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Factors affecting the course of Graves’ Orbitopathy and poor response to glucocorticoid treatment followed by orbital radiotherapy. 影响Graves眼病病程的因素及对糖皮质激素治疗后眼眶放疗的不良反应。
Pub Date : 2022-05-19 DOI: 10.24292/01.ot.190522
Agnieszka Jagiełło-Korzeniowska, A. Sokołowski, A. Hubalewska-Dydejczyk, B. Romanowska-Dixon, A. Bałdys-Waligórska
Graves’ orbitopathy is a rare autoimmune disorder characterized by the inflammation of orbital tissues. The course of disease can be described in terms of its activity and severity. Aim: The aim of our study was to determine the factors affecting the activity and severity of Graves’ orbitopathy, as well as to identify the predictive factors of poor response to glucocorticoid treatment followed by orbital irradiation. Methods: We performed a prospective observational study of 214 patients with Graves’ orbitopathy who were divided into two groups depending on the treatment they had previously obtained for their Graves’ disease. They received i.v. methylprednisolone pulses followed by orbital radiotherapy. They were examined and had their TSH, TRAb and FT4 levels evaluated prior to treatment and after 1, 6 and 12 months. Results: A pre-treatment TRAb concentration higher by one unit (U/L) implied a mean increase in the relative risk of active orbitopathy by 4.7% (p = 0.0362). A TRAb concentration higher by one U/L 1 month after treatment implied a mean increase in the relative risk of moderate-to-severe and severe GO by 8.7% (p = 0.0167) 6 months after treatment. As regards poor response to treatment, patients with moderate-to-severe and severe Graves’ orbitopathy on admission carried a higher risk of being non-responders. Each point scored on the NOSPECS scale prior to treatment increased the relative risk of the patient being a non-responder by 30%. Conclusions: Patients with higher TRAb levels have a higher risk of active Graves’ orbitopathy and moderate-to-severe and severe Graves’ orbitopathy. Monitoring TRAb serum concentration in those patients is of great importance. Patients with more severe Graves’ orbitopathy carry a higher risk of being poor responders to immunosuppressive treatment. Therefore, careful monitoring of patients with Graves’ orbitopathy and their early referral to specialized centers is essential.
Graves眼窝病是一种罕见的自身免疫性疾病,以眼眶组织炎症为特征。疾病的病程可以根据其活动性和严重程度来描述。目的:本研究的目的是确定影响Graves眼病活动性和严重程度的因素,并确定糖皮质激素治疗后眼窝照射不良反应的预测因素。方法:我们对214例Graves眼病患者进行了一项前瞻性观察研究,根据他们之前接受的Graves眼病治疗分为两组。他们接受甲基强的松龙静脉注射,然后进行眼眶放疗。在治疗前、治疗后1、6、12个月对患者进行TSH、TRAb和FT4水平的评估。结果:治疗前TRAb浓度每升高1单位(U/L),活动性眼病的相对风险平均增加4.7% (p = 0.0362)。治疗后1个月TRAb浓度升高1 U/L意味着治疗后6个月发生中重度和重度氧化石墨烯的相对风险平均增加8.7% (p = 0.0167)。至于治疗反应差,入院时患有中重度和重度Graves眼病的患者出现无反应的风险较高。治疗前NOSPECS量表得分每增加一分,患者无反应的相对风险增加30%。结论:TRAb水平较高的患者发生活动性Graves眼病、中重度和重度Graves眼病的风险较高。在这些患者中监测TRAb的血清浓度非常重要。Graves眼病较严重的患者对免疫抑制治疗反应不良的风险较高。因此,仔细监测格雷夫斯眼病患者并尽早转诊到专科中心是必要的。
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引用次数: 0
Patient with cataract – observations after 2 years of the pandemic and future prospects 白内障患者-大流行2年后的观察及未来展望
Pub Date : 2022-05-11 DOI: 10.24292/01.ot.110522
M. Misiuk-Hojło, Anna Dołowiec-Kwapisz
Cataract is a disease in which the natural lens becomes completely or partially cloudy. During the pandemic, there was a significant decrease in the number of cataract surgeries performed compared to previous years, due to fear of the disease and the safety of the procedures performed. Cataract surgery should be performed in patients whose visual acuity deterioration has an impact on the performance of life or work activities. Due to the pandemic, some patients report to a more advanced stage of cataract, which leads to a reduction in their quality of life. Such surgery can be associated with a higher risk of surgical complications and longer recovery time. The development of new intraocular lens technologies, increased life expectancy, as well as changing lifestyles and increased activity of the elderly contribute to the increasing choice of premium intraocular lenses by patients. These lenses enable patients to achieve satisfactory uncorrected visual acuity not only for distance, but also for near and intermediate distances.
白内障是一种自然晶状体完全或部分浑浊的疾病。在大流行期间,由于对疾病的恐惧和手术的安全性,白内障手术的数量与前几年相比大幅减少。视力恶化影响生活或工作活动表现的患者,应进行白内障手术。由于流感大流行,一些患者的白内障进展到较晚期,这导致他们的生活质量下降。这种手术有较高的手术并发症风险和较长的恢复时间。新型人工晶状体技术的发展,预期寿命的延长,以及生活方式的改变和老年人活动量的增加,使得患者对优质人工晶状体的选择越来越多。这些镜片使患者不仅在远距离,而且在近距离和中距离都能获得令人满意的未矫正视力。
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引用次数: 2
Myopia differential diagnosis 近视鉴别诊断
Pub Date : 2022-03-31 DOI: 10.24292/01.ot.310322.2
Katarzyna Perz-Juszczyszyn
Due to the prevalence and the possibility of myopia progression, myopia is currently of particular interest to many specialists in both the field of optometry and ophthalmology. In the initial diagnosis of the patient, it is important to determine whether the refractive error is isolated or if it coexists with other eye disorders/diseases or general health problems. This refractive error can be divided into axial and refractive myopia. In the latter case, the change in refraction may result from too great curvature of the cornea in relation to the length of the eyeball, or an increase in the optical curvatures other than the anterior surface of the cornea, or an increase in the refractive index of at least one of the optical structures, or a shallower anterior chamber of the eye. It is also worth distinguishing myopia associated with complex syndromes. Uncorrected myopia can significantly hinder daily functioning. It is therefore important to detect it as early as possible, correct it properly.
由于近视的普遍性和发展的可能性,近视目前是许多验光和眼科专家特别感兴趣的问题。在对患者的初步诊断中,重要的是要确定屈光不正是孤立的,还是与其他眼疾/疾病或一般健康问题共存。这种屈光不正可分为轴性近视和屈光性近视。在后一种情况下,折射的变化可能是由于角膜的曲率相对于眼球的长度太大,或角膜前表面以外的光学曲率增加,或至少一个光学结构的折射率增加,或眼睛的前房较浅。与复杂综合征相关的近视也值得区分。未矫正近视会严重妨碍日常活动。因此,尽早发现并适当纠正是很重要的。
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引用次数: 0
Recommendations for an improved referral system for specialized glaucoma clinics in Poland 波兰青光眼专科诊所改进转诊系统的建议
Pub Date : 2022-03-31 DOI: 10.24292/01.ot.310322.4
Aneta Choręziak, A. Brązert, A. Borys, A. Gotz-Więckowska
This study assessed the quality of referral letters to the Glaucoma Outpatient Clinic and patients’ first consultation results. A retrospective study included 196 patients newly referred to the clinic. Referrals were mainly issued by ophthalmologists (156; 79.6%). Regarding their urgency level, the planned referrals (184; 93.9%) were dominant. The majority of referral diagnoses (147; 75%) were confirmed as glaucoma in the clinic, whereas 17 (8.2%) glaucoma diagnoses were rejected. 64 (32.7%) patients did not require further ophthalmological review. The assessment of the quality of referral letters revealed that important clinical data was missing. There is a need to improve the referral system to specialist glaucoma clinics in Poland.
本研究评估了青光眼门诊转诊信的质量和患者的首次会诊结果。一项回顾性研究纳入了196例新就诊的患者。转介主要由眼科医生发出(156;79.6%)。关于紧急程度,计划的转诊(184;93.9%)占主导地位。大多数转诊诊断(147;75%)临床确诊为青光眼,17例(8.2%)青光眼诊断被拒绝。64例(32.7%)患者不需要进一步的眼科检查。对转诊信质量的评估显示,重要的临床数据缺失。有必要改善转诊系统专科青光眼诊所在波兰。
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引用次数: 0
Ptosis – diagnostics and treatment 上睑下垂-诊断和治疗
Pub Date : 2022-03-31 DOI: 10.24292/01.ot.310322.5
Mateusz Jacuński, Dominika Białas, R. Różycki
It is estimated that the low position of the upper eyelid affects over 1 million patients in Poland. Ptosis limits the visual field, causes compensatory head positions and the feeling of visual deterioration. The unaesthetic appearance of the eyes additionally contributes to low self-esteem. The aim of this article is to review modern diagnostic algorithms used in the case of a dropped eyelid. The paper also discusses the surgical techniques that are used in the case of ptosis and the guidelines for the correct qualification of the patient to a given surgical method.
据估计,波兰有超过100万患者受上眼睑位置过低的影响。上睑下垂限制了视野,导致代偿性头部位置和视觉退化的感觉。眼睛不美观的外观也会导致自卑。这篇文章的目的是回顾现代诊断算法在眼睑下垂的情况下使用。本文还讨论了在上睑下垂的情况下使用的手术技术和指导方针的正确资格的病人给一个给定的手术方法。
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引用次数: 0
Discriminating capabilities of neural and vascular parameters of optical coherent tomography in glaucoma 青光眼光学相干断层扫描神经和血管参数的鉴别能力
Pub Date : 2022-03-31 DOI: 10.24292/01.ot.310322.1
J. Wierzbowska
Optical coherent tomography (OCT) of the retina and optic nerve disc is the gold standard for imaging in the diagnosis and monitoring of glaucoma and optical coherence tomography angiography (OCTA) is an imaging technique with great scientific and clinical potential in patients with glaucomatous neuropathy. The main advantages of OCT and OCTA are non-invasiveness, speed, repeatability and availability of the procedure. In the article, on the basis of recent meta-analyses, the discriminating abilities of the peripapillary retinal nerve fiber layer (pRNFL) and macular parameters as measured with spectral domain (SD) and swept source (SS) OCT, in all glaucoma patients and in different glaucoma subpopulations were discussed. In addition, the results of the most important research on OCTA in the diagnosis and monitoring of glaucoma and the limitations of this method are listed.
视网膜和视神经盘光学相干断层扫描(OCT)是青光眼诊断和监测成像的金标准,光学相干断层扫描血管成像(OCTA)是一项在青光眼神经病变患者中极具科学和临床潜力的成像技术。OCT和OCTA的主要优点是无创、快速、可重复性和手术的可用性。本文在最近meta分析的基础上,讨论了在所有青光眼患者和不同青光眼亚群中,用光谱域(SD)和扫频源(SS) OCT测量的乳头状周围视网膜神经纤维层(pRNFL)和黄斑参数的识别能力。此外,还列出了OCTA在青光眼诊断和监测中的重要研究成果及该方法的局限性。
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引用次数: 0
Contact lens-related combined Pseudomonas aeruginosa, Acanthamoeba and Candida keratitis among adolescents girls 少女隐形眼镜相关性铜绿假单胞菌、棘阿米巴和念珠菌性角膜炎
Pub Date : 2022-03-31 DOI: 10.24292/01.ot.310322.3
M. Świerczyńska, Agnieszka Tronina, Michał Bogocz, E. Mrukwa-Kominek, E. Filipek
Background: We present a case of combined Pseudomonas aeruginosa, Acanthamoeba and Candida keratitis and clinical course of treatment in two adolescents girls who did not follow the rules of proper use of soft contact lenses. Case reports: Two teenage contact lens users sought medical attention, reporting visual impairment, redness and pain of the eye. Slit lamp examination showed unilateral corneal ulcer. Confocal microscopy revealed images compatible with amoebic cysts and yeasts cells, whereas the results of conjunctival swabs confirmed the presence of Pseudomonas aeruginosa. After topical and general treatment in the first patient, the corneal defect was healed, and visual acuity improved. The girl remains under the constant supervision of an ophthalmological clinic. The medications were gradually reduced, but with time she developed crystalline keratopathy. Regrettably, the second patient, despite the applied treatment had recurrent inflammation and progressive corneal thinning, which required amniotic membrane transplantation to prevent perforation. Conclusion: The early identification of the pathogen as well as adequate treatment is crucial, as contact lens-associated keratitis are potentially sight threatening. Patient and caregiver education, adequate contact lens hygiene and consistent follow-up are important to prevent serious complications.
背景:我们报告了一例铜绿假单胞菌、棘阿米巴和念珠菌合并角膜炎的病例,以及两名未遵守正确使用软性隐形眼镜规则的青少年女孩的临床治疗过程。案例报告:两名青少年隐形眼镜使用者寻求医疗照顾,报告视力受损,眼睛发红和疼痛。裂隙灯检查显示单侧角膜溃疡。共聚焦显微镜显示图像与阿米巴囊肿和酵母细胞相容,而结膜拭子结果证实铜绿假单胞菌的存在。第1例患者经局部及综合治疗后,角膜缺损愈合,视力改善。这个女孩一直在眼科诊所的监护下。药物逐渐减少,但随着时间的推移,她患上了结晶性角膜病变。遗憾的是,第二位患者,尽管应用了治疗,但炎症复发,角膜逐渐变薄,需要羊膜移植以防止穿孔。结论:由于隐形眼镜相关性角膜炎具有潜在的视力威胁,早期发现病原体和适当的治疗至关重要。对患者和护理人员进行教育、适当的隐形眼镜卫生和持续的随访对预防严重并发症非常重要。
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引用次数: 0
Comment to: Disease aetiology-based design of multifunctional microemulsion eye drops for moderate or severe dry eye: a randomized, quadruple-masked and active-controlled clinical trial 基于疾病病原学的设计用于中度或重度干眼症的多功能微乳滴眼液:一项随机、四盲和主动对照的临床试验
Pub Date : 2022-03-14 DOI: 10.24292/01.ot.080322
A. Nowinska
Sacha inchi (Plukenetia volubilis) is an oil plant native to tropical rainforests in South America. The seeds of the plant are a potential source of macro- and microelements, α-linolenic acid and phytochemicals. A single-centre, prospective, masked clinical study was designed to investigate the efficacy and safety of multi-ingredient sacha inchi microemulsion (SIME) eye drops in the treatment of patients with dry disease. Sacha inchi microemulsion (SIME) proved safe and efficacious in re-establishing the physiological protective tear film function and restoring the homeostasis of the ocular surface.
印度树(Plukenetia volubilis)是一种原产于南美洲热带雨林的油料植物。该植物的种子是宏量元素和微量元素、α-亚麻酸和植物化学物质的潜在来源。一项单中心、前瞻性、蒙面临床研究旨在探讨多成分皂荚微乳(SIME)滴眼液治疗干眼症患者的疗效和安全性。结果表明,腮红微乳能安全有效地重建眼表泪膜生理保护功能,恢复眼表内环境平衡。
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引用次数: 0
Dry eye syndrome triggered by wearing hard contact lens in keratoconus – case report 圆锥角膜配戴硬隐形眼镜引起干眼综合征1例报告
Pub Date : 2022-03-04 DOI: 10.24292/01.ot.311221.a
Karolina Stanienda-Sokół, Marzena Wysocka-Kosmulska, Jakub Słoka, Olga Łach-Wojnarowicz, D. Dobrowolski, E. Wylęgała
A 48-year-old woman suffering from keratoconus of both eyes sought medical attention at the ophthalmology clinic with her left eye having been painful for prior 3 weeks, as well as increased sensitivity to light, foreign body sensation, stinging and watering eye. Her left eye was diagnosed with the dry eye syndrome, in addition to being treated with hard contact lens. Physical examination revealed corneal punctate epithelial erosions that stained positively with fluorescein in the left eye. The patient was ultimately diagnosed with dry eye disease of the left eye caused by hard contact lens usage.
一名48岁妇女,双眼圆锥角膜,左眼疼痛3周,对光敏感、异物感、刺痛、流泪,到眼科就诊。她的左眼被诊断出患有干眼综合症,并接受了硬隐形眼镜的治疗。体检发现左眼角膜点状上皮糜烂,荧光素染色呈阳性。患者最终被诊断为使用硬隐形眼镜引起的左眼干眼病。
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引用次数: 0
Gojenie rogówki w wybranych rodzajach zabiegów laserowej korekcji wady wzroku
Pub Date : 2022-02-09 DOI: 10.24292/01.ot.311221.b
Joanna Wierzbowska, Barbara Czarnota-Nowakowska
Gojenie się rogówki po zabiegach laserowej korekcji wad wzroku jest istotnym czynnikiem wpływającym na ich skuteczność i profil bezpieczeństwa. W artykule przedstawiono główne mechanizmy gojenia się rogówki po najczęściej przeprowadzanych metodach laserowej korekcji wad wzroku i podkreślono różnice w biologii procesów naprawczych między zabiegami powierzchniowymi a stromalnymi.
{"title":"Gojenie rogówki w wybranych rodzajach zabiegów laserowej korekcji wady wzroku","authors":"Joanna Wierzbowska, Barbara Czarnota-Nowakowska","doi":"10.24292/01.ot.311221.b","DOIUrl":"https://doi.org/10.24292/01.ot.311221.b","url":null,"abstract":"Gojenie się rogówki po zabiegach laserowej korekcji wad wzroku jest istotnym czynnikiem wpływającym na ich skuteczność i profil bezpieczeństwa. W artykule przedstawiono główne mechanizmy gojenia się rogówki po najczęściej przeprowadzanych metodach laserowej korekcji wad wzroku i podkreślono różnice w biologii procesów naprawczych między zabiegami powierzchniowymi a stromalnymi.","PeriodicalId":112284,"journal":{"name":"OphthaTherapy. Therapies in Ophthalmology","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122078064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
OphthaTherapy. Therapies in Ophthalmology
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