Cesk Slov Oftalmol [JOURNAL]
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95TH ANNIVERSARY OF THE CZECHOSLOVAK OPHTHALMOLOGICAL SOCIETY.
Pitrová Š, Řehák J
Cesk Slov Oftalmol · 2022 · PMID 35300498 · Publisher ↗
After the end of the First World War, the most important event in the history of our country was the establishment of the Czechoslovak Republic on October 28, 1918. Professor Deyl repeatedly spoke about the need to estab...
After the end of the First World War, the most important event in the history of our country was the establishment of the Czechoslovak Republic on October 28, 1918. Professor Deyl repeatedly spoke about the need to establish a Czechoslovak Ophthalmological Society. Only his successor, professor. O. Lešer implemented Deyl's idea and, in agreement with the heads of the Bratislava and Brno departments of ophthalmology, convened the opening general meeting of the Czechoslovak Ophthalmological Society on April 3, 1926, in the auditorium of the Czech department of ophthalmology with the participation of 37 ophthalmologists. Not all Czechoslovak ophthalmologists were present at this first meeting of the Czechoslovak Ophthalmological Society; their number can be estimated at about 55 in 1926. Immediately after the founding of the Czechoslovak Ophthalmological Society in 1926, a yearbook of congress works began to be published in the same year, every year until 1932, a total of 7 volumes. By the decision of the General Meeting of the Czechoslovak Ophthalmological Society, held on 15 May 1933, the publication of congress works was built on a new basis. The current form of the collection was abandoned, and the periodical journal Czechoslovak Ophthalmology was founded. In 1954, the Slovak branch of the ophthalmological section of the Czechoslovak Ophthalmological Society was founded, which quickly developed its activities and twice a year organized very successful and scientifically valuable congresses with rich participation and discussion. The name of the organization "Slovak branch of the Ophthalmological Section of the Czechoslovak Medical Society of J. E. Purkyně" was chosen. In 1969, under the Federalization Act, medical societies were reorganized; the Czech and Slovak Ophthalmological Society is established. The Federal Committee has since consisted of the chairs and secretaries of the two National Committees, who took turns in the leadership of the Federal Committee during their term of office. After the division of Czechoslovakia in 1993, the name of the magazine changed. Until 1994 it was published under the name Czechoslovak Ophthalmology and since 1995 the name has been changed to Czech and Slovak Ophthalmology. The first issue was published in February 1995, the continuity of the journal and the numbering has been preserved.
BROLUCIZUMAB - A NEW PLAYER IN THE FIELD OF ANTI-VEGF THERAPY OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. A REVIEW.
Šín M
Cesk Slov Oftalmol · 2022 · PMID 35300497 · Publisher ↗
Vascular endothelial growth factor (VEGF) has been identified as a major promoter of the development of choroidal neovascularization in age-related macular degeneration. The development of choroidal neovascularization ca...
Vascular endothelial growth factor (VEGF) has been identified as a major promoter of the development of choroidal neovascularization in age-related macular degeneration. The development of choroidal neovascularization can be slowed by preventing the binding of vascular endothelial growth factor to cellular VEGF receptor-2 present on vascular endothelial cells, which represents the major proangiogenic stimulus. Advances in the development of anti-VEGF therapy have led to significant improvement in visual acuity outcomes in recent years that neovascular age-related macular degeneration can no longer be considered an incurable disease. Despite its many advantages, the current standard of care, which is the frequent application of VEGF blockers to the vitreous, is a significant burden on both the patient and the healthcare system. This review is aim on a new brolucizumab molecule (also known as RTH 258 or formerly ESBA 1008). The article focuses on the molecular aspects of the drug and an overview of the basic preclinical and clinical studies that were performed during drug development. Brolucizumab is a single chain fragment of a humanized monoclonal antibody with a molecular weight of 26 kDa that inhibits VEGF-A. Preclinical animal studies have shown good penetration of the molecule through the retina with minimal systemic exposure. The SEE study (phase 1/2) demonstrated safety and tolerability after drug administration. The OSPREY (phase 2) study demonstrated the same efficacy of brolucizumab on visual acuity in the 8-week dosing regimen compared to aflibercept. In the same study, patients were also pilot tested in a 12-week dosing regimen. The HAWK and HARRIER studies (phase 3) demonstrated the efficacy of the drug at a dose of 6 mg in a 12-week dosing schedule in 55.6 % and 51 % of patients, respectively.
INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY -AVAILABLE TECHNOLOGIES AND POSSIBILITIES OF USE. A REVIEW.
Benda T, Studený P
Cesk Slov Oftalmol · 2022 · PMID 35148610 · Publisher ↗
Optical coherence tomography (OCT) is a non-contact and non-invasive imaging and diagnostic method, that allows the imaging of ocular tissues on transverse sections in extremely high quality of micrometer resolution. The...
Optical coherence tomography (OCT) is a non-contact and non-invasive imaging and diagnostic method, that allows the imaging of ocular tissues on transverse sections in extremely high quality of micrometer resolution. The physical principle of OCT is analogous to ultrasound, but it uses infrared radiation instead of acoustic waves. By using a low coherent radiation source, it is possible to achieve a higher resolution. Based on the obtained data, the computer can reconstruct two or three-dimensional images of the examined tissue. In recent years, we have seen a rapid development in ophthalmic surgery, especially in surgical instruments and imaging methods. However, the technology of surgical microscopes does not change significantly and thus becomes a limiting factor in the development of ophthalmic microsurgery. The integration of the OCT into surgical microscopes, so the introduction of the Intraoperative Optical Coherence Tomography (iOCT), opens up further possibilities for displaying/looking at the operating field and adapting surgical techniques to the current situation during the surgery. On the contrary, the disadvantage is the prolongation of the surgery time and thus the theoretical increase in possible complications related to the surgery. iOCT can be used for operations on the anterior and posterior segment of the eye. In anterior segment surgery, it is used mostly in penetrating and lamellar keratoplasty, glaucoma surgery and cataract surgery. In posterior segment surgery, it is used during pars plana vitrectomy. The aim of the article is to provide a comprehensive overview of the current possibilities of using iOCT in eye surgery.
SCOTOMAS IN THE VISUAL FIELD AS THE FIRST SIGN OF INTRACRANIAL EXPANSION. CASE REPORT.
Horkovičová K, Krásnik V, Liška M
Cesk Slov Oftalmol · 2021 · PMID 35130707 · Publisher ↗
The most common cause of visual field loss in ophthalmology is glaucoma. Other causes of visual field damage include local damage to the eye itself in intrabulbar or retrobulbar neuritis or injuries. However, they can al...
The most common cause of visual field loss in ophthalmology is glaucoma. Other causes of visual field damage include local damage to the eye itself in intrabulbar or retrobulbar neuritis or injuries. However, they can also be caused by general diseases, e.g. in endocrine orbitopathy, toxic and nutritional neuropathy, or in diseases that are localized intracranially. Each of these findings in itself suggests the nature of the lesion, its intracranial location, lateral occurrence, as well as in which part of the visual pathway the lesion is located. The use of perimeter has therefore become the primary examination method, which is available, is not demanding and will quickly allow a diagnosis to be made. When found on a perimetric examination, it is necessary to indicate targeted imaging examinations, such as computed tomography or magnetic resonance imaging. The article describes a patient who was primarily examined at the Department of Ophthalmology, Faculty of Medicine, Comenius University and the University hospital of Bratislava. The patient reported visual field outages, and after subsequent computed tomography, she was interdisciplinary managed and surgery was done on at the Neurosurgical Department. After the operation, there was a significant improvement without a pathological finding on the perimeter.
CORNEAL NEUROTIZATION IN A PATIENT WITH SEVERE NEUROTROPHIC KERATOPATHY. CASE REPORT.
Rusňák Š, Hecová L, Štěpánek D … +1 more , Sobotová M
Cesk Slov Oftalmol · 2021 · PMID 35130706 · Publisher ↗
PURPOSE: Neurotrophic keratopathy (NK) is a degenerative corneal disease caused by damage to the trigeminal innervation due to a decrease in corneal sensitivity or complete anaesthesia. Impaired corneal innervation leads...
PURPOSE: Neurotrophic keratopathy (NK) is a degenerative corneal disease caused by damage to the trigeminal innervation due to a decrease in corneal sensitivity or complete anaesthesia. Impaired corneal innervation leads to morphological and metabolic disorders of the epithelium. In addition, it also leads to the development of recurrent or persistent epithelial defects in corneal ulcers, which may progress to stromal lysis and corneal perforation. One possible solution for severe NK is reinnervation of the anaesthetic cornea (corneal neurotization) using the supraorbital nerve and an autologous sensory nerve graft (indirect neurotization). This article presents the results of corneal neurotization in a young male patient with persistent epithelial defects and corneal ulcers due to corneal denervation. RESULTS: A 22-year-old man with a history of neurosurgery for astrocytoma of the cerebellum and trunk on the right side at the age of 2 years, was observed for postoperative paresis of the right facial nerve with lagophthalmos in his childhood. The presence of asymptomatic dysfunction of the right trigeminal nerve was also noted. At the age of 22 years, after right eyeball contusion, the vision of the right eye decreased and a persistent epithelial defect developed, followed by corneal ulceration. Due to the exhaustion of therapeutic options in a young patient with corneal anaesthesia, the cornea was reinnervated via the contralateral supraorbital nerve using an autologous sural nerve graft. Five months after the surgery, the sensitivity of the cornea of the right eye began to recover. After amniotic membrane transplantation, the extensive epithelial defect healed, and the opaque corneal stroma gradually cleared up. CONCLUSION: The reinnervation of the anaesthetic cornea (corneal neurotization) using the supraorbital nerve and the autologous sensory nerve graft represents a new solution for severe NK treatment. The severe corneal condition in our patient healed after the surgery.
CYCLOCRYOCOAGULATION IN SECONDARY NEOVASCULAR GLAUCOMA AND OUR RESULTS.
Tarková A, Hejsek L, Jirásková N … +1 more , Studnička J
Cesk Slov Oftalmol · 2021 · PMID 35130705 · Publisher ↗
PURPOSE: To retrospectively evaluate the use of cyclocryocoagulation (CCK) in secondary neovascular glaucomas performed at the Department of Ophthalmology, Faculty of Medicine, Charles University and University Hospital...
PURPOSE: To retrospectively evaluate the use of cyclocryocoagulation (CCK) in secondary neovascular glaucomas performed at the Department of Ophthalmology, Faculty of Medicine, Charles University and University Hospital Hradec Králové in the years 2016-2019. MATERIAL AND METHODS: In a retrospective study, 30 procedures of 26 eyes of 24 patients were evaluated. All patients underwent CCK surgery. The main entry criteria were the presence of secondary neovascular glaucoma in diabetes or on the basis of occlusion of the retinal artery or vein and subsequent dispensarization of the patient in the 1st and 6th month after the operation. The parameters evaluated were: the best-corrected visual acuity (BCVA), intraocular pressure value (IOP), data of pain and change in the number of active substances of antiglaucoma therapy. RESULTS: The mean age of patients at the time of the procedure was 62 years (range 22-85 years). The average number of procedures per eye was 1.15 out of a total of 30 procedures, 26 eyes were performed on 24 patients. The most common indication for CCK in secondary glaucoma-vascular complications in diabetes were in 21 procedures, vascular complications - after occlusion of the retinal vein or artery were in 9 cases. Two patients had both eyes operated on within one year. Three patients underwent two procedures on the same eye during the study period. One of them had two procedures on both eyes. The average value of the number of active substances of antiglaucoma drugs decreased from 3.10 to 2.87 after the 1st month (p = 0.318) and after 6 months it was 2.6 (p.
OCT ANGIOGRAPHY AND DOPPLER ULTRASOUND IN HYPERTENSION GLAUCOMA.
Lešták J, Fůs M, Benda A … +2 more , Bartošová L, Marešová K
Cesk Slov Oftalmol · 2021 · PMID 35130704 · Publisher ↗
AIMS: The main aim of this work was to find out if there is a correlation between vessel density (VD) and results of measured perfusion values in ophthalmic artery and in central retinal artery of the same eye in a group...
AIMS: The main aim of this work was to find out if there is a correlation between vessel density (VD) and results of measured perfusion values in ophthalmic artery and in central retinal artery of the same eye in a group with hypertension glaucoma (HTG). MATERIALS AND METHODS: The file included 20 patients with HTG, thereof 13 women of average age 68.7 years (49-80 years) and 7 men of average age 58.4 years (27-81 years). Criteria for inclusion in the study: visual acuity 1,0 with possible correction less than ±3 diopters, approximately the same changes in visual fields in every patient, intraocular pressure (IOP) less than 18 mmHg, no other ocular or neurological diseases. VD was measured by Avanti RTVue XR by Optovue firm, perfusion parameters were measured using Doppler ultrasound with Affinity 70G machine by Philips firm. The peak systolic velocity (PSV) and end diastolic velocity (EDV) and resistance index (RI) were measured both in ophthalmic artery (AO) and in central retinal artery (CRA). Visual field (VF) was examined by quick threshold glaucoma program by Medmont M 700 machine. The sum of sensitivities in apostilbs (abs) was evaluated in the range 0-22 degrees of visual field. The results of sensitivities in visual field were compared to VD and perfusion parameters in CRA and AO of the same eye. RESULTS: Pearsons correlation coefficient (p = 0,05) was used to assess the dependency between chosen parameters. By comparing VF and VD from measured areas, strong correlation (r = 0.64, resp. 0.65) was revealed. It was then proved that VD (WI-VDs) correlates with RICRA weakly (r = -0.35) and moderately strongly (WI-VDa r = -0.4, PP-VDs r = -0.43 and PP-VDa r = -0.45). This means that with increasing resistance index in CRA the density in VD decreases. The other correlations between VD and perfusion parameters (PSV and EDV) in CRA and AO were not significant. CONCLUSION: Measured values showed that the vascular component of VD has a huge impact on the changes in visual fields in HTG. Weak to moderate influence exists between VD and RI in CRA. OCTA has proven to be more suitable than Doppler ultrasound for determining the condition of blood circulation in the eye.
RETROSPECTIVE ANALYSIS OF THE PRESENCE OF CHOROIDAL NEOVASCULARISATION USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE TREATMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY WITH THE AID OF PHOTODYNAMIC THERAPY.
Myslík Manethová K, Ernest J
Cesk Slov Oftalmol · 2021 · PMID 35130703 · Publisher ↗
PURPOSE: Analysis of the presence of choroidal neovascularization (CNV) by optical coherence tomography angiography (OCTA) in eyes treated with photodynamic therapy in a reduced dosing regimen (HD-PDT, half dose of verte...
PURPOSE: Analysis of the presence of choroidal neovascularization (CNV) by optical coherence tomography angiography (OCTA) in eyes treated with photodynamic therapy in a reduced dosing regimen (HD-PDT, half dose of verteporfin) for the chronic form of central serous chorioretinopathy (cCSC). MATERIALS AND METHODS: Retrospective evaluation of OCTA findings in 54 eyes of 52 patients treated for cCSC with HD-PDT. OCTA was performed on Angioplex Zeiss Cirrus 5000 (Carl Zeiss Meditec, Dublin, CA, USA) 1 year after HD-PDT to verify changes typical of cCSC. By analyzing the results of this examination, we evaluated in particular the presence or absence of concomitant CNV and the correlation of the present CNV with the average resulting best corrected visual acuity (BCVA). RESULTS: We analyzed the OCTA findings of 54 eyes (52 patients), in which we demonstrated the presence of concomitant CNV in 35 eyes (35.2 %). Revealed CNV occurred in 82 % below the undulating hyperreflective RPE line. In eyes with CNV, the mean BCVA (72 letters ETDRS) was statistically significantly lower than in eyes without CNV (82.7 letters ETDRS) (p = 0.0179). CONCLUSION: In our retrospective evaluation of a group of patients who underwent HD-PDT for cCSC, we demonstrated with OCTA the presence of CNV in 35.2 % eyes 1 year after the treatment. We believe that the presence of type I CNV is a complication of the chronic disease itself rather than an adverse effect of HD-PDT.
SARS-COV-2 PANDEMIC FROM THE OPHTHALMOLOGIST`S PERSPECTIVE. A REVIEW.
Navarčík R, Popov I, Valašková J … +1 more , Horkovičová K
Cesk Slov Oftalmol · 2022 · PMID 35105149 · Publisher ↗
In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong to enveloped ssRNA viruses and are classified into...
In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong to enveloped ssRNA viruses and are classified into four genera: Alpha coronavirus, Beta coronavirus, Gamma coronavirus and Delta coronavirus. It is assumed that SARS-CoV-2 is spread primarily during a personal contact via bigger respiratory droplets. These droplets with viruses can be directly inhaled by other people or can lend on the surfaces with the possibility of further spreading. The ocular surface has been suggested as one of possible infection entries. Human eye has its own renin-angiotensin system with present ACE2 receptors, which bind the virus through spike protein. The most common symptoms of the SARS-CoV-2 infection are fever, cough and dyspnoea. Several clinical entities, such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been associated with this infection. The most common ophthalmologic symptom associated with COVID-19 disease is conjunctivitis. Some studies indicate that eye symptoms are commonly present in patients with severe COVID-19 pneumonia and that it is possible to detect viral RNA from the conjunctival sac of these patients. In ophthalmologic praxis, we manage not only the therapy of the eye structures` inflammation in relation with this infection, but also the overall management of the visits and the supervision of the patients who are at risk and positive for coronavirus. Ophthalmologists could potentially have a higher risk of SARS-CoV-2 infection due to personal communication with the patients, frequent exposure to tears and eye secrets and the use of devices. We would like to provide an ophthalmologist`s perspective on this topic.
INTRAVENOUS THROMBOLYTIC THERAPY FOR ACUTE NONARTERITIC CENTRAL RETINAL ARTERY OCCLUSION. A REVIEW.
Janská K, Bodnár R, Janský P … +1 more , Vosko M
Cesk Slov Oftalmol · 2022 · PMID 35105148
Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke. It is a critical condition that often leads to severe visual loss or blindness and can be a harbinger of further cerebrovascular events. Due to...
Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke. It is a critical condition that often leads to severe visual loss or blindness and can be a harbinger of further cerebrovascular events. Due to the lack of scientific data, there are no effective evidence-based forms of therapy for this condition. None of the conservative therapies have proven effective. The results of some previously published studies suggest a benefit of intravenous thrombolytic therapy in the same regimen as in the treatment of ischemic stroke. This work aims to present an overview of published clinical studies focused on the use of intravenous thrombolysis for CRAO, evaluate its efficacy and safety, and propose an optimal diagnostic and therapeutic algorithm for acute management of CRAO. Summary statistics of patient data from relevant studies indicate that a significant visual acuity improvement was achieved by a total of 45 % of patients receiving alteplase within 4.5 hours of symptoms onset. The occurrence of adverse events in this time window was not significant. Intravenous thrombolytic therapy in CRAO thus appears to be effective and safe. However, we still lack data from adequate prospective randomized controlled trials to confirm this conclusion. To date, two randomized trials are being conducted. The intravenous thrombolysis administration, patient monitoring, etiologic workup, and setting of effective secondary prevention should be ensured at the centre of highly specialized cerebrovascular care. Urgent transport of the CRAO patient to the nearest centre is essential.
MICROBIOME AND UVEITIDES. A REVIEW.
Brichová M, Svozílková P, Klímová A … +3 more , Dušek O, Kverka M, Heissigerová J
Cesk Slov Oftalmol · 2022 · PMID 35105146 · Publisher ↗
Microorganisms inhabiting all surfaces of mucous membranes and skin and forming a complex ecosystem with the host is called microbiota. The term microbiome is used for the aggregate genome of microbiota. The microbiota p...
Microorganisms inhabiting all surfaces of mucous membranes and skin and forming a complex ecosystem with the host is called microbiota. The term microbiome is used for the aggregate genome of microbiota. The microbiota plays important role in the mechanisms of number of physiological and pathological processes, especially of the hosts immune system. The origin and course of autoimmune diseases not only of the digestive tract, but also of the distant organs, including the eye, are significantly influenced by intestinal microbiota. The role of microbiota and its changes (dysbiosis) in the etiopathogenesis of uveitis has so far been studied mainly in experimental models. Reduction of severity of non-infectious intraocular inflammation in germ-free mice or in conventional mice treated with broad-spectrum antibiotics was observed in both the induced experimental autoimmune uveitis model (EAU) and the spontaneous R161H model. Studies have confirmed that autoreactive T cell activation occurs in the intestinal wall in the absence of retinal antigen. Recent experiments focused on the effect of probiotic administration on the composition of intestinal microbiota and on the course of autoimmune uveitis. Our study group demonstrated significant prophylactic effect of the administration of the probiotic Escherichia coli Nissle 1917 on the intensity of inflammation in EAU. To date, only a few studies have been published investigating intestinal dysbiosis in patients with uveitis (e.g., in Behcets disease or Vogt-Koyanagi-Harada syndrome). The results of preclinical studies will be presumably used in clinical practice, mainly in the sense of prophylaxis and therapy, such as change in the lifestyle, diet and especially the therapeutic use of probiotics or the transfer of faecal microbiota.
INTRAOCULAR LYMPHOMA WITH RETROBULBAR INFILTRATION. A CASE REPORT.
Jurenová D, Plesníková P, Lysková D … +3 more , Babál P, Kobzová D, Furdová A
Cesk Slov Oftalmol · 2021 · PMID 35081721 · Publisher ↗
Subjective and objective symptoms following intraocular lymphoma could lead to a misdiagnosis at the beginning of the disease, which is the cause for the delay in an effective treatment. The most common manifestation of...
Subjective and objective symptoms following intraocular lymphoma could lead to a misdiagnosis at the beginning of the disease, which is the cause for the delay in an effective treatment. The most common manifestation of lymphoma is an inflammatory disease affecting the uvea. A multidisciplinary approach to the diagnosis is required. Suspicion based on the ophthalmological examinations has to be verified by histology. We present a case report of a 78-year-old patient examined at our clinic, with progressive loss of vision in the left eye over 6 months, suspected of retinal detachment. Objectively the visual acuity was counting fingers in front of the left eye. Intraocular pressure changed from normotensive to hypertensive values during regular examinations. We realised imaging exams, ultrasonography and magnetic resonance, which proved an intraocular tumour with retrobulbar infiltration and retinal detachment. The patient was indicated for enucleation, which enabled assignment of a histological type of intraocular B-Non-Hodgkin lymphoma from marginal zone B-cells. We sent the patient to a haematologist-oncologist for management of the subsequent treatment and we prescribed an individual prosthesis to the patient after the enucleation. The patient remains under observation; no surgical treatment, chemotherapy or radiotherapy have been used for 15 months after the enucleation. The enucleation was both a diagnostic and treatment modality.
PARANEOPLASTIC OPTIC NEUROPATHY AS AN INITIAL CLINICAL MANIFESTATION OF SMALL CELL LUNG CANCER. A CASE REPORT.
Akbulut E, Bayraktar H, Tugcu B
Cesk Slov Oftalmol · 2021 · PMID 35081720 · Publisher ↗
Paraneoplastic optic neuropathy (PON) is a very rare condition. In this study, a case of PON whose first complaint was painless vision loss in one eye is presented. In the follow-up of our case, optic neuropathy develope...
Paraneoplastic optic neuropathy (PON) is a very rare condition. In this study, a case of PON whose first complaint was painless vision loss in one eye is presented. In the follow-up of our case, optic neuropathy developed in the fellow eye. Electromyography examination performed due to diffuse body pain and motor loss in the left extremity is compatible with peripheral sensorimotor polyneuropathy. Lung biopsy was planned due to EMG result and and lymphadenopathy detection in thorax computed tomography (CT). The biopsy result of the patient was reported as nonspecific hyperplasia. As the patient's complaints increased, the paraneoplastic antibody panel was requested and CV2 / CRMP5 antibody was found positive. Thereupon, as a result of repeated biopsy, our patient was diagnosed with small cell lung cancer. We think that paraneoplastic optic neuropathy should be considered in the differential diagnosis in patients with advanced age, smoking, painless subacute vision loss, optic disc swelling, and we should insist on research in this direction as in our case.
COMPARISON OF OPTICAL BIOMETERS ARGOS AND IOL MASTER 700.
Románek J, Sluková K
Cesk Slov Oftalmol · 2021 · PMID 35081719 · Publisher ↗
PURPOSE: To compare the biometric data obtained by the new optical biometer Argos and the conventionally used biometer IOL Master 700. PATIENTS AND METHODS: Retrospective analysis of the biometric data of 57 patients (10...
PURPOSE: To compare the biometric data obtained by the new optical biometer Argos and the conventionally used biometer IOL Master 700. PATIENTS AND METHODS: Retrospective analysis of the biometric data of 57 patients (106 eyes) who were examined at TANA Ophthalmology Clinic s.r.o in Olomouc. Patient measurements were carried out on both devices on the same day by the same optometrist within the standard preoperative calculation of the intraocular lens before cataract surgery. Evaluated and statistically analyzed biometric data were axial lenght, anterior chamber depth, average keratometry and lens thickness. RESULTS: The correlation between all compared data was high, with statistical significance p < 0.01. Bland-Altman plots showed good agreement with a 95% limit of agreement. Axial lenght, average keratometry and lens thickens did not show significant differences (p = 0.941; p = 0.773; p = 0.860). IOL Master 700 showed flatter average keratometry, however, the differences were numerically small and insignificant. Anterior chamber depths obtained by Argos were longer, with a significance p < 0.05. CONCLUSION: The segmental refractive index technology used by Argos caused differences in anterior chamber depths. Overall axial length was, however, not, in our cohort of patients, affected by this. In general, the optical biometers Argos and IOL Master 700 show excellent agreement in the measured biometric data.
TREATMENT OPTIONS FOR PREMACULAR AND SUB-INTERNAL LIMITING MEMBRANE HEMORRHAGE.
Kováčová M, Kousal B, Meliška M … +3 more , Fichtl M, Dušková J, Kalvodová B
Cesk Slov Oftalmol · 2021 · PMID 35081718 · Publisher ↗
INTRODUCTION: Premacular hemorrhage (PH) and sub-internal limiting membrane hemorrhage (sub-ILM-H) are among the causes of sudden deterioration of central visual acuity. Anatomical and functional outcomes of different th...
INTRODUCTION: Premacular hemorrhage (PH) and sub-internal limiting membrane hemorrhage (sub-ILM-H) are among the causes of sudden deterioration of central visual acuity. Anatomical and functional outcomes of different therapeutic options were evaluated retrospectively. METHODS: The study included three eyes of three patients (2 females and 1 male). Location of the hemorrhage was determined by spectral domain optical coherence tomography. Subhyaloid premacular location of the hemorrhage was proven in one eye of each woman and sub-ILM location of the hemorrhage in one eye of the male. The baseline best corrected visual acuity (BCVA) was 0.63 in the eyes of the females and 0.16 in the eye of the male. Conservative treatment option was chosen in case of juxtafoveolar PH in the eye of the female patient on anticoagulant warfarin therapy. The female patient with PH secondary to proliferative diabetic retinopathy (PDR) underwent Nd: YAG laser hyaloidotomy. The male patient with unexplained cause of the sub- ILM-H underwent 25-Gauge vitrectomy with ILM peeling and subsequent ultrastructural morphometric and histopathological examination of the ILM. RESULTS: Both BCVA and retinal finding improvement were achieved in all patients. Final BCVA was 0.8 in the eye of the female patient with PDR and 1.0 in rest of the eyes of the other patients. No complications were recorded at follow-up visits. Histopathological and morphometric examination demonstrated variable ILM thickness (2.70 ±1.58 μm) and proved presence of fibroblasts and macrophages with hemosiderin deposits on the retinal side of ILM. CONCLUSION: The choice of the treatment option of PH and sub-ILM-H depends on input parameters such as the initial BCVA, the extent and the location of the hemorrhage, as well as the overall health of the patient. Nd: YAG laser hyaloidotomy is an effective method for rapid recovery of visual functions. Surgical ILM peeling and aspiration of the underlying hemorrhage result in the removal of breakdown products of hemoglobin and minimization of the risk of secondary epiretinal membranes development.
OCT ANGIOGRAPHY, VISUAL FIELD AND RNFL WITH VARIOUS MEDICATIONS IN HYPERTENSIVE GLAUCOMAS.
Lešták J, Fůs M, Bartošová L … +1 more , Marešová K
Cesk Slov Oftalmol · 2021 · PMID 35081717 · Publisher ↗
AIM: The aim of the study was to determine whether hypertensive glaucoma (HTG) with different types of treatment leads to significant damage in any of the evaluated parameters. SAMPLE AND METHODOLOGY: The sample, consist...
AIM: The aim of the study was to determine whether hypertensive glaucoma (HTG) with different types of treatment leads to significant damage in any of the evaluated parameters. SAMPLE AND METHODOLOGY: The sample, consisting of 36 HTG patients (72 eyes), was divided into three subgroups: In the first group, patients were treated with combination therapy (latanoprost + timolol, latanoprost + dorzolamide + timolol, dorzolamide + timolol). The group consisted of seven women and five men, with an average age of 64 years (49-81). In the second group, patients were treated with beta-blockers (carteolol, betaxolol, timolol). The group consisted of five women and five men, with an average age of 62 years (27-77). In the third group, patients were treated with prostaglandins (latanoprost, bimatoprost). The group consisted of eleven women and three men, with an average age of 61 years (61-78). Criteria for inclusion in the study were visual acuity of 1.0 with a possible correction of less than ±3 dioptres, approximately the same changes in the visual fields of all patients, an intraocular pressure (IOP) of less than 18 mmHg, and no other ocular or neurological disease. The retinal nerve fibre layer (RNFL) on the optic nerve target and vessel density (VD) was measured using an Avanti RTVue XR from Optovue. We determined the values of VD in whole image (WI) and VD of peripapillary (PP). In both cases, we then measured all vessels (VDa) and small vessels (VDs). The visual field was examined by means of a fast threshold glaucoma program with a Medmont M 700 instrument. In addition to the sum of sensitivities in apostilbs (asb) in the range of 0-22 degrees, the overall visual field defect (OD) was also evaluated. The statistical analysis was carried out using a multivariate regression model with adjustment for age and gender. The measured values of the third group were taken as baseline. RESULTS: In the statistical analysis, we have found differences in visual field in the combination treatment group (p = 0.0006) and differences were recorded for RNFL in the beta-blocker group (p = 0.04).
PHOTOREFRACTIVE SURGERY WITH EXCIMER LASER AND ITS IMPACT ON THE DIAGNOSIS AND FOLLOW-UP OF GLAUCOMA. A REVIEW.
Arango AF, Tello A, Parra JC … +1 more , Galvis V
Cesk Slov Oftalmol · 2021 · PMID 35081716 · Publisher ↗
Excimer laser refractive surgery is a procedure performed worldwide to solve refractive errors and reduce dependence on glasses or contact lenses. There has been an increase in the number of procedures performed around t...
Excimer laser refractive surgery is a procedure performed worldwide to solve refractive errors and reduce dependence on glasses or contact lenses. There has been an increase in the number of procedures performed around the world. Myopia is the most common indication for corneal photorefractive surgery. Myopic patients have a higher risk of developing some type of glaucoma in their lifetime, such as primary open-angle glaucoma and others. Refractive surgery ablates central corneal stromal tissue, altering its thickness and biomechanics, which in turn makes it difficult to accurately measure intraocular pressure (IOP), since it underestimates it. This underestimation of IOP may delay the diagnosis of de novo glaucoma in patients with a history of refractive surgery. Each patient who wishes to undergo corneal refractive surgery should undergo a thorough glaucoma examination in order to monitor and detect the possible development and / or progression of glaucoma. A very useful practical approach is to perform a series of IOP measurements before and after surgery, when the eye is already stable, and the difference between the averages of the two sets of readings can then be used as a personalised correction factor for postoperative IOP monitoring in that eye. Also, if there is any suspicion of a possible glaucoma, paraclinical tests, such as coherent optical tomography of the retinal nerve fibre layer (RNFL), visual fields and photos of the optic nerve should be requested. All this data prior to refractive surgery should be provided to these patients, so that they can save it and give it to their treating ophthalmologists in the future.
ABNORMAL CORNEAL LESION FOLLOWING CATARACT SURGERY; A CORNEAL PYOGENIC GRANULOMA? A CASE REPORT.
Ghafarian S, Sheikhghomi S, Asadi-Amoli F
Cesk Slov Oftalmol · 2022 · PMID 36858961 · Publisher ↗
BACKGROUND: Description of an abnormal corneal lesion as a complication of a clear corneal incision in cataract surgery. CASE PRESENTATION: A 55-year-old woman presented, complaining of right eye pain and redness for 6 m...
BACKGROUND: Description of an abnormal corneal lesion as a complication of a clear corneal incision in cataract surgery. CASE PRESENTATION: A 55-year-old woman presented, complaining of right eye pain and redness for 6 months, which started 1 month after her uncomplicated cataract surgery. On gross examination, the bulbar conjunctiva was hyperemic and a vascularized salmon-pink nodule with a smooth surface was noted over the supratemporal region of the cornea, just anterior to the previous superior corneal incision, with superficial feeder vessels originating from the adjacent conjunctiva toward the lesion. The lesion was removed and histopathological examination revealed an inflammatory tissue containing inflammatory cells and capillaries within a background of fibrotic tissue throughout the lesion. CONCLUSIONS: Reactive fibrovascular nodules are rare corneal lesions following corneal trauma and vascularization, including a clear corneal cataract surgery incision. Ophthalmologists may encounter these lesions during postoperative visits and should be familiar with their appearance and management.
RHEOHEMAPHERESIS IN THE TREATMENT OF DRY FORM OF AMD. A CASE REPORT.
Stepanov A, Langrová H, Studnička J … +1 more , Burova M
Cesk Slov Oftalmol · 2022 · PMID 36858960 · Publisher ↗
AIM: We present a case report of a patient with dry form of age-related macular degeneration (AMD) in whom we monitored the effect of rheohemapheresis (RhF) treatment over 6 years. METHODS: A 67-year-old man was examined...
AIM: We present a case report of a patient with dry form of age-related macular degeneration (AMD) in whom we monitored the effect of rheohemapheresis (RhF) treatment over 6 years. METHODS: A 67-year-old man was examined in April 2014 at the Department of Ophthalmology at the University Hospital in Hradec Králové for metamorphopsia and decreased visual acuity of the left eye. The patient received general treatment for hypercholesterolemia with Lipfix 10 mg once a day (atorvastatin 10 mg). The cholesterol level in the blood was 3.41 mmol/l, the lipid profile was normal. The patient's previous ocular medical history was unremarkable. The patient reported ocular complaints over the course of the last year, the main symptom of which was image distortion on the Amsler grid on the left eye. Baseline best corrected visual acuity of the left eye was 6/10. Visual acuity in the right eye was 6/6. In both eyes, the findings on the anterior segment corresponded to the patient's age, with the exception of incipient cortical cataract. On the fundus of both eyes, the border of the optic nerve was demarcated, in the macula of the left eye there were a number of soft confluent drusen, in the central periphery there were no pathological changes. On the fundus of the right eye the finding was similar, but to a lesser degree. Optical coherence tomography on the macula of the left eye showed drusoid ablation of the retinal pigment epithelium (RPE), with accumulation of hyperreflectivities below the RPE. Pattern-reversal electroretinography (pERG): showed a slightly prolonged retention of the activity of the central region of the retina (p50 wave) and ganglion cells (N95 wave). Multifocal electroretinography (mfERG) in the central 30° of the retina was within normal limits. Electroretinography (ERG) demonstrated physiological photopic and scotopic rod activity. The patient was treated with 8 RhF procedures, two per week, with a 2-week interval, and the pulse was repeated 4 times. RESULTS: We noted a gradual resorption of soft drusen in the patient, with attachment to the RPE line according to OCT examination at the following sixmonthly check-ups over the next 6 years. Visual acuity of both eyes was maintained at the baseline values at the last check-up in April 2020, the area of soft drusen was significantly reduced. The function of the rod, cone system and the central region of the retina mfERG fluctuated only to an insignificant degree during the entire follow-up period, with a tendency towards a slight increase in activity after RhF treatment. CONCLUSION: We noted an improvement of the anatomical and functional findings in a patient with dry form of AMD during a 6-year follow-up period after RhF treatment. The visual acuity of the affected eye remained at the baseline values.
PROF. DR CARL FERDINAND RITTER VON ARLT (1812-1887): HIS LIFE AND WORK DURING HIS OPHTHALMOLOGICAL CAREER IN PRAGUE.
Ivanišević M
Cesk Slov Oftalmol · 2022 · PMID 36858959 · Publisher ↗
The aim of this paper is to provide an overview of the life and work in Prague of the famous ophthalmologist Carl Ferdinand Ritter von Arlt (1812‒1887). The paper presents data on his stay in Prague while studying Medici...
The aim of this paper is to provide an overview of the life and work in Prague of the famous ophthalmologist Carl Ferdinand Ritter von Arlt (1812‒1887). The paper presents data on his stay in Prague while studying Medicine and working as a private physician and ophthalmologist. Professor von Arlt was Head of the Chair of Ophthalmology at Charles University. He was Director of the Eye Clinic at Prague General Hospital from 1849 to 1856. A detailed description is given of his residences and their appearance today. Very little has been written about this aspect, so the paper will be a supplement to his impressive biography. A brief, chronological, systematic and concise biography is also provided, including details of his family and his contributions to Ophthalmology. During his 25-year stay in Prague (1831-1856), he commuted between the city centre and the General Hospital where he worked. He changed the location of his residence five times. It is important to note and not to forget where one of the greatest ophthalmologists of the 19th century worked and resided in Prague.
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