cu unghi deschis	D. Chiselita, C. Danielescu, Oana Gagos - Zaharia, C. Gherman - Central thickness of the cornea in ocular hipertension and open-angle glaucoma
PROBLEME DE TERAPEUTICA	THERAPEUTICAL PROBLEMS
A. Barar, Ioana Daniela Apatachioaie, C. Apatachioaie, L. Marceanu - Oftalmologul practician si „computer vision syndrome”	A. Barar, Ioana Daniela Apatachioaie, C. Apatachioaie, L. Marceanu - Ophthalmologist and „computer vision syndrome”
STUDII EXPERIMENTALE	EPERIMENTAL STUDY
M. Zemba
INFORMATII PENTRU CITITORI	INFORMATIONS FOR READERS
RECENZII	REVIEWS

1. GLAUCOMUL MALIGN

Dr. Diana Melinte Dumitrica, Dr. Cornel Stefan

Spitalul Clinic Militar de Urgenta “Carol Davila’’, Bucuresti, Clinica de Oftalmologie

REZUMAT

Glaucomul malign reprezinta o provocare importanta pentru medicul oftalmolog prin neelucidarea exacta a mecanismelor etiopatogenice si prin faptul ca reprezinta tipul de glauccom secundar cel mai dificil de tratat si cu prognostic rezervat.

ABSTRACT

Malign glaucoma is an important challenge for the ophthalmologist by the incomplete knowledge of the exact ethiopathologycal mechanisms and by the fact that represent the most difficult type of secondary glaucoma to treat, that has a reserved prognostic.

2. OCULAR MIGRAINE AND ANTIPHOSPHOLIPID ANTIBODIES- WHERE WE STAND?

Mihaela Coroi, Ecaterina Bontas, Rodica Visan, Mladen Defranceschi, Cristiana Daniela Cioranu

Department of Ophthalmology, Oradea University, Oradea, Romania

Department of Internal Medicine & Rheumatology, Dr. I. Cantacuzino Clinical Hospital, Bucuresti, Romania

Clinical Hospital Center Rijeka, Clinic for Internal Medicine, Department of Clinical Immunology and Rheumatology, Croatia

Laborator medical Valcri, Bucuresti, Romania

ABSTRACT

There is no doubt that ocular migraine also known as retinal migraine or ophtahlmic migraine should not be confused with ophthalmoplegic migraine.

The hallmark of ocular migraine is the unilateral visual loss or “monocular transient loss of vision” associated or followed by the headache. Better safe than sorry, therefore an ophthalmologic examination during the migraine attack is the most diagnostic method.

Additional investigations are not necessary in patients under 40 years of age with typical history for ocular migraine. Importantly , supportive data sustain that different neuro-ophthalmologic manifestation as amaurosis fugax, retinal vascular thrombosis and optic neuropathy, may be consideret as the ocular hallmarks of the Hughes’s syndrome. Clues for the evaluating of antiphospholipid antibodies include recurrent thrombosis especially in young people, recurrent fetal loss, and thrombocytopenia.

There are no studiea that focus exclusively on the prophylaxis of ocular migraine. Ocular features due to antiphospholipid antibodies- induced thrombosis or Hughes’s syndrome should be treated with anticoagulant therapy

KEY WORDS:

· ocular migraine,

· headache,

· retinal migraine,

· antiphospholipid antibodies,

· Hughes’s syndrome,

· autoimmune diseases,

· thrombophilia,

· ophthalmic migraine.

3. OCULAR MANIFESTATIONS OF ANTIPHOSPHOLIPID (HUGHES’) SYNDROME- MINOR FEATURES?

Mihaela Coroi, Ecaterina Bontas, Mladen Defranceschi, Daniela Bratos, Maria Dorobantu

Department of Ophthalmology, Oradea University, Oradea, Romania

Department of Internal Medicine & Cardiology, Clinical Emergency Hospital, Bucuresti, Romania

Clinical Hospital Center Rijeka, Clinic for Internal Medicine, Department of Clinical Immunology and Rheumatology, Croatia

ABSTRACT

The ocular manfestation are described in autoimmune disease, being most common associated with systemin lupus erythematosus, scleroderma, rheumatoid arthritis, insulin- dependent diabetes mellitus, and dermatomyositis. Nonetheless, the antiphospholipid syndrome is a relatively newly recognized autoimmune disorder. Ocular conditions in which to consider antiphospholipid syndrome include amaurosis fugax, transient ischemic attack, retinal haemorhages and cotton wool spots, central retinal vein and artery occlusion, anterior ischemic optic neuropathy, ophthalmic and cilioretinal artery occlusions.

Ocular features due to antiphospholipid antibodies- induced thrombosis should be treated with anticoagulant drugs. In opposition, for the treatment of ocular features due to immunological mechanisms such as vasculitis, immunosupressants seem to be more suitable.

The aim of this article is to underline the mainly ocular features of Hughes’ syndrome and for the most part attention sholud be paid to the patients with central retinal vascular occlusion with no cause but most likely caused by lupus anticoagulant.

KEY WORDS:

· Hughes’ syndrome,

· antiphospholipid syndrome

· antiphospholipid antibodies

· autoimmune disorders

· systemic lupus erythematosus

· ocular manifestation

· eye

4. EFECTELE RADIOTERAPIEI OPTICE ASUPRA STRUCTURILOR OCULARE

Ruxandra Angela Pascu

Spitalul Clinic de Urgenta Militar Central

REZUMAT

Ochiul si pielea sunt organe expuse in mod particular agresiunilor externe si in principal factorilor fizici precum radiatia electromagnetica, adica radiatia ultraviolet, radiatia din spectrul vizibil( in special lumina albastra) si radiatia infrarosie.

Mecanismele prin care aceste agresiuni au loc sunt mecanismul fototermic, mecanismul fotochimic sic el fotomecanic. Daunele produse pot fi temporare sau chiar permanente, daca ochiul a fost expus unei mari cantitati de radiatie sau pe o perioada de timp prelungita fara protectia adecvata.

In ziua de azi se cunosc suficiente date pentru a se lua masuri de protectie specifice impotriva potentialului daunator al radiatiei optice. Aceste masuri sunt numeroase, de la implanturi cristaliniene si pana la ochelarii de soare prevazuti cu filter UV dar si gesturi chirurgicale care tin de protejarea ochiului intraoperator sau expuneri limitate la acest tip de radiatie. In cele din urma, efectele pe care radiatia optica le poate avea asupra structurilor oculare tin de luarea la cunostinta a fiecarui individ cu privire la riscurile expunerii necontrolate la acest tip de radiatie si la modul in care se poate proteja de eventualele efecte nedorite ale acesteia.

CUVINTE CHEIE:

· radiatia electromagnetic

· mecanism fototermic

· mecanism fotochimic

· mecanism fotomecanic

· filtre UV

5. GLAUCOM, HIDROCEFALIE, CVADRANOPSIE- CAZ CLINIC

Irina Nae, Cornel Stefan

Sectia Clinica Oftalmologie- Spitalul Clinic de Urgenta Militar Central, Sef Clinica: Prof. Dr. Benone Carstocea

REZUMAT

Se prezinta cazul unui pacient diagnosticat cu galucom juvenile in urma examenului oftalmologic. Pacientul are in antecedente diagnosticul de hidrocefalie.

CUVINTE CHEIE:

· hidrocefalie

· glaucoma

· cvadranopsie homonima

ABSTRACT

The autors presents the case of a male patient who was diagnosed with juvenile glaucoma after an ophthalmologic examination. Tha patient had a previous diagnosis: hidrocephaly

KEY WORDS:

· hydrocephaly

· glaucoma

· homonymous quadranopsia

6. Sindrom Sturge- Weber in asociere cu melanoza oculo-dermala prezentare de caz

Anca Irimia, Mirela Preda, Cristi Adelina Ciuca, Carmen Damian, I. Gavrila

Clinica de oftalmologie, Craiova

Clinica de Neuropsihiatrie infantila Craiova

REZUMAT

Prezentam cazul unui pacient in varsta de 10 ani la care, pe baza examenului clinic, examinarilor interclinice si investigatiilor paraclinice efectuate s-a pus diagnosticul de sindrom Sturge- Weber, melanoza oculo- dermala dreapta.

Particularitatea cazului consta in asocierea extrem de rara a celor doua afectiuni.

CUVINTE CHEIE:

· angiomatoza

· melanoza

ABSTRACT

We present the case repost of a 10 years old pacient to whom, based on the clinical examination, lab and imaging studies we established the diagnosis: Sturge- weber syndrome, oculo- dermal melanocytosis- right side.

This case is interesting because of the unusual and rare association of these two deseases.

KEY WORDS:

· angiomatosis

· melanocytosis

7. GALUCOM PSEUDOEXFOLIATIV- PREZENTARE DE CAZ

C. Stefan, Eliza Tebeanu, A. Nenciu

SCUMC “ Dr. Carol Davila”

Sectia Clinica de Oftalmologie, Sef Clinica: Prof. Dr. Benone Carstocea

REZUMAT

Sindromul pseudoexfoliativ este o manifestare oculara importanta a unei anomalii sistemice. Prezenta materialului pseudoexfoliativ determina modificari importante atat la nivelul corneei, unghiului camerular, cat si la nivelul cristalinului si aparatului zonular. Glaucomul pseudoexfoliativ este agresiv, fiind caracterizat prin diferente mari ale PIO intre cei doi ochi, precum si prin variatii mari circadiene ale PIO, avand un prognostic rezervat. Prezentam cazul unei paciente cu glaucom pseudoexfoliativ.

CUVINTE CHEIE:

· glaucom primitiv cu unghi deschis

· sindrom pseudoexfoliativ

· glaucom pseudoexfoliativ

ABSTARACT

The pseudoexfoliative syndrome is a systemic anomaly that primarily affects the eye. The presence of the pseudoexfoliative material causes important changes to the cornea, camerular angle, lens and zonules. Pseudoexfoliative glaucoma is aggressive, with great pressional differences between the two eyes, also with important circadian variations of intraocular pressure and has a poor prognostic. We present the case of a patient with pseudoexfoliative glaucoma.

KEY WORDS:

· primary open angle glaucoma

· pseudoexfoliative syndrome

· pseudoexfoliative glaucoma

8. INTERRELATII NEUROOFTALMOLOGICE IN SINDROMUL CERVICAL

D. Cioroianu, Clinica de Neuro- Recuperare, UMF Craiova

REZUMAT

In lucrare sunt prezentate trei cazuri de afectiuni oculare manifestate prin keratita trofica, hipoestezie a corneei si precipitate descemetice, care s-au dovedit a fi in legatura cu fenomene datorate unei insuficiente circulatorii vertebro-bazilare, prin interesarea nucleilor bulbo-protuberantiali si care au prezentat tulburari vestibulare, vizuale si cefalee occipitala, semnificand afectari ale simpaticului cervical.

CUVINTE CHEIE:

· osteofiti

· coloana cervicala

· sindrom simpatic

SUMMARY

In this article are reported three cases with ocular disturbances manifested by trophic keratitis, hypoesthesia of cornea and descemetic precipitates. These disturbances have a connection with fenomens caused by circulatory insuffiency within the territory of the vertebral artery, with involvement of the bulbo-protuberential nuclei. The clinical manifestations are vestibular and visual disturbances, occipital headaches wich means that the cervical sympatic nerv was affected.

KEY WORDS:

· ostephytes

· cervical spine

· sympathic syndrom

9. UVEITA ANTERIOARA LA UN ADOLESCENT CU ARTRITA CRONICA JUVENILA, FORMA OLIGOARTICULARA

Mirela Preda, Carmen Damian, Rodica Manescu, Livia Davidescu, Anca Irimia, Mihaela Sollosy, Clinica de Oftalmologie , Spitalul Clinic de Urgenta, Craiova

REZUMAT

Prezentam cazul unui adolescent de 16 ani care se interneaza in Clinica de Oftalmologie Craiova cu : OS Uveita anterioara acuta neglijata.

Anterior manifestarilor oculare si simultan cu acestea pacientul a acuzat dureri la nivelul articulatiei soldurilor. Examenul pediatric, ce a avut la baza aspecte clinice si investigatiile paraclinice efectuate a stabilit diagnosticul de Artrita cronica juvenila, forma oligoarticulara.

Evolutia a fost favorabila sub corticoterapie

CUVINTE CHEIE:

· uveita

· artrita

ABSTRACT

We present the case of a 16-year-old male teen-ager admitted in the Ophthpalmology Clinic Craiova, diagnosed with Anterior neglected acute uveitis in the left eye.

Before and simultaneous with the ocular manifestations, the pacient complained of pain on the hips joints.

The pediatric examination, based on the clinical features and the laboratory findings, diagnosed him with Juvenile chronic arthritis, oligoarthritis type.

The evaluation was good under the corticosteroid therapy

KEY WORDS:

· uveitis

· arthritis

10. LEZIUNI RETINIENE IN ANEMIA APLASTICA CONSTITUTIONALA EREDITARA

Carmen Damian, Anca Irimia, Mirela Preda, Stefania Creitoiu, Livia Davidescu, Florentina Marinescu – clinica de oftalmologie, spitalul clinic de urgenta Craiova

REZUMAT

Prezentam cazul unui copil de sex feminin in varsta de 6 ani internat in clinica de pediatrie diagnosticat cu anemie aplastica constitutionala ereditara (anemie Fanconi)

La consultul oftalmologic se constanta la OS, pe fondul unui edem macular important, o hemoragie preretiniana mare de aproximativ de 4 DP, situata la polul posterior. Tratamentul afectiunii generale a determinat involutia manifestarilor oculare.

CUVINTE CHEIE:

· Anemie

· Hemoragii retiniene

ABSTRACT

We present a case report of a 6 year old female child, admitted in the Pediatric Clinic, diagnosed with aplastic constitutional hereditary anaemia (Fanconi anaemia).

On ophthalmic examination, on the left eye were noted important macular edema and a big preretinal haemorrhage of 4 DP situated on the posterior pole.

The treatment of the systemic condition established the involution of the ophthalmic manifestations.

KEY WORDS

· Anaemia

· Retinal haemorrhages

11. DISTROFIA CONURILOR; CAZ CLINIC

S. Macarie, Simona Sevan, Emese Kaucsar, Sorina Demea, H Demea

Clinica de oftalmologie Cluj

REZUMAT

Este comunicat cazul unei paciente cu distrofie de conuri. Se evidentiaza importanta examenului OCT in cazul suspectarii unei maculopatii cu semne oftalmoscopice minime.

CUVINTE CHEIE:

· tomografia in coerenta optica

· distrofia conurilor

SUMMARY

In this issue we present the importance of OCT in the diagnosis of macular cones distrophy.

KEY WORDS:

· optical coherence tomography

· cone dystrophy

12. SINDROMUL WYBURN – MASON

Gh. Munteanu, Stela Giuri, M. Munteanu

Clinica oftalmologica, Timisoara

REZUMAT

Introducere: sindromul Wyburn – Mason sau Bonnet, Dechaume si Blanc este o anomalie congenitala rara, formata din malformatii ale vaselor retiniene, orbito-cerebrale si rar faciale.

Observatie clinica: pacient, 19 ani, consultat pentru scaderea acuitatii vizuale si exoftalmia ochiului stang. Oftalmoscopia releva extinse anomalii arterio-venoase retiniene, confirmate si la nivelul orbito-cerebral prin ecografie si IRM.

Discutii: sindromul Wyburn – Mason este consecinta unor anastomoze arterio-venoase, fiind incadrat in grupa facomatozelor. Clinic cuprinde 3 grupe de gravitate. Sunt discutate aspectele de diagnostic diferential, patogenie si tratament.

Concluzii: sindromul Wyburn – Mason poate fi suspicionat cu prilejul unui angiom facial, exoftalmii sau scaderi ale acuitatii vizuale. Diagnosticul impune examene suplimentare in imagistica orbito-cerebrala.

CUVINTE CHEIE:

· Sindromul Bonnet, Dechaume si Blanc

· Sindromul Wyburn – Mason

· Hemangiomul recemic/cirsoid

ABSTRACT

Introduction: the Wyburn – Mason or Bonnet, Dechaume and Blanc syndrome is a rare congenital anomalie, formed of malformation of the retinal vessels, orbitocerebral vessels and rarely, facial vassels.

Case report: male pacient, 19 years old, examined because of a severe visual loss and exophthalmos at the left eye. The ophthalmoscopic examination releaves extinsive retinal arterio-venous malformations, also confirmed at orbitocerebral level by ultrasound and MRI.

Discussions: the Wyburn – Mason syndrome is due the arterio-venous anastomosis, being included in the phakomatoses group. Clinicaly we describe 3 groups of severity. Aspects of differential diagnosis, pathogeny and treatment are discussed.

Conclusions: the Wybrum – Mason syndrome can be suspected in cases of facial angioma, exophthalmos or decreased visual acuity. The diagnosis imposes additional examination with orbito-cerebral imagery.

KEY WORDS

· Bonnet, Dechaume and Blanc syndrome

· Wyburn – Mason syndrome

· Racemous haemangioma.

13. BOALA TAKAYASU. CONSIDERATII ASUPRA UNUI CAZ CLINIC

Carmen Damian, Mirela Preda, Rodica Manescu, Anca Irimia, C. Bataiosu

Clinica de oftalmologie Craiova

Centrul de cardiologie Craiova

REZUMAT:

Vasculita cronica, ce provoaca ingrosarea peretilor arterelor afectate, boala Takayasu este o afectiune rar intalnita. Se caracterizeaza prin diminuarea lumenului vascular al marilor trunchiuri arteriale, incepand de la crosa aortica. Urmarea este hipotensiunea arteriala, semne de ischemie la nivel cerebral si retinian, absenta pulsului la nivelul membrelor inferioare. Manifestarile sunt specifice: modificari ale lumenului vascular, microanevrisme, hemoragii, exudate, ocluzii vasculare. Autorii prezinta cazul unei pacienta de 20 de ani cu modificari retiniene vasculare, internata pentru dureri oculare, claudicatii la nivelul membrelor superioare si la masticatie. Examenul obiectiv constata puls absent la nivelul arterelor radiale si brahiale, tensiune arteriala nedecelabila la ambele brate.

CUVINTE CHEIE:

· Boala Takayasu

· Sindrom de ischemie retiniana

ABSTRACT

Chronic vasculitic which determines the thickness of the affected arteries, Takayasu disease is an uncommon finding.

It si characterized by narrowing if the big arteries beginning from the aortic arch. The result is arterial hypotension, cerebral and retinal ischemic signs, he absence of pulse and the upper limbs.

Manifestations includes: vascular narrowing, microaneurysms, hemorrhages, cotton wool spots, vascular occlusions.

The authors present the case of a 20 years old female patient with retinal vascular signs, admitted for ocular pain, upper limbs and mastication pains.

The clinical examination reveales radial and brahial arteries pulseless, arterial tension undetermined at both upper limbs.

KEY WORDS:

· Takayasu disease

· Retinal ischemic syndrome

14. INFLUENTA INTERVENTIILOR CHIRURGICALE PE GLOB DESCHIS ASUPRA SECRETIEI LACRIMALE

O. Samoila, Cristina Stan, Oana Visan, Alexandra Craciun, Lucia Dican, Mihaela Mera – clinica oftalmologica Cluj Napoca

REZUMAT

Sindromul de ochi uscat ramane o problema de actualitate in masura in care tot mai multi pacienti sunt afectati iar date exacte legate de etiopatogenie intarzie sa apara.

Studiul cerceteaza ipoteza alterarii secretiei lacrimale (cantitativ, calitatativ sau compozitional) in urma interventiilor chirurgicale pe glob deschis. Simptomatologia oculara a fost cuantificata cu ajutorul unor chestionare tipizate, testele lacrimale fiind aplicate preoperator si postoperator la 6 saptamani.

S-a diferentiat secretia lacrimala bazala si reflexa prin testul Schirmer si s-a determinat calitatea secretiei lacrimale prin testul de rupere a filmului lacrimal si coloratii cu Roz Bengal. Preoperator s-a realizat analiza protemica a secretiei lacrimale (proteine totale, electroforeza) si biopsia conjunctivala).

Interventiile chirurgicale pe glob deschis au alterat secretia lacrimala la 91% din cei 22 de pacienti investigati.

CUVINTE CHEIE:

· sindromul de ochi uscat

· chirurgie oculara

ABSTRACT

Dry eye syndrome remains a constant health problem while more and more patients are being involved and final data concerning the etiopathogeny is still missing.

This study investigates the hypothesis that ocular surgery inflicts damage on the tear production (regarding quantity, quakity or the compositional aspect).

Ocular sympthomalogy was registered with the help of a questionnaire. Lacrimal tests were applied before and after surgery at 6 weaks.

Basic and reflex tear secretion was differentiated through Schirmer tests and tear quality was assessed with BUT. Proteonic analysis (global proteins, electrophoresis) and conjunctival biposy was realized before surgery.

Open eye surgery altered tear secretion in 91% of the 22 patients examined.

KEY WORD:

· dry eye

· eye surgery

15. OCHIUL USCAT – CORELATII ETIOPATOGENICE SI HISTOPATOLOGICE

Conf. dr. Stan Cristina, dr. Mera Mihaela, dr. Samoila Ovidiu, dr. Bedeoan Simona

Universitatea de medicina Iuliu Hatieganu – clinica de oftalmologie Cluj Napoca

Institutul de anatomie patologica Cluj Napoca,

Clinica oftalmologica Cluj Napoca

ABSTRACT

Aims: to assess the role of the common inflammatory mechanism in the pathogenesis of the dry eye syndrome.

Methods: 64 patients with eye surface symptoms were studied using a diagnostic algorithm: questionnaire (eye symptoms were graded and a symptomatology SCORE was calculated), objective eye examination (including Schirmer’s test and the tear film breakup time-BUT). Histopathological examination of 14 conjunctival bioptic fragments was performed.

Results: 59.37% of the patients had a positive Shirmer’s test, while only 23% tested positively for the BUT. No statistically significant correlation was established between Schirmer’s test and the BUT or the symptomatology score. There was a significant correlation between BUT and the symptomatology score (p<0.05) and between BUT and the duration of the disease (p<0.01). The histopathological examination for the dry eye conjuctival samples evidenced the following alterations: loss of caliciform cells, squamous metaplasia of the epithelium, subepithelial inflammation.

Conclusions: the histological analysis confirms the implication of inflamtion in the pathogenesis of the disease. The time of onset of the inflammation can not be established, it may be initial or it may occur with the quantitative decrease of tears or with eye surface alterations.

KEYWORDS:

· dry eye

· inflammation

16. AMPRENTA CONJUNCTIVALA LA BOLNAVII DIABETICI

Rodica Manescu, Mihaela Niculescu, Doina Barascu, Carmen Mocanu, I. Mindril

Catedra de anatomie UMF Craiova, Clinica de oftalmologie UMF Craiova

REZUMAT

Autorii isi propun sa evidentieze modificarile amprentei conjunctivale la bolnavii diabetici. A fost examinat oftalmologic un lot de bolnavi cu diabet zaharat cu varsta intre 50 si 80 de ani carora li s-a determinat testul Schirmer si testul BUT. De la acesti pacienti am recoltat amprente conjunctivale care dupa fixare si colorare Giemsa, au fost examinate in microscopie fotonica. Pentru comparatie am recoltat amprente conjunctivale de la un lot martor caruia I s-a determinat de asemenea testul Schirmer si testul BUT.

Rezultate si concluzii: testul Schirmer si testul BUT au pledat pentru hiposecretie lacrimala la majoritatea bolnavilor diabetici. La acesti bolnavi amprentele conjunctivale au prezentat modificari la nivelul celulelor epiteliale si caliciforme. Amprentele conjunctivale sunt modificate semnificativ la bolnavii varstnici cu evolutie indelungata a diabetului sustinand diagnosticul de sindrom de hiposecretie lacrimala la acesti pacienti.

CUVINTE CHEIE

· celule caliciforme

· hiposecretie lacrimala

· diabet zaharat

· amprente conjunctivale

ABSTRACT

The authors have suggested to reveal conjunctiva stamp changes in diabetic patients. A set of patients aged between 50 – 80 and having been diagnosed with diabetes mellitus were available for our study, therefore they have been ophtalmologically examined; both Schrimer and BUT tests have been performed. We removed conjunctiva stamps which, after being fixed and Giemsa stained, they were investigated by photonic microscopy. As to compare them we removed conjunctiva stamps from a group of control which was also Schrimer and BUT tested.

Results and conclusions – both Schrimer nad BUT tests pleaded for lacrimal hiposecretion in most of the diabetic patients; their conjunctiva stamps presented changes at the levels of both epithelial and calyciforme cells. Conjunctiva stamps were significantly changed in the old patients with a long lasted diabetes evolution pleading for the diagnosis of lacrimal hiposecretion syndrome (dry eye syndrome) in those patients.

KEY WORDS:

· calyciforme cells

· lacrimal hiposecretion

· diabetus melitus

· conjunctiva stamp

17. ADAPTAREA LA INTUNERIC LA PACIENTII DIABETICI

Dr. Adriana Neckell, Clinica de oftalmologie Timisoara

REZUMAT

Scopul lucrarii: studiul modificarii adaptogramei la pacientii cu retinopatie diabetica (RD).

Material si metoda: s-au studiat 3 loturi de pacienti diabetici cu diferite grade de modificare retiniana la care s-a facut adaptograma. S-a folosit adaptometrul Hartinger, iar inregistrarile obtinute s-au comparat cu adaptometria normala.

Rezultate: s-au obtinut modificari de tip scotopic si fotopic, de diferite intensitati in functie de leziunile fundului de ochi (FO) datorate RD. Adaptarea la intuneric a pacientilor a fost cu atat mai precara cu cat RD a fost mai avansata. S-au inregistrat si modificari ale adaptometriei la pacientii cu FO normal, dar cu o vechime a diabetului intre 7 si 10 ani.

Concluzii: retinopatia diabetica modifica adaptometria si acest lucru trebuie stiut pentru orientarea profesionala a pacientilor.

CUVINTE CHEIE:

· adaptograma

· retinopatia diabetica

SUMMARY

Purpose: to study the adaptometry’s changes in diabetic patients.

Material and methods: we studied the adaptometries in 3 groups of diabetic patients with different stages of retinal changes in diabetic retinopathy (DR). we used the Hartinger nyctometer. We compared the results with normal adaptometries.

Results: we obtained photopic and scotopic changes of different intensity in correlation with fundus lesions due to DR. We found a correlation between the progression of DR and the adaptometry changes. We also noted changes in the adaptometry in patients with no fundus lesions but diabetes mellitus diagnosed for 7 or 10 years.

Conclusions: diabetic retinopathy is a cause of changes in the adaptometry; this is an important issue for patients in choosing the occupation.

KEY WORDS:

· adaptometry

· diabetic retinopathy

18. GROSIMEA CENTRALA A CORNEEI IN HIPERTENSIUNEA OCULARA SI GLAUCOMUL PRIMITIV CU UNGHI DESCHIS

D. Chiselita, C Danielescu, Oana Gagos-Zaharia, C Gherman

Clinica I Oftalmologie Iasi

SCOPURILE LUCRARII: aprecierea utilitatii pahimetriei in diagnosticul si urmarirea pacientilor cu glaucom primitiv cu unghi deschis (GPUD) sau hipertensiune intraoculara (HTIO) precum si stabilirea unor corelatii intre grosimea corneei si progresia GPUD.

Material si metoda: studiul retrospectiv ce a inclus 199 de ochi (108 pacienti) aflati in evidenta clinicii cu unul din urmatoarele diagnostice: GPUD, glaucom cu tensiune normala, HTIO sau suspect de GPUD. Parametrii urmariti au fost presiunea intraoculara, grosimea corneei centrale, raportul C/D si campul visual (perimetria standard automatizata). Pentru ochii la care s-au efectuat minimum 3 campuri visuale s-a cercetat aparitia progresiei perimetrice a bolii si au fost notate presiunile intraoculare inregistrate in perioada de urmarire.

REZULTATE: grosimea corneei este mai mare in HTIO (559.28 +/- 26.35 µm) decat in GPUD (542.83 +/- 31.07 µm). In cele 10 cazuri de HTIO nou diagnosticata grosimea corneei a influentat diagnosticul (incadrarea in grupa cu risc si deci administrarea tratamentului medicamentos). La 57 de ochi s-au efectuat cel putin 3 campuri visuale. Curba de supravietuire Kaplan-Meyer a aratat ca in ochii cu glaucom si cornee mai subtire de 520 µm progresia bolii apare semnificativ mai devreme decat in grupul cu grosimea corneei >520 µm (presiunea intraoculara medie fiind de 17.59 +/- 2.33 mmHg, respectiv 18.28 +/- 1.55 mmHg, p=0.36).

CONCLUZII: grosimea corneei centrale este semnificativ mai mare in ochii cu hipertensiune intraoculara fata de cei cu glaucom primitiv deshis. In ochii cu cornee subtire progresia glaucomului tinde sa apara mai repede ceea ce sugereaza necesitatea unui tratament mai agresiv in aceste cazuri.

CUVINTE CHEIE:

· glaucom,

· hipertensiune oculara

· grosimea corneei

· progresia glaucomului

PURPOSES: to assess the necessity for corneal pachimetry in the primary open angle glaucoma (POAG) and ocular hypertension (OHT) diagnosis and follow up. To establish a correlation between central corneal thickness (CCT) and glaucoma progression.

Method: retrospective study that included 199 eyes (108 patients) with POAG, normal tension glaucoma, OHT or glaucoma suspects. The evaluation included the intraocular pressure, CCT, C/D ratio and visual field (standard automated perimetry). For the patients that had performed at least 3 visual fields we have searched the perimetric progression of glaucoma and we have noted the mean IOP troughout the follow up period.

RESULTS: the mean CCT was higher in OHT (559.28 +/- 26.35 µm) that in POAG (542.83 +/- 31.07 µm). In the 10 cases of newly diagnosed OHT the CCT has influenced the diagnosis (the OHT with a high risk of progression to glaucoma was assigned to antiglaucoma treatment). 57 eyes had at least 3 visual fields. The Kaplan-Meyer survival analysis showed that the eyes with CCT 520 µm had signifficantly earlier glaucoma progression (the mean IOP was 17.59 +/-2.33 mmHg, compared to 18.28 +/- 1.55mm Hg in the eyes with CCT >520 µm, p=0.36).

CONCLUSIONS: the central corneal thickness is significantly higher in eyes with ocular hypertension than in those with POAG. In eyes with thin cornea the glaucoma progression tends to appear earlier, which suggests a need for lower target IOP in these cases.

KEY WORDS

· glaucoma

· ocular hypertension

· corneal thickness

· glaucoma progression

19. OFTALMOLOGUL PRACTICIAN SI “COMPUTER VISION SYNDROME”

Dr A Barar, dr Ioana Daniela Apatachioaie, dr C Apatachioaie, dr L Marceanu – Brasov

REZUMAT

Autorii au incercat sa culeaga informatii disponibile pe internet in legatura cu un subiect pe care il consideram absolut insuficient tratat in literatura stiintifica romaneasca si neasteptat de putin in literatura oftalmologica de specialitate.

Cunoscut in literatura de specialitate sub numele generic de computer vision syndrome, este definit de catre American Optometric Association drept complexul de probleme oculare si vizuale referitoare la lucrul la apropiere aparat in timpul sau in legatura cu utilizarea computerului.

Adesea in timpul consultatiilor auzim frecvent acuze cum ar fi astenopia, cefaleea, vederea incetosata pentru distanta si/sau aproape, ochi uscati si iritati, readaptarea prea lenta la schimbarea fixatiei, fotofobie, senzatie de diplopie, dureri cervicale si dorsale, dar neavizati le trecem poate prea usor cu vederea fara a aprofunde motivele reale.

In majoritatea tarilor dezvoltate exista recomandari emise de asociatii medicale de renume cu privire la definirea, diagnosticarea, metodele de prevenire, tratament, control periodic, a simptomelor intalnite la utilizatorii de computere asociat cu o legislatie ergonomica deosebit de precisa. Constatam ca la noi aceste probleme starnesc mult prea putin interesul.

Dorim sa sensibilizam colegii oftalmologi cu privirea la intelegerea, recunoasterea acestor simptome, tratamentul sau cel putin ameliorarea lor prin masuri de specialitate sau prin colaborarea cu colegii specialisti in medicina muncii.

CUVINTE CHEIE:

· computer vision syndrome

· ergonomia utilizarii computerului

· efectele utilizarii vdt asupra sanatatii.

ABSTRACT

The author had tried to collect the data available on the internet about a subject that we consider as being totally ignored in the romanian scientific literature and unexpectedly insufficiently treated in the specialized ophtalmologic literature.

Known in the specialty literature under the generic name of computer vision syndrome, it is defined by the American Optometric Association as a complex of eye and vision problems related to the activities which stress the near vision and which are experienced in relation, or during the use of the computer.

During the consultation we hear frequent complains of eyestrain – astenopia, headaches, blurred distance and/or near vision, dry and irritated eyes, slow refocusing, neck and backaches, photophobia, sensation of dilopia, light sensitivity and double vision, but because the lack of information we overlooked them too easily, without going throughly into the real motives.

In the most of developed countries, there are recomandation issued by renowned medical associations with regard to the definition, diagnosis and the method for the prevention, treatment and periodical controls of the symptoms found in computer users, in conjunction with an extremly detailed ergonomic legislation. We found out that this problems incite a much too low interest in our contry.

We would like to rouse the interest of our ophthalmologist colleagues in the understanding and recognition of this symptoms and in their treatment, or at least their improvement, through specialized measures or through the cooperation with our specialist ocupational medicine colleagues.

KEY WORDS:

· computer vision syndrome

· ergonomics of computer use

· the effects of vt use on health

20. CONSERVAREA CORNEEI LA 34˚C IN ATMOSFERA IMBOGATITA CU DIOXID DE CARBON – STUDIU EXPERIMENTAL

M. Zemba, B. Cucu, Veronica Bobeico, Alina Stinghe, Sorana Andrei, Nadia Dobrescu, M. Curea

Spitalul Clinic de Urgenta Militar Central , Clinica de Oftalmologie

Spitalul Clinic de Urgenta Militar Central, Laboratorul de anatomie patologica

REZUMAT

Scopul: studierea comportarii corneei conservata in atmosfera imbogatita cu dioxid de carbon.

Material si metoda:

- Studiu experimental

- S-au studiat 10 cornei de porc

- 5 ochi conservati in mediu tip Inosol la 34˚C

- 5 ochi conservati in mediu tip Inosol la 34˚C , dar in atmosfera imbogatita cu dioxid de carbon

- Corneile au fost examinate inainte de recoltare si la 1,2,4,6,9 zile

- Dupa examinarea la microscopie speculara inversa corneile au fost examinate anatomopatologic

Rezultate:

- Dupa o zi de conservare rezultatele sunt similare

- Dupa 2 zile rezultatele sunt mai bune in atmosfera cu dioxid de carbon

- Dupa 4,6 zile rezultatele mai sunt acceptabile doar in atmosfera cu dioxid de carbon

- Dupa 9 zile rezultatele sunt necorespunzatoare in ambele situatii

Concluzii: atmosfera imbogatita cu dioxid de caron permite prelungirea timpului de conservare.