Biomedical subjects
Publications and source records attributed to M Călugăru.
The fellow eyes of 9 Patients suffering of unilateral classical malignant glaucoma have been throughly examined short after the onset of malignant glaucoma. In 3 cases they were apparently normal, in other 3 cases they exhibited an intermittent primary angle closure glaucoma and in the remaining 3 ones an absolute glaucoma. The therapeutic options of these fellow eyes are discussed.
The present paper reports a double-blind, cross-over, randomized study in which 31 patients (62 eyes) suffering from open-angle glaucoma were included. These patients were treated for one year with 0.5% levobunolol and 0.5% timolol ophthalmic solutions and followed up. Tonographic examinations of outflow facility showed a statistically significant increase following topical applications of 0.5% levobunolol, while there was little change with 0.5% timolol. The difference in the effect of outflow facility due to instillations of 0.5% levobunolol and 0.5% timolol can be explained by the different pharmacokinetic profiles of the two beta-blocker solutions in topical ocular application.
Thirty-two acute hypertensive unilateral, non granulomatous uveitis were clinically and functionally examined to try to determine the pathogenic factors of the occurrence of intraocular hypertension. The witness group included an equal number of acute non-hypertensive, non-granulomatous and unilateral uveitis cases, with a clinical aspect and etiology similar to the first group. The determination of the coefficient of outflow facility to the patients with hypertensive unilateral uveitis emphasized pathological values in 93.7% of the eyes with uveal inflammation and in 56.2% of the fellow eyes. Gonioscopy in the fellow eyes disclosed a narrow indocorneal angle in 90.6% of the cases. Corroboration of fellow eyes, all the examinations of the emphasized 4 had history cases of simple glaucoma (of which 2 had a familial of primitive glaucoma) and 6 cases of suspicious glaucoma (of which 4 had a familial history of primitive glaucoma). The patients with non-hypertensive unilateral uveitis presented normal values of the outflow facility in the two eyes. Clinically and functionally their fellow eyes were normal. Taking into account the statistically significant difference between the mean age of uveitis with and without hypertension, it is concluded that advanced age represents indirectly a factor of hypertension in uveitis, because, since, it diminishes the degree of opening of the camerular angle and as well, it reduces the outflow facility and increases the frequency of occurrence of simple and suspicious glaucomas.
The study of a number of 36 unilateral, nongranulomatous hypertensive acute uveitis (35 anterior and one total uveitis) emphasized in 7 cases familial history of primary glaucoma. The fellow eye of the 7 patients with unilateral hypertensive uveitis was normal in 1 case, glaucoma was suspected in 4 cases and glaucoma was demonstrated in 2 cases. The examination of 39 members (age older than 35) belonging to the families of the 7 patients with unilateral hypertensive uveitis and with familial history of primary glaucoma emphasized 13 cases of glaucoma and 5 cases suspicious of glaucoma. The topical steroid test on the eyes of the patients with unilateral hypertensive uveitis and with familial history of primary glaucoma revealed that the reaction is similar to the one presented by the patients with simple glaucoma.
Thirteen patients (15 eyes) were treated for simple congenital blepharoptosis by means of transcutaneous levator resection. The patients' ages ranged from 6 to 23 years, the postoperative follow-up period from 29 to 63 months. In 2 cases the operation was performed because of residual ptosis following transconjunctival levator resection. In 11 eyes the results were very good, with postoperative ptosis of between 0 and +/- 0.5 mm and complete lid closure. In 3 eyes the results were good, with ptosis between greater than + 0.5 mm and + 1.5 mm and complete lid closure; and there was one failure, with postsurgical ptosis of greater than + 1.5 mm. The major cosmetic defect in all cases was lid lag on extreme downward gaze. In view of these good results and the multiple advantages of the anterior transcutaneous levator resection procedure as compared to the posterior (conjunctival) approach, the authors feel able to claim that transcutaneous levator resection is the method of choice for most types of simple ptosis. The operation is extremely laborious but fully justified by the good results.
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The clinical and histopathological findings are described in a 10-year-old girl with xeroderma pigmentosum and multiple ophthalmic complications, including the eyelids, conjunctiva, orbit, cornea and iris; some of these complications took an unusual form. Histological examination following right orbital exenteration revealed an epibulbar squamous cell carcinoma penetrating the orbit and building a noose all around the ocular globe with subsequent strangulation. Moreover, a palpebral squamous cell carcinoma developed-independently from the right lower lid and, unconnected with the epibulbar tumor, penetrated to the orbit.
During the period mentioned above there ware hospitalized 54 patients having epibulbar tumours. The anatomopathological exam which was effectuated for 33 patients hes shown Bowen's disease for 14 cases, spinocellular carcinoma for 15 patients and basocellular for 3 patients. There were 4 cases for epibulbar precancerous. There was retinoblastoma for 19 cases; it had been practiced the enucleation of ocular globe for 17 patients and for two cases it had been practiced the exenteration of the eye socket. At the same period there were 91 uveal melanosis 6 of which having iridial localization, 10 cases of ciliary body [correction of cylar corpus], 75 cases of choroid. The hepatic scintigraphy was practiced for 56 patients and had shown for 8 cases hepatic metastasis. The histopathological exam of the melanomata of ciliary and choroidal corpus had shown type A fusiform cells for 22 cases, type B for 43 cases, epithelioid cells for 6 cases and mixed type cells for 13 cases. The hepatic metastasis were epithelioid cells for all the cases and, for 2 cases there were with mixed type cells, It is necessary an active discovering of intraocular and episcleral malign tumours, for increasing the chance of an earlier diagnosis during a stadium that would be able to be treated as conservator as possible be.
The paper reports on the main pathogenic types of anatomical blocking of the aqueous humor circulation in malignant glaucoma: pupillary, secondary iridolenticular, ciliovitreolenticular, iridociliovitreous blocks and in suprachoroidal effusion. The paper also presents some of the entities correlated with malignant glaucoma: glaucoma with blocked angle following the administration of miotics, traumatisms, the operations of scleral obstruction for retina detachment, panretinal photocoagulation and thrombosis of the retina central vein.
The authors present two cases of classical unilateral malignant glaucomas, having at the congeneric eye, a chronic primary glaucoma with extremely advanced blocked angle. The evolution of these two cases might indicate the possibility of transforming the chronic primary glaucoma with blocked angle into a primitive malignant glaucoma (spontaneous). The probable dynamics of these changes is described.
The study was carried out on a group of 127 patients, admitted into the Cluj-Napoca Clinic of Ophthalmology, suspected of primary glaucoma with open angle. The complex antiglaucomatous investigation confirmed the diagnosis in 57 cases.