Publications by authors named "Dragos Serban"

17 Publications

  • Page 1 of 1

Clinical and therapeutic features of acute cholecystitis in diabetic patients.

Exp Ther Med 2021 Jul 13;22(1):758. Epub 2021 May 13.

4th Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.

The present study aimed to compare the clinical, paraclinical, intraoperative findings, and postoperative complications in acute cholecystitis in diabetic patients vs. non-diabetic patients. A 2-year retrospective study was performed on the patients who underwent emergency cholecystectomy for acute cholecystitis between 2017 and 2019 at the 4th Department of Surgery, Emergency University Hospital Bucharest. The diabetic subgroup numbered 46 eligible patients and the non-diabetic one 287 patients. Demographics, the severity of the clinical forms, biological variables (including white cell count, urea, creatinine, coagulation and liver function tests) comorbidity status, surgical approach, postoperative complications, and hospital stay were analyzed. Statistical analyses were performed to assess comparative results between the aforementioned data (SPSS V 13.0). The CCI and ASA risk classes were increased in the diabetic group, with 34.78% of patients having 3 or more associated comorbidities. No statistically significant associations were demonstrated between diabetes and the severity of the cholecystitis and risk for conversion. Postoperatively both minor complications such as surgical site infections and major cardiovascular events were more common in the diabetic subgroup (P=0.0254), well associated with the preoperative status and baseline cardiovascular comorbidities. Laparoscopic cholecystectomy is a safe procedure for diabetic patients, which can provide the best outcomes, by decreasing the risks of surgical wounds. Attentive perioperative care and good glycemic control must be provided to minimize the risk of complications.
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http://dx.doi.org/10.3892/etm.2021.10190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135114PMC
July 2021

Incidence of thyroid carcinomas in an extended retrospective study of 526 autopsies.

Exp Ther Med 2021 Jun 14;21(6):607. Epub 2021 Apr 14.

Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Thyroid cancer accounts for 1% of all malignancies, and is becoming increasingly common worldwide. The literature reports a prevalence of ~50% of thyroid nodules detected during autopsies in subjects with unknown thyroid pathology. An extended retrospective study of 526 autopsy cases was performed to identify the prevalence of thyroid carcinoma, among various types of thyroid nodules identified incidentally. Tissue samples were taken from thyroid nodules, for investigation of the presence of thyroid carcinoma, along with their macroscopic and microscopic features by means of histopathology and immunohistochemistry (IHC) methods. Histopathological diagnosis of malignancy was found in 51 cases of analyzed thyroid samples. Systematic detailed studies demonstrated that a thyroid gland, apparently normal on macroscopic examination, may be the site of pathological manifestations, sometimes presenting carcinomatous findings. Among thyroid carcinomas, the highest frequency was that of papillary microcarcinomas, which have a long evolution, and are incidentally detected during autopsies. Papillary microcarcinoma is an extremely common incidental finding and the vast majority of these tumors pursue a benign course. Furthermore, it is therefore necessary to create national screening programs for the early detection of thyroid carcinoma.
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http://dx.doi.org/10.3892/etm.2021.10039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082578PMC
June 2021

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula.

Exp Ther Med 2021 May 23;21(5):537. Epub 2021 Mar 23.

Discipline of Pediatrics, Department of Pediatrics, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

The rareness of H-type tracheoesophageal fistula in conjunction with its unspecific clinical presentation and wide range of anatomical presentation makes its diagnosis and treatment a problematic topic for both ear, nose and throat (ENT) specialists and pediatric surgeons worldwide. Symptoms and clinical signs of H-TOF are easily misleading. Diagnostic methods, most of the times, are dependent on the physician's experience; therefore, various errors may be made. We analyzed our experience in managing H-TOF cases over the last 15 years. Advice and strategies of action for health professionals directly involved in the diagnosis and treatment were identified, but also errors and mistakes while managing 6 cases. We analyzed 'red flags' but also important steps in the practical safety concerning this rare congenital malformation. Choosing the surgical access for division of the fistula throughout the cervical or thoracic approach is sometimes difficult. A scrupulous perioperative planning is mandatory. A dynamic overview of the patient's presentation never underestimating the subtlety of H-TOF presentation should be conducted for its early recognition and achieving best outcomes.
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http://dx.doi.org/10.3892/etm.2021.9970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014971PMC
May 2021

Acute surgical abdomen during the COVID-19 pandemic: Clinical and therapeutic challenges.

Exp Ther Med 2021 May 22;21(5):519. Epub 2021 Mar 22.

Third Department of Surgery, Faculty of Medicine, 'Lucian Blaga' University Sibiu, 550169 Sibiu, Romania.

The present study investigated the effects of the COVID-19 pandemic on the clinical presentation and therapeutic management of acute surgical abdomen. A retrospective study of emergency hospitalizations with a diagnosis of acute surgical abdomen between April and July 2020 vs. a similar period in 2019 was performed. The observation sheets and the operating protocols were analyzed. Between April and July 2020, 50 cases of acute surgical abdomen were hospitalized and treated, compared to 43 cases in the same period last year. The main types of pathology in both groups included: Occlusions (60%, respectively 44.2% in 2019) and peritonitis (32%, respectively 41.8% in 2019). There was an increased rate of patients with colorectal cancers neglected therapeutically or uninvestigated, who presented during the pandemic period with emergencies for complications such as occlusion or tumor perforation (32 vs. 6.97%, P=0.0039). One case, with gastric perforation, was COVID-positive, with no pulmonary symptoms at admission. The number of postoperative infectious complications was lower during the pandemic (2 vs. 13.95%, P=0.0461). As the COVID-19 pandemic appears to be still far from ending, we should learn to adapt our surgical protocols to the new evidence. Oncological patients are a vulnerable group, who were neglected in the first months of the pandemic. SARS-Cov-2 infection may be a cause of abdominal pain and should be taken into account in different diagnoses of acute abdomen in surgical wards. Correct wearing of adequate personal protective equipment (PPE) and respecting strict rules of asepsis and antisepsis are required for preventing in-hospital transmission of infection.
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http://dx.doi.org/10.3892/etm.2021.9950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014977PMC
May 2021

Safety of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly: A Multivariate Analysis of Risk Factors for Intra and Postoperative Complications.

Medicina (Kaunas) 2021 Mar 2;57(3). Epub 2021 Mar 2.

3rd Department Surgery, Faculty of Medicine, "Lucian Blaga" University Sibiu, 550169 Sibiu, Romania.

This study investigates the impact of age upon the safety and outcomes of laparoscopic cholecystectomy performed for acute cholecystitis, by a multivariate approach. A 2-year retrospective study was performed on 333 patients admitted for acute cholecystitis who underwent emergency cholecystectomy. The patients included in the study group were divided into four age subgroups: A ≤49 years; B: 50-64 years; C: 65-79 years; D ≥80 years. Surgery after 72 h from onset ( = 0.007), severe forms, and higher American Society of Anesthesiologists Physical Status Classification and Charlson comorbidity index scores ( < 0.001) are well correlated with older age. Both cardiovascular and surgical related complications were significantly higher in patients over 50 years ( = 0.045), which also proved to be a turning point for increasing the rate of conversion and open surgery. However, the comparative incidence did not differ significantly between patients aged from 50-64 years, 65-79 years and over 80 years (6.03%, 9.09% and 5.8%, respectively). Laparoscopic cholecystectomy (LC) was the most frequently used surgical approach in the treatment of acute cholecystitis in all age groups, with better outcomes than open cholecystectomy in terms of decreased overall and postoperative hospital stay, reduced surgery related complications, and the incidence of acute cardiovascular events in the early postoperative period ( < 0.001). The degree of systemic inflammation was the main factor that influenced the adverse outcome of LC in the elderly. Among comorbidities, diabetes was associated with increased surgical and systemic postoperative morbidity, while stroke and chronic renal insufficiency were correlated with a high risk of cardiovascular complications. With adequate perioperative care, the elderly has much to gain from the benefits of a minimally invasive approach, which allows a decreased rate of postoperative complications and a reduced hospital stay.
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http://dx.doi.org/10.3390/medicina57030230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002041PMC
March 2021

Association between vascular comorbidity and glaucoma progression: A four-year observational study.

Exp Ther Med 2021 Mar 26;21(3):283. Epub 2021 Jan 26.

Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Glaucoma, one of the significant causes of blindness worldwide, is a chronic optic neuropathy, characterized by progressive loss of retinal ganglion cells and specific perimetric defects. This study aimed to assess the association between the risk of glaucoma progression and different systemic vascular abnormalities. A 4-year prospective study was carried out on 204 patients diagnosed with open-angle glaucoma. Associated systemic vascular pathology was documented in 102 cases. Progression was encountered in 57 (55.9%) patients with vascular comorbidities and only in 10 (9.8%) patients with no associated vascular diseases (OR 13.81, P<0.01). The vascular risk factors associated with glaucoma progression in the study group were diastolic hypotension (OR 5.444, P=0.027), ischemic cardiac disease (OR 5.826; P<0.01), peripheral vasospasm (OR 3.108, P=0.042) and arterial hypertension (OR 2.593, P=0.05). Diabetes was not significantly correlated with progression in the study group, but only patients without diabetic retinopathy were included. This study highlights that systemic comorbidities associated with endothelial lesions, atherosclerosis and hypoperfusion can lead to damage to the retinal nerve fiber layer and the underlying conjunctive tissue.
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http://dx.doi.org/10.3892/etm.2021.9714DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851678PMC
March 2021

Heterogeneity of antigenic constellation in human hepatocellular carcinoma.

Exp Ther Med 2021 Mar 25;21(3):270. Epub 2021 Jan 25.

Pathology Department, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania.

Hepatocellular carcinoma is one of the primary liver malignancies responsible for over a million deaths per year worldwide (approximately 10% of all deaths in the adult age range). The diagnosis of HCC can be difficult and often requires the use of more than one microscopic technique. A retrospective study was performed on a study batch of 42 cases that died of HCC due to metastasis or other secondary complications. Tissue samples were taken in order to investigate the tumour antigenic constellation by means of IHC method using a large variety of antibodies. hybridization was also performed for albumin mRNA to assess the albumin expression in some selected cases. Telomerase activity was investigated using IHC method for the hTERT catalytic subunit. A cocktail of hepatic cytokeratins (CK8, 18) combined with Hep Par-1 and associated to albumin proved to be more powerful than albumin alone in differentiating HCC and increased the value of tumour diagnosis. hTERT expression was proportionally reverse to the tumour degree of differentiation, but was independent from the expression of tumour-proliferating indexes. The heterogeneity of the antigenic constellation in hepatocellular carcinoma suggests an antigenic mosaicism, which can be expressed a synchronous or metachronous manner, depending on the tumour degree of differentiation.
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http://dx.doi.org/10.3892/etm.2021.9701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851646PMC
March 2021

Fibroblast involvement in cardiac remodeling and repair under ischemic conditions.

Exp Ther Med 2021 Mar 25;21(3):269. Epub 2021 Jan 25.

Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Cardiac fibroblasts play a main role in the physiological turnover of the extracellular matrix, as well as its pathological remodeling. A study was performed on a batch of 23 cases who died of various cardiac complications secondary to scarring myocardial infarctions. The aim of the study was to assess the fibroblast involvement in cardiac repair under ischemic conditions after myocardial infarction. Tissue myocardial samples from the left ventricle were taken from these cases for microscopy examination, in order to investigate the type and degree of fibrosis as well as the presence of cardiac interstitial fibroblasts. Multiple series of histological sections were also performed and examined, along with immunohistochemical analysis. The fibroblasts were diffusely distributed in the interstitium among the residual cardiomyocytes, showing variable expression of vimentin and smooth muscle actin. During cardiac remodeling, there was a successive interstitial deposition, first of reticulin fibers and then of collagen fibers, leading to interstitial fibrosis and myocardial replacement. There was a correlation between vimentin and smooth muscle actin expression and collagen deposition. Fibrosis with cardiac remodeling is based on maintaining proliferation capacity of the fibroblast and its capacity of protein synthesis in the extracellular matrix. Under hypoxic ischemic conditions, followed by myocardial infarction, the fibroblast switches phenotype and transdifferentiate into myofibroblast, contributing to the healing by secreting extracellular matrix proteins and collagen deposition, with subsequent cardiac remodeling and regulation of the micro-environment metabolism.
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http://dx.doi.org/10.3892/etm.2021.9700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851673PMC
March 2021

Diabetic Retinopathy in Patients With Diabetic Foot Ulcer: A Systematic Review.

Int J Low Extrem Wounds 2021 Jun 22;20(2):98-103. Epub 2020 Dec 22.

University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania.

This review discusses the evidence on diabetic retinopathy (DR) in patients with diabetic foot ulceration (DFU). A systematic literature review was performed on PubMed, Medline, Springer Nature, and Scopus, following the PRISMA guidelines, using the following terms, individually or in combination: "diabetic foot ulcer" OR "diabetic foot syndrome" OR "DFU" and "diabetic retinopathy." The initial search yielded 648 articles published between 1975 and 2020. After applying exclusion and inclusion criteria, a total of 9 articles were analyzed, assessing the correlations between DR and DFU. In all cases, DR and especially proliferative diabetic retinopathy were significantly higher in the presence of DFU, though the frequency of DR showed large variability (22.5% to 95.6%). There was a significant correlation between advanced stages of DFU and increased frequency of DR and proliferative diabetic retinopathy. On the other hand, there is a risk of accelerated progression of DR in nonhealing DFUs, possibly related to chronic inflammation and associated infection. Hence, patients with DFUs should be monitored by an ophthalmologist, and those with DR should be promptly referred to a specialized diabetic foot clinic.
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http://dx.doi.org/10.1177/1534734620982237DOI Listing
June 2021

Caudal Duplication Syndrome Systematic Review-A Need for Better Multidisciplinary Surgical Approach and Follow-Up.

Medicina (Kaunas) 2020 Nov 27;56(12). Epub 2020 Nov 27.

Discipline of Pediatrics, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Caudal duplication syndrome is a rare association of anatomical anomalies describing duplication of the hindgut, spine, and uro-genital structures, leading to varied clinical presentations. The current literature focuses on case reports which describe the embryological etiology and anatomical spectrum of the condition giving little attention to the surgical preparation, the need for a well-structured follow-up program, or the transition into adult healthcare of these complex patients. No reviews have been published regarding this complex pathology. : A review of caudal duplication syndrome cases was done to assess the range of the clinical malformations, timing, and types of surgical interventions. Inconsistencies in multidisciplinary care, follow-up, and risk events were described. Hindgut duplication always involved the anorectal region. Anorectal malformations were evenly distributed as unilateral and bilateral. Colon duplication extended from the anal region to the transverse colon or ascending colon in most of the cases and less to terminal. In females, genital duplication was present in all cases. The follow-up period varied between 3 months and 12 years. In all adult females, the motive of presentation was related to pregnancy (complications after successful delivery, fertility evaluation) or late complications (fecalith obstruction of the end-to-side colon anastomosis, repeated UTIs with renal scarring). : Complex malformations affecting multiple caudal organs may have a strong impact in many aspects of the long-term quality of life; therefore, patients with caudal duplication syndrome need increased awareness and joined multidisciplinary treatment.
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http://dx.doi.org/10.3390/medicina56120650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759832PMC
November 2020

NLRP3 Inflammasome Biomarker-Could Be the New Tool for Improved Cardiometabolic Syndrome Outcome.

Metabolites 2020 Nov 6;10(11). Epub 2020 Nov 6.

Internal Medicine Department, Ovidius University, 900470 Constanta, Romania.

Metabolomics, the research area studying chemical processes involving metabolites, finds its utility in inflammasome biomarker discovery, thus representing a novel approach for cardiometabolic syndrome pathogeny acknowledgements. Metabolite biomarkers discovery is expected to improve the disease evolution and outcome. The activation of abundantly expressed NLRP3 inflammasome represents the background process of the diabetes mellitus disturbances like hyperglycemia and insulin resistance, as well as for myocardial cell death and fibrosis, all of them being features characteristic for cardiometabolic syndrome. Many molecules like troponins, brain natriuretic protein (BNP), ST2/IL-33, C-reactive protein (CRP), TNF, IL-1β, and IL-18 cytokines have been already examined as molecular markers for diagnosing or predicting different cardiac disturbances like myocardial infarction, heart failure, or myocarditis. In addition, metabolomics research comes with new findings arguing that NLRP3 inflammasome becomes a promising molecular tool to use for clinical and therapeutical management providing new targets for therapies in cardiometabolic syndrome. Inflammasome markers analyses, along with other molecular or genetic biomarkers, will result in a better understanding of cardiometabolic syndrome pathogenesis and therapeutic targets. Screening, diagnostic, and prognostic biomarkers resulted from inflammasome biomarker research will become standard of care in cardiometabolic syndrome management, their utility becoming the first magnitude.
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http://dx.doi.org/10.3390/metabo10110448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694742PMC
November 2020

Indocyanine Green-Enhanced Colorectal Surgery-between Being Superfluous and Being a Game-Changer.

Diagnostics (Basel) 2020 Sep 24;10(10). Epub 2020 Sep 24.

IVth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.

Nowadays, surgical innovations incorporate new technological conquests and must be validated by evidence-based medicine. The use of augmented reality-assisted indocyanine green (ICG) fluorescence has generated a myriad of intraoperative applications such as demonstration of key anatomical landmarks, sentinel lymph nodes, and real-time assessment of local blood flow. This paper presents a systematic review of the clinical evidence regarding the applications of ICG near-infrared (NIR) fluorescence in colorectal surgery. After we removed duplicate publications and screened for eligibility, a total of 36 articles were evaluated: 23 on perfusion assessment, 10 on lymph node mapping, and 3 on intraoperative identification of ureters. Lack of homogenous studies, low statistical power, and confounding evidence were found to be common amongst publications supporting the use of ICG in colorectal surgery, raising concerns over this seductive technique's cost efficiency and redundancy. The compiled data showed that ICG NIR fluorescence may be a game-changer in particular situations, as proven for low colorectal anastomosis or lateral pelvic lymph node dissection, but it remains controversial for routine use and sentinel lymph node assessment. Further randomized studies are needed to confirm these conclusions. Future research directions include tumor-targeted fluorescence imaging and digital software for quantitative evaluation of fluorescence.
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http://dx.doi.org/10.3390/diagnostics10100742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600504PMC
September 2020

Laparoscopic Surgery in COVID-19 Era-Safety and Ethical Issues.

Diagnostics (Basel) 2020 Sep 4;10(9). Epub 2020 Sep 4.

IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.

(1) Background: The paper aims to review the available evidence regarding the health risk of the aerosolization induced by laparoscopy induced and impact of the COVID-19 pandemic upon minimally invasive surgery. (2) Materials and methods: A systematic review of the literature was performed on PubMed, Medline and Scopus until 10 July. (3) Results: Chemicals, carcinogens and biologically active materials, such as bacteria and viruses, have been isolated in surgical smoke. However, the only evidence of viral transmission through surgical smoke to medical staff is post-laser ablation of HPV-positive genital warts. The reports of SARS-CoV-2 infected patients who underwent laparoscopic surgery revealed the presence of the virus, when tested, in digestive wall and stools in 50% of cases but not in bile or peritoneal fluid. All surgeries did not result in contamination of the personnel, when protective measures were applied, including personal protective equipment (PPE) and filtration of the pneumoperitoneum. There are no comparative studies between classical and laparoscopic surgery. (4) Conclusions: Previously published data showed there is a possible infectious and toxic risk related to surgical smoke but not particularly proven for SARS-CoV-2. Implementing standardized filtration systems for smoke evacuation during laparoscopy, although increases costs, is necessary to increase the safety and it will probably remain a routine also in the future.
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http://dx.doi.org/10.3390/diagnostics10090673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555582PMC
September 2020

Fulminant bilateral acute retinal necrosis after chickenpox - a case report.

Rom J Ophthalmol 2016 Jul-Sep;60(3):184-187

"Carol Davila" University of Medicine and Pharmacy, Bucharest.

We present the case of a 34-year-old male, admitted for progressive bilateral loss of vision after a recent episode of chickenpox. Ophthalmological exam revealed bilateral acute retinal necrosis. As the patient was following a drug detoxification program, he was tested for HIV, HVB, HVC, and results highly positive. Immediate intravenous therapy with high doses of acyclovir and methylprednisolone was initiated, but the evolution was extremely severe resulting in necrotic retinal detachment. Surgery was performed in right eye, but no improvement of visual acuity was observed.

Conclusions: The fulminant evolution of bilateral acute retinal necrosis and the lack of response to maximal intravenous therapy were clinical elements indicating coexistent immunosuppressive disease. Very severe acute retinal necrosis may occur in immunosuppressed patients, leading to blindness.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720133PMC
May 2018

"Off-label" use of intravitreal bevacizumab in non-ischemic macular edema secondary to retinal vein obstructions.

Rom J Ophthalmol 2016 Apr-Jun;60(2):90-95

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania Department of Ophthalmology, University Emergency Hospital Bucharest, Romania.

Objective: To evaluate the safety and efficacy of intravitreal Bevacizumab in treatment of non-ischemic macular edema secondary to retinal vein obstruction (RVO).

Materials And Methods: A 2-year-retrospective study was performed on 26 patients hospitalized for non-ischemic macular edema secondary to RVO. All the patients underwent a complete ophthalmologic exam, with best corrected visual acuity (BCVA) testing, fundus photography, fluorescein angiography (FA) and macular thickness measurement by optical coherence tomography (OCT). Reevaluation was performed monthly for VA, OCT, and ophthalmoscopy and, at every 3 months, by FA. A standard protocol of 0.05 ml intravitreal Bevacizumab injection was applied. Further administrations were performed according to clinical evolution.

Results: The medium follow-up period was of 9,7 months (6-20 months). There were no significant complications following the procedure. The number of intravitreal Bevacizumab injections varied from 2-5/ patient. All the patients experienced an improvement in VA and a significant regression of macular edema. The smallest number of intravitreal Bevacizumab injections and the best visual prognosis were observed in cases with branch retinal vein obstruction (BRVO) and early presentation (p<0.05).

Conclusions: As a pathogenic therapy, intravitreal Bevacizumab is a safe, repeatable procedure and it may be considered an effective and lasting treatment for non-ischemic macular edema secondary to RVO. Intravitreal Bevacizumab should be included in the therapeutic protocol of RVO, both for early and delayed presentations. RVO = retinal vein obstruction, BRVO = branch retinal vein obstruction, CRVO = central retinal branch obstruction, BCVA = best corrected visual acuity, FA = fluorescein angiography, OCT = optical coherence tomography.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711371PMC
April 2018

ASSESSMENT OF CLINICAL AND IMAGISTIC STRUCTURAL PROGRESSION IN GLAUCOMA.

Rom J Ophthalmol 2015 Jul-Sep;59(3):129-32

Glaucoma is a progressive optic neuropathy, characterized by loss of retinal ganglion cells and retinal nerve fiber layer as well as visual field loss. Therefore, in glaucoma, the correlation between structure and function is important, since it can be useful for tracking glaucomatous changes and for following the progression of the disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5712955PMC
April 2016

[Different significance in normal subjects and in glaucoma patients tested with Optopol PTS-910, in the galucoma program].

Oftalmologia 2013 ;57(1):33-9

Universitatea de Medicină şi Farmacie Carol Davila Bucureşti.

Purpose: to quantify the inter-test variability (dB) for the Optopol PTS automated perimeter, Glaucoma Fast threshold program.

Materials And Method: A prospective study was performed on 166 glaucomatous patients and a control group of 30 normal subjects, tested by complete ophthalmological exam and automated perimetry (Optopol PTS-910). The visual field was tested weekly for 4 consecutive weeks. The visual field defects were classified according to the Aulhorn-Karmeyer descriptive scale.

Results: For the control group, the medium inter-test variability was of 1.57 +/- 0.24 dB, lower next to fixation and increasing towards the 50 degree isopter. The medium inter-test variability increases along with the perimetric stage :1.57 +/- 0.66 dB for pre-perimetric glaucoma, 2.13 + 1.04 dB for non-specific defects group, 3.23 + 1.01 dB for the stage 1, 3.52 + 2.61 dB, for the stage 2, 3.65 + 1.19dB for the stage 3 and 5.82 +/- 1.67dB for the stage 4. For the cases of preperimetric glaucoma and non-specific defects, a similar profile of variability to the normal subjects can be observed. For the stages 2-4, the profile of the areas with maxim inter-test variability moves towards the relative scotoma and the surrounding area.

Conclusions: A better description of the inter-test variability and the evolution of this intricate parameter of the retinal light sensitivity is useful for the differential diagnostic between the real change and the "background noise" in early detection of the functional progression in glaucoma.
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January 2014