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Anterior Eye Segment: HELP
Articles from Bulgaria
Based on 22 articles published since 2010
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These are the 22 published articles about Anterior Eye Segment that originated from Bulgaria during 2010-2020.
 
+ Citations + Abstracts
1 Review Simple limbal epithelial transplantation: a review on current approach and future directions. 2018

Borroni, Davide / Wowra, Bogumil / Romano, Vito / Boyadzhieva, Maria / Ponzin, Diego / Ferrari, Stefano / Ahmad, Sajjad / Parekh, Mohit. ·Department of Ophthalmology, Riga Stradins University, Riga, Latvia; Department of Genetics, Riga Stradins University, Riga, Latvia. · Department of Ophthalmology, Medical University of Silesia, Katowice, Poland. · Department of Corneal and External Eye Diseases, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, University of Liverpool, Liverpool, UK. · Department of Ophthalmology, Medical University of Varna, Varna, Bulgaria. · International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy. · Moorfields Eye Hospital NHS Foundation Trust, London, UK; University College London Institute of Ophthalmology, London, UK. · International Center for Ocular Physiopathology, The Veneto Eye Bank Foundation, Venice, Italy. Electronic address: mohit.parekh@fbov.it. ·Surv Ophthalmol · Pubmed #29800578.

ABSTRACT: Simple limbal epithelial transplantation is a recently developed technique for treating limbal stem cell deficiency caused by ocular burns. A small limbal biopsy from the donor eye, usually from the patient's healthy eye, is excised and dissected into multiple pieces. An amniotic membrane is atttached using fibrin glue on the diseased eye after removing the conjunctivalized pannus from the corneal surface. The limbal biopsy pieces are placed onto the amniotic membrane, fixed with fibrin glue, followed by bandaging of the ocular surface with a contact lens. This technique (auto simple limbal epithelial transplantation) offers easier surgical manipulations and economic advantages over other techniques for the treatment of limbal stem cell deficiency. We therefore review simple limbal epithelial transplantation along with recent modifications in the technique and case studies, including challenges and failures.

2 Article UV damage of the anterior ocular surface - microstructural evidence by in vivo confocal microscopy. 2018

Grupcheva, Christina N / Grupchev, Dimitar I / Radeva, Mladena N / Hristova, Elitsa G. ·Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria. Electronic address: cgrupcheva@gmail.com. · Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria. Electronic address: dgrupchev@gmail.com. · Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria. Electronic address: mladenaradeva@gmail.com. · Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria. Electronic address: elica_gercheva@abv.bg. ·Cont Lens Anterior Eye · Pubmed #30458934.

ABSTRACT: PURPOSE: To evaluate and describe the microstructural changes at the ocular surface in response to habitual ocular sun exposure, correlate them with the UV protection habits and follow their dynamics using in vivo confocal microscopy(ICM). METHODS: For a period of minimum 4 months 200 subjects (400 eyes), aged 28 ± 7.3 years, were recruited with the agreement that they will spend their summer exclusively in the region of the Black Sea coast at 43 °N latitude and will be examined before and after the summer. All subjects filled in a questionnaire about habitual UV protection and were examined clinically and by ICM. RESULTS: Questionnaire results demonstrated that 83.5% (167 participants) of the subjects considered the sun dangerous for their eyes, but 78% (156 subjects) believed that there is danger exclusively during the summer period. Although no clinical changes were detected, microstructural analysis of the cornea demonstrated statistically significant (p = 0.021) decrease of the basal epithelial density - from 6167 ± 151 cells/mm CONCLUSION: Summer sun exposure for one season leads to clinically undetectable, microstructural changes affecting the cornea, bulbar and palpebral conjunctiva with transient, but possibly cumulative nature.

3 Article Catheter-assisted 360-Degree Trabeculotomy for Congenital Glaucoma. 2018

Toshev, Anani P / Much, Martin M / Klink, Thomas / Pfeiffer, Norbert / Hoffmann, Esther M / Grehn, Franz. ·Department of Ophthalmology, University Medical Center Mainz, Mainz. · Department of Ophthalmology, Alexandrovska University Hospital, Sofia, Bulgaria. · Kliniken der Stadt Köln, Augenklinik, Krankenhaus Köln-Merheim, Cologne. · Department of Ophthalmology, University Hospitals Wuerzburg, Wuerzburg, Germany. · Herzog Carl Theodor Eye Hospital, Munich. ·J Glaucoma · Pubmed #29965889.

ABSTRACT: PURPOSE: To determine feasibility, efficacy, and safety of ab externo 360-degree trabeculotomy with illuminated microcatheter for congenital glaucoma. PATIENTS AND METHODS: The postoperative results of 36 eyes in 23 consecutive patients who underwent 360-degree trabeculotomy for primary congenital glaucoma (PCG) or secondary congenital glaucoma using an illuminated microcatheter were retrospectively analyzed. Success criteria were defined as intraocular pressure (IOP) ≤18 mm Hg without (complete success) and with medication (qualified success). RESULTS: In all previously nonoperated eyes with PCG (group 1), the Schlemm's canal was identified and circumferentially cannulated for 360-degree trabeculotomy. In group 2 comprising of operated eyes with PCG and eyes with secondary congenital glaucoma, the performance of 360-degree trabeculotomy failed in 4 eyes because of the Schlemm's canal occlusion or high tissue resistance of the trabecular meshwork. Mean preoperative IOP was 28.6±5 and 29.6±9 mm Hg with 7 of 20 eyes and 7 of 9 eyes receiving IOP-lowering medication in group 1 and group 2, respectively. Mean postoperative IOP was reduced to 13±2.7 and 20.2±7.1 mm Hg after a mean follow-up of 15.3 and 12.7 months with 4 of 20 eyes and 5 of 9 eyes receiving medication in group 1 and group 2, respectively. Four eyes underwent further surgery. Complete success was achieved in 16 and 3 eyes, whereas qualified success was achieved in 20 and 4 eyes from group 1 and group 2, respectively. In all eyes, a mild to moderate postoperative hyphema was observed. CONCLUSIONS: Ab externo catheter-assisted 360-degree trabeculotomy controls IOP in a majority of patients with congenital glaucoma after a single operation. Moderate blood reflux in the anterior chamber is considered as a common postoperative finding. We did not observe hypotony or other severe complications in our series. In 1 patient, we experienced catheter misdirection in an eye that had previously undergone trabeculotomy.

4 Article In vivo confocal microstructural analysis of corneas presenting Kayser-Fleischer rings in patients with Wilson's disease. 2018

Grupchev, Dimitar Ivanov / Radeva, Mladena Nikolaeva / Georgieva, Miglena / Grupcheva, Christina N. ·Medical University of Varna, Varna, Bulgaria. ·Arq Bras Oftalmol · Pubmed #29846416.

ABSTRACT: PURPOSE: To evaluate microstructural differences between corneas with and without Kayser-Fleischer rings in age-matched subjects with Wilson's disease with neurological symptoms, using confocal laser scanning microscopy. METHODS: The study included 12 subjects with Wilson's disease with neurological symptoms. Twelve corneas presented clinically with classic Kayser-Fleischer rings, visible on slit lamp examination; the other 12 served as controls. The subjects underwent a comprehensive clinical examination. Microstructural analysis using confocal laser scanning microscopy evaluated increased corneal thickness, decreased number of cells, increased debris or specific deposits, and unusual microstructures. RESULTS: Clinically, the subjects with Kayser-Fleischer rings had similar corneal findings and normal intraocular pressure; two had typical sunflower cataracts and decreased visual acuity. The control eyes all presented normal visual acuity, intraocular pressure, and corneal appearance. The microstructural analysis demonstrated similar findings in all the affected corneas. Compared with the control corneas, there were fewer keratocytes in the anterior stroma (17.380 vs. 22.380/mm3). Round, "hollow" dark areas were observed between the keratocytes; these were universal and similar in appearance in all affected corneas and all cornea layers. In the peripheral posterior stroma, there were dust-like, bright, granular deposits that tended to increase in number and density toward Descemet's membrane, masking the peripheral endothelium. The control corneas presented a normal microstructure apart from dust-like granular deposits in the periphery. CONCLUSIONS: In vivo confocal microscopy is a useful tool for evaluating the corneal microstructure when a Kayser-Fleischer ring is clinically present. The ring consists of granular, bright particles that increase in density toward Descemet's membrane, and is associated with a decreased number of keratocytes and peculiar dark, round areas in all stromal layers, probably a sign of corneal damage. When the ring is not visible in subjects with Wilson's disease, changes to the corneal microstructure are insignificant.

5 Article Ophthalmomyiasis caused by larvae of the parasite Oestrus ovis. 2018

Velev, V / Mikov, O. ·University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Medical University of Sofia, Sofia, Bulgaria. · National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria. ·QJM · Pubmed #29800329.

ABSTRACT: -- No abstract --

6 Article Microstructural evaluation of the mucin balls and their relations to the corneal surface-Insights by in vivo confocal microscopy. 2017

Grupcheva, Christina N / Grupchev, Dimitar I / Radeva, Mladena N / Vankova, Desislava I / Manolova, Yana M. ·Department of Ophthalmology and Visual Science, Medical University of Varna, 55 Marin Drinov Str. Varna, Bulgaria. Electronic address: cgrupcheva@gmail.com. · Department of Ophthalmology and Visual Science, Medical University of Varna, 55 Marin Drinov Str. Varna, Bulgaria. Electronic address: dgrupchev@gmail.com. · Department of Ophthalmology and Visual Science, Medical University of Varna, 55 Marin Drinov Str. Varna, Bulgaria. Electronic address: mladenaradeva@gmail.com. · Department of Ophthalmology and Visual Science, Medical University of Varna, 55 Marin Drinov Str. Varna, Bulgaria. Electronic address: vanko07@gmail.com. · Department of Ophthalmology and Visual Science, Medical University of Varna, 55 Marin Drinov Str. Varna, Bulgaria. Electronic address: y.m.manolova@gmail.com. ·Cont Lens Anterior Eye · Pubmed #28666677.

ABSTRACT: PURPOSE: The purpose of the current study was to observe and correlate the characteristics of mucin balls to the ocular surface properties, and furthermore, to report the effect of different mucin balls size and number on structural alteration of the anterior cornea. METHODS: The study included, two groups of patients fitted with one-month continuous, extended wear lenses for therapeutic (group 1) and optical (group 2) purposes; the later serving as a control group. Group 1 was comprised of patients with recurrent erosion syndrome, while group 2 included subjects with mild myopia and voluntary use of continuous wear lenses. The examination was performed when mucin balls were encountered during a routine visit. Clinical examination was reinforced with laser scanning in vivo confocal microscopy, which provided microstructural observations. The appearance and size of the mucin balls were described and measured at two independent time points. Qualitative analysis included shape (round, elliptical and irregular) and reflectivity (bright, homogenous and dark, heterogonous). RESULTS: Clinically 1460 mucin balls were encountered (822 in group 1 and 638 in group 2). The number of mucin balls analyzed by in vivo confocal microscopy was 820. Diversity was higher in group 1. The mucin balls of group 2, were more uniform - rounded in shape 81,2% and regular in reflectivity 98%. Qualitative analysis revealed a negative correlation between the size of the balls and impact on the basal epithelium morphology and also "activation" of the anterior stroma in adjacent areas. CONCLUSIONS: Mucin balls affect corneal surface including both epithelia disintegration as well as keratocyte "activation". The main predisposing factor for mucin ball formation appear to be the corneal surface irregularity. As structural alterations of the cornea are transient, mucin balls might be beneficial for corneal restoration due to mechanical and/or biochemical stimulation. In vivo, confocal microscopy is an innovative tool for evaluating mucin balls in their diversity and dynamics.

7 Article Immunological and pathological investigations in equine experimental uveitis. 2016

Simeonova, Galina P / Krastev, Svetozar Z / Simeonov, Radostin S. ·Department of Veterinary Surgery, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria. galinavet@abv.bg. · Department of Veterinary Surgery, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria. · Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria. ·Vet Res Commun · Pubmed #27344152.

ABSTRACT: BACKGROUND: The pathogenic mechanism of equine recurrent uveitis (ERU) is still poorly defined and many variations between experimental animal models and spontaneous disease exist. OBJECTIVES: The aim of our study was to investigate if Th17 cell-mediated response plays role in the pathogenesis of the used experimental model in horses and to reveal its pathological findings. METHODS: Experimental uveitis was induced in 6 healthy horses. The concentrations of retinal autoantigen CRALBP and IL-17 were measured using ELISA in aqueous humor and vitreous body of the 12 inflamed eyes as well as in 12 control non-inflamed eyes taken from 6 horses in slaughter house. After centrifugation of the two eye media, smears were prepared and cytological investigation was performed. Tissue specimens were taken from all eye globes and were submitted to histopathological investigation. RESULTS: CRALBP and IL-17 concentrations were significantly elevated in eye media of horses with experimental uveitis in comparison with controls. Cytological and histopathological findings corresponded to the changes characteristic of chronic immune-mediated inflammation with mononuclear cell infiltration of uvea, choroid, retina, and eye media as well as severe retinal destruction. CONCLUSIONS: Our study demonstrated the involvement of the retinal autoantigen CRALBP as well as IL-17 in the pathogenesis of experimental uveitis in horses. These findings suggests that this experimental uveitis in horses may serve as a suitable animal model for investigation of IL-17- mediated immune response during spontaneous autoimmune uveitis in horses as well as in humans.

8 Article Nanosecond laser-assisted cataract surgery: Endothelial cell study. 2016

Tanev, Ivan / Tanev, Vesselin / Kanellopoulos, Anastasios John. ·From the Department of Ophthalmology (I. Tanev), Faculty of Medicine, Medical University, and the Eye Hospital Zrenie (V. Tanev), Sofia, Bulgaria · the LaserVision.gr Clinical & Research Eye Institute (Kanellopoulos), Athens, Greece · the New York University Medical School (Kanellopoulos), New York, New York, USA. ·J Cataract Refract Surg · Pubmed #27255249.

ABSTRACT: PURPOSE: To evaluate corneal endothelial cell density (ECD) and morphology after cataract surgery using coaxial ultrasound (US) phacoemulsification or a recently introduced coaxial nanosecond laser technique. SETTING: Department of Ophthalmology, Medical University of Sofia, Sofia, Bulgaria. DESIGN: Prospective cohort study. METHODS: Coaxial US phacoemulsification was performed in 1 eye (US group) and coaxial nanosecond laser-assisted cataract surgery in the contralateral eye (laser group) of the same patient. Nuclear sclerosis was graded from nuclear opalescence (NO) 3, nuclear color (NC) 3 to NO4, NC4 using the Lens Opacities Classification System III. The central ECD, coefficient of variation (CoV) in cell size (objective measure of polymegethism), and percentage of hexagonal cells (an index of pleomorphism) were evaluated. RESULTS: Eighty-two eyes (41 patients) had uneventful surgery. The mean ECD was 2517 cells/mm(2) ± 137 (SD) preoperatively and 2287 ± 155 cells/mm(2) at 2 years in the US group and 2521 ± 233 cells/mm(2) and 2420 ± 292 cells/mm(2), respectively, in the laser group (both P < .001). The mean CoV was 0.27 ± 2.4 preoperatively and 0.30 ± 2.4 at 2 years in the US group and 0.27 ± 2.8 and 0.27 ± 2.0, respectively, in the laser group (both P < .001). The mean percentage of hexagonal cells was 42.3% ± 3.6% preoperatively and 37.74% ± 3.54% at 2 years in the US group and 42.8% ± 3.2% and 43.00% ± 2.68%, respectively, in the laser group (both P < .001). CONCLUSION: Nanosecond laser phacoemulsification had advantages over US phacoemulsification in terms of endothelial cell structure preservation. FINANCIAL DISCLOSURES: Dr. Kanellopoulos is consultant to Alcon Surgical, Inc., Allergan, Inc., Avedro, Inc., Keramed, Inc., Optovue, Inc., i-Optics Corp., and Carl Zeiss Meditec AG. Neither of the other authors has a financial or proprietary interest in any material or method mentioned.

9 Article Keratopigmentation to Change the Apparent Color of the Human Eye: A Novel Indication for Corneal Tattooing. 2016

Alió, Jorge L / Rodriguez, Alejandra E / El Bahrawy, Mohamed / Angelov, Alexander / Zein, Ghasam. ·*IDI Department, VISSUM Instituo Oftalmológico de Alicante, Alicante, Spain; †Division of Ophthalmology, Miguel Hernandez University, Alicante, Spain; ‡Corneal Surgery Unit, Resbiomed/VISSUM Center, Sofia, Bulgaria; and §Ophthalmic Surgery Unit, Beverly Hills Medical Center, Kuwait City, Kuwait. ·Cornea · Pubmed #26845312.

ABSTRACT: BACKGROUND: Recently developed surgical techniques of keratopigmentation, assisted by femtosecond laser technology, using adequately developed micronized mineral pigments, have been reported to be efficient and conveniently safe as they are not associated with significant sight-threatening complications for changing the apparent color of the eye in cases of cosmetic therapeutic and functional keratopigmentation. We report the use of intrastromal keratopigmentation for electively changing the apparent color of the eyes, for purely cosmetic reasons. METHODS: In a case series, 7 patients underwent purely cosmetic keratopigmentation to change the apparent color of the eye. The indication was compassionate and the procedure was conducted under the tenets of the Helsinki Declaration. Superficial automated keratopigmentation, manual intralamellar keratopigmentation, and femtosecond-assisted keratopigmentation were used. In this study cosmetic outcome, patient satisfaction, visual outcomes, stability of pigmentation, and presence of any related complications are reported. RESULTS: In this study 42.8% were females, with a mean age of 40 years (27-63). In 4 patients, pigment retouch was done to improve the cosmetic outcome. Results were monitored by an independent observer with follow-up ranging from 6 months to 2.5 years. All patients expressed high satisfaction with the cosmetic outcomes, with no complications and stable visual acuity during the period of follow-up. CONCLUSIONS: As a novel indication, purely cosmetic keratopigmentation demonstrated stable pigmentation with no visual disability, high patient satisfaction, and favorable outcomes in all patients. Elective keratopigmentation seems to be a viable and convenient modality for changing the apparent color of the eye in selected cases.

10 Article Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus. 2015

Lang, Stefan J / Messmer, Elisabeth M / Geerling, Gerd / Mackert, Marc J / Brunner, Tobias / Dollak, Sylvia / Kutchoukov, Borislav / Böhringer, Daniel / Reinhard, Thomas / Maier, Philip. ·Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. stefan.lang@uniklinik-freiburg.de. · Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. elisabeth.messmer@med.uni-muenchen.de. · Department of Ophthalmology, University Hospital Würzburg, Würzburg, Germany. Geerling@med.uni-duesseldorf.de. · Department of Ophthalmology, Heinrich-Heine-University, Düsseldorf, Germany. Geerling@med.uni-duesseldorf.de. · Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Marc.Mackert@med.uni-muenchen.de. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. Brunner@sehkraft.de. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. sylvia.dollak@googlemail.com. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. kutchoukov@abv.bg. · Department of Ophthalmology, University Hospital "Alexandrovska", Sofia, Bulgaria. kutchoukov@abv.bg. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. Daniel.Boehringer@uniklinik-freiburg.de. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. thomas.reinhard@uniklinik-freiburg.de. · Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. philip.maier@uniklinik-freiburg.de. ·BMC Ophthalmol · Pubmed #26194634.

ABSTRACT: BACKGROUND: Corneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy. METHODS: The efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model. RESULTS: A total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/-standard deviation) by 0.35 +/- 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/- 0.61 dioptres/year. This difference was statistically significant (p = 0.02). CONCLUSIONS: Our data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not. TRIAL REGISTRATION: NCT00626717, Date of registration: February 20, 2008.

11 Article Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures. 2015

Romanova, K / Vassileva, J / Alyakov, M. ·Military Medical Academy, Sofia, Bulgaria kati_z@abv.bg. · National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria. · Military Medical Academy, Sofia, Bulgaria. ·Radiat Prot Dosimetry · Pubmed #25944961.

ABSTRACT: The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens.

12 Article Eye lens exposure to medical staff during endoscopic retrograde cholangiopancreatography. 2015

Zagorska, A / Romanova, K / Hristova-Popova, J / Vassileva, J / Katzarov, K. ·National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria; Medical University, Sofia, Bulgaria. Electronic address: zagorska.anna@gmail.com. · Military Medical Academy, Sofia, Bulgaria. · National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria. ·Phys Med · Pubmed #25937006.

ABSTRACT: The paper presents a study of the radiation doses to eye lens of medical staff during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed in a busy gastroenterology department. For each procedure the dose equivalent to the eye, exposure time, dose rate, Kerma Area Product and fluoroscopy time were recorded. Measurements were performed for a period of two months in four main positions of the operating staff, and then extrapolated to estimate annual doses. The fluoroscopy time per ERCP procedure varied between 1.0 min and 28.8 min, with a mean value of 4.6 min. The calculated mean eye dose per procedure varied between 34.9 μSv and 93.3 μSv. The results demonstrated that if eye protection is not used, annual doses to the eye lens of the gastroenterologist performing the procedure and the anesthesiologist can exceed the dose limit of 20 mSv per year.

13 Article Risk of radiation exposure to medical staff involved in interventional endourology. 2015

Hristova-Popova, J / Zagorska, A / Saltirov, I / Petkova, K / Vassileva, J. ·National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria yulia.hp@gmail.com. · National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria Medical University, Sofia, Bulgaria. · Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria. · National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria. ·Radiat Prot Dosimetry · Pubmed #25855076.

ABSTRACT: The aim is to estimate the possibility the new annual dose limit for eye lens to be exceeded and to study the impact of protective shield. Radiation exposure to medical personnel was evaluated with EDD-30 dosemeter in positions of operating surgeon, assisting doctor and nurse. At the operator's typical position for diagnosis and treatment of the urinary tract, the lens dose rates were 0.9 mSv h(-1) and 0.06 mSv h(-1) without and with lead shield. At the operator's position typical for percutaneous intervention dose rates were 1.9 and 0.02 mSv h(-1), respectively. At typical workload, the annual eye lens dose to the main operator without protective screen was estimated to be 29 mSv. With lead screen, operator lens dose can be reduced by a factor of 15-95 according to the procedure. Installation and use of lead screen and use of lead glasses were recommended to the endourology medical team.

14 Article Supraciliary Micro-stent Implantation for Open-Angle Glaucoma Failing Topical Therapy: 1-Year Results of a Multicenter Study. 2015

García-Feijoo, Julian / Rau, Magda / Grisanti, Swaantje / Grisanti, Salvatore / Höh, Helmut / Erb, Carl / Guguchkova, Pravoslava / Ahmed, Iqbal / Grabner, Günther / Reitsamer, Herbert / Shaarawy, Tarek / Ianchulev, Tsontcho. ·Instituto de Investigación, Biomedica Hospital Clinico San Carlos, UCM, Oftared, Madrid, Spain. · Eye Clinic, Cham, Germany. · University Clinic Schleswig-Holstein, Luebeck, Germany. · Eye Hospital, Luebeck, Germany. · Eye Hospital at the Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany; Teaching Hospital of the Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany. · Eye Clinic Wittenbergplatz, Berlin, Germany. · Eye Clinic of Sofia, Sofia, Bulgaria. · University of Toronto, Toronto, Canada. · Paracelsus Medical University, Salzburg, Austria. · University of Geneva, Geneva, Switzerland. · University of California at San Francisco, San Francisco, California. Electronic address: sianchulev@transcendmedical.com. ·Am J Ophthalmol · Pubmed #25747677.

ABSTRACT: PURPOSE: To evaluate the safety and efficacy of a supraciliary micro-stent (CyPass Micro-Stent; Transcend Medical, Menlo Park, California, USA) for surgical treatment of glaucoma in patients refractory to topical medications. DESIGN: Multicenter, single-arm interventional study. METHODS: Patients with open-angle glaucoma (Shaffer Grade 3 and 4) and uncontrolled medicated intraocular pressure (IOP) >21 mm Hg at baseline and candidates for conventional glaucoma surgery were enrolled. Glaucoma medications were discontinued at surgery and resumed at investigator discretion. CyPass Micro-Stent implantation was completed in all patients using a standard clear corneal approach. Adverse events, postoperative IOP changes, and need for IOP-lowering medications during the first 12 postoperative months (12M) were monitored. RESULTS: Sixty-five eyes were enrolled, and 55 were available at 12M, accounting for loss to follow-up and early termination. Baseline IOP was 24.5 ± 2.8 mm Hg, and the mean number of medications recorded was 2.2 ± 1.1. There were no serious intraoperative events or major adverse events (eg, retinal or choroidal detachment, persistent uveitis, persistent hyphema, hypotony maculopathy). The most common adverse events included IOP increases >30 mm Hg beyond 1 month (11%, 7/65), transient hyphema (6%, 4/65), and cataract progression (12%, 5/41 phakic eyes). Mean IOP was 16.4 ± 5.5 mm Hg at 12 months-a 34.7% reduction (P < .0001). Mean medication usage also decreased from baseline to a mean of 1.4 ± 1.3 medications at 12M (P = .002). In eyes originally indicated for conventional glaucoma surgery, no secondary surgery was performed in 83% (53/64). CONCLUSION: Supraciliary stenting with the CyPass Micro-Stent effectively lowers IOP as a surgical treatment for glaucoma, precluding the need for more invasive glaucoma surgery in >80% of patients at 1 year, thereby reducing postoperative glaucoma surgical complications.

15 Article The precorneal tear film as a fluid shell: the effect of blinking and saccades on tear film distribution and dynamics. 2014

Yokoi, Norihiko / Bron, Anthony J / Georgiev, Georgi As. ·Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: nyokoi@koto.kpu-m.ac.jp. · Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK. · Department of Biochemistry, Faculty of Biology, University of Sofia, Sofia, Bulgaria. ·Ocul Surf · Pubmed #25284771.

ABSTRACT: We conducted a series of experiments to elucidate the behavior of the human precorneal tear film (PCTF) during blinking and horizontal and vertical saccades. Methodology included video-interferometry with subsequent image cross-correlation (tear film lipid layer [TFLL]) and video-microscopy (mucoaqueous subphase [MAS]). We observed that the TFLL interference pattern deteriorates rapidly with successive blinks and degrades slowly with repeated horizontal saccades during blink suppression when dark arcs of thinning appear in the fluorescein-stained PCTF. Furthermore, after full downgaze and a return to the primary position, a transient horizontal bright band appears, deep to the spreading TFLL. It may be followed by local disturbances in the interference pattern. Two horizontal dark bands form in the stained PCTF after the return saccade. PCTF disruption may occur below the lower band during blink suppression. We concluded that shearing during horizontal saccades is insufficient to disturb the tear film structure greatly. The MAS and TFLL move together as a fluid shell. The dark arcs/bands are caused by meniscus-induced thinning, imprinted onto the PCTF at the lid margin. Their stability during blink suppression suggests that the MAS has gel-like properties. The horizontal bright bands are probably due to transient corneal indentation in downgaze. In downgaze, the disturbance of the TFLL and MAS below the dark bands is possibly due to shearing across the MAS in the return phase. This could cause desiccating stress in everyday activities, such as working at a computer.

16 Article Application of solid-phase extraction for the concentration of chromophores, fluorophores, and photosensitizers from lens protein digests. 2014

Argirov, Ognyan K / Hubenova, Yolina / Argirova, Mariana D. ·Mason Eye Institute, University of Missouri, Columbia, MO, USA; Department of Organic Chemistry, Plovdiv University "Paisii Hilendarski", Plovdiv, Bulgaria. ·J Sep Sci · Pubmed #25143146.

ABSTRACT: Solid-phase extraction was applied for the separation of protein digests obtained from aged human lenses, cataractous human lenses, calf lens proteins in vitro glycated with dehydroascorbic acid and native calf lens proteins. Four fractions were collected after stepwise elution with different solvents. The first fraction contained about 80% of the digested material possessing free amino groups. At the same time, the third and the fourth fractions were enriched in chromophores, fluorophores, and photosensitizing structures that originate mainly from advanced protein glycation. The comparison between the total digest and the fourth fraction based on their UV absorption at 330 nm, intensity of fluorescence (excitation/emission 350/450 nm), and production of singlet oxygen upon UVA irradiation argues that the solid-phase extraction was capable of concentrating the advanced glycation end-products about a hundredfold. Thus, this technique is a useful step for separation and concentration of fluorophores, chromophores, and photosensitizers from aged and glycated lens protein digests.

17 Article ABC transporters in the eyes of dogs and implications in drug therapy. 2013

Haritova, Aneliya M / Krastev, Svetozar Z / Santos, Regiane R / Schrickx, Johannes A / Fink-Gremmels, Johanna. ·Department of Pharmacology, Physiology of Animals and Physiological Chemistry, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria. haritova@uni-sz.bg ·Curr Eye Res · Pubmed #23373631.

ABSTRACT: PURPOSE: The current study aims to quantifies the level of expression of selected adenosine triphosphate-binding cassette (ABC) efflux transporters and the major drug metabolizing enzyme CYP450 3A12 in the eyes of dogs. MATERIALS AND METHODS: The levels of expression were quantified by real-time polymerase chain reaction in the cornea, conjunctiva and retinal tissue. RESULTS: ABCB1 mRNA is present at high levels in all analysed tissues. ABCC1, ABCC3 and ABCC4 are expressed predominantly in the conjunctiva and at very low levels in the cornea. ABCC2 could not be detected in any of the tissues. CYP3A12 expression was found in the retina and conjunctiva. CONCLUSION: These data are presented for the first time for ocular tissues of dogs of different breeds and a comparison with other species such as humans and rabbits demonstrated remarkable species differences, which might be of clinical relevance. The impact of these findings is discussed with reference to topical and systemic drug application in the treatment of ophthalmological diseases.

18 Article Surface chemistry study of the interactions of pharmaceutical ingredients with human meibum films. 2012

Georgiev, Georgi A / Yokoi, Norihiko / Ivanova, Slavyana / Krastev, Rumen / Lalchev, Zdravko. ·Department of Biochemistry, Faculty of Biology, University of Sofia, Sofia, Bulgaria. ggeorg@biofac.uni-sofia.bg ·Invest Ophthalmol Vis Sci · Pubmed #22695955.

ABSTRACT: PURPOSE: To perform a surface chemistry study of the interactions between the benzalkonium chloride (BAC)-preserved eyedrops Travatan, the SofZia-preserved TravatanZ, and the Polyquad-preserved DuoTrav, and tear film (TF) constituents. The interactions of TF compounds with the individual preservatives, BAC, SofZia, and Polyquad, were also examined. METHODS: Langmuir surface balance measurements were used to examine the interactions between the pharmaceuticals and films of human meibum and rabbit corneal cell lipid extracts. Surface pressure-area isocycles were used to assess the sample's capability to compress and spread during dynamic area changes. The dilatational rheologic properties of human meibum films, pure and in the presence of preservatives, were probed by stress-relaxation studies. Lipid film morphology was monitored by Brewster angle microscopy. The viability of SofZia- and Polyquad-treated Statens Seruminstitut Rabbit Cornea (SIRC) cell cultures was also evaluated. RESULTS: The interactions between BAC-preserved eyedrops and lipids resulted in impaired lipid spread, formation of discontinuous nonuniform surface layers, and increased surface pressure-area hysteresis during compression/expansion. In contrast, TravatanZ, DuoTrav, and the individual preservatives SofZia and Polyquad proved to be safe to the lipid film structure and isothermal reversibility. The stress-relaxation experiments revealed that the viscoelastic properties of meibomian film are impaired by BAC, and remain unaffected by SofZia and Polyquad. SIRC cells' viability and capability to form confluent cellular monolayer were also maintained after exposure to SofZia and Polyquad. CONCLUSIONS: Surface chemistry studies present criteria for preclinical in vitro molecular scale characterization of the interactions between eyedrop compounds and TF constituents.

19 Article Pharmacodynamic equivalence study of two preparations of eye drops containing dorzolamide and timolol in healthy volunteers. 2011

Gatchev, Emil / Petrov, Andrey / Kolev, Emil / Hristova, Russka / Demircheva, Irena / Koytchev, Rossen / Richter, Wolfram / Tegel, Friedrich / Thyroff-Friesinger, Ursula. ·Department of Clinical Pharmacology and Therapeutics, Medical University of Sofia, University Hospital Tsaritsa Joanna-ISUL, Bulgaria. ·Arzneimittelforschung · Pubmed #21755811.

ABSTRACT: OBJECTIVE: The aim of the present study was to assess the pharmacodynamic equivalence (lowering of intraocular pressure) of two preparations of eye drops containing 20 mg dorzolamide (CAS 120279-96-1) and 5 mg timolol (CAS 26839-75-8). METHOD: The study was conducted as a monocentric, observer-blinded, randomized, single-dose, two-period crossover study in 38 healthy volunteers. Each volunteer received on day 1 in each period in a random way a single dose of 1 drop of the test or the reference formulation in the conjunctival sac of the right eye separated by a wash-out period of 7 days. Measurement of intraocular pressure (IOP) of the right eye (by a blinded observer) was performed on day 1 of each study period pre-dose and 2 h post dosing by means of Goldmann applanation tonometry. In order to investigate the pharmacodynamic equivalence of both products, the two-sided 95% confidence interval was calculated for the difference of the primary target parameter (absolute decrease in IOP 2 h post dose), by means of a parametric (ANOVA) statistical method. RESULTS: The results of the statistical evaluation of the primary target parameter "absolute decrease in IOP 2 h post dose" demonstrated a decrease in the IOP of 4.72 mmHg for the eye treated with the test formulation (dorzolamide 20 mg/ml + timolol 5 mg/ml eye drops) and 4.61 mmHg for the treated with the reference formulation. The mean difference was 0.11 mmHg. The 95% confidence interval was between -0.33 and 0.55 mmHg and thus entirely within the pre-defined equivalence range (+/- 1.5 mmHg). The results of the statistical evaluation of the secondary target parameter relative (as % of baseline) decrease in IOP 2 h post dose demonstrated essentially similar effectiveness in lowering the IOP by 27.63% (test formulation) and 27.12% (reference formulation), respectively. Both drug products were well tolerated. CONCLUSION: Both formulations showed comparable results obtained at a time probably equal to the maximum effect concerning the primary target parameter lowering of IOP 2 h post dose. The safety profile of both preparations showed no difference.

20 Article Surface chemistry study of the interactions of benzalkonium chloride with films of meibum, corneal cells lipids, and whole tears. 2011

Georgiev, Georgi A / Yokoi, Norihiko / Koev, Krassimir / Kutsarova, Elena / Ivanova, Slavyana / Kyumurkov, Alexander / Jordanova, Albena / Krastev, Rumen / Lalchev, Zdravko. ·Department of Biochemistry, Faculty of Biology, University of Sofia, Bulgaria. ggeorg@biofac.uni-sofia.bg ·Invest Ophthalmol Vis Sci · Pubmed #21474774.

ABSTRACT: PURPOSE: To perform a surface chemistry study of the interactions between benzalkonium chloride (BAC), a common preservative used in ophthalmic formulations, and tear film (TF) constituents. METHODS: The interactions between BAC and human tears, meibum, and rabbit corneal cell lipid extracts at the air-water interface were examined in vitro during controlled compression-expansion of the film area by a Langmuir surface balance, surface potential measurements, and pendant drop-axisymmetric drop shape analysis (PD-ADSA). Surface pressure-area isotherms and isocycles were used to assess the sample's lateral elasticity and capability of compressing and spreading during dynamic area changes. Lipid film morphology was monitored by Brewster angle microscopy. The viability of BAC-treated Statens Seruminstitut rabbit cornea (SIRC) cell cultures was also examined. The BAC concentration was kept within the clinical range of 0.001% to 0.02%. RESULTS: In the Langmuir balance and PD-ADSA experiments, the interactions between BAC and lipids or tears resulted in (1) impaired lipid spread and formation of discontinuous nonuniform surface layers, (2) increased surface pressure-area hysteresis during compression and expansion, and (3) displacement of the lipids by BAC from the surface. A decrease (>50%) in SIRC cell viability was observed. The effects occurred within seconds after BAC exposure, and their magnitude increased with BAC concentration. CONCLUSIONS: The surface chemistry approach used in this study provided molecular-scale insights into the detrimental effect of BAC on TF, which well explain the TF instability and corneal epithelial barrier dysfunction after exposure to BAC in the in vivo human eye.

21 Minor Reply: To PMID 25747677. 2015

García-Feijoo, Julian / Rau, Magda / Grisanti, Swaantje / Grisanti, Salvatore / Höh, Helmut / Erb, Carl / Guguchkova, Pravoslava / Ahmed, Iqbal / Grabner, Günther / Reitsamer, Herbert / Shaarawy, Tarek / Ianchulev, Tsontcho. ·Madrid, Spain. · Cham, Germany. · Luebeck, Germany. · Neubrandenburg, Germany. · Berlin, Germany. · Sofia, Bulgaria. · Toronto, Canada. · Salzburg, Austria. · Geneva, Switzerland. · San Francisco, CA. ·Am J Ophthalmol · Pubmed #26422828.

ABSTRACT: -- No abstract --

22 Minor Malignant melanoma of the conjunctiva – successful surgical excision of the primary tumor and reconstruction by conjunctival auto transplantation from the contralateral eye. 2014

Sivkova, N / Chokoeva, A A / Dobrev, H / Staribratova, D / Belovezhdov, V / Tchernev, G / Wollina, U. ·University Eye Clinic, University Hospital “St George”- Plovdiv, Department of Ophthalmology, Medical University of Plovdiv, Bulgaria. · Onkoderma- Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26 Sofia, Bulgaria. · Department of General and Clinical Pathology, Medical University of Plovdiv, University hospital St. George, Plovdiv, Bulgaria. · Policlinic for Dermatology and Venereology, Saint Kliment Ohridski University, Medical Faculty, University Hospital, Sofia, Bulgaria. · Department of Dermatology and Allergology, Dresden- Friedrichstadt Hospital, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany. ·Int J Immunopathol Pharmacol · Pubmed #25572743.

ABSTRACT: Malignant melanoma of the conjunctiva is a rare tumor with incidence of 0.5 cases/year per million population. It may also occur as de novo, as on the basis of preexisting melanocytic lesions (nevus or freckle) or most often from the so-called primary acquired melanosis of the conjuctiva (PAM). It metastasizes mainly lymphogenic and hematogenous. The size of the primary tumor lesion, histopathological findings and absolute tumor thickness are essential for unfavorable prognosis. Conjunctival auto transplantation from the other eye is modern and innovative, but also a seldomly feasible method of reconstruction after conjunctival excision of tumors in this area. We present a rare case of a 75-year-old patient with epithelioid cell malignant melanoma of the bulbar conjunctiva of the right eye, which de novo occurred, successfully treated by excision of the primary tumor and subsequent reconstruction by conjunctival auto transplant from the other eye. A very good therapeutic and aesthetic result was achieved.