Purpose: Avastin (bevacizumab) intravitreal injections are widely used for treatment of diabetic retinopathy. The aim of our study was to analyze effect of 1.25 mg of intravitreal Avastin on serum concentration of vascular endothelial growth factor (VEGF) in diabetic patients. Methods: Participants were 10 diabetic patients on insulin therapy, without any other eye or systemic disease, and no kidney disfunction. Both eyes of diabetic patients were injected simultaneously with 1.25 mg of intravitreal Avastin, as a first step in treatment of nonproliferative diabetic retinopathy with clinically significant macular edema (4 patients), and of proliferative diabetic retinopathy (6 patients). Fluorescein angiography was performed prior to and laser therapy followed 1 month after Avastin treatment. VEGF concentration in patients serum was measured by ELISA technique: on the day of the Avastin administration, and 1, 7, and 28 days after intravitreal injection. Results: In all analyzed participants, 24 hours after Avastin treatment, serum levels of VEGF were lower then basal (preinjection value). Maximal reduction of serum VEGF was noted on the 7th postoperative day. Twenty-eight days after, VEGF level in serum was raised, without completely reaching basal preoperative concentrations in most patients. Conclusions: Intravitreal injections of anti-VEGF drugs have an effect on decreasing systemic VEGF values. Rhythm of changes in serum VEGF concentrations and lowest detected concentration on the seventh postinjection day are according to pharmacokinetics of Avastin in serum and vitreous, reported by similar studies. The small number of patients involved in this pilot study implicates the need for further studies.

Background: Erythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2. Methods: The research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for 10 years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method. Results: The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p = 0.007). Conclusions: Significantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.

Rhegmatogenous retinal detachment, a severe eye condition, presents anatomic separation of the neurosensory retina from its outermost layer—the retinal pigment epithelium. Early recognition of this relatively common finding and proper referral of patients to the retinal surgery department is essential in order to minimize its consequent possible severe reduction in vision. Several major surgical methods for the repair of primary rhegmatogenous retinal detachment have been in use over the last several decades, and they all aim to find and close the break in the retina that has caused the detachment. Surgery can be performed as pneumatic retinopexy, pars plana vitrectomy, and/or episcleral surgery (buckling). General surgical trends for reattaching the retina include moving from extraocular to intraocular surgery and from bigger gauge to smaller gauge via minimal invasive vitrectomy surgery (MIVS), with implementing shorter-lasting intraocular tamponades. Surgical options for rhegmatogenous retinal detachment treatment nowadays emphasize gaining retinal reattachment, preferably with one surgery and with minimum damage to the eye. The procedure should not bring secondary eye conditions and complications with severe impairment of visual acuity, and it should be performed on as much as a smaller budget, with possibly peribulbar anesthesia, enabling the patient the quickest possible recovery. It should be adjusted to the patient’s condition, not to the surgeon’s skills or preferences.

Backgrounds and Objectives: To analyze the influence of multiple anti-VEGF intravitreal injections for exudative age-related macular degeneration on the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC + IPL) using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: A prospective interventional study of consecutive patients treated with intravitreal bevacizumab (IVB) was performed. Average and sectorial values of RNFL and GC + IPL thickness were recorded using Cirrus SD-OCT at 0, 6, 12, and 24 months. Patients suffering from any ocular disease that could affect RNFL or GC + IPL thickness were excluded. Results: A total of 135 patients (70 women and 65 men, aged 65 ± 15 years) were included. The average number of injections per patient was 12.4 ± 2.4. Average RNFL and GC + IPL thickness prior to the first injection (87.6 ± 12.2 and 47.2 ± 15.5 respectively), and after 24-month follow-up (86.2 ± 12.6 and 46.7 ± 11.9 respectively) did not differ significantly (p > 0.05). There was a significant decrease in GC2, GC5 segments, and minimum GC + IPL thickness. Conclusion: Repeated anti-VEGF treatment did not cause significant changes in the thickness of RNFL and GC + IPL layers over a period of 24 months. The detected decrease in GC2 and GC5 sectors, as well as in minimum GC + IPL thickness, could be a sign of ganglion cell damage induced by the treatment or could occur during the natural course of the disease.

Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant compared to preoperative values. The average span of silicon oil tamponade was 162 +/− 23 days. Conclusions: Silicon oil tamponade during 23-gauge rhegmatogenous retinal detachment surgery leads to a transitory reduction of central macular thickness, central macular volume cube and average macular thickness cube in eyes that underwent retinal surgery. After silicon oil removal, macular parameters returned to preoperative values in most of the patients.

Introduction. Since 1996, advanced methods and new instruments for the assessment of vision quality of life (VisQoL) index (37 and 15) have been developed and applied at the University Eye Clinic in Novi Sad. Many researches assume that postoperative results should not be evaluated only by postoperative visual acuity, but also by subjective perception of visual function and the patients ability to perform everyday activities, i.e. by quality of life. Therefore, our clinical results were based on both parameters of visual function, as the most objective attributes for assessing outcomes of certain types of cataract surgery. Material and Methods. Based on the results of the Cataract Study in Vojvodina in 2004, 5.7% of patients waiting for cataract surgery were already blind, 16.5% had low vision with cataract on both eyes, and 57% of patients had monocular blindness. Results and Discussion. With improvement of visual acuity to 0.5 or higher, after cataract surgery in 96.5% of patients, the cumulative VisQoL 15-index changed from 59.3 to 95.5. Intraocular lens implantation contributed most to the significant improvement in the vision related quality of life. Our study showed that pseudophakic patients had better quality of life than aphakic patients, who had the same visual acuity and refractive correction. Difficulties in performing everyday activities, such as shopping, using the telephone and reading, were found in 12.7% of aphakic, but only in 3% of pseudophakic patients. Conclusion. Advanced phacoemulsification techniques enable operated cataract patients immediate vision recovery, better quality of life, and personal satisfaction with visual function in everyday activities.