Marija Bozic

Prevalence and Early Detection of Abdominal Aortic Aneurysm in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

Purpose: The goals of this study were to demonstrate the frequency of infrarenal abdominal aortic aneurysm (AAA) in patients with pseudoexfoliation (PEX) syndrome (PEXS) and PEX glaucoma (PEXG), and to determine whether limited screening for AAA in specific subgroups of patients with PEX is reasonable and justifiable. Materials and Methods: This prospective study comprised 60 patients with PEXS and 60 with PEXG (examined group), and 60 patients with primary open-angle glaucoma (POAG) and 60 with cataract (control group). Clinical ophthalmic examination included slit-lamp biomicroscopy of the anterior segment and direct slit-lamp gonioscopy (using a Goldmann three-mirror lens) of the anterior chamber angle. All patients underwent routine Color Doppler duplex ultrasonography of the infrarenal aorta and iliac arteries. Results: There was a statistically significant difference (p < 0.05) between the PEXG group and control group vis-a-vis presence of AAA, which occurred more frequently in patients with greater amounts of angle pigmentation (p < 0.05). Univariate logistic regression analysis indicated statistically significant associations between AAA and PEX (p < 0.01), angle pigmentation (p < 0.05), gender (p < 0.01), diabetes mellitus (DM) (p < 0.05), and arterial hypertension (AHT) (p < 0.01). Multivariate regression analysis, adjusted to gender and age, showed that the most important clinical parameters related to AAA in patients with PEXS and PEXG are gender, presence of PEX, DM, and AHT (p < 0.05). Conclusion: The frequency of AAA is significantly higher in patients with PEXS and PEXG than in patients with POAG or cataract. Restricted screening for AAA in male PEXS patients, who also have elevated degrees of angle pigmentation, arterial hypertension, and DM, is clinically warranted.

Human external ophthalmomyiasis caused by Lucilia sericata Meigen (Diptera: Calliphoridae) – a green bottle fly

Ophthalmomyiasis externa is the result of infestation of the conjunctiva by the larval form or maggots of flies from the order Diptera. If not recognized and managed appropriately, it can be complicated by the potentially fatal condition ophthalmomyiasis interna. Ophthalmomyiasis externa is mainly caused by the sheep bot fly (Oestrus ovis). We present the first case, to our knowledge, of ophthalmomyiasis externa in an elderly woman from Belgrade caused by Lucilia sericata Meigen--a green bottle fly.

Lifelong learning, certification and recertification in the field of project management

This paper describes the importance of lifelong learning, certification and recertification courses conducted under the rules of the global association of project managers PMI (Project Management Institute), as well as volunteer activities of members of PMI Serbia Chapter to the promotion and advancement of knowledge in the field of project management. It points out the need for education in this area in full-time education.

Agreement in identification of glaucomatous progression between the optic disc photography and Heidelberg retina tomography in young glaucomatous patients.

AIM To evaluate concordance between the clinical assessment of glaucomatous progression of the optic disc photography and progression identified by Heidelberg Retina Tomograph (HRT) in patients with suspected primary juvenile open angle glaucoma (JOAG). METHODS Optic disc photographs and corresponding HRT II series were reviewed. Optic disc changes between first and final photographs were noted as well as progression identified by HRT topographic change analysis (TCA) and rim area regression line (RARL) Agreement between progression indentified by photography and HRT methods was assessed. Progression, determined from optic disc photographs by consensus assessment was used as the reference standard. RESULTS A total of 31 patients (59 eyes) with suspected JOAG were studied. Agreement for progression/no progression between TCA and photography was obtained in 4 progressing eyes and 38 stable eyes (71.19%, k=0.11). Agreement for progression/no progression between RARL and photography was detected in 5 progressing eyes and in 34 stable eyes (66.10%, k=0.15). The number of HRT per patient was statistically higher in the progressing group (P=0.034). CONCLUSION Agreement for detection of longitudinal changes between photography and HRT analysis was poor. One way to improve the chance of discovery of the progression could be increasing the number of HRT examinations.

Prevention of intraocular pressure elevation after argon laser trabeculoplasty in primary open angle glaucoma

INTRODUCTION Argon laser trabeculoplasty (ALT) is an intraocular pressure lowering method that is overall safe and powerful, but often complicated by transient postoperative intraocular pressure rises. In prevention of this complication, we frequently use two potent alpha-adrenergic agonists--brimonidine and apraclonidine. OBJECTIVE The aim of this study was to compare brimonidine 0.2% and apraclonidine 0.5% efficacy and safety in prevention of intraocular pressure elevation after ALT. METHODS This was a prospective, randomized, double-masked and comparative study. This study included 27 POAG patients, 15 received 0.2% brimonidine, and 12 received 0.5% apraclonidine before laser surgery (22 eyes in both groups). Intraocular pressure readings were taken 1, 2, 3, 24 hours and 7 days after ALT. Students t-test was used to analyse data between two groups, and chi2 test to compare data within groups. Value p less than 0.05 was considered statistically significant. RESULTS We found statistically significantly lower IOP in eyes that received 0.2% brimonidine at readings taken 1 hour after ALT (p = 0.001). There were no statistically significant differences in other IOP readings between two groups. CONCLUSION A single preoperative drop of brimonidine 0.2% had similar efficacy and safety as apraclonidine 0.5% in preventing transient IOP elevations after ALT.

The frequency of secondary glaucoma in patients with iridocorneal endothelial syndrome in correlation to the presence of uveal ectropion

Introduction/Objective Iridocorneal endothelial (ICE) syndrome incudes 3 clinical forms: progressive iris atrophy, Chandler’s syndrome, and Cogan–Reese syndrome. It is characterized by various degrees of iris atrophy, corneal endothelial changes, uveal ectropion, corectopia, peripheral anterior synechiae (PAS) and secondary glaucoma. The aim of the study was to illustrate forms of ICE syndrome, determine frequency of secondary glaucoma with emphasis on cases with uveal ectropion, analyze response to medicament treatment and the need for surgical treatment in intraocular pressure (IOP) control. Methods Patients underwent slit lamp examination, applanation tonometry, gonioscopy, ophthalmoscopy, Humphrey visual field testing and Heidelberg retina tomography. Patients were divided into two groups: group I, without uveal ectropion (22 patients) and group II, with uveal ectropion (14 patients). Results A total of 36 patients were examined in a 10-year period. The average age was 38 years, male to female ratio 1:2. Secondary glaucoma was confirmed in 26 (72.2%) patients, out of which 12 (54.5%) in group I and 14 (100%) in group II. PAS were more frequent in group II. In group I, mean initial IOP was 37 mmHg, and after medicament treatment 26 mmHg. Secondary glaucoma was controlled in 50% and remaining 50% underwent surgical treatment. In group II, mean initial IOP was 49 mmHg, and after medicament treatment 32 mmHg. All 14 patients (100%) underwent surgical treatment in order to achieve IOP control. Conclusion ICE syndrome is a rare, progressive disease, with high incidence of secondary glaucoma, which is more frequent in cases with uveal ectropion. In these cases, medicament treatment is not effective and trabeculectomy with antimetabolite application is necessary.

Ocular pulse amplitude after panretinal photocoagulation in normotensive eyes with proliferative diabetic retinopathy

Purpose To assess the effect of panretinal laser photocoagulation on ocular pulse amplitude (OPA) in normotensive eyes with proliferative diabetic retinopathy. Methods Prospectively, we performed unilateral argon laser panretinal photocoagulation (PRP) in 30 patients with diabetes mellitus type II and previously untreated bilateral proliferative diabetic retinopathy. Before and 7 and 30 days after the treatment, OPA was measured using dynamic contour tonometer. Results Compared with the untreated contralateral eyes, laser photocoagulation led to a reduction of OPA. Ocular pulse amplitude did not significantly differ in photocoagulated eyes 7 days after the treatment, but there was a significant difference in OPA 30 days after the treatment. The decrease in OPA values was 15% 7 days after PRP and 40% 30 days after PRP. Conclusions Ocular pulse amplitude reduction after PRP indirectly informs us about choriocapillary closure, already reported in previous studies.

Spectral analysis of intraocular pressure pulse wave in ocular hypertensive and primary open angle glaucoma patients.

Context: In attempt to find an alternative way to determine conversion from ocular hypertension to primary open angle glaucoma (POAG) (besides visual field and optic disc changes), we analyzed intraocular pressure (IOP) pulse wave in spectral domain. Aims: The aim of this study was to test the potential differences in spectral content of IOP pulse wave between ocular hypertension and POAG patients, which could indicate conversion. Settings and Design: Cross-sectional study designed to test the differences in the spectral content of pressure pulse wave between nontreated ocular hypertensive and nontreated, freshly diagnosed POAG patients. Methods: The total of 40 eyes of 40 subjects was included: 20 previously untreated ocular hypertensive patients, and 20 previously untreated POAG patients. Continuous IOP measuring gained by dynamic contour tonometry was submitted to fast Fourier transform signal analysis and further statistical data processing. Statistics Analysis Used: Ocular and systemic characteristics of the tested subjects were compared by analysis of variance appropriate for this study design. A P < 0.05 was considered to be statistically significant. Results: Higher spectral components of the IOP pulse wave was discerned up to the fifth harmonic in both of the tested groups. No statistically significant differences were found in any of the tested harmonic amplitudes. Conclusions: There are no differences in the spectral content of IOP pulse wave between ocular hypertensive and primary open angle glaucoma patients which could be indicative for conversion.

Compensation of nonlinear distortion in MIMO OFDM wireless communication systems

This paper presents analysis of nonlinear distortion and crosstalk compensation in Multiple Input Multiple Output (MIMO) OFDM wireless transmitters. This paper demonstrates that nonlinear crosstalk affects the performance of digital predistorter and it cannot be compensated by the conventional Memory Polynomial digital predistortion technique. Also, it has been shown that proposed CO-DPD technique can compensate the effect of nonlinear crosstalk in 2×2 MIMO OFDM wireless transmitters.