Cesk Slov Oftalmol [JOURNAL]
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200 papers
Binocular Function in Adults before and after Strabismus Surgery.
Šneidrová J, Novotný T
Cesk Slov Oftalmol · 2023 · PMID 38086701 · Publisher ↗
PURPOSE: To evaluate the state of binocular vision, the amount and direction of the ocular deviation before and after strabismus surgery in adult patients and to monitor the occurrence of postoperative complications. MET...
PURPOSE: To evaluate the state of binocular vision, the amount and direction of the ocular deviation before and after strabismus surgery in adult patients and to monitor the occurrence of postoperative complications. METHODS: The retrospective study of 58 adult patients with selected types of strabismus who were surgically treated in the Eye Department of the Tomas Bata Regional Hospital in Zlín. We evaluated the amount and the degree of the primary ocular deviation and the binocular alignment before and after surgery, as well as the state of binocular vision after surgery and the occurrence of postoperative complications. RESULTS: The average deviation in convergent strabismus before surgery was +23.46 degrees, after surgery +6.6 degrees, in divergent strabismus it was -21.5 degrees, after surgery -1.48 degrees, for vertical strabismus before surgery +12.5 degrees and +3.75 degrees after surgery and in paralytic strabismus +20 degrees before surgery and +3 degrees postoperatively. Preoperatively there was effectively no binocular vision in up to 63.9% of patients, superposition occurred in 31%, fusion in 5.1%. No patient had stereopsis before surgery. After surgery, superposition was present in 39.7%, fusion in 31% and stereopsis in 6.9% of patients. Only 22.4% of patients experienced no binocular vision after surgery. Of the selected 21 patients out of 58 with an observation period of at least 3 years, we observed an improvement or development of binocular vision functions after surgery in 12 patients and no improvement of binocular vision functions in 9 patients. In the first group, 58.3% had a stable deviation throughout the follow-up period. While in the second group the deviation was stable in only 33.3%. We can assume that the improvement in binocular vision function after strabismus surgery, leads to a greater longer-term stability of postoperative deviations. CONCLUSION: Strabismus surgery in adult patients is an effective and safe method, which is not only a cosmetic procedure used to adjust the position of the eyes, but also enables us to induce or improve the state of binocular vision functions.
Computed tomography and magnetic resonance imaging of the orbit in the diagnosis and treatment of thyroid-associated orbitopathy - experience from practice. A Review.
Karhanová M, Čivrný J, Kalitová J … +4 more , Schovánek J, Pašková B, Schreiberová Z, Hübnerová P
Cesk Slov Oftalmol · 2023 · PMID 38086700 · Publisher ↗
The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of thyroid-associated orbitopat...
The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of thyroid-associated orbitopathy (TAO). Methods: IMs of the orbit are an indispensable accessory in the clinical and laboratory examination of TAO patients. The most frequently used and probably most accessible method is an ultrasound examination of the orbit (US), which, however, has a number of limitations. Other methods are CT and MRI. Based on the published knowledge implemented in our practice and several years of experience with the diagnosis and treatment of TAO patients, we would like to point out the benefits of CT and MRI in the given indications: visualisation of the extraocular muscles, assessment of disease activity, diagnosis of dysthyroid optic neuropathy and differential diagnosis of other pathologies in the orbit. Our recommendation for an ideal MRI protocol for disease activity evaluation is also included. Conclusion: IMs play an irreplaceable role not only in the early diagnosis of TAO, but also in the monitoring of the disease and the response to the applied treatment. When choosing a suitable IM for this diagnosis, a number of factors must always be taken into account; not only availability, cost and burden for the patient, but especially the sensitivity and specificity of the given method for the diagnosis of TAO.
CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.
Stepanov A
Cesk Slov Oftalmol · 2023 · PMID 38016808
INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 μm, which is caused by dilatat...
INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 μm, which is caused by dilatation of the choroidal vessels of the Haller's layer, thinning of the Sattler's layer and the choriocapillaris layer. METHODOLOGY: Literary research focused on the current view of pachychoroid spectrum diseases, including clarification of the pathophysiological theories of the formation of "pachychoroid". RESULTS: It is assumed that "pachychoroid" disease has an autosomal dominant type of heredity. Depending on the further activity of various exogenous and/or endogenous factors, pachychoroid diseases may appear. According to the current knowledge, the spectrum of pachychoroid disease covers six clinical entities: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation and peripapillary pachychoroid syndrome. In this study, we describe the clinical symptoms and objective findings of focal choroidal excavation and peripapillary pachychoroid syndrome. The current pathophysiological theory of pachychoroid diseases is based on impaired venous outflow from the choroid ("venous overload choroidopathy") and thickening of the sclera in the eyes of affected patients. CONCLUSION: Pachychoroid diseases should be included in the differential diagnosis of characteristic features observed during multimodal imaging analysis of choroidal changes.
Eyelid Schwannoma. A Case Report.
Sheikhghomi S, Shafaat M, Hasani H
Cesk Slov Oftalmol · 2023 · PMID 37996247 · Publisher ↗
In this case report, we describe a 53-year-old woman who presented with a slow-growing lower lid mass in her right eye. On gross examination, a remarkable lower lid bulging was noted. On palpation, a subcutaneous oval-sh...
In this case report, we describe a 53-year-old woman who presented with a slow-growing lower lid mass in her right eye. On gross examination, a remarkable lower lid bulging was noted. On palpation, a subcutaneous oval-shaped mass with a firm consistency, measuring about 2cm, was noted. The uncorrected visual acuities of the patient were 20/20 (by Snellen chart) bilaterally, and the examinations of the anterior and posterior segments of both eyes were unremarkable. On the orbital Computed Tomography scan of the patient, a solitary and homogenous solid globular mass with the same density of the brain tissue was obvious. The patient underwent surgical excision. Microscopic assessment of the lesion revealed a biphasic hypercellular area (Antoni A) and myxoid hypocellular areas (Antoni B), containing slender cells with tapered ends, interspersed with collagen fibers, consistent with a diagnosis of schwannoma. In addition, some foci of nuclear palisading around the fibrillary process (Verocay bodies) could frequently be found throughout the highly cellular regions. Schwannomas rarely occur in the eyelids, but have clinical and paraclinical indicators which indicate the probable diagnosis. In conclusion, we suggest that eyelid schwannoma be considered as an element of the differential diagnoses list for subcutaneous lesions of the eyelid.
Determination of Corneal Power after Refractive Surgery with Excimer Laser: A Concise Review.
Galvis V, Tello A, Otoya V … +4 more , Arba-Mosquera S, Villamizar SJ, Translateur A, Morales R
Cesk Slov Oftalmol · 2023 · PMID 37993276 · Publisher ↗
Refractive surgery with excimer laser has been a very common surgical procedure worldwide during the last decades. Currently, patients who underwent refractive surgery years ago are older, with a growing number of them n...
Refractive surgery with excimer laser has been a very common surgical procedure worldwide during the last decades. Currently, patients who underwent refractive surgery years ago are older, with a growing number of them now needing cataract surgery. To establish the power of the intraocular lens to be implanted in these patients, it is essential to define the true corneal power. However, since the refractive surgery modified the anterior, but not the posterior surface of the cornea, the determination of the corneal power in this group of patients is challenging. This article reviews the different sources of error in finding the true corneal power in these cases, and comments on several approaches, including the clinical history method as described originally by Holladay, and a modified version of it, as well as new alternatives based on corneal tomography, using devices that are able to measure the actual anterior and posterior corneal curvatures, which have emerged in recent years to address this issue.
Torpedo Maculopathy. A Case Report.
Šulavíková Z, Krásnik V
Cesk Slov Oftalmol · 2023 · PMID 37993275 · Publisher ↗
AIM: Torpedo maculopathy is an incidental, congenital retinal lesion. The typical clinical finding is a unilateral, symmetric, oval, hypopigmented lesion in the inferotemporal macula. In most cases, the lesion is along t...
AIM: Torpedo maculopathy is an incidental, congenital retinal lesion. The typical clinical finding is a unilateral, symmetric, oval, hypopigmented lesion in the inferotemporal macula. In most cases, the lesion is along the horizontal raphe, is torpedo-shaped, and the nasal edge is directed into the foveola. The diagnosis is determined on the basis of its characteristic shape, localization and findings on optical coherence tomography (OCT). The etiology and pathogenesis of torpedo maculopathy is unclear, but it is believed to be a congenital defect of the retinal pigment epithelium (RPE). The aim of this publication is highlight this diagnosis and to present an incidental finding of torpedo maculopathy in an adult patient. CASE REPORT: A 30-year-old female patient reported for a routine eye examination. Fundus examination of the right eye revealed an oval hypopigmented lesion with a size of 1 disk diameter inferotemporally from the fovea, which was followed by a satellite lesion in the same axis directed into the foveola. Based on OCT, OCT angiography, fundus autofluorescence, and the typical shape and location of the lesion, the patient was diagnosed with torpedo maculopathy in the right eye. CONCLUSION: In general, torpedo maculopathy is an asymptomatic, congenital, benign retinal lesion, which is mostly diagnosed accidentally during a routine fundus examination. TM is non-progressive retinal finding with a minimal risk of deterioration of visual functions, which does not require any treatment. Nevertheless, due to the rare risk of a choroidal neovascular membrane, it is recommended to examine patients once a year. It is necessary to consider this diagnosis when a unilateral hypopigmented lesion is found inferotemporally from the fovea, and to distinguish it from chorioretinal atrophy, scar, vitelliform dystrophy, or other RPE lesions as part of the differential diagnosis.
Use of Corneal Topography in Pediatric Ophthalmology.
Popová V, Tomčíková D, Bušányová B … +3 more , Kecer F, Gerinec A, Popov I
Cesk Slov Oftalmol · 2023 · PMID 37993274 · Publisher ↗
AIM: To introduce the topic of pediatric keratoconus, highlighting the importance of routine corneal topography and tomography in children and adolescents from predisposed groups. To attempt to ensure the early detection...
AIM: To introduce the topic of pediatric keratoconus, highlighting the importance of routine corneal topography and tomography in children and adolescents from predisposed groups. To attempt to ensure the early detection of keratoconus and its subclinical form, enabling early treatment, which brings better expected postoperative results. Material and methods: Using the corneal tomograph Pentacam AXL we examined children and adolescents with astigmatism equal or greater than 2 diopters (in at least one eye) and patients with at least one risk factor such as eye rubbing in the case of allergic pathologies, positive family history of keratoconus or certain forms of retinal dystrophy. In total, we included 231 eyes (116 patients), of which 54 were girls and 62 were boys. RESULTS: The Belin-Ambrósio deviation index parameter was evaluated, in which we classified a total of 41 eyes as subclinical keratoconus and 12 eyes as clinical keratoconus. Next, the corneal maps were evaluated individually, in which we included a total of 15 eyes as subclinical keratoconus and 6 eyes as clinical keratoconus. In our group, compared to the control group, subclinical and clinical keratoconus occurred most often in the group of patients with astigmatism and in the group of so-called "eye rubbers". After individual evaluation, keratoconus occurred more frequently in boys than in girls in our cohort. CONCLUSION: Most patients with keratoconus are diagnosed when there is a deterioration of visual acuity and changes on the anterior surface of the cornea. Corneal topography and tomography allows us to monitor the initial changes on the posterior surface of the cornea, and helps us to detect the subclinical form of keratoconus and the possibility of its early treatment. Therefore, it is important to determine which groups are at risk and groups in which corneal topography and tomography should be performed routinely.
Diabetic Retinopathy and Diabetic Macular Edema - Screening.
Němčanský J, Studnička J, Vysloužilová D … +2 more , Ernest J, Němec P
Cesk Slov Oftalmol · 2023 · PMID 37993273 · Publisher ↗
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of severe visual loss in the working population. Therefore, both DR and DME have a significant socioeconomic and health impact, which taking i...
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of severe visual loss in the working population. Therefore, both DR and DME have a significant socioeconomic and health impact, which taking into account the epidemiologic predictions is expected to increase. A crucial role in the management of DR and DME (not only for individuals, but also for the population) is played by an adequate screening program. This is based on the structure and organization of the healthcare system, the latest scientific developments in diagnostics (imaging) as well as technological advancements in computing (artificial intelligence, telemedicine) and their practical use. The recommendation presented by World Health Organization is also important. This paper evaluates all these factors, including evidence-based medicine reports and experience from existing DR and DME screening programs in comparable countries. Based on an evaluation of these parameters, recommended guidelines have been formulated for screening for DR and DME in the Czech Republic, including linkage to the Czech National Screening Center and the organization of the healthcare system.
Diabetic Retinopathy – Diagnostics and Treatment Guidelines.
Studnička J, Němčanský J, Vysloužilová D … +2 more , Ernest J, Němec P
Cesk Slov Oftalmol · 2023 · PMID 37993272 · Publisher ↗
Diabetic retinopathy is one of the most common complications of diabetes mellitus and represents a serious health, social and economic problem. With the expected increase in the number of patients with diabetes, it is be...
Diabetic retinopathy is one of the most common complications of diabetes mellitus and represents a serious health, social and economic problem. With the expected increase in the number of patients with diabetes, it is becoming the leading cause of severe vision loss in the working-age population. The presented guidelines summarize the current knowledge about this disease in order to standardize and update the procedures for the diagnosis, classification and treatment of diabetic retinopathy.
Diabetic Macular Edema - Diagnostics and Treatment Guidelines.
Ernest J, Němčanský J, Vysloužilová D … +3 more , Veith M, Studnička J, Němec P
Cesk Slov Oftalmol · 2023 · PMID 37993271 · Publisher ↗
Together with diabetic retinopathy, diabetic macular edema (DME) ranks among the most common causes of severe loss of vision in working adults. Due to recent developments in imaging methods, new classification schemes of...
Together with diabetic retinopathy, diabetic macular edema (DME) ranks among the most common causes of severe loss of vision in working adults. Due to recent developments in imaging methods, new classification schemes of DME have been created. In addition to this, new treatment options have been introduced (new intravitreal drugs as well as treatment protocols). At the same time laser, surgical as well as combination therapy is still available. In this paper we evaluate the current knowledge about DME diagnostic and treatment options and formulate recommended guidelines for the management of DME.
RARE NON-SURGICAL RELATED MASSIVE SPONTANEOUS SUPRACHOROIDAL HEMORRHAGE. A CASE REPORT.
Hasan, Musa M, Ali … +2 more , Mustapha M, Halim
Cesk Slov Oftalmol · 2023 · PMID 37567776 · Publisher ↗
AIMS: We present two rare cases of non-surgical-related massive spontaneous suprachoroidal hemorrhage. CASE REPORT: The first case was a 73-year-old male with uncontrolled hypertension, who presented with left vision los...
AIMS: We present two rare cases of non-surgical-related massive spontaneous suprachoroidal hemorrhage. CASE REPORT: The first case was a 73-year-old male with uncontrolled hypertension, who presented with left vision loss, only able to perceive light, with very high intraocular pressure (IOP) and blood pressure (BP), 68 mmHg and 196/106 mmHg, respectively. Ocular examination showed a limited fundus view, and the B-scan revealed near kissing suprachoroidal hemorrhage. The second case was a 59-year-old male, post valve replacement surgery on life-long warfarin, who presented with hand movement vision and IOP of 47 mmHg. The B-scan showed massive submacular and suprachoroidal hemorrhage with therapeutic range International Normalized Ratio (INR). CONCLUSION: Suprachoroidal hemorrhage is one of the rare complications that can be seen in any ocular surgery. However, spontaneous suprachoroidal hemorrhage is a rarer disease. Most of the reported cases are associated with underlying medical conditions. Thus prevention is crucial. This involves ophthalmologists, physicians and general practitioners in managing this group of patients with associated risk factors, for better recognition of this devastating ocular complication in which early detection may reduce ocular morbidity.
ACUTE KERATOUVEITIS WITH CORNEAL GRAFT MELTING AS A LATE COMPLICATION OF MILD CHEMICAL BURN POTENTIALLY ASSOCIATED WITH COVID-19 INFECTION: A CASE REPORT.
Majtánová N, Kurilová V, Krišková P … +5 more , Kéri P, Fellner Z, Cholevík D, Majtán J, Kolář P
Cesk Slov Oftalmol · 2023 · PMID 37567775 · Publisher ↗
UNLABELLED: Chemical burns are sight-threatening injuries that require immediate management. The main goal of the initial treatment is prompt and copious irrigation to neutralize and eliminate the chemical, followed by v...
UNLABELLED: Chemical burns are sight-threatening injuries that require immediate management. The main goal of the initial treatment is prompt and copious irrigation to neutralize and eliminate the chemical, followed by various therapeutic options (conservative and surgical) according to the individual patient's postinjury findings. PURPOSE: In this case report, we describe the course and treatment of a patient with chemical alkali burns of both eyes. This study reports the outcomes of an ocular alkali burn patient who became infected with COVID-19 and where severe keratouveitis with corneal graft melting and hypopyon occurred, ultimately resulting in evisceration of the eye. OBSERVATIONS: We report the case of a 35-year-old woman, after an alkali burn of both eyes. Complete re-epithelialization of both corneas occurred within three weeks. Due to this observation, we assumed a satisfactory healing prognosis. However, corneal lysis occurred in the left eye over time. The condition was managed, but subsequently severe keratouveitis with hypopyon and corneal lysis occurred in the left eye, apparently in connection with the COVID-19 infection, which ultimately led to the evisceration of the affected eye. CONCLUSIONS AND IMPORTANCE: In the case report, we describe the management of a mild chemical alkali burn of the right eye and a complicated moderate burn of the left eye with an alkaline chemical. Both eyes were completely healed within three weeks. However, the findings on the left eye became complicated, which ultimately led to the evisceration of the affected eye. The disease of COVID-19 could have contributed to the deterioration of the findings on the cornea, or it could have just been a coincidence of two diseases, with the keratouveitis having a serious course due to the previous difficult course of healing and many complications after the chemical burn.
THE PREVALENCE OF MYOPIA IN SCHOOL-AGE CHILDREN IN SLOVAKIA AND THE COVID-19 PANDEMIC.
Pršová L, Halička J, Kozár M … +5 more , Kuderavá Z, Pršo M, Jakušová Ľ, Bánovčin P, Žiak P
Cesk Slov Oftalmol · 2023 · PMID 37567774 · Publisher ↗
AIMS: The aim of the authors' study was to determine the prevalence of myopia and premyopia in children and adolescents attending primary school in a village in the north of Slovakia in the period before and after the pe...
AIMS: The aim of the authors' study was to determine the prevalence of myopia and premyopia in children and adolescents attending primary school in a village in the north of Slovakia in the period before and after the peak of the Covid-19 pandemic. MATERIAL AND METHODS: Changes in the spherical equivalent and axial length of the eyes were measured in 2019 and 2022 in a group of 47 children and adolescents within the age range of 7-12 years at the time of first measurement. In all the individuals, refraction was measured using an automatic keratorefractometer without the use of cycloplegic eye drops, and axial length was measured with an optical biometer. Refraction was also measured using an automatic keratorefractometer after using cycloplegic eye drops. RESULTS: We recorded a significant change in the mean spherical equivalent (1.02 ±1.16 D vs. 0.72 ±1.29) and the axial length of the eyes (23.05 ±0.72mm vs. 23.30 ±0.74mm) when comparing the measurements from 2019 to 2022. The probands manifested a myopic refractive shift of -0.30 D throughout the entire cohort (-0.24 D in boys and -0.38 D in girls), and the mean axial length increased by 0.2 mm in the entire cohort (by 0.3 mm in boys and 0.2 mm in girls). The percentage of myopic and premyopic eyes increased (4.3% vs. 8.5% a 31.9% vs. 48.9%). CONCLUSION: We noted a decrease in the spherical equivalent and increase in the axial length of the eyes after the Covid-19 pandemic compared to the period before the pandemic in Slovak school-aged children. During this period, the prevalence of myopia and premyopia increased.
EFFECT OF ACUTE HYDROGEN-RICH WATER INTAKE ON INTRAOCULAR PRESSURE IN HEALTHY SUBJECTS.
Najmanová E, Manethová H, Botek M … +1 more , Pluháček F
Cesk Slov Oftalmol · 2023 · PMID 37567773 · Publisher ↗
PURPOSES: The primary aim of the study was to assess the response of intraocular pressure (IOP) to the acute ingestion of hydrogen-rich water (HRW) compared to hydrogen-free water (placebo) in healthy subjects. The effec...
PURPOSES: The primary aim of the study was to assess the response of intraocular pressure (IOP) to the acute ingestion of hydrogen-rich water (HRW) compared to hydrogen-free water (placebo) in healthy subjects. The effect of HRW intake on central corneal thickness (CCT) was also monitored. SUBJECTS AND METHODS: Twenty-four healthy volunteers (5 men, 19 women) aged between 20 and 33 were included in the study, in which one eye of each subject was measured. The study was prospective, randomized and double-blind, with crossover design. Each subject underwent two parts of the experiment, each part on a different day and in random order. In each part of experiment, a total volume of 1260 ml of HRW or placebo was administered over 15 minutes in three doses. IOP and CCT were measured before and during the course of 75 minutes from the start of the HRW or placebo intake. RESULTS: Administration of both HRW and the placebo caused a significant increase in IOP. The maximum IOP increase was 2.7 mmHg ±2.0 mmHg in minute 25 after the commencement of the experiment (HRW intake), and 1.4 mmHg ±2.0 mmHg in minute 35 (placebo intake). The values of IOP did not differ significantly between both parts, but there were significantly more clinically significant individual IOP increases after HRW intake (58%) compared to the placebo (25%). CCT did not change significantly during the experiment. CONCLUSION: The rapid intake of 1260 ml of both HRW and hydrogen-free water causes a statistically significant increase in IOP compared to the baseline in healthy individuals. In the case of HRW, the increase was also clinically significant in most of the subjects. Thus, the results indicate that acute intake of HRW may pose a higher risk than placebo intake in terms of IOP. However, in the case of risk groups such as subjects with glaucoma, ocular hypertension or suspected glaucoma, it is necessary to verify this conclusion by further studies.
TRANSCONJUNCTIVAL APPROACH FOR SURGICAL REPAIR OF INFRAORBITAL RIM FRACTURES AND ORBITAL FLOOR FRACTURES.
Abelovský J, Slávik R, Hocková B … +5 more , Štorcelová D, Gembeš J, Kubec F, Kilipiris E, Stebel A
Cesk Slov Oftalmol · 2023 · PMID 37567772 · Publisher ↗
AIMS: The aim of this study is to retrospectively evaluate the use of a transconjunctival surgical approach in maxillofacial surgery on the fractures of the infraorbital rim and the orbital floor by analyzing the operati...
AIMS: The aim of this study is to retrospectively evaluate the use of a transconjunctival surgical approach in maxillofacial surgery on the fractures of the infraorbital rim and the orbital floor by analyzing the operating time, the incidence of perioperative and postoperative complications, as well as the functional and aesthetic outcomes of transconjunctival surgical treatment. MATERIALS AND METHODS: All the patients on whom we used a transconjunctival approach from December 2017 to December 2021 were included in this retrospective study. The epidemiological causes of fractures of the midface skeleton were analyzed. The length of the operating time of the transconjunctival approach with lateral canthotomy was compared with a control group in which the supraorbital eyebrow approach was performed. In addition, we analyzed the incidence of perioperative and postoperative complications in comparison with publications from other centers. RESULTS: We used the transconjunctival approach 103 times on 89 patients (in 14 patients the transconjunctival approach was performed bilaterally). In cases where the lateral canthotomy was used to extend the transconjunctival approach, there was no prolongation of the operating time. Perioperative complications included the perforation of the lower eyelid in 2 patients. In the postoperative period we recorded complications in 3 patients. Ectropion of the lower eyelid was present in one patient and entropion of the lower eyelid was observed in two patients. The percentage of perioperative and postoperative complications does not exceed the incidence of complications in transcutaneous approaches on the infraorbital rim. CONCLUSION: Based on the results of our study, we can consider the transconjunctival approach, either alone or in combination with lateral canthotomy.
CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.
Stepanov A
Cesk Slov Oftalmol · 2023 · PMID 37567771 · Publisher ↗
INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 μm, which is caused by dilatat...
INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 μm, which is caused by dilatation of the choroidal vessels of the Haller's layer, thinning of the Sattler's layer and the choriocapillaris layer. METHODOLOGY: Literary research focused on the current view of pachychoroid spectrum diseases, including clarification of the pathophysiological theories of the formation of "pachychoroid". RESULTS: It is assumed that "pachychoroid" disease has an autosomal dominant type of heredity. Depending on the further activity of various exogenous and/or endogenous factors, pachychoroid diseases may appear. According to the current knowledge, the spectrum of pachychoroid disease covers six clinical entities: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation and peripapillary pachychoroid syndrome. In this study, we describe the clinical symptoms and objective findings of focal choroidal excavation and peripapillary pachychoroid syndrome. The current pathophysiological theory of pachychoroid diseases is based on impaired venous outflow from the choroid ("venous overload choroidopathy") and thickening of the sclera in the eyes of affected patients. CONCLUSION: Pachychoroid diseases should be included in the differential diagnosis of characteristic features observed during multimodal imaging analysis of choroidal changes.
BILATERAL ACUTE MACULAR NEURORETINOPATHY IN ACUTE COVID-19 INFECTION: A CASE STUDY.
Ferková N, Hudečková H, Barnau A
Cesk Slov Oftalmol · 2023 · PMID 37344217 · Publisher ↗
AIM: The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19. METHODS: A 32-year-old female patient with impaired vision bila...
AIM: The aim of the present paper is to describe the case study of a female patient with bilateral AMN, suffering from active acute infection with COVID-19. METHODS: A 32-year-old female patient with impaired vision bilaterally persisting for 2 days reported to the emergency Department of Ophthalmology at the Central Military Hospital in Ružomberok, Slovakia. The patient manifested symptoms of COVID-19 infection persisting for 3 days before the onset of visual complaints. RESULTS: At the primary examination, initial best corrected central visual acuity was 20/40 bilaterally, paracentral scotomas were present more in the right eye. Upon examination of the ocular fundus, the edges of the optic nerve disc were out of focus more in the left eye; brownish red petaloid lesions were present around the fovea, the periphery was without pathological findings. OCT and OCTA were performed, with a conclusion of bilateral AMN upon a background of COVID-19 infection. Low molecular weight heparin (LMWH) was administered in a preventive dose. CONCLUSION: The number of documented ocular complications of COVID-19 infection, including microvascular events, is currently increasing.
GIANT PROLACTINOMA. A CASE REPORT.
Šulavíková Z, Krásnik V
Cesk Slov Oftalmol · 2023 · PMID 37344216 · Publisher ↗
AIM: Prolactinoma is a pituitary adenoma that secretes prolactin. Approximately 40% of all pituitary adenomas are prolactinomas. According to size, they are divided into micro, macro and giant prolactinomas. In women, pr...
AIM: Prolactinoma is a pituitary adenoma that secretes prolactin. Approximately 40% of all pituitary adenomas are prolactinomas. According to size, they are divided into micro, macro and giant prolactinomas. In women, prolactinomas cause irregularities of the menstrual cycle such as amenorrhea, galactorrhea, weight gain, in both sexes they cause sterility, hypogonadism, decreased libido and depression. In macroadenomas, symptoms due to the compression of the surrounding structures are also manifested, such as headache, vomiting, lower chiasmatic syndrome and ophthalmoplegia. Loss of the visual field due to compression of the optic chiasm is caused by a tumor larger than 10-15 mm with suprasellar spreading, which breaks through the diaphragma sellae. Giant prolactinomas are larger than 40 mm and make up 1-5% of all prolactinomas. CASE REPORT: In this article I present the case of a 38-year-old woman from Ukraine with advanced chiasmatic syndrome caused by a giant prolactinoma. The tumor is infiltrating the left cavernous sinus, causing left-sided amaurosis and right-sided temporal hemianopsia. CONCLUSION: Inferior chiasmatic syndrome is characterized by bitemporal hemianopsia, a deterioration of visual acuity, bilateral bow-tie descendent atrophy of the optic nerve disc, and hemianopic rigidity of the pupils. Macroprolactinomas occur more frequently in men than in women. The diagnosis is often delayed, probably because the symptoms of hyperprolactinemia are less obvious in men, while women tend to present earlier due to menstrual cycle irregularities. Prolactinomas usually have a good prognosis. Effective medical treatment with dopamine agonists is available. Knowledge of the prolactinoma symptoms could help the diagnosis of compressive lesions of the optic chiasm.
OCULAR DISCOMFORT IN PROFESSIONAL POLO-WATER PLAYERS: A PRACTICAL EXPERIENCE WITH TOPICAL HYALURONIC ACID AND GLYCURONATE ENOXOLONE.
La Mantia I, Bannò P, Scollo P … +1 more , Ciprandi G
Cesk Slov Oftalmol · 2023 · PMID 37344215 · Publisher ↗
AIMS: Professional polo-water athletes are exposed to chlorine in the swimming pool. Chlorine is an irritant agent, so polo-water athletes commonly experience irritative eye symptoms. Hyaluronic acid and glycuronate enox...
AIMS: Professional polo-water athletes are exposed to chlorine in the swimming pool. Chlorine is an irritant agent, so polo-water athletes commonly experience irritative eye symptoms. Hyaluronic acid and glycuronate enoxolone exert anti-inflammatory and cytoprotective activity. Therefore, the present practical experience explored the efficacy and safety of eye drops containing both components. MATERIAL AND METHODS: The current study included 59 professional polo-water athletes. The ocular surface disease index (OSDI) and dry eye-related quality of life (QoL) score (DEQS) questionnaires were used to assess the efficacy. Subjects took the eye drops for one month. The study consisted of a baseline visit (T0) and an end-treatment one (T1). RESULTS: Athletes experienced a significant improvement in symptoms and QoL as assessed by OSDI and DEQS scores (p < 0.001 for both). CONCLUSION: The present study showed that professional polo-water athletes frequently experience ocular discomfort associated with swimming pool attendance. Eye drops with hyaluronic acid and glycuronate enoxolone can significantly relieve eye symptoms and improve the quality of life in these athletes.
LASER THERAPY OF RETINAL TEARS.
Kristian P, Cholevík D
Cesk Slov Oftalmol · 2023 · PMID 37344214 · Publisher ↗
AIM: To report the clinical results of treatment of patients with retinal tears or holes, including rhegmatogenous retinal detachment, who were treated primarily with laser retinopexy. MATERIAL AND METHODS: The effect an...
AIM: To report the clinical results of treatment of patients with retinal tears or holes, including rhegmatogenous retinal detachment, who were treated primarily with laser retinopexy. MATERIAL AND METHODS: The effect and results of the therapy of patients with one or more retinal tears who underwent therapy with the green laser IQ 532 IRIDEX between December 2019 and August 2022 at our center with a follow-up observation period of at least 3 months were retrospectively evaluated. RESULTS: A total of 14 eyes of 14 patients were treated by this method during the monitored period. All the tears found were primarily successfully repaired. The overall success rate of prophylaxis of rhegmatogenous retinal detachment was 93% in our cohort. In one patient, subsequent pars plana vitrectomy was required due to the progression of retinal detachment from another biomicroscopically inaccessible hole, which was part of lattice degeneration in the peripheral part of the retina. This pathology was only verified during intraocular surgery. Postoperatively, the retina was attached with a very good anatomical and functional effect. The other patients did not require any adjuvant therapy. Visual functions improved or remained stable in all patients in the cohort. The follow-up observation period ranged from 3 to 36 months. CONCLUSION: Laser retinopexy is a sparing, safe and effective method of retinal tear therapy. From our clinical experience, the technique is also applicable in the case of partial vitreous hemorrhage or incipient rhegmatogenous detachment. We did not record any complications of perioperative or postoperative treatment among our patients.
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