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AIM OF THE STUDY: The purpose of this study was to estimate and evaluate costs of glaucoma therapy in Poland in 1998-2000 years. MATERIAL AND METHODS: 315 patients (591 eyes) including 364 POAG eyes and 227 PACG eyes were evaluated. Progression of the disease was measured in two modes: by changes in the optical nerve disc (c/d) and by IOP level. Duration of the study was 12 months. Total costs (e.g. number of visits, amount of medications used, surgical and laser procedures performed) were calculated on 100 eyes/12 months. RESULTS: Pharmacological therapy constitutes 40-50% of the total costs in both glaucoma types. Timolol was the mostly prescribed drug in POAG, while pilocarpine led in PACG group. Dorzolamide was on the third place, but it generated the biggest part of total costs. Patients with advanced forms of the disease more frequently saw doctor on visits (average 6 visits per year); patients with elevated IOP (> 21 mm Hg) underwent surgical procedures more commonly than these with optical nerve disc changes (c/d > 0.6). The total costs of the therapy of non-advanced cases amounted 70.243 PLN on the average, while in advanced cases it reached the average of 155.230 PLN. CONCLUSION: 1. The total cost of glaucoma therapy depends on progression of the disease. 2. The most cost-generating part is the pharmacological therapy of glaucoma.

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PURPOSE: Analysis of local and systemic effects of RS-timolol enantiomer and S-timolol in patients with ocular hypertension and glaucoma: evaluation of Risk/Benefit Ratio. MATERIAL AND METHODS: 19 patients (38 eyes) receiving 0.85% RS-timolol and 10 patients (20 eyes) receiving 0.5% S-timolol were evaluated using a double-blank test. Intraocular pressure, heart rate, systemic arterial blood pressure, ECG and spirometry were recorded before and 2 hours after drugs administration and after 7 days of treatment. RESULTS: There were no statistically significant differences between intraocular pressure-lowering effects of RS-timolol and S-timolol. In patients receiving both medicines bradycardia was detected 2 hours after drugs administration. Patients receiving RS-timolol showed increased expiratory capacity in comparison to those receiving S-timolol. There was no detectable influence of both medicines on ECG and systemic arterial blood pressure. CONCLUSIONS: 0.85% RS-timolol and 0.5% S-timolol produced comparable intraocular pressure-lowering effects. 0.85% RS-timolol exerted less severe influence on respiratory system.

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PURPOSE: It is assumed that S-timolol can produce more severe systemic adverse reactions than R-timolol. The aim of this study was to estimate the intraocular pressure-lowering effect of RS-timolol in comparison to R-timolol and S-timolol in water-loaded rabbits. MATERIAL AND METHODS: Ocular hypertension was provoked in rabbits by orogastric water loading. Topical administration of one of three timolol solutions: 0.85%, RS-timolol, or 3% R-timolol, or 0.5% S-timolol was performed to the right eyes 40 min before starting the water loading procedure. Left eyes served as a control group. Intraocular pressure was measured before and 30, 60, 90, 120 min after the water loading. RESULTS: Intraocular pressure-lowering effect of all three timolol solutions was comparable. CONCLUSION: RS-timolol can be effective for lowering intraocular pressure in rabbits.

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A case of a 25-year-old female patient with reduction of visual acuity, strabismus convergence with corneal scars and paralimbal neovascularisation of her left eye with skin changes of linear skin naevus type is presented. The diagnosis of Jadassohn-Lewandowsky syndrome was based on characteristic skin and eye disturbances. There are also typical changes in mucous membranes and central nervous system. The treatment is difficult and a certain role may be played by cosmetic and repair surgery.

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PURPOSE: Evaluation of eye drops Dipivefrine chloride 0.1% produced by WZF "Polfa". MATERIAL AND METHODS: Drug influence on the level of intraocular pressure and outflow facility coefficient was examined, as well as general blood pressure and pulse in patients with open angle glaucoma. Effectiveness of the drug was compared with its analogue produced abroad. The drug was tested in 2 groups of patients, 30 eyes in each. Statistic analysis of examined parametres we done after 2 weeks administration. RESULTS: Significant decrease of intraocular pressure was found after the administration of 0.1% Dipivefrine Chloride, especially in combined treatment with 0.5% Oftensin. No significant differences were found in outflow facility, and in comparison with the foreign analogue of the drug.

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Presented are the results of trials with hydrogel inserts received by radiation method and applied into the conjunctival sac of rabbits. In the future they can serve for incorporation of some definite drugs.

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Presented is a case of Weill-Marchesani syndrome complicated by acute attacks not responding to conservative treatment. The authors discuss a correct procedure in these cases and indications for a surgical intervention.

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Investigations were carried out in 25 patients with carotid arteries changes. A 2 MHz head was used. Direction of the flow, the average speed and index of pulsation were determined. The results were compared with examinations in 13 healthy subjects. Disturbances of vision were shown by 11 patients (44 p.c.). A normal direction of blood perfusion was observed in 8 arteries (25 p.c.), a reversed one in 22 (69 p.c.), in 2 patients no Doppler's signal could be obtained. In arteries with a reversal flow of blood the authors observed the maximal mean speed and the lowest pulsation index. In neither case did the ophthalmological examinations reveal any embolic material. It seems that visual disturbances in patients with carotid arteries changes may be caused by a change of direction of the blood flow from a normal to a reversed one.

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An analysis of visual field changes in 105 patients treated conservatively and in 57 patients treated surgically is presented. Both groups have been observed for 5 years. It was established that the surgical procedure should be undertaken before the development of the changes in the visual field.

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The paper presents the results of surgical treatment of 171 eyes with primary glaucoma. Evaluated was the visual acuity, the visual fields, the coefficient of the aqueous outflow and the mean values of the IOP, 5, 3 and below 3 years since operation. The pharmacological treatment was included in 18% of the operated patients.

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