Faculty of Medicine

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PARTIAL AVULSION OF THE OPTIC NERVE HEAD: A CASE REPORT
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-07-18)
Klenkoski, Suzana
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Pandilov, Stefan
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Ristovska Smichkovska, Ema
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Avulsion of the optic nerve is a rare but quite serious injury characterized by severe and permanent visual impairment. It is mainly encountered in the working-age population, with a male predominance. In this paper, we describe the case of a 15-year-old patient who presented for an ophthalmological examination due to pain and sudden loss of vision in the left eye after an injury caused by a wooden object. Clinical and imaging examinations revealed a tissue defect at the level of the optic disc with surrounding intraretinal and preretinal hemorrhages and partial hemophthalmus in the central parts of the vitreous. A diagnosis of partial avulsion of the optic nerve papilla was made. The patient was evaluated over six months, during which there was a gradual resolution of the hemorrhages and a modest improvement in visual acuity. This case indicates the seriousness of the problem and the need for appropriate prevention as the most effective strategy in its management.
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BULL’S EYE: IS THIS PHENOMENON GIVEN ENOUGH ATTENTION
(Macedonian Association of Anatomists and Morphologists, 2024)
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Mediha Lushi Selimi
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Pecanova, Blagica
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Pachoska, Vesna
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Chloroquine maculopathy is not such a rare complication of long-term use of chloroquine preparations in the treatment of rheumatological diseases. Its early detection is of exceptional importance for timely discontinuation of the drug in order to preventirreversible vision damage.The aim of this Article is to present a case of a 62-year-old patient with bull's eye maculopathy as a result of long-term use of chloroquine due to systemic lupus erythematosus. The patient appeared with blurring and distortion of the pericentral vision. She was ophthalmologically evaluated with fundoscopic examination, autofluorescence, perimetry, optical coherent tomography which together with her medical history established a diagnosis of chloroquine maculopathy. Chloroquine therapy was discontinued and the patient is regularly monitored by a Rheumatologist and an Ophthalmologist, with no disease progression so far.
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THE ROLE OF MICROBIOME IN IMMUNE-MEDIATED UVEITIS -LITERATURE REVIEW
(Macedonian Association of Anatomists and Morphologists, 2024)
Pandilov, Stefan
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Nikolovska, Biljana
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The microbiome has important physiological functions and is an essential element in the control of the immune response in the body. Its dysbiosis is today associated with the pathogenesis of a number of diseases, including non-infectious uveitis. These are immunologically mediated conditions, where disruption of autotolerance towards intraocular structures and immune mimicry are the basis of the pathophysiological mechanism. The aim of this paper is to present the current knowledge related to this complex interaction between the microbiome and intraocular homeostasis, as well as directions for possible therapeutic solutions through quantitative and qualitative modification of the microbiota. During the preparation of this literature review, a meta-analysis of data obtained from several large databases was approached: PubMed, Medline and EMBASE. Keywords such as: non-infectious uveitis, microbiome, intestinal microbiome, probiotics, immune-mediated diseases, human microbiota were used in the search. The obtained results were selected, processed and didactically arranged in order to present relevant current scientific views.
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Рана детекција на кератоконус со оптичка кохерентна томографија за преден сегмент-преглед на литература
(Здружение на офталмолози на Македонија = Macedonian Association of Ophthalmologists, 2023-10)
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Pandilov, Stefan
Кератоконусот како најчесто ектатично заболување на корнеата при востановен облик претставува релативно лесно препознатлива состојба. Сепак раните субклинички форми, како и form-fruste формата на кератоконус претставуваат предизвик во офталмолошката пракса. Корнеалната топографија иако златен стандард во поставувањето на дијагнозата за кератоконус, има одредени ограничувања при неговата рана детекција. Токму при вакви случаи, оптичката кохерентна томографија (ОКТ) на предниот сегмент претставува значајна алатка во детектирањето на раните стадиуми на ова корнеално заболување. Фокусот на овој труд е насочен кон препознавање на иницијалните патохистолошки механизми кои се случуваат кај корнеата со кератоконус и визуелизација на таа состојба преку мапите на оптичката кохерентна томографија на предниот сегмент. Епителното ремоделирање на корнеата кое настанува на местото на формирање на конусот е пресликано на епителната мапа на дебелина на ОКТ. Дополнително на тоа пахиметриските мапи и анализата на истите ни даваат уште подетална слика за промените на корнеата при кератоконус. Значењето на раната дијагноза на оваа корнеална ектазија е исклучително големо поради можноста за тепраписки модалитети кои што доколку се применат навремено ќе се намали потребата од идна кератопластика.
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Mutation of ABCA4 gene as a cause of autosomal recessive form of Stargardt disease – case report
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-12)
Spirkovska Mangeroska, Angelka
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Pandilov, Stefan
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Rushiti, Muhamedin
Stargardt disease is the most common type of juvenile macular dystrophy. It is inherited autosomal recessively, although autosomal dominant forms have also been described. It affects both sexes equally, without racial predisposition. Patients experience a progressive deterioration of the macular region and loss of central vision, leading to legal blindness in the majority of affected individuals.In this paper, we describe the case of an 11-year-old boy who presented for an ophthalmological evaluation due to a progressive decrease in visual acuity. The fundoscopic examination supplemented with imaging ophthalmological methods were sufficient to establish a working diagnosis of Stargardt disease. The diagnosis was confirmed by genetic testing, a mutation of the ABCA4 gene, which is associated with this dystrophy. The importance of this case report is that it is one of the first documented cases of Stargardt disease with ABCA4 mutation in Macedonia
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ROLE OF IMMUNOMODULATORY AND BIOLOGICAL THERAPY IN THE TREATMENT OF PATIENTS WITH BEHCET'S UVEITIS -CASES FROM CLINICAL PRACTICE
(Macedonian Association of Anatomists and Morphologists, 2023-11)
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Pandilov, Stefan
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Guchev, Filip
Morbus Behcet is a multisystemic, chronic disease, vasculitis, of unknown etiology. The highest incidence is in the countries of the so-called â€œsilk roadâ€. In Macedonia, the frequency of this disease is currently unknown, but it is often under-diagnosed and unrecognized. In addition to the others, one of the main manifestations is ocular, which is presented by involvement of any of the structures of the uveal tract, the retina and the optic nerve. The diagnosis is established on the basis of clinical parameters, complemented by genetic analyses-HLA-B51 typing and Pathergy positive test and ophthalmic imaging-techniques such as OCT, OCT-A, FFA. Treatment of the condition is multidisciplinary with local and systemic corticosteroid therapy, conventional immunosuppressive drugs, and biological therapy. The aim of this paper is to present our experience in diagnosis and therapeutic modalities in patients with this disease.
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Bilateral congenital cataract in a newborn- literature review and case report
(Macedonian Association of Anatomists and Morphologists, 2023-12)
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Pandilov, Stefan
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Congenital cataract is the leading cause of childhood blindness. The etiology for its occurrence can be different: metabolic diseases, genetic factors, infectious agents, but mostly idiopathic. The purpose of this paper is to present a case of congenital cataract in a 10-day-old infant who presented with leukocoria in the first days of life, as well as to provide an overview of modern diagnostic and therapeutic modalities in the management of this ophthalmic condition. In the preparation of this topic, medically relevant data obtained from three large databases were used: PubMed, Embase and Scopus. Keywords such as: congenital cataract, newborn, leukocoria, red reflex were used during the search. The obtained data were selected and processed, while the latest and most relevant knowledge from this field was included in the preparation of this paper. Rapid recognition of this condition is important in order to preserve good visual function and avoid the potential complications of its presence: deprivation amblyopia, strabismus, nystagmus and glaucoma.
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OPHTHALMOLOGICAL MANIFESTATION OF ALBINISM
(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2023)
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Pandilov, Stefan
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Ivanova Cekov, Maja
Albinism is a large group of hereditary diseases characterized by reduced or completely absent synthesis of melanin in tissues of ectodermal origin. Patients with this pathology have frequent affection of the ocular structures, which are manifested by: reduced visual acuity, transillumination of the iris, hypoplasia of the fovea, nystagmus, strabismus, refractive errors and other. Prevention of UV rays, and early and appropriate management of ophthalmic manifestations is a key link in the treatment of patients with this condition. In this paper we have presented the most significant forms of albinism that are known in science today, as well as the spectrum of ophthalmological changes and their possible treatment.
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Adult -onset foveomacular vitelliform dystrophy-case report
(ZOM, 2023-04)
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Pandilov, Stefan
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Фовеомакуларната вителиформна дистрофиа (ФМВД) е вид на pattern дистрофија чие наследување најчесто е автозомно доминантно и се одликува со билатерално зафаќање на двете очи.Сепак во литературата се опишани и спорадични случаи, каде не е најдена генетска мутација, специфчна за заболувањето. Се карактеризира со акумулација на жолтеникав дистрофичен матерјал во предел на макулата, над ретинален пигментен епител.Болеста се развива постепено во неколку стадиуми, па така може да се откријат различни промени во различен временски период, почнувајќи од мали жолтеникави точки, па последователна вителиформна лезија во фовеоларна регија со централна хиперпигментирана точка, се до хориоретинални лузни и атрофии. Цел Приказ на спорадичен случај на адултна форма на фовеомакуларна вителиформна дистрофија кај пациент на 52 годишна возраст. Кај пациентот при рутински офталмолошки преглед беше забележана овална жолтеникаво пребоена елевирана лезија во предел на макула, обострано. Наодот беше евалуиран со повеќе сликовни техники како ОЦТ. ОЦТ-А, АФ, ФФА при штосе постави клиничка дијагноза за адултна форма на фовеомакуларна вителиформна дистрофија.Генетските анализи и фамилјарната анамнеза не дадоа податок за хередитарност на заболувањето, со што случајот се води како спорадичен и редовно се следи на нашата Клиника за можна прогресија. Заклучок Адултната форма на ФМВД не е така често заболување кое со помош на офталмолошките сликовни техники се диференцира од останатите pattern дистрофии како и останатите фовео-макуларни заболувања со сличен клинички аспект, се со цел пациентите со овој наод да бидат соодветно следени и лекувани.
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EVALUATION OF THE EFFECTS OF ANTI-VEGF TREATMENT ON SUBRETINAL FLUID IN THE WET FORM OF MACULAR DEGENERATION
(Македонско лекарско друштво = Macedonian medical association, 2022)
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Pandilov, Stefan
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Velkovska, Bisera
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Introduction. AMD is a progressive disease that can lead to changes and obstruction of the central vision. The neurodegenerative process starts at the level of the Burch membrane/choriocapillaris and a complex of photoreceptors/and retinal pigment epithelium (RPE). Agerelated macular degeneration (ARMD) in the United States and industrialized countries is a major cause of blindness in individuals aged 55 years and older. Degenerative changes affect the macula lutea (yellow dot) in the center of the retina. The World Health Organization (WHO) ranks AMD among the leading ophthalmic causes of blindness globally, and the third most common cause of legal blindness in 8.7% of the population in industrialized countries. In 2020, the number of patients with ARMD increased from 3 to 6 million, while by 2050, an increase of 17.8 million cases of senile macular degeneration is projected. Wet-exudative AMD covers 10-15% of patients with ARMD and is at high risk of severe impairment and/or loss of visual function. Neovascular ARMD is characterized by the appearance of a choroidal neovascular membrane (CNVM) and a secondary finding of pigment epithelium detachment (RPE rip), i.e., its tractional dehiscence or macular disciform scar. Common features of all exudative, wet forms of AMD are: 1. Leakage of fluid and serum components as a result of impaired blood-ocular barrier, 2. Intraretinal and subretinal fluid (IRF, SRF), 3. Lipid or (solid) exudates, 4. Subretinal hyperreflective material (SHRM)

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