Papers by Dimitar Dzhelebov
trakia journal of sciences, 2020
Angio-OCT clearly presents the blood supply to the retinal vascular plexus in the macular area. T... more Angio-OCT clearly presents the blood supply to the retinal vascular plexus in the macular area. The purpose of this study is to compare the data received from the examination of the vascular microvascular network in patients with diabetic retinopathy. Vascular density and perfusion have been found to be important indicators in diagnosing and monitoring disease progression.
Zur Pathogenese des akuten Winkelblocks: die Iris als Schwamm
Die Ophthalmologie, Feb 8, 2023
Open Access Macedonian Journal of Medical Sciences, Oct 28, 2018
BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease ... more BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease in premature babies. The presentation and course of ROP are determined by a complex interaction of a series of risk factors, including artificial reproductive technology (ART). AIM: To analyse and combine the information relating ART as an independent risk factor for retinopathy of prematurity. METHODS AND MATERIAL: The article is systematic review and meta-analysis using RevMan 5. Pubmed, Scopus and Medline were searched for articles from 1990 to 2018. RESULTS: Studies suggest that ROP is observed more frequently in ART children. They are more likely to be premature and of low birth weight than those conceived naturally. Results vary from just a tendency to a five-fold increase in risk to develop ROP in ART babies. At the same time, they might develop ROP later, and more mature newborns might be affected. CONCLUSION: The data relating ART as a risk factor for ROP is inconclusive, but most studies show at least a tendency. The ART newborns need to be considered as a risk group for ROP and observed with greater suspicion. Even more mature ART newborns might need to be screened in order not to miss any significant pathology.
Acta Medica Bulgarica, Sep 1, 2020
Background and purpose: The occurrence of primary orbital lymphoma comprises approximately 1% of ... more Background and purpose: The occurrence of primary orbital lymphoma comprises approximately 1% of non-Hodgkin's lymphoma and 8% of extranodal lymphoma. The vast majority of orbital lymphomas are of B-cell origin, of which extranodal marginal zone B-cell lymphoma is the most common subtype. The purpose of this paper was to present the diagnostic challenges in a case of orbital lymphoma. Case presentation: An 84year-old woman with orbital tumour was operated on after a long period of inappropriate treatment. It was later diagnosed as B-cell lymphoma. Conclusion: Orbital lymphoma can be easily mistaken for another ocular disease due to the slowly progressing non-specific complaints of the patients. We should be alert to the possibility of this ocular diagnosis when we are presented with an elderly patient with proptosis.
Biocompatibility and Antifibrotic Effect of UV-Cross-Linked Hyaluronate as a Release-System for Tranilast after Trabeculectomy in a Rabbit Model—a Pilot Study
Current Eye Research, May 11, 2012
To analyze the release kinetics and the clinical and histological effects of UV-cross-linked hyal... more To analyze the release kinetics and the clinical and histological effects of UV-cross-linked hyaluronic acid as a release-system for the transforming growth factor β-2 antagonist tranilast with anti-phlogistic properties on intraocular pressure after trabeculectomy in an aggressive scarring animal model. Hyaluronate acid was UV-cross linked and loaded with tranilast. The release of tranilast into a buffered salt solution was assessed spectrophotometrically. Glaucoma filtration surgery, similar to that performed in clinical practice, was performed on chinchilla rabbits. The rabbits were divided in 3 groups. (Group A: trabeculectomy alone, group B: trabeculectomy with a cross-linked hyaluronic acid gel preparation and group C: trabeculectomy with cross-linked hyaluronic gel preparation mixed with tranilast). Antifibrotic efficacy was established by clinical response and histologic examination. The cross-linked gels released tranilast for up to 26 h. The release plotted as a function of the square root of time was consistent with a largely diffusion-controlled release system. Both the gel preparation alone and the gel preparation mixed with tranilast were well tolerated in vivo. No adverse effects such as inflammation, corneal toxicity or blurring of the optical media were observed. The intraocular pressure reached preoperative levels within 9 days after surgery in control animals and group B, but remained significantly reduced (p = 0.00016) in the group with tranilast until day 22. The data of this pilot study suggest that the intraoperative application of UV-crossed linked hyaluronic acid used as a slow release system for tranilast may improve the surgical outcome of glaucoma filtration surgery.
Therapeutic advances in ophthalmology, 2023
The PreserFlo ® MicroShunt (Santen, Osaka, Japan) is effective in lowering IOP in primary open-an... more The PreserFlo ® MicroShunt (Santen, Osaka, Japan) is effective in lowering IOP in primary open-angle glaucoma. 5 It, however, is currently unclear whether it can reduce IOP fluctuations and to what extent. Here, we report the case of a patient who performed telemetric self-measurements with an EYEMATE-IO™ and underwent minimally invasive filtering bleb surgery with the PreserFlo ® MicroShunt. Case A 70-year-old patient with primary open-angle glaucoma was implanted with a second-generation
Klinische Monatsblatter Fur Augenheilkunde, Sep 13, 2011
Trakia Journal of Sciences, 2020
Angio-OCT clearly presents the blood supply to the retinal vascular plexus in the macular area. T... more Angio-OCT clearly presents the blood supply to the retinal vascular plexus in the macular area. The purpose of this study is to compare the data received from the examination of the vascular microvascular network in patients with diabetic retinopathy. Vascular density and perfusion have been found to be important indicators in diagnosing and monitoring disease progression.
Acta Medica Bulgarica, 2020
Background and purpose: The occurrence of primary orbital lymphoma comprises approximately 1% of ... more Background and purpose: The occurrence of primary orbital lymphoma comprises approximately 1% of non-Hodgkin’s lymphoma and 8% of extranodal lymphoma. The vast majority of orbital lymphomas are of B-cell origin, of which extranodal marginal zone B-cell lymphoma is the most common subtype. The purpose of this paper was to present the diagnostic challenges in a case of orbital lymphoma. Case presentation: An 84-year -old woman with orbital tumour was operated on after a long period of inappropriate treatment. It was later diagnosed as B-cell lymphoma. Conclusion: Orbital lymphoma can be easily mistaken for another ocular disease due to the slowly progressing non-specific complaints of the patients. We should be alert to the possibility of this ocular diagnosis when we are presented with an elderly patient with proptosis.
Zur Pathogenese des akuten Winkelblocks: die Iris als Schwamm
Die Ophthalmologie
Archäologische und forensische Ophthalmopathologie
Klinische Monatsblätter für Augenheilkunde, 2011
Obwohl die augenärztliche morphologische Diagnostik heutzutage großenteils von den Pathologen übe... more Obwohl die augenärztliche morphologische Diagnostik heutzutage großenteils von den Pathologen übernommen wird, ist die von Augenärzten ausgeübte Ophthalmopathologie weiterhin ein ganz wesentlicher Bestandteil der Augenheilkunde. Dabei geht es dieser alten ophthalmologischen Subdisziplin nicht allein um die feingewebliche Diagnose von Erkrankungen der Augen und der periokulären Region, sondern zunehmend auch um das Studium der Auswirkungen von Operationen auf das Auge und seine Adnexe sowie die Untersuchung der Interaktionen zwischen okulären Geweben und Kunststoffen. Auf diese Weise erfüllt die Ophthalmopathologie in der modernen Augenheilkunde ganz wesentliche Aufgaben in Forschung und Qualitätssicherung [1]. Sie bleibt darüber hinaus Grundlage aller operativer Interventionen am Auge [2]. Die Archäologie und die forensische Pathologie liegen „sehr weit an der Peripherie“ ophthalmopathologischer Tätigkeit und haben daher bisher, auch international gesehen, das Interesse von nur sehr wenigen Ophthalmopathologen gefunden, obwohl alle diese Disziplinen zum Teil ganz ähnliche Untersuchungstechniken verwenden.
Emile Javal (1839 – 1907) und seine Glaukom-Erblindung – ein Leben für Politik, Publizistik, sinnesphysiologische Forschung und Erblindete
Klinische Monatsblätter für Augenheilkunde, 2011
Annals of Clinical and Analytical Medicine, 2017
Retinal kanamalar, sağlıklı yenidoğanlarda doğumdan sonraki saatlerde izlenen, sık görülen bir du... more Retinal kanamalar, sağlıklı yenidoğanlarda doğumdan sonraki saatlerde izlenen, sık görülen bir durumdur. Bunların büyük bir yüzdesi, doğumdan sonraki ilk iki hafta içinde rezorbe olmaktadır ve sadece tek bir vakada dört haftadan sonra retinal kanamalar bildirilmektedir. Olgu Sunumu: Hastamız, gebeliğin 26. haftasında doğmuş, 690 gram ağırlığında prematüre bir bebektir. Prematürite Retinofatisi taraması sırasında alakalı herhangi bir bulguya rastlanmayıp, kanama bulundu. Tarama indirekt oftalmoskopi ile yapılmış olup, fotoğraflar ise, iphone'a uyarlı welch-allyn oftaloskop ile çekildi. Kanama 20 haftanın sonunda ancak tamamiyle rezorbe edilebildi. Vakanın retcam ile dökümantasyonu, oftalmoloji bölümüne sevkinden sonra mümkün olmuştur. Tartışma: Kanamaların prematüre ve sezeryanla doğmuş bebeklerde nadiren görülmesine rağmen, çok düşük kiloyla doğan ve yapay havalandırmaya tabi tutulan bebekler için hala büyük bir risk teşekkül etmektedir.
Eyelid Myokymia – is It a Warning Sign?
Science & Research, 2019
Background: Orbicularis myokymia frequently occurs in young, otherwise healthy individuals. The i... more Background: Orbicularis myokymia frequently occurs in young, otherwise healthy individuals. The intermittent muscle fasciculations are transient and generally disappear with time. Aims and tasks: to synthetise and analyse the causes, significance and treatment of eyelid myokymia Methods: a literature review; Data was collected from Pubmed, Scopus, Google Scholar, free search. Results: Eyelid myokymia, unlike myokymia of other facial muscles, is assumed to be a benign, selflimited disorder. It is associated with fatigue, anxiety, stress, exercise, physical exertion, cold weather, excessive use of caffeine, energy drinks, smoking, alcohol, female gender, and reduced sleep. Some authors reported it as a side effect of Topiramate. When it is chronic it might be considered as a separate disease entity of the facial nerve. In rare cases, the eyelid myokymia gradually spreads over several months to affect additional muscles on one or both sides of the face, producing benign essential bleph...
Detailed intraocular pressure curve by telemetric tonometry with an implanted pressure sensor before and after PreserFlo® MicroShunt implantation: a case report
Therapeutic Advances in Ophthalmology
Continuous control of intraocular pressure (IOP) is crucial to preventing long-term damage to the... more Continuous control of intraocular pressure (IOP) is crucial to preventing long-term damage to the optic nerve in glaucoma. Recently, a novel telemetric IOP sensor (EYEMATE-IO™, Implandata Ophthalmic Products GmbH, Hannover, Germany) has been developed that continuously records IOP. The patient can read the IOP measurements wirelessly using a hand-held reading device. We present the case of a 70-year-old patient with primary open-angle glaucoma who had been implanted with an EYEMATE-IO™ and recently underwent minimally invasive bleb-filtering surgery with the PreserFlo® MicroShunt (Santen, Osaka, Japan). This case demonstrates both the benefits of continuous pressure measurement with EYEMATE-IO™ and the ability of the PreserFlo® MicroShunt to significantly reduce IOP fluctuations.
Open Access Macedonian Journal of Medical Sciences, Oct 28, 2018
BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease ... more BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease in premature babies. The presentation and course of ROP are determined by a complex interaction of a series of risk factors, including artificial reproductive technology (ART). AIM: To analyse and combine the information relating ART as an independent risk factor for retinopathy of prematurity. METHODS AND MATERIAL: The article is systematic review and meta-analysis using RevMan 5. Pubmed, Scopus and Medline were searched for articles from 1990 to 2018. RESULTS: Studies suggest that ROP is observed more frequently in ART children. They are more likely to be premature and of low birth weight than those conceived naturally. Results vary from just a tendency to a five-fold increase in risk to develop ROP in ART babies. At the same time, they might develop ROP later, and more mature newborns might be affected. CONCLUSION: The data relating ART as a risk factor for ROP is inconclusive, but most studies show at least a tendency. The ART newborns need to be considered as a risk group for ROP and observed with greater suspicion. Even more mature ART newborns might need to be screened in order not to miss any significant pathology.
Open Access Macedonian Journal of Medical Sciences
BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease ... more BACKGROUND: Retinopathy of Prematurity (ROP) is a potentially blinding vasoproliferative disease in premature babies. The presentation and course of ROP are determined by a complex interaction of a series of risk factors, including artificial reproductive technology (ART). AIM: To analyse and combine the information relating ART as an independent risk factor for retinopathy of prematurity. METHODS AND MATERIAL: The article is systematic review and meta-analysis using RevMan 5. Pubmed, Scopus and Medline were searched for articles from 1990 to 2018. RESULTS: Studies suggest that ROP is observed more frequently in ART children. They are more likely to be premature and of low birth weight than those conceived naturally. Results vary from just a tendency to a five-fold increase in risk to develop ROP in ART babies. At the same time, they might develop ROP later, and more mature newborns might be affected. CONCLUSION: The data relating ART as a risk factor for ROP is inconclusive, but mo...
Biocompatibility and Antifibrotic Effect of UV-Cross-Linked Hyaluronate as a Release-System for Tranilast after Trabeculectomy in a Rabbit Model—a Pilot Study
Current Eye Research, 2012
To analyze the release kinetics and the clinical and histological effects of UV-cross-linked hyal... more To analyze the release kinetics and the clinical and histological effects of UV-cross-linked hyaluronic acid as a release-system for the transforming growth factor β-2 antagonist tranilast with anti-phlogistic properties on intraocular pressure after trabeculectomy in an aggressive scarring animal model. Hyaluronate acid was UV-cross linked and loaded with tranilast. The release of tranilast into a buffered salt solution was assessed spectrophotometrically. Glaucoma filtration surgery, similar to that performed in clinical practice, was performed on chinchilla rabbits. The rabbits were divided in 3 groups. (Group A: trabeculectomy alone, group B: trabeculectomy with a cross-linked hyaluronic acid gel preparation and group C: trabeculectomy with cross-linked hyaluronic gel preparation mixed with tranilast). Antifibrotic efficacy was established by clinical response and histologic examination. The cross-linked gels released tranilast for up to 26 h. The release plotted as a function of the square root of time was consistent with a largely diffusion-controlled release system. Both the gel preparation alone and the gel preparation mixed with tranilast were well tolerated in vivo. No adverse effects such as inflammation, corneal toxicity or blurring of the optical media were observed. The intraocular pressure reached preoperative levels within 9 days after surgery in control animals and group B, but remained significantly reduced (p = 0.00016) in the group with tranilast until day 22. The data of this pilot study suggest that the intraoperative application of UV-crossed linked hyaluronic acid used as a slow release system for tranilast may improve the surgical outcome of glaucoma filtration surgery.
Uploads
Papers by Dimitar Dzhelebov