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Biomedical subjects

Svetislav Milenković

Publications and source records attributed to Svetislav Milenković.

4 recordsLinked to original sources

[Radiation retinopathy in patients treated for sinus and epipharingeal malignancies].

BACKGROUND: Radiation retinopathy is vasculopathy induced by ionising radiation delivered by either brachytherapy or teletherapy for ocular and nonocular malignancies. The first signs of radiation retinopathy typically occur a few months to a few years after the exposure to ionizing radiation. CASE REPORT: In the 3 of our patients, changes like capillary telangiectasia, microaneurysms, intraretinal hemorrhages, hard exudation, and capillary nonperfusion showed a clinical picture of macular edema. Two of the patients were suspected of diabetic retinopathy, and 1 patient had optic neuropathy. In our group of patients a latent period was between 3 and 8 years. The incidence of radiation retinopathy increases significantly with the total doses of radiation above 45 Gy, and, thus, it has not been found in the lower doses. CONCLUSION: Radiation retinopathy is a diagnostical and therapentical problem. Clinical picture can be identical to that of diabetic retinopathy suggesting a common pathophysiologic mechanism of the damage to capillary endothelial cells, and the importance of clinical examination, anamnesis and fluorescein angiography.

Adult↗

Metabolic syndrome and central retinal artery occlusion.

BACKGROUND: The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. CASE REPORT: We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. Specific laboratory investigations and fluorescein angiography excluded the presence of vasculitis, collagen vascular diseases, hypercoagulable state and antiphospholipid syndrome. CONCLUSION: The patient met all the five of the National Cholesterol Education Program (NCEP) criteria for the metabolic syndrome: hypertension, abnormal lipid profile, abnormal glucose metabolism, obesity and hyperuricemia. Measurement of C-reactive protein is useful for the assessment of therapeutic systemic effect on any abnormality in the metabolic syndrome. Individual therapy for all risk factors in the metabolic syndrome is necessary to prevent complications such as cardiovascular, retinal vascular diseases and stroke.

Fluorescein Angiography↗

[Ocular rosacea].

Five cases of ocular rosacea (one male and four females) are reported in this paper. Two of the patients were with keratoconjunctivitis sicca, one with conjunctivitis chronica and blepharitis, one with conjunctivitis chronica and meibomitis, and one with reccurent corneal erosions with meibomitis and chordeloum. In four patients ocular symptoms preceded the occurence of skin lesions. The treatment with oral tetracyclines significantly improved the state of ocular rosacea in four patients, while in one case the changes of the anterior eye segment progressed in more severe state of ulcerative keratitis. It is considered that in almost 20% of the patients with rosacea ocular lesions may precede the skin changes, representing a diagnostic problem. Thus, in those cases multidisciplinary approach is suggested. Such approach is particularly important because of the decrease of morbidity and the prevention of the onset of the eye complications such as drastic worsening of visual acuity, i.e., the blindness.

Adult↗

[Rosacea as a multisystemic disease].

Rosacea is a chronic skin disorder, affecting the face and chest, and develops mostly in the 3rd to 6th decades of life. It is characterized by erythema, telangiectasias, and recurrent flushings. During the time of this chronic inflammation, skin typically develops papules, pustules, and swelling. Ocular involvement occurs in 3 to 58% of patients with skin changes. Common ocular signs include blepharoconjunctivitis, meibomitis, and dry eyes. Rosacea keratitis, when present, however, has a poor prognosis and may lead to blindness. Among skin diseases, Helicobacter pylori infection has been often related with rosacea. A higher prevalence of indigestion and Helicobacter pylori infection in rosacea patients than in healthy controls has been reported. However, no causal relation has been identified. On the other hand, oral treatment with metronidazole is beneficial in all of three mentioned manifestations of rosacea (skin, eye, indigestion). There is obvious need for multidisciplinary approach, and investigation to rosacea.

Eye Diseases↗