Biomedical subjects

Nenad Vukojević

Publications and source records attributed to Nenad Vukojević.

10 recordsLinked to original sources

PubMed2006

[Combined therapy in glaucoma treatment: travoprost 0.004% and brinzolamid].

AIM: To evaluate the efficacy of travoprost 0.004% and brinzolamide 1% combined therapy in patients unsuccessfully treated with a combination of timolol 0.5% and brinzolamide 1%. PATIENTS AND METHODS: The study was conducted in 30 adult patient with primary open angle glaucoma (14 men and 16 women, mean age 68.5 years) who required change in therapy. Intraocular pressure was measured at entry, and on day 15, 45 and 90 thereafter. RESULTS: The initial mean intraocular pressure was 21.62 mm Hg. Therapy modification (travoprost 0.004% instead of timolol 0.5%), resulted in intraocular pressure reduction by 5.67 mm Hg on day 15, and by 6.37 mm Hg on days 45 and 90. CONCLUSION: The study showed travoprost 0.004% combined with brinzolamide 1% to provide a statistically significant reduction (p < 0.001) in intraocular pressure in patients who could not been successfully treated with timolol 0.5% and brinzolamide 1%.

Adrenergic beta-Antagonists↗

PubMed2006

[Acute retinal necrosis].

AIM: To draw attention to this relatively common disease, which may cause major visual function impairment, and to present our own experience in the diagnosis, treatment and follow-up of acute retinal necrosis patients. METHODS: The manifestation, detection, treatment options and complications of unilateral acute retinal necrosis are illustrated by six case reports. RESULTS: Five patients were immunocompetent, whereas the sixth one suffered from chronic leukemia. In two patients the disease developed in association with herpes zoster, whereas the remaining four showed no signs of herpes disease. Systemic therapy with acyclovir, corticosteroids, salicylates and photocoagulation produced favorable response in five patients. Therapy had to be discontinued in leukemia patient for complications, which resulted in the disease recurrence with retinal detachment and proliferative vitreoretinopathy. Other patients remained stable with preserved visual function and only minor complications. DISCUSSION: In all six patients, the accurate diagnosis was reached relatively late. Obviously, anterior uveitis alone attracted ophthalmologists' attention, and their diagnostic and therapeutic efforts had mostly been focused on anterior uveitis impairment in the visual acuity developed. Appropriate therapy with virostatics, which is necessary in the treatment of this disease, was introduced relatively late, however, all patients responded favorably to this therapy, which also held for the immunocompromised patients administered a half usual dose of acyclovir. Our experience confirmed that virostatic therapy for acute retinal necrosis should be administered for at least 6 weeks. Retinal photocoagulation for prevention of rhegmatogenous retinal detachment appers to be beneficial, as this type of retinal detachment did not develop in these patients. The patient who did not undergo laser photocoagulation of retina did not develop rhegmatogenous retinal detachment but did develop proliferative vitreoretinopathy. CONCLUSION: Acute retinal necrosis is a relatively common disease affecting visual function, which occurs in both immunocompetent and immunocompromised subjects. The disease with its typical clinical picture and many complications should be taken in consideration on the differential diagnosis of uveitis. Therapy for acute retinal necrosis is complex, long-term and associated with frequent systemic complications that may threaten the patient's general health status.

Adult↗

PubMed2005

Axial eye length after retinal detachment surgery.

Changes in the eye axial diameter were studied to assess the eye globe impact of conventional operation for retinal detachment. The study included 69 eyes in 69 patients operated on for rhegmatogenous retinal detachment. There were 46.4% of men and 53.6% of women, mean age 52.7 (+/- 15.21) years. Results of preoperative and postoperative ultrasonographic measurement of axial diameter are presented. The mean preoperative and postoperative eye axial diameter was 23.69 (+/- 1.84) mm and 24.43 (+/- 1.91) mm, respectively. Postoperative results showed the axial eye length to increase by a mean of 0.74 (+/- 0.44) mm, yielding a statistically significant difference from the preoperative measurement (p < 0.001). The mean myopia induced by this eyeball elongation was 1.77 D. The encircling band with and without segmental buckling used in surgical repair of retinal detachment creates circular and segmental indentation of the eyeball, thus increasing its axial length. The myopia induced by elongation of the eyeball results in considerable myopia, which requires appropriate correction in the early postoperative period to achieve favorable vision rehabilitation.

Croatia↗

PubMed2005

Obesity--a risk factor for diabetic retinopathy in type 2 diabetes?

The aim of the study was to investigate whether obesity, independently or associated with other risk factors, increases the risk for the diabetic retinopathy in type 2 diabetic persons. Data of 156 diabetic persons that have consecutively attended the Outpatient Department in the Vuk Vrhovac Institute in Zagreb during two months period were studied. According to their body mass index (BMI) they were divided into three groups: group 1 (BMI < or = 25; n = 49), group 2 (BMI 26-29.9; n = 52) and group 3 (BMI > or = 30; n = 55). The three groups did not differ in age, duration of diabetes, treatment, cholesterol, HDL-cholesterol and triglycerides. With increase in BMI, we observed a significant deterioration of HbA1c and a significant increase in LDL-cholesterol, systolic and diastolic blood pressure. Statistical analyses shown that the prevalence of retinopathy increased significantly with higher body weight (gr. 1: 40.8%, gr. 2: 63.4%, gr. 3: 63.6%;p < 0.05), but also with correlation to quality of metabolic control (HbA1c) and systolic blood pressure. Therefore, obesity may be, because of its significant correlation to quality of metabolic control (HbA1c) and systolic blood pressure, considered as risk factor for diabetic retinopathy in type 2 diabetic persons.

Aged↗

PubMed2005

Ocular blood flow parameters in patients with rhegmatogenous retinal detachment.

The aim of the present study is to evaluate the potential statistically significant differences in the ocular blood flow parameters in eyes with rhegmatogenous retinal detachment (RD). Eleven patients, 5 females and 6 males, mean age 46 years (range 22-70), with the unilateral rhegmatogenous RD were enrolled in the study. Colour Doppler Ultrasound was used to measure ocular blood flow velocities in the ophthalmic artery (OA), posterior ciliary's arteries (PCA) and ophthalmic vein (OV). The contralateral eye served as a control. All Doppler examinations were performed 1 day before and exactly 3 days after the retinal detachment surgery. The measurements of the peak systolic velocity (Vmax), diastolic velocity (Vd), minimum velocity (Vmin), time-averaged velocity (TAV), resistive index (RI) and pulsatility index (PI) showed no statistically significant difference (by paired Student's t-test, p > 0.05) between the OA, PCA and OV in healthy eyes and eyes with RD before operation, as well as between the eyes with RD before and after the operation. Only was increased RI in OV of eyes with RD after the surgery (p < 0.05). All these parameters were not related with 2 or more quadrants of RD, but the difference in duration of retinal detachment in days is statistically significant (by Wilcoxon t-test p > 0.05). Pearson correlation method gave statistically significant correlation between RI and PI of the OA in healthy eyes (r = 0.826, p < 0.01), eyes with RD before operation (r = 0.847, p < 0.01) and eyes with RD after the operation (r = 0.856, p < 0.01). Formula for the calculation of PI by RI was derived using linear regression analysis in all three cases. Scleral buckling surgery leaves the ocular blood parameters in OA unchanged. The correlation between RD and logarithm of duration of RD in days is statistically significant.

Adult↗

PubMed2005

Treatment of pseudophakic cystoid macular oedema.

Cystoid oedema of macula is the most frequent problem following non-complicated cataract surgery, which leads to weakening of visual acutity. We have studied the treatment outcomes of the topical therapy with corticosteroids and nonsteroid antirheumatics during prospective randomized study in comparison with orally applied acethazolamide. However, 8 weeks later in treatment was observed a positive effect in both groups, on the eyes of patients, treated with acetazolamide, resorption of the oedema was faster, more intensive and ultimate visual acutity was statistically significantly better. Results demonstrated a benefit of combined therapy with antiinflamative drugs and orally prescribed acetazolamide in pseudophakic macular oedema.

Acetazolamide↗

PubMed2005

Intraocular histiocytosis in a 12-year-old girl without systemic disease.

Isolated intraocular histiocytosis is a rare disease that may manifest by recurrent uveitis and solid subretinal masses. The course, diagnosis and treatment of isolated intraocular histiocytosis in a 12-year-old girl are presented. As extensive diagnosis and therapy with corticosteroids and tuberculostatics failed to produce satisfactory results, diagnostic-therapeutic vitrectomy was performed. The intraoperatively obtained material was examined by the methods of histopathology, cytology and immunocytochemistry, along with herpes and cytomegalovirus polymerase chain reaction. The vitreous inflammatory exudate and subretinal masses were operatively removed. Analysis of the intraoperatively obtained material pointed to histiocytosis, whereas additional examinations revealed no systemic manifestations of the disease. Chronic uveitides that respond poorly to classic immunosuppressive therapy require multidisciplinary analysis of intraocular material. Pars plana vitrectomy is an appropriate diagnostic-therapeutic operative procedure.

Child↗

PubMed2005

Serum sickness and uveitis.

Serum sickness is immune response to a foreign antigen, usually a heterologous protein. Incidence rate is less than 0.5%. Antigens and responding antibodies form circulating immunocomplex that is characteristic for serum sickness. The condition occurs 7-15 days after exposure to the antigen, usually with clinical picture of glomerulonephritis. The immunocomplex circulates to other tissues where it sediments and causes inflammation, such as arteritis, neuritis, synovitis. The aim of this research is to present the break out of serum sickness in form of anterior uveitis due to azithromycin therapy administered by mouth. Identifying of anterior uveitis may help in early diagnostics and treatment of serum sickness.

Anti-Bacterial Agents↗

PubMed2005

Target intraocular pressure in the management of glaucoma.

Achievement of target intraocular pressure is the goal of every efficient antiglaucoma therapy. Target intraocular pressure is the level of intraocular pressure which is associated with minimal likelihood of visual field or optic nerve lesion, or an existing lesion progression due to elevated intraocular pressure. Results of large clinical studies which have offered some new concepts on target intraocular pressure in the management of glaucoma are reviewed. An association between the curve of intraocular pressure decrease and glaucoma progression was demonstrated in these studies. Generally, a lower value of target intraocular pressure implies better protection from the loss of vision and visual field impairment in glaucoma patients. In advanced glaucoma, the greatest possible reduction from the initial intraocular pressure should be attempted. A 20% reduction from the initial intraocular pressure or decrease to < 18 mmHg in advanced glaucoma has been recognized as a favorable strategy to reach target intraocular pressure. In normal tension glaucoma, a lower value of target intraocular pressure is associated with a slower disease progression. In patients with initial glaucoma, 25% reduction from the initial intraocular pressure will slow down the disease progression by 45%. The value of target intraocular pressure depends on the pretreatment level of intraocular pressure, optic nerve condition, glaucoma disease state, rate of glaucoma progression, patient's age, and other risk factors for the development of glaucoma.

Disease Progression↗

PubMed2003

Familial idiopathic intracranial hypertension.

AIM: To analyze the development and occurrence of the idiopathic intracranial hypertension and consequent visual loss in a family affected with idiopathic intracranial hypertension. METHODS: We studied 15 members of the same family and found six of them affected with idiopathic intracranial hypertension, which was accompanied with visual loss as a repercussion of the disease. Idiopathic intracranial hypertension was diagnosed on neurological and radiological examination. Visual examination to establish visual loss included fundoscopy, visual acuity, visual field testing, and ultrasonography of the optic nerve. RESULTS: The construction of a family tree and detailed examination of 15 family members revealed idiopathic intracranial hypertension with visual disturbances, even amaurosis, and different stages of visual field constriction in three members of the family: the mother and her two daughters. Due to the symptoms of idiopathic intracranial hypertension, such as headaches, nausea, vertigo, and the presence of transient visual obscuration and papilledema, in three other members of this family (aged 16, 17, and 25 years), we considered a presumptive diagnosis of idiopathic intracranial hypertension, and the need for thorough follow-up. Medical data on the family grandmother, who died 34 years ago, suggested that she also had symptoms of idiopathic intracranial hypertension. One of the patients underwent surgical treatment by a lumbo-peritoneal shunt operation worsening of the symptoms. CONCLUSION: It is very important to include idiopathic intracranial hypertension in differential diagnosis of papilledema and recognize it in early stages to prevent vision loss. Current successful therapeutic approaches and close follow-up of such patients require teamwork of neurologists, ophthalmologists, and neurosurgeons.

Adolescent↗