The key role of the ophthalmologist in diagnosing botulism: two case reports.

Introduction: Botulinum toxin, the strongest known neurotoxin, is the cause of a rare fatal neuroparalytic disease characterized by the so-called "four Ds": diplopia, dysarthria, dysphagia, dry mouth. If left untreated, botulism may cause paralysis of the respiratory muscles, impairing the respiratory function which can ultimately lead to death.

Case Report: We describe the cases of two patients who presented, two years apart, with similar ocular symptoms such as blurred vision due to accommodation palsy, diplopia, accompanied by xerostomia and swallowing disorders, which were further confirmed as botulism.

Identifying Optical Coherence Tomography Markers for Multiple Sclerosis Diagnosis and Management.

Background: Multiple sclerosis (MS) is a common neurological disease affecting the optic nerve, directly or indirectly, through transsynaptic axonal degeneration along the visual pathway. New ophthalmological tools, arguably the most important being optical coherence tomography (OCT), could prove paramount in redefining MS diagnoses and shaping their follow-up protocols, even when the optic nerve is not involved.

Methods: A prospective clinical study was conducted.

Spiritual and religious perspectives in persons with visual impairment due to age-related macular degeneration.

Introduction: Age-related macular degeneration (AMD) is one of the global leading causes of severe vision loss. Patients suffering from AMD face complex spiritual and mental challenges that have an impact on the course of their disease, their quality of life, and their relationship with their surroundings.

Methods: A survey was carried out using a 21-item questionnaire between August 2020 and June 2021 among 117 patients from different countries to investigate how spirituality, religion, and their way of practicing them affected the experiences and daily lives of patients suffering from AMD, and whether it helped them cope with the disease.

Topical Treatment for Retinal Degenerative Pathologies: A Systematic Review.

The topical administration of medicines is the preferred route in ocular therapy, at least for the anterior segment of the eye. However, the eye's inherent functional and biological barriers all work against the active pharmaceutical ingredient (API) to efficiently reach the targeted retinal structures. The main objective of this article is to offer a systematic review of the scientific literature in recent years, focusing on the latest developments of topical treatment intended for retinal degenerative diseases.

Blue Light-Ocular and Systemic Damaging Effects: A Narrative Review.

Light is a fundamental aspect of our lives, being involved in the regulation of numerous processes in our body. While blue light has always existed in nature, with the ever-growing number of electronic devices that make use of short wavelength (blue) light, the human retina has seen increased exposure to it. Because it is at the high-energy end of the visible spectrum, many authors have investigated the theoretical harmful effects that it poses to the human retina and, more recently, the human body, given the discovery and characterization of the intrinsically photosensitive retinal ganglion cells.

Perspectives of Molecularly Imprinted Polymer-Based Drug Delivery Systems in Ocular Therapy.

Although the human eye is an easily accessible sensory organ, it remains a challenge for drug administration due to the presence of several anatomical and physiological barriers which limit the access of drugs to its internal structures. Molecular imprinting technology may be considered the avant-garde approach in advanced drug delivery applications and, in particular, in ocular therapy. In fact, molecularly imprinted polymers hold the promise to compensate for the current shortcomings of the available arsenal of drug delivery systems intended for ocular therapy.

Stem Cells in the Path of Light, from Corneal to Retinal Reconstruction.

The future of eye reconstruction invariably includes stem cells transplantation. Corneal limbus, corneal stroma, trabeculum, retinal cells, optic nerve, and all structures that are irreversibly damaged and have no means to be repaired or replaced, through conventional treatment or surgery, represent targets for stem cell reconstruction. This review tries to answer the question if there is any clinical validation for stem therapies, so far, starting from the cornea and, on the path of light, arriving to the retina.

Orbital metastatic neuroblastoma presenting as posttraumatic exophthalmos.

A 2-year-old female patient with a recent history of head trauma was admitted to the Ophthalmology Clinic with left exophthalmos. A differential diagnosis between traumatic and tumoral etiology was made. The orbitocranial MRI and fine needle ganglion biopsy settled the malignant etiology of the exophthalmia.

Clinical Outcomes From Cultivated Allogenic Stem Cells vs. Oral Mucosa Epithelial Transplants in Total Bilateral Stem Cells Deficiency.

Total bilateral limbal stem cell deficiency results from various pathologies, from burns (either chemical or physical) to Sjogren Syndrome, aniridia or ocular cicatricial pemphigoid. After the loss of stem cells, normal corneal epithelium is replaced by a more opaque and vascularized conjunctival epithelium, causing loss of vision. After 1997, cultivation techniques for limbal stem cells became possible.

Medicinal Plants and Natural Products Used in Cataract Management.

Cataract is the leading reason of blindness worldwide and is defined by the presence of any lens opacities or loss of transparency. The most common symptoms of cataract are impaired vision, decreased contrast sensitivity, color disturbance, and glare. Oxidative stress is among the main mechanisms involved in the development of age-related cataract.

Topical nanodelivery system of lutein for the prevention of selenite-induced cataract.

Cataracts are responsible for half of the world blindness, surgery being the only viable treatment. Lutein, a naturally occurring carotenoid in the eye, has the potential to reduce cataract progression by protecting the eye from photo-oxidative stress. To restore the eye's natural line of defense against photo-oxidative stress, a formulation was developed using zein and poly(lactic-co-glycolic acid) nanoparticles (NPs) embedded in an optimized bioadhesive thermosensitive gel for the delivery of lutein via topical application.

Epidemiology of ocular emergencies in Cluj ophthalmology clinic.

This study focused on the epidemiology of ocular diseases in the Eye Emergency Room. A cross-section retrospective study was performed in the Ophthalmology Clinic in Cluj-Napoca and included 11786 patients who presented to the Eye Emergency Room throughout the whole year, from January to December. Every month, between 782 to 1189 patients with an average age of 39.

Cultivation and characterization of limbal epithelial stem cells in rabbits.

Purpose: In the last decades, strong evidence emerged regarding the presence of stem cells located at the corneal limbus. Our objective was to find a way to isolate and cultivate rabbit corneal stem cells in vitro, into an epithelial tissue.

Materials And Methods: Two in vitro systems were developed to culture rabbit corneal stem cells: (1) limbal biopsies used as explants and cultivated on fresh denuded amniotic membrane and (2) a monolayer culture obtained by enzymatic treatment of the corneal biopsies.

In vitro expansion and characterization of corneal stem cells isolated from an eye with malignant melanoma.

Purpose: The objective of this study was the identification, characterization and in vitro replication of the human corneal stem cells, taking into consideration the difficulties in obtaining sufficient corneal material from living donors. The study explored a variety of stem cell markers, usually found in embryonic or adult mesenchymal stem cells. Culture medium and replication substrates had to be identified, with no data available on this subject in our country (there are no other reports on corneal stem cells in Romania, to our knowledge).

[Methods for sealing of corneal perforations].

A variety of corneal pathology can lead to corneal ulcers and perforations. A deep corneal ulcer may need surgical treatment to allow good volume restoration and reepithelisation. Corneal perforation must be sealed and when the perforation is large, the task of repairing the defect can be underwhelming.

[Amniotic membrane in conjunctivoplasty].

The basic principles of conjunctival reconstruction are similar in all pathologies that inflict conjunctival tissue loss. Large conjunctival defects are difficult to treat, with little conjunctival reserve that can be used to close the defect. The study had the objective to find alternatives to conjunctival autograft.

[Corneal stem cells].

Corneal stem cells are adult type stem cells located in the basal layer of the epithelium at the sclero-corneal limbus. Modern concepts regarding corneal stem cells are discussed, focusing on stem niche location, corneal healing mechanisms, methods to cultivate stem cells in vitro or genetic and structural characterization. Most of the research in this area was performed in the last decade.

Polymorphic variants of extracellular superoxide dismutase gene in a Romanian population with atheroma.

Extracellular superoxide dismutase (EC-SOD) is the main SOD isoform in the arterial wall contributing to cardiovascular defense against oxidative stress by removing the superoxide anion. In our study, the Thr40Ala and Arg213Gly polymorphic variants of the EC-SOD gene (SOD ( 3 )) were investigated for associations with atherosclerosis and other related factors in 144 subjects with significant atheroma (having one, two, or three major coronary arteries with >50% obstruction, and/or peripheral artery lesions, and/or carotid artery stenosis demonstrated by angiography and echography) and in 150 subjects with no significant atheroma. For the Arg213Gly polymorphism, only five heterozygous subjects were found.

[Changes in lacrimal secretion in rabbits according to meibomian glands activity].

Purpose: The purpose of this issue is to create an experimental animal model of dry eye and study the alteration of lachrymal secretion in time.

Materials And Methods: We used a group of 8 rabbits in which the Meibomian gland orifices of the right eye were individually closed by cauterization, the results being related to the sound left eye.

Results: We studied: the quantitative alteration of the lachrymal secretion using Schirmer 1 test; the alteration of lachrymal film using rose-bengal and fluorescein staining; the variation in tear protein concentration and histopathological changes in conjunctiva.

[Acute multifocal placoid pigment epiteliopathy].

Acute multifocal placoid pigment epitheliopathy is a fairly rare disease with unknown etiology and pathogenesis, possibly a focal response to a systemic inflammatory process. We present the case of a young patient who developed bilateral placoid retinal lesions, in different stages of evolution - cicatriceal lesions of the right eye and mixed cicatriceal and active lesions of the left eye. Investigations showed old immunity to cytomegalovirus and toxoplasma.

[Dry eye--etiopathogenic and histopathologic correlations].

Aims: To assess the role of the common inflammatory mechanism in the pathogenesis of the dry eye syndrome.

Methods: 64 patients with eye surface symptoms were studied using a diagnostic algorithm: questionnaire (eye symptoms were graded and a symptomatology SCORE was calculated), objective eye examination (including Schirmer's test and the tear film breakup time-BUT). Histopathological examination of 14 conjunctival bioptic fragments was performed.

[The influence of ocular surgery for lacrimal secretion].

Dry eye syndrome remains a constant health problem while more and more patients are being involved and final data concerning the etiopathology is still missing. This study investigates the hypothesis that ocular surgery inflicts damage on the tear production (regarding quantity, quality or the compositional aspect). Ocular symptoms were registered with the help of a questionnaire.

[Clinical and fluorescein angiographic aspects in retinal angiomatosis (von Hippel)].

Retinal angiomas represent a rare condition consisting of hamartomas isolated or associated with a systemic disease (Von Hippel-Lindau Disease). We present a patient with multiple retinal angiomas, with atypical fluorescein angiography possible due to vascular thrombotic phenomena. Visual acuity was slightly diminished because of hemorrhagic complications.

[Orbital lymphoma--a case report].

We present the case of a patient with an uncommon diagnosis in ophthalmologic practice. Clinical exam and complex investigations, including ocular echography and Doppler established the diagnosis of non-Hodgkin orbital and parotid lymphoma. With specific therapy (cytostatics) the evolution has been favorable.