Ceska a Slovenska Oftalmologie最新文献

A 70-year-old woman was examined with a 10-day history of photopsia and floaters in her left eye. Her best-corrected visual acuity was 20/25 in both eyes, with a normal intraocular pressure and some nuclear sclerosis. Spectral-domain optical coherence tomography revealed a separated posterior vitreous, with a rolled internal limiting membrane flap and inner retinal dimples in the left eye. Optical coherence tomography angiography demonstrated reduced vessel density in both the superficial and deep capillary plexuses of the left fundus. Sixteen months earlier, she had received a single intravitreal Dexamethasone implant injection, due to inferotemporal branch retinal vein occlusion-related macular edema. A diagnosis of internal limiting membrane tear following an uneventful posterior vitreous detachment was reached and no treatment was recommended.

Aim: To evaluate changes in the subjective perception of visual acuity in everyday life during intravitreal ranibizumab treatment in patients with diabetic macular edema using the Slovak version of the international NEI VFQ-25 questionnaire.

Material and methods: In a prospective study, 48 eyes of 30 treatment-naive patients were evaluated, and met the indication criteria. We determined best-corrected visual acuity in letter score (LS), intraocular pressure (IOP), central retinal thickness (CRT) and total macular volume (TMV). Patients received the NEI VFQ-25 questionnaire before the first and then after three, six and twelve months of treatment.

Results: Before treatment, LS averaged 68.1 letters, IOP 17.6 mmHg, CRT 480.5 μm, and TMV 11.2 mm3. After twelve months of intravitreal treatment, LS averaged 72.6 letters, IOP 17.0 mmHg, CRT 332.4 μm, and TMV 9.3 mm3. Comparison of data relating to subjective perception of vision before and after twelve months of treatment: perception of general health improved by 7%, vision in general improved by 15%, eye pain decreased by 8%, near vision improved by 12%, distance activities improved by 5%, social functioning improved by 4%, mental health improved by 6%, difficulties with functioning improved by 16%, dependency improved by 1%, driving improved by 2%, color vision improved by 7%, and peripheral vision improved by 9%.

Conclusion: We determined that anti-VEGF ranibizumab treatment improved objective parameters after one year of intravitreal therapy in LS, CRT and TMV. Subjective changes in visual perception improved in all the monitored parameters after one year of treatment.

Aim:  To report long-term postoperative outcomes of external dacryocystorhinostomy (Ext-DCR) with U-flap and nasolacrimal intubation in adult patients with small lacrimal sac and primary nasolacrimal duct obstruction (NLDO).

Material and methods:  This case series was conducted in a tertiary health care center of North India and included 26 patients who underwent Ext-DCR with U-flap with nasolacrimal intubation for primary NLDO and small lacrimal sac from June 2021 to January 2024 with a minimum follow-up period of 12 months.

Results:  Out of 26 patients, 22 were females with a mean age of 50 years (range 21-60). All patients had a history of purulent discharge from the affected eye. Excessive bleeding was the most common intraoperative challenge faced in most of the cases (6, 23%). The intubation set was removed 12 weeks after surgery. Two female patients had tube-related complications in the form of granuloma formation, and two patients had tube retraction, one had slitting of the punctum, and another acquired an infection. The remaining 20 patients had an uneventful postoperative period. The outcomes of only 2 patients were reported as failures (8%), and the remaining 24 reported successful outcomes (92%) after 12 months of follow-up.

Conclusion:  Ext-DCR with U-flap and nasolacrimal intubation is an effective procedure with a high long-term success rate in adult patients with a small lacrimal sac and primary NLDO.

Aims: Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disorder affecting multiple systems and characterized by bilateral granulomatous uveitis, frequently together with neurological, auditory, and integumentary manifestations. Prompt diagnosis and intervention are a must to prevent irreversible vision loss and possible systemic complications. Fundus imaging plays a pivotal role in the management of VKH, not only to reach the diagnosis but also to monitor  disease activity and response to treatment. Fundus photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT) are among the imaging modalities. These methods provide invaluable insights into the different phases of the disease. In addition, OCT angiography enables clinicians to visualize associated retinal and choroidal microvascular changes. Continuous advances in imaging technology assist ophthalmologists to comprehend the VKH pathophysiology and to facilitate its differential diagnosis. Thus, clinical outcomes are improving with timely interventions and personalized treatment approaches. This mini-review provides an overview of VKH disease, with a particular focus on the fundus imaging techniques utilized in its management.

Retinopathy of prematurity (ROP) is always a serious and sight-threatening condition, and its treatable stages require early detection and adequate treatment. It is necessary to focus on the principles of screening of ROP and recurrences thereof, which occur more often with the onset of intravitreal treatment using anti-vascular endothelial growth factor (anti-VEGF) agents. In this study, we evaluate the recurrence of ROP after primary treatment with intravitreally administered bevacizumab or ranibizumab, its frequency and timing of occurrence. Also discussed are the rules for screening of ROP, its recurrence and the need for long-term follow-up monitoring of children with any form of ROP.

Aim: Retinal detachment is an acute sight-threatening condition that requires immediate surgical intervention. The aim of this study is to compare the outcomes of pars plana vitrectomy (PPV) for uncomplicated rhegmatogenous retinal detachment (RRD) between the different types of gases used, the position, and the number of tears.

Material and methods: This is a retrospective non-randomized comparative study of patients with uncomplicated RRD treated at the Department of Ophthalmology from March 2018 to April 2021 using PPV. A total of 494 evaluated eyes were included in the study. The anatomical success of the surgery was monitored with regard to the extent of retinal detachment, the number and position of tears, and the tamponade used.

Results: The success rate of retinal reattachment with a single operation was 90.7% (448 eyes), and the final anatomical success rate was 100%. A very weak paired relationship was found between the success of the surgery for tears in the 4-8 hours region and the 9-3 hours region (89.1% vs. 92%). Similarly, no significant differences were observed between procedures using SF6 and C3F8 gases for RRD with a tear in the 4-8 hours region (success rate 93.4% for SF6 vs. 89.1% for C3F8). The average postoperative improvement of best corrected visual acuity was 29.6 ETDRS letters, and a gain of 15 letters was recorded in 55.1% (272 eyes). Overall, the complication rate was very low.

Conclusion: PPV is a safe and effective method for treating RRD. Extensive experience with this method allows the use of short-acting tamponades in selected patients.

Purpose: To describe the clinical course, treatment, and subsequent care of a full-term newborn with atypical, unilateral, recurrent cytomegalovirus chorioretinitis.

Case report: The perinatal period of a full-term newborn girl was complicated by the development of petechiae on the skin. The initial laboratory findings were notable for thrombocytopenia, hyperbilirubinemia, and polycythemia. An ultrasound of the brain revealed cystic changes in the area of the lateral ventricles. MRI confirmed pseudocystic periventricular changes with periventricular calcifications. PCR testing confirmed CMV positivity, and the condition was diagnosed as congenital CMV infection requiring systemic treatment with ganciclovir. Indirect ophthalmoscopy revealed nonspecific lucency in the central area of the right eye, with several small hemorrhages on the retinal periphery. Although systemic therapy was initiated promptly, the original lesion reactivated multiple times on its periphery over the following months. The lesions were gradually healed, with pigmented scarring limiting the visual function of the affected eye.

Conclusion: In contrast with the focal changes in the peripheral retina observed in adults, congenital CMV infection affecting children is characterized by macular involvement. The degree of visual impairment is directly proportional to the extent of reparative scarring affecting the central retina. From the perspective of prognosis and prevention of potential late retinal complications, screening and regular ophthalmological examinations are essential.

Aim: To report a case of progressive corneal thinning and spontaneous corneal perforation in the setting of recurrent keratoconjunctivitis of undetermined etiology in a 20-year-old female patient.

Material and methods: Longitudinal follow-up of the reported case was performed with regular slit-lamp examination, anterior segment optical coherence tomography, and laboratory evaluation. Relevant scientific literature was reviewed to discover potential etiologies and causes of the reported case.

Case report: Recurrent bilateral keratoconjunctivitis was detected and followed up in a 20-year-old female patient. Long-standing blepharitis and several ocular inflammatory episodes were observed involving the conjunctiva and cornea causing corneal thinning and irregular astigmatism on both eyes. Patient's history, physical and laboratory examination did not reveal any systemic inflammatory or dermatological disorder. After 4 years from the onset of symptoms, spontaneous corneal perforation was observed on the right eye and treated with amniotic membrane transplantation. At that time, eyelid margin culture was positive for Streptococcus mitis. The graft healed completely with paracentral stromal scarring. Best spectacle corrected visual acuity was 20/25 OD and 20/40 OS a month after the procedure.

Conclusion: Corneal and ocular surface inflammation is a potential multifactorial disease. Bacterial hypersensitivity, atopy and dermatological disorders such as atopic dermatitis and rosacea may play a role in recurrent keratitis, corneal thinning and eventually corneal perforation. Frequent and regular follow-ups are required to detect complications early as well as to discover all possible local and systemic contributing factors of keratoconjunctivitis.

Aim: The aim of the study is to evaluate the simultaneous effect of mild myopia and glare on contrast sensitivity under mesopic conditions corresponding to the conditions of night driving.

Material and methods: The study included 22 volunteers (11 women and 11 men) aged between 20 and 42 years (mean age 26.5 years, standard deviation 5.2 years) with normal or corrected to normal binocular and monocular vision acuity and normal healthy eyes. The study was designed as a prospective study. After adaptation to mesopic conditions, three series of contrast sensitivity measurements (with fully corrected refractive error, with induced myopia -0.50 D and -1.0 D) were performed in random order using the Mesotest II device. In each series, measurements were performed with and without glare. All measurements were performed twice, and their average was considered as the result. The effect of induced myopia and glare was assessed using the analysis of variance method for repeated measures.

Results: Significant effects of myopia (p.

Aim: To evaluate the safety and efficacy outcomes of PRESERFLO™ MicroShunt implantation in patients with primary open-angle glaucoma.

Material and methods: Retrospective data analysis of 19 eyes of 12 patients, comprising 5 females and 7 males. The patients underwent surgery between August 2020 and February 2022. The follow-up period was 24 months after surgery. During the follow-up period, intraocular pressure (IOP), the need to apply topical antiglaucoma medication and its spectrum, visual field status, optic nerve target findings and postoperative complications were recorded. The indication for PRESERFLO™ MicroShunt implantation was primary open angle glaucoma (POAG), poorly controlled with maximum tolerated medical therapy.

Results: Average IOP was reduced from 19.05 ±5.58 mmHg preoperatively to 11.47 ±2.48 mmHg at 3 months postoperatively, 12.26 ±2.48 mmHg at 6 months postoperatively, 14.0 ±2.43 mmHg at 12 months postoperatively, 11.78 ±2.37 mmHg at 18 months postoperatively, and 12.73 ±2.51 mmHg at 24 months postoperatively (p.