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.

Introduction. Combining two medications in one bottle may improve compliance by reducing the time required to administer drops and the frequency of the total number of medication bottles. Objective. To compare the efficacy of reduced intraocular pressure (IOP) and safety of fixed combination travoprost 0.004%/timolol 0.5% vs. fixed combination dorzolamide 2%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension. Methods. Prospective randomized clinical study included 60 patients divided into 2 groups. Follow-up was done at day 14 and 45 and month 3. IOP measurements were taken at each follow-up examination at 8 am, 10 am and 4 pm. Results. Both fixed combinations reduced IOP significantly compared to initial values at all follow-ups (p<0.001). Mean pooled IOP at all visits and time points was slightly lower in the travoprost/timolol group compared with the dorzolamide/timolol group (16.13 mmHg vs. 16.15 mmHg). Mean IOP reduction from baseline ranged from -7.46 mmHg to -9.92 mmHg in the travoprost/timolol group and from -6.93 mmHg to -8.93 mmHg for the dorzolamide/timolol group. Mean (?standard error of the mean) reduction in diurnal IOP from baseline to 3rd month was 8.96?2.79 in the travoprost/timolol group versus 8.07?2.91 in patients receiving dorzolamide/timolol fixed combination (p=0.196). The most frequent treatment-related adverse events were conjunctival hyperemia in the travoprost/timolol group, and dry eye and foreign body sensation in the dorzolamide/timolol group. Conclusion. Travoprost/timolol fixed combination was slightly more effective than dorzolamide/timolol fixed combination in reducing mean diurnal IOP. Travoprost/timolol group resulted in an IOP reduction for up to 1.07 mmHg higher than dorzolamide/timolol group. Both fixed combinations were well tolerated and safe.

Background/Aim. Refractory glaucoma is glaucoma resistant to conventional management (maximally tolerated medical therapy, one or more glaucoma surgeries) and glaucoma in cases of neovascularisation after panretinal photocoagulation or cryoablation. The aim of the study was to determine the intraocular pressure (IOP) lowering efficacy of transscleral diode laser cyclophotocoagulation (DCPC) treatment in the management of pain and IOP in patients with refractory glaucoma. Methods. This nonrandomized, retrospective study, included 95 patients (95 eyes) with refractory glaucoma treated at the University Eye Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia, between November 2007 and November 2012 in accordance with the established protocols (16-18 spots, 270?, up to 5J of energy). All the eyes were treated with transscleral DCPC (Iris Medical OcuLight SLx, Iridex Co, Mountain View, USA). Patient's symptoms, bests corrected visual acuity and IOP were recorded 7 days, and 1, 3 and 6 months after the DCPC treatment. Results. Out of 95 patients (95 eyes) enrolled in this study 24 (25.2%) were with primary (the group I), and 71 (74.5%) with secondary (the group II) glaucoma. The mean baseline IOP in these two groups was similar: 36.08 ? 8.39 mmHg for the first group and 37.36 ? 8.19 mmHg in the second group. Measurement of the mean IOP in the group I showed the following results: on the day 7 it was 13.96 ? 8.30 mmHg (62.1% decrease of the baseline value), on the day 30 it was 18.44 ? 8.85 mmHg (48.9% decrease regarding the baseline value), after 3 months it was 22.44 ? 7.36 mmHg (37.8% decrease regarding the baseline value), and after 6 months it was 25.92 ? 7.65 mmHg (28.2% decrease regarding the baseline value). Measurement of IOP in the group II showed the following results: on the day 7 it was 15.77 ? 9.73 mmHg (57.8% decrease of the baseline value), on the day 30 it was 20.14 ? 10.20 mmHg (46.1% decrease regarding the baseline value), after 3 months it was 23.46 ? 9.83 mmHg (37.2% decrease regarding the baseline value) and after 6 months it was 27.23 ? 9.87 mmHg (27.2% decrease regarding the baseline value). Pain was the main symptom in 70 (73.6%) patients before the treatment and it persisted in only 4 (4.2%) of our patients. Other complaints (burning, stinging, foreign body sensation) were experienced by 39 (41%) of the patients, postoperatively. A total of 52 (54.7%) patients had no complaints after the treatment. Conclusion. Our study confirmed that transscleral DCPC is a useful, effective and safe procedure with predictable amount of IOP decrease, which makes it the treatment of choice for refractory glaucoma.

Treating advanced glaucoma often requires numerous therapeutic modalities in order to achieve the desired intraocular pressure (IOP) reduction. The purpose of this study was to evaluate the IOP lowering efficacy of both cyclocryotherapy...

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p < 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting < 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p < 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.