Cesk Slov Oftalmol [JOURNAL]
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200 papers
Therapy for Vitreous Seeding Caused by Retinoblastoma. A Review.
Kodetová M, Švojgr K, Širc J … +2 more , Vaněček J, Pochop P
Cesk Slov Oftalmol · 2024 · PMID 38538290 · Publisher ↗
Retinoblastoma is the most common primary malignant intraocular tumor in children. Seeding, specifically the dispersion of the tumor into the adjacent compartments, represents a major parameter determining the degree of...
Retinoblastoma is the most common primary malignant intraocular tumor in children. Seeding, specifically the dispersion of the tumor into the adjacent compartments, represents a major parameter determining the degree of retinoblastoma according to the International Classification of Retinoblastoma. In this article we focused on vitreous seeding, one of the main limiting factors in the successful "eye preservation treatment" of retinoblastoma. This article presents an overview of the history of vitreous seeding of retinoblastoma, established treatment procedures and new-research modalities. The introduction of systemic chemotherapy in the treatment of retinoblastoma at the end of the 1990s represented a significant breakthrough, which enabled the progressive abandonment of radiotherapy with its attendant side effects. However, the attained concentrations of chemotherapeutics in the vitreous space during systemic chemotherapy are not sufficient for the treatment of vitreous seeding, and the toxic effects of systemic chemotherapy are not negligible. A significant change came with the advent of chemotherapy in situ, with the targeted administration of chemotherapeutic drugs, namely intra-arterial and intravitreal injections, contributing to the definitive eradication of external radiotherapy and a reduction of systemic chemotherapy. Although vitreous seeding remains the most common reason for the failure of intra-arterial chemotherapy, this technique has significantly influenced the original treatment regimen of children with retinoblastoma. However, intravitreal chemotherapy has made the greatest contribution to increasing the probability of preservation of the eyeball and visual functions in patients with advanced findings. Novel local drug delivery modalities, gene therapy, oncolytic viruses and immunotherapy from several ongoing preclinical and clinical trials may represent promising approaches in the treatment of vitreous retinoblastoma seeding, though no clinical trials have yet been completed for routine use.
Kaposi's Sarcoma. A Case Report.
Polách O, Kopecký A, Wandrolová Z … +2 more , Židlík V, Němčanský J
Cesk Slov Oftalmol · 2024 · PMID 38531684 · Publisher ↗
AIM: The aim of this case report is to present the case of a patient with iatrogenic Kaposi's sarcoma afflicting several organs, ocular manifestation. CASE REPORT: In a 74-year-old kidney transplant patient receiving imm...
AIM: The aim of this case report is to present the case of a patient with iatrogenic Kaposi's sarcoma afflicting several organs, ocular manifestation. CASE REPORT: In a 74-year-old kidney transplant patient receiving immunosuppressive therapy, iatrogenic Kaposi's sarcoma (KS) developed in both lower eyelids. Subsequently, KS was confirmed in the region of the left forearm, with suspicion of lesions in the lungs. The ocular tumor was surgically removed with negative margins, requiring no further therapy. The lesion on the left forearm was completely excised. The patient underwent radiotherapy for the lung lesions, and immunosuppressive therapy was reduced. CONCLUSION: The case highlights the importance of early identification of KS, its histological verification, radical resection, and multidisciplinary collaboration. Knowledge of the epidemiology of this condition is a key factor in determining the correct diagnosis.
The Impact of the COVID-19 Pandemic on the Quality of Examination in Eye Clinics in the Czech Republic - Questionnaire Study.
Karhanová M, Cyžová Z, Schreiberová Z … +5 more , Kalitová J, Mlčák P, Kalábová S, Mlčáková E, Marešová K
Cesk Slov Oftalmol · 2024 · PMID 38531683 · Publisher ↗
PURPOSE: The aim of the study was to map the behavior of ophthalmologists regarding protective equipment during the COVID-19 pandemic (coronavirus disease 2019), both during the time of the mandatory restrictive measures...
PURPOSE: The aim of the study was to map the behavior of ophthalmologists regarding protective equipment during the COVID-19 pandemic (coronavirus disease 2019), both during the time of the mandatory restrictive measures and after their relaxation. Another aim was to evaluate the awareness of ophthalmologists in the Czech Republic about the possible impact of nose and mouth protective measures (masks, respirators) on the quality of eye examinations, especially on the results of standard automated perimetry (SAP) and intraocular pressure (IOP) measurement. MATERIALS AND METHODS: As part of two professional ophthalmological events in the Czech Republic, which took place in 2022, we obtained and evaluated data from the ophthalmologists in attendance using a questionnaire. We evaluated demographic parameters, frequency of use and type of nose and mouth protective equipment and their influence on the quality of ophthalmological examination as well as the awareness of ophthalmologists about their possible influence on the outcome of SAP and IOP measurements. RESULTS: We obtained data from a total of 212 respondents (148 women, 44 men, in 20 cases gender was not stated). In 91.5% of cases, ophthalmologists agreed that the use of respirators and masks makes ophthalmological examination more difficult. The most common problems were eyepiece fogging (85.8%), examination lens fogging (85.8%), and lens fogging when spectacles correction was prescribed (79.2%). The respondents most often combated these problems either by completely removing the respirator (24.1%) or at least by pulling it under the nose (39.2%). At the time when the measures were relaxed, significantly more men did not use any nose and mouth protection at all during ophthalmological examinations (15.8% of men vs. 4.2% of women; p = 0.032). An alarming finding was the fact that 35.6% of respondents did not know whatsoever whether the nurse was performing a perimetry examination on a patient with a respirator/mask or without protective equipment, i.e. they were not aware whatsoever of the possible formation of artifacts. Only 21.2% of respondents were aware of the possible difficulties of measuring IOP while wearing a respirator, while 59.9% of respondents were not aware of this risk (39.6% had never considered this problem, 20.3% of respondents were convinced that a respirator could not have an effect on the measurement of IOP). CONCLUSION: The use of nose and mouth protective equipment clearly affects the ophthalmological examination and makes it more difficult. Although ophthalmologists belong to a group at high risk for the possible transmission of infection in the performance of their profession, they often removed nose and mouth protection in an effort to eliminate fogging of eyepieces and examination lenses. The awareness of ophthalmologists regarding the possible influence on the results of SAP and IOP measurement by wearing a respirator was low in our questionnaire survey. It is therefore advisable to discuss this issue more widely and warn doctors about these risks.
Comparison of Early Vision Quality of SBL-2 and SBL-3 Segmented Refractive Lens.
Ratajová M, Hoppeová V, Janeková A
Cesk Slov Oftalmol · 2024 · PMID 38531682 · Publisher ↗
PURPOSE: To compare objective quality of vision in patients undergoing phacoemulsification with implantation of a bilateral segmented multifocal intraocular lens (SMIOL). METHODS: A retro-prospective study included 110 e...
PURPOSE: To compare objective quality of vision in patients undergoing phacoemulsification with implantation of a bilateral segmented multifocal intraocular lens (SMIOL). METHODS: A retro-prospective study included 110 eyes of 55 patients who underwent cataract surgery with bilateral SMIOL implantation. Patients were divided according to the type of implanted intraocular lens into group 1 (SBL-2, 62 eyes) and group 2 (SBL-3, 48 eyes). Postoperatively, monocular and binocular uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UCIVA, at 66 cm), uncorrected near visual acuity (UCNVA, at 40 cm), corrected near visual acuity (BCNVA) and defocus curve were measured and evaluated. The follow-up period was 6 months. RESULTS: Mean UCDVA in group 1 (SBL-2) was 0.010 ±0.15 LogMAR monocularly, 0.01 ±0.10 LogMAR binocularly, and in group 2 (SBL-3) was 0.02 ±0.11 LogMAR monocularly and -0.07 ±0.09 LogMAR binocularly. Binocular defocus curves showed that the SBL-3 group performed better than the SBL-2 lens at a vergence of -1.50 D corresponding to 66 cm (center distance), averaging 0.03 ±0.11 LogMAR, while the SBL-2 group averaged 0.12 ±0.14 LogMAR (p = 0.01). The -2.50 D vergence characterizing near vision (40 cm) was achieved by the SBL-2 lens in our study at 0.33 ±0.15 LogMAR and by the SBL-3 lens at 0.00 ±0.11 LogMAR (p = 0.00). CONCLUSION: Both SMIOLs provided very good vision at all tested distances 6 months postoperatively. The SBL-2 lens performed better in UCIVA, while the SBL-3 lens excelled in UCDVA and UCNVA.
Central Serous Chorioretinopathy. A Review.
Myslík Manethová K
Cesk Slov Oftalmol · 2024 · PMID 38531681 · Publisher ↗
Central serous chorioretinopathy (CSC) is a disease characterized by serous detachment of the neuroretina, especially in the posterior pole of the eye. It is often accompanied by serous detachment of the retinal pigment...
Central serous chorioretinopathy (CSC) is a disease characterized by serous detachment of the neuroretina, especially in the posterior pole of the eye. It is often accompanied by serous detachment of the retinal pigment epithelium (RPE) and associated with the leakage of fluid into the subretinal space through the defective RPE. CSC most often affects men of working age. The exact pathophysiology of the disease is not completely known. Based on indocyanine green angiography (ICG), which revealed increased permeability of choroidal vessels, and optical coherence tomography (OCT) showing increased choroidal thickness, choroidal vasculopathy is assumed to be the primary cause of CSC. In most cases, CSC has a good prognosis with spontaneous resorption of the subretinal fluid (SRF) and improvement of visual functions. However, in a small percentage of patients the disease progresses to a chronic or recurrent course, and can lead to irreversible functional and anatomical changes of the retina with a final clinical picture of diffuse retinal pigment epitheliopathy (DRPE). The optimal treatment approach for patients with CSC remains controversial. In recent decades, myriad therapeutic approaches have been used in the treatment of chronic forms of CSC (cCSC); these included for example laser photocoagulation, pharmaceutical treatment, standard photodynamic therapy (PDT) or anti-VEGF. In recent years a less destructive method, specifically PDT in reduced dose regimens, either with a reduced dose of verteporfin or the laser beam energy used, has been preferred in the treatment of cCSC. Comparable efficacy and safety has been demonstrated using reduced-dose or reduced-fluence PDT regimens in patients with cCSC, with an improvement in best-corrected visual acuity and reduction of SRF.
Analysis of 50 Most Cited Articles About Refractive Surgery From an Altmetric Perspective.
Berhuni M, Ozcan OZ
Cesk Slov Oftalmol · 2024 · PMID 38527913 · Publisher ↗
AIMS: The purpose of this study is to evaluate an Altmetric analysis of the 50 most cited refractive surgery articles in Ophthalmology journals and to compare them with traditional metrics. METHODS: The term "refractive...
AIMS: The purpose of this study is to evaluate an Altmetric analysis of the 50 most cited refractive surgery articles in Ophthalmology journals and to compare them with traditional metrics. METHODS: The term "refractive surgery" was searched, using a time filter between 2010-2020 in the Web of Science core collection database. The 50 most cited articles between 2010 and 2020 were recorded. Descriptive statistics were performed. The Spearman correlation test was used to evaluate the correlation between traditional metrics and Altmetrics. RESULTS: The Altmetric scores of the top 50 articles ranged from 0 to 25, and the median Altmetric score was 4. The citation numbers of the 50 articles ranged from 83 to 523, and the median citation number was 119.5. The most cited article topic was "Toric Intraocular Lens"; the topics with the highest Altmetric scores were "Toric Intraocular Lens" and "Trifocal Intraocular Lens". There was no significant correlation between Altmetric scores and number of citations. There was a weak correlation between Altmetric scores and the average citation per year. CONCLUSION: The Altmetric score is insufficient, compared with traditional metrics, to show the scientific value of articles on refractive surgery. Altmetrics can be used to supplement traditional metrics.
Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes.
Hutsaliuk K, Skalska N, Ulianova N
Cesk Slov Oftalmol · 2024 · PMID 38527912 · Publisher ↗
AIMS: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal changes, according to funduscopy data in patients with different clinical courses of COVI...
AIMS: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal changes, according to funduscopy data in patients with different clinical courses of COVID-19. MATERIALS AND METHODS: 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical). RESULTS: As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal changes occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05). CONCLUSIONS: The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.
Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia.
Hasan AN, Mustapha M, Wan HAHW
Cesk Slov Oftalmol · 2024 · PMID 38413229 · Publisher ↗
AIMS: We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia. CASE SERIES:...
AIMS: We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia. CASE SERIES: There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21-64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impair- ment (6/18-6/60); 35.71% each, followed by mild visual impairment (6/12-6/18), and severe visual impairment (6/60-3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up. CONCLUSION: VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment and systemic corticosteroids.
Visual Neuroprosthesis - Stimulation of Visual Cortical Centers in The Brain. Design of Non-Invasive Transcranial Stimulation of Functional Neurons.
Lešták J
Cesk Slov Oftalmol · 2024 · PMID 38413228 · Publisher ↗
PURPOSE: The purpose of the article is to present the history and current status of visual cortical neuroprostheses, and to present a new method of stimulating intact visual cortex cells. METHODS: This paper contains an...
PURPOSE: The purpose of the article is to present the history and current status of visual cortical neuroprostheses, and to present a new method of stimulating intact visual cortex cells. METHODS: This paper contains an overview of the history and current status of visual cortex stimulation in severe visual impairment, but also highlights its shortcomings. These include mainly the stimulation of currently damaged cortical cells over a small area and, from a morphological point of view, possible damage to the stimulated neurons by the electrodes and their encapsulation by gliotic tissue. RESULTS: The paper also presents a proposal for a new technology of image processing and its transformation into a form of non-invasive transcranial stimulation of undamaged parts of the brain, which is protected by a national and international patent. CONCLUSION: The paper presents a comprehensive review of the current options for compensating for lost vision at the level of the cerebral cortex and a proposal for a new non-invasive method of stimulating the functional neurons of the visual cortex.
Diagnostic Challenges of Ocular Rosacea.
Motešická S
Cesk Slov Oftalmol · 2024 · PMID 38413227 · Publisher ↗
OBJECTIVE: This study aims to address the issues surrounding the diagnosis of ocular rosacea and to evaluate the development of the patients’ condition after treatment, as well as to distinguish between healthy and disea...
OBJECTIVE: This study aims to address the issues surrounding the diagnosis of ocular rosacea and to evaluate the development of the patients’ condition after treatment, as well as to distinguish between healthy and diseased patients using a glycomic analysis of tears. METHODOLOGY: A prospective study was conducted to assess a total of 68 eyes in 34 patients over a six-week period. These patients were diagnosed with ocular rosacea based on subjective symptoms and clinical examination. The study monitored the development of objective and subjective values. The difference between patients with the pathology and healthy controls was established by means of analysis of glycans in tears. RESULTS: Skin lesions were diagnosed in 94% of patients with ocular rosacea, with the most commonly observed phenotype being erythematotelangiectatic (68.8%). The mean duration of symptoms was 29.3 months (range 0.5–126 months) with a median of 12 months. Throughout the study, an improvement in all monitored parameters was observed, including Meibomian gland dysfunction, bulbar conjunctival hyperemia, telangiectasia of the eyelid margin, anterior blepharitis, uneven and reddened eyelid margins, and corneal neovascularization. The study also observed improvements in subjective manifestations of the disease, such as foreign body sensation, burning, dryness, lachrymation, itching eyes, photophobia, and morning discomfort. The analysis of glycans in tears partially separated tear samples based on their origin, which allowed for the differentiation of patients with rosacea from healthy controls. In the first sample, the pathology was determined in a total of 63 eyes (98.4%) of 32 patients, with further samples showing a change in the glycomic profile of patients’ tears during treatment. CONCLUSION: The study demonstrated objective and subjective improvements in all the patients. Tear sampling and analysis could provide a means of timely diagnosis of ocular rosacea.
Multimodal Imaging of Choroidal Nodules in Neurofibromatosis Type I.
Kecer F, Sharashidze A, Popová V … +3 more , Bušányová B, Gerinec A, Tomčíková D
Cesk Slov Oftalmol · 2024 · PMID 38413225 · Publisher ↗
AIM: To clarify the possibilities and role of posterior segment imaging in patients with neurofibromatosis type I (NF1), and to show the prevalence of this disease in the pediatric population in Slovakia. MATERIAL AND ME...
AIM: To clarify the possibilities and role of posterior segment imaging in patients with neurofibromatosis type I (NF1), and to show the prevalence of this disease in the pediatric population in Slovakia. MATERIAL AND METHODS: Until recently, ophthalmologic consultations in patients with NF1 were limited mainly to the observation of Lisch nodules of the iris and the presence of optic nerve glioma. However, advances in imaging capabilities have made it possible to investigate and describe new f indings concerning the ocular manifestations of this disease. Between October 2020 and November 2021, we examined the anterior and posterior segment of 76 eyes (38 children – 12 boys and 26 girls) with genetically confirmed NF1 gene mutation at our clinic. The age of the patients ranged from 4 to 18 years. The anterior segment was checked for the presence of Lisch nodules biomicroscopically with a slit lamp. On the posterior segment, the presence of choroidal nodules was checked by various imaging methods – fundus camera, infrared confocal selective laser ophthalmoscopy, MultiColor imaging, OCT, and OCT angiography. All the patients had magnetic resonance imaging performed in order to detect potential optic nerve gliomas for the purpose of diagnosis. We observed the correlation between the patients’ age, presence of Lisch nodules and the presence of choroidal nodules. Eight patients also had other manifestations of the disease – optic nerve gliomas or microvascular changes (so-called “corkscrew” vessels). RESULTS: Out of 38 patients, Lisch iris nodules were present in 20 patients (53%) and choroidal nodules in 24 patients (63%). There was no positive correlation between the presence of these two manifestations within the same patient or eye, but there is a clear correlation between the presence of choroidal nodules and patient age. CONCLUSION: The results suggest that a previously unknown ocular manifestation of neurofibromatosis type I, namely choroidal nodules, has a higher prevalence than Lisch nodules also in the pediatric population and can be easily visualized using various imaging modalities. It will be important to include follow-up observation of this finding among the standard controls for ocular findings in NF1, and it will be very interesting to correlate this f inding with the exact NF1 mutation
Evaluation of Clinical Results of Implantation of Toric Intraocular Lenses Including their Rotational Stability.
Pašková B, Marešová K, Schreiberová Z … +2 more , Malušková M, Karhanová M
Cesk Slov Oftalmol · 2024 · PMID 38413224 · Publisher ↗
PURPOSE: The aim of the study was to evaluate the clinical results of the implantation of the toric intraocular lens Acrysof IQ Toric SN6AT3_8 (Alcon Laboratories, Inc., Fort Worth, TX, USA), including an evaluation of i...
PURPOSE: The aim of the study was to evaluate the clinical results of the implantation of the toric intraocular lens Acrysof IQ Toric SN6AT3_8 (Alcon Laboratories, Inc., Fort Worth, TX, USA), including an evaluation of its rotational stability. MATERIAL AND METHODS: 30 eyes of 16 patients (4 males, 12 females; mean age 68 years) with regular corneal astigmatism ranging from -1.5 to -4.0 Dcyl were included in this retrospective study. All the patients underwent uncomplicated cataract surgery with the implantation of a toric intraocular lens (TIOL) at the Department of Ophthalmology of the Faculty of Medicine and Dentistry of Palacký University in Olomouc and University Hospital Olomouc during the course of 2020. Follow-up examinations were performed 3-6 months after cataract surgery. We monitored the resulting uncorrected distance visual acuity (UDVA), postoperative refraction, rotational stability of the implanted lens and subjective patient satisfaction. RESULTS: mean preoperative corneal astigmatism was -2.41 ±0.67 Dcyl. UDVA improved from a mean value of 0.45 ±0.25 (expressed in decimal Snellen optotype values) to 0.91 ±0.16. The spherical equivalent value of 0.41 ±2.92 improved to -0.11 ±0.27 postoperatively. The mean deviation from the planned axis was 4.87 ±4.75. Subjective satisfaction was rated by patients on a scale of 1-5, with a mean score of 1.5. CONCLUSION: TIOL implantation is a safe and effective solution for patients with corneal astigmatism and cataract. Our results demonstrate improved UDVA, rotational stability of the TIOL and subjective patient satisfaction with the outcome of the surgery.
Improvement of Visual Field Defects after Neuroembolization Treatment of Intracranial Aneurysms. Case Reports.
Majtánová N, Kolář P, Krišková P … +4 more , Kéri P, Balazs T, Cholevík D, Kurilová V
Cesk Slov Oftalmol · 2024 · PMID 38365581 · Publisher ↗
PURPOSE: Intracranial aneurysms and their hemorrhagic and thromboembolic complications represent a serious nosological unit that significantly endangers those afflicted. They are mostly asymptomatic until rupture occurs....
PURPOSE: Intracranial aneurysms and their hemorrhagic and thromboembolic complications represent a serious nosological unit that significantly endangers those afflicted. They are mostly asymptomatic until rupture occurs. In two case reports, we present our observations of young patients with impaired vision and headaches, in whom we found the presence of intracranial aneurysms. OBSERVATIONS: Presentation of two case reports of patients who came to our department with impaired vision and headaches. The patients underwent a complete eye examination at our center, including a visual field examination. Based on the results of the examination, they were referred for an imaging examination of the brain, which revealed the presence of intracranial aneurysms. The patients were subsequently sent to the interventional neuroradiology center, where they underwent a noninvasive endovascular neuroembolization procedure with flow diverter implantation. We continued to monitor the patients after the procedure and document the examination results up to 1 year after the procedure. CONCLUSIONS AND SIGNIFICANCE: Thanks to the fast detection, diagnosis, and management of both patients, we prevented the occurrence of aneurysm rupture, thus a life-threatening complication. After endovascular procedures with flow diverter implantation, we observed a significant improvement in visual acuity as well as perimetric findings in both patients. When intracranial aneurysms are found within a week of the onset of eye symptoms and treated within three months, defects in the visual fields improved in our two patients within 6-12 months, and in one of the two patients the defects almost completely disappeared.
Refractive Errors Among Members of the Armed Forces of the Czech Republic.
Poláčková V, Šindelářová H, Lahodová K … +2 more , Němcová I, Šín M
Cesk Slov Oftalmol · 2024 · PMID 38365580 · Publisher ↗
Objective: To evaluate the prevalence of refractive errors among members of the Armed Forces of the Czech Republic, to recommend a safe way of correcting refractive errors with regard to the specific needs of military pe...
Objective: To evaluate the prevalence of refractive errors among members of the Armed Forces of the Czech Republic, to recommend a safe way of correcting refractive errors with regard to the specific needs of military personnel (especially members of combat units and flying personnel), and to propose a system for solving these errors in order to increase combat effectivity. Methodology: Questionnaire to determine previous refractive surgery and spectacle correction wear. Measurement of refraction with a hand-held autorefractometer and evaluation of current visual acuity on ETDRS optotypes (Landolt rings). Results: 259 servicemen (518 eyes) were investigated. The return rate of the questionnaires was 100%. The incidence of myopia greater than -0.75D was 22% (113 eyes), myopia greater than -0.5D 32% (166 eyes). The mean value of myopia was -0.78 D (SD ±0.6). Hypermetropia values ranged from +0.25 to +5.0 D. The mean value of hypermetropia was 0.63 D (SD ±0.7). Astigmatism values ranged from -0.25 to -3.75. The mean value of astigmatism was -0.55 Dcyl (SD ±0.49). The average visual acuity was 84.1 letters ETDRS SD (±6.1), visual acuity worse than 80 letters was manifested by 23% of the members of the monitored group. 25 people (10%) had undergone laser refractive surgery. Visual acuity after laser refractive surgery was measured in 19 people (38 eyes). Mean uncorrected post-laser visual acuity was 83.87 (SD ±6.1) ETDRS letters. The mean follow-up period after laser refractive surgery was 6.78 (SD ±4.8) years. Conclusion: Despite the initial selection of military personnel and entry limitations, the prevalence of refractive errors is comparable to the general population. However, in contrast with the general population, refractive errors larger than -3.0 D were not represented in the group. Due to the finding of insufficient correction of refractive errors, increased emphasis should be placed on identifying and regularly observing military personnel with refractive errors
Diagnostic Importance of OCT Pachymetry in Keratoconus.
Benca KK, Javorka M, Vida R … +4 more , Halička J, Kralik M, Prídavková Z, Žiak P
Cesk Slov Oftalmol · 2024 · PMID 38365579 · Publisher ↗
AIMS: To demonstrate changes in distance and near fusional vergence measured with prism bars, while compensating for present heterophoria using current ametropia correction. In addition, to determine the differences in v...
AIMS: To demonstrate changes in distance and near fusional vergence measured with prism bars, while compensating for present heterophoria using current ametropia correction. In addition, to determine the differences in values of the AC/A ratio determined by the heterophoric (calculation) and gradient methods. MATERIAL AND METHODS: The basic sample includes 19 subjects with a mean age of 21.5 ±3.0 years (min. 18, max. 27). We used the Von Graefe technique for examination of distance and near phoria, and prism bars for examination of fusion vergences measured in prism diopters. We divided the basic cohort into six research sets according to the size of distance and near heterophoria. This was a cohort of patients with distance (D OR) and near orthophoria (N OR), a cohort of patients with distance (D EX) and near exophoria (N EX) and a set of patients with distance (D ES) and near esophoria (N ES). RESULTS: In the case of both groups with exophoria (distance, near) we found a statistically significant result only for negative fusion vergence (NFV). There was a statistically significant increase in NFV in the sample with distance and near exophoria (D EX, p = 0.01 and B EX, p = 0.02, respectively). In our study, we also demonstrated a statistically significant difference (p < 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method. CONCLUSION: By comparing fusion vergence values in patients with exophoria and orthophoria, we demonstrated that in the presence of distance or near exophoria there is an increase in ipsilateral fusion vergence. In the case of an increase in ipsilateral fusion vergence, the finding was statistically significant both distance and near (p = 0.01 and p = 0.02, respectively). By contrast, we were unable to prove this fact in the group of patients with esophoria. In our study, we also demonstrated a statistically significant difference (p < 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method.
The Effect of Heterophoria on the Size of Distance and Near Fusion Vergence.
Veselý P, Beneš P, Sokolová JŠ … +2 more , Záděrová P, Došková H
Cesk Slov Oftalmol · 2024 · PMID 38365578 · Publisher ↗
AIMS: To demonstrate changes in distance and near fusional vergence measured with prism bars, while compensating for present heterophoria using current ametropia correction. In addition, to determine the differences in v...
AIMS: To demonstrate changes in distance and near fusional vergence measured with prism bars, while compensating for present heterophoria using current ametropia correction. In addition, to determine the differences in values of the AC/A ratio determined by the heterophoric (calculation) and gradient methods. MATERIAL AND METHODS: The basic sample includes 19 subjects with a mean age of 21.5 ±3.0 years (min. 18, max. 27). We used the Von Graefe technique for examination of distance and near phoria, and prism bars for examination of fusion vergences measured in prism diopters. We divided the basic cohort into six research sets according to the size of distance and near heterophoria. This was a cohort of patients with distance (D OR) and near orthophoria (N OR), a cohort of patients with distance (D EX) and near exophoria (N EX) and a set of patients with distance (D ES) and near esophoria (N ES). RESULTS: In the case of both groups with exophoria (distance, near) we found a statistically significant result only for negative fusion vergence (NFV). There was a statistically significant increase in NFV in the sample with distance and near exophoria (D EX, p = 0.01 and B EX, p = 0.02, respectively). In our study, we also demonstrated a statistically significant difference (p < 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method. CONCLUSION: By comparing fusion vergence values in patients with exophoria and orthophoria, we demonstrated that in the presence of distance or near exophoria there is an increase in ipsilateral fusion vergence. In the case of an increase in ipsilateral fusion vergence, the finding was statistically significant both distance and near (p = 0.01 and p = 0.02, respectively). By contrast, we were unable to prove this fact in the group of patients with esophoria. In our study, we also demonstrated a statistically significant difference (p < 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method.
Pars Plana Vitrectomy in the Treatment of Rhegmatogenous Retinal Detachment.
Chrapek O, Matušková V, Vysloužilová D … +4 more , Beránek J, Souček J, Sičová K, Březík M
Cesk Slov Oftalmol · 2024 · PMID 38365577 · Publisher ↗
AIM: The aim of the study is to retrospectively evaluate the anatomical success rate and functional results of 25G+ PPV in the treatment of newly diagnosed rhegmatogenous retinal detachment (RRD). MATERIAL AND METHODS: T...
AIM: The aim of the study is to retrospectively evaluate the anatomical success rate and functional results of 25G+ PPV in the treatment of newly diagnosed rhegmatogenous retinal detachment (RRD). MATERIAL AND METHODS: The set consists of 152 eyes of 152 patients, of which 71 (47%) were men, average age 54 years, operated on by one surgeon for RRD at the Eye Clinic of the University Hospital and Medical Faculty of Masaryk University Brno from 1.7.2019 to 4.5.2021 using the 25G+ PPV technique. 25G+ PPV with pre-equatorial cerclage was performed on 7 patients. The patients' anamnesis included blunt ocular trauma and uncomplicated cataract surgery with implantation of a posterior chamber intraocular lens. The cause of RRD was retinal tear/s, regardless of their number and location. The transparency of the anterior segment of the eye enabled reliable visualization of the posterior segment. Preoperative proliferative vitreoretinopathy (PVR) grade A-D2 was admissible. Patients with a history of penetrating ocular trauma were excluded. The postoperative findings and functional outcomes of the patients were evaluated 1-3 months after PPV. The operation was anatomically successful if the retina was fully attached. Final visual acuity (VA) was evaluated for each patient. The final visual acuity examination was carried out typically on a Snellen optotype, either without correction, with the patient's own spectacle correction or with correction according to the current values on the autorefractometer. The arithmetic average was used for the numerical expression of the attained results, and the numerical values were also expressed in percentages. Since the different groups were not compared with each other, no statistical test was necessary to analyze the results. RESULTS: In 150 (98.7%) of the 152 patients in the group, we achieved complete retinal reattachment, in 2 (1.3%) patients the retina remained detached, and we recorded anatomical failure of the treatment. Fifty (33%) patients achieved VA ≥ 4/8. CONCLUSION: In 133 (87.5%) patients, we are able to state anatomical success even without the presence of intraocular tamponade in the operated eye. These patients can be considered completely cured. 25G+ PPV has demonstrated its contribution to resolving RRD.
Comparison of Three Methods of Tonometry in Patients with Inactive Thyroid-Associated Orbitopathy.
Karhanová M, Kalitová J, Malušková M … +4 more , Schovánek J, Zapletalová J, Mlčák P, Marešová K
Cesk Slov Oftalmol · 2023 · PMID 38086704 · Publisher ↗
INTRODUCTION: Intraocular pressure (IOP) measurement in patients with thyroid-associated orbitopathy (TAO) can be difficult and misleading, particularly in patients with diplopia and eye deviation (esotropia or hypotropi...
INTRODUCTION: Intraocular pressure (IOP) measurement in patients with thyroid-associated orbitopathy (TAO) can be difficult and misleading, particularly in patients with diplopia and eye deviation (esotropia or hypotropia). However, when measuring IOP, it is also necessary to pay sufficient attention to TAO patients without diplopia in primary gaze direction and without motility disorder that might not be readily apparent. PURPOSE: The aim of this study was to evaluate the accuracy of measurement of intraocular pressure (IOP) using three different types of tonometers: the rebound tonometer (iCARE), the Goldmann applanation tonometer (GAT) and the non-contact airpuff tonometer (NCT) in patients with inactive TAO. Materials and Methods: A total of 98 eyes of 49 adult patients with TAO were examined. The study group included 36 females and 13 males, with an age range of 19-70 years and a median age of 55.0. All the patients had evidence of thyroid disease, a history of mild to moderate TAO, no clinical signs or symptoms of active disease, and no diplopia in direct gaze direction. In addition to a comprehensive eye examination, all the patients underwent measurement of intraocular pressure with three tonometers: NCT, iCARE, and GAT. The measurements with these three devices were compared. RESULTS: The mean IOP was 18.1 ± 2.4 mmHg (range 13-25 mmHg) with GAT, 22.3 ±5.0 mmHg (range 13-35 mmHg) with NCT, and 18.0 ±2.4 mmHg (range 13.3-26 mmHg) with iCARE. The mean difference between the GAT and iCARE measurements (using the Bland-Altman analysis) was -0.1 ±1.16 mmHg (limits of agreement -2.4 to 2.1). The mean difference between the GAT and NCT measurements was 4.2 ±3.6 mmHg (limits of agreement -2.8 to 11.2). The mean difference between the iCARE and NCT measurements was -4.3 ±3.7 mmHg (limits of agreement -11.6 to 2.9). No significant difference was found between GAT and iCARE (p = 1.000). However, there was a significant difference between GAT and NCT (p < 0.0001), as well as between iCARE and NCT (p < 0.0001). Conclusions: In patients with TAO, NCT significantly overestimates IOP values compared to the GAT and ICare. By contrast, the iCARE rebound tonometer provides IOP measurements comparable to the gold standard GAT in these patients.
The Far Nasal Part of the Field of Vision - Part II. Contribution to the Timely Diagnosis of Glaucoma.
Lešták J, Fůs M, Lešták T … +1 more , Pitrová Š
Cesk Slov Oftalmol · 2023 · PMID 38086703 · Publisher ↗
AIM: The aim of this study was to examine possible changes in the conventionally undiagnosed nasal visual field in patients diagnosed with early primary open angle glaucoma. MATERIAL AND METHODS: Examination of the far n...
AIM: The aim of this study was to examine possible changes in the conventionally undiagnosed nasal visual field in patients diagnosed with early primary open angle glaucoma. MATERIAL AND METHODS: Examination of the far nasal part of the visual field was performed in 30 patients (60 eyes) with early stage of primary open angle glaucoma (preperimetric stage of changes). The cohort consisted of 16 women (mean age 46.5 years) and 14 men (mean age 44.7 years). In all eyes, the glaucoma program (rapid threshold program of 50 degrees nasally and 22 degrees temporally) was performed with the Medmont M700 instrument to determine the physiological visual field. Visual acuity was 1.0 with a possible correction less than or equal to ±3 diopters and they had no other ocular defect except glaucoma disease. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli and a range of 0-120 degrees nasally. RESULTS: The far nasal limit of the visual field reached 100° in 13.33% of eyes, 105° in 20% of eyes and up to 110° in 66.67% of eyes. CONCLUSION: In all eyes, depression of the distal periphery of the nasal part of the visual field was found to range from 50 to 95 degrees, with a normal visual field examined by the glaucoma program.
The Far Nasal Part of the Visual Field - Part I.
Lešták J, Fůs M, Lešták T … +1 more , Pitrová Š
Cesk Slov Oftalmol · 2023 · PMID 38086702 · Publisher ↗
AIMS: The aim of the study was to determine the limits of the far nasal part of the visual field. MATERIAL AND METHODS: Visual field examination was performed in 15 healthy subjects (30 eyes), specifically nine women age...
AIMS: The aim of the study was to determine the limits of the far nasal part of the visual field. MATERIAL AND METHODS: Visual field examination was performed in 15 healthy subjects (30 eyes), specifically nine women aged 20-43 years and six men aged 22-35 years. All eyes were found to have physiological ocular findings and visual acuity of 1.0 with correction less than or equal to 3 diopters. The visual field was examined with a Medmont M700 instrument by shifting the fixation point 40 degrees temporally and simultaneously turning the head nasally, with a spatial accommodation program. A total of 89 examination points were included using flicker stimuli. RESULTS: The far nasal limit of the visual field reached 100° in 13.3% of eyes, 105° in 20% of eyes and up to 110° in 66.7% of eyes. CONCLUSION: The limit of the far nasal part of the field of vision reached 100-110 degrees (when nose shielding was eliminated).
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