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Forum ophthalmicum – how to take control over accumulation of diagnostic data from macular OCT with benefit for both doctor and patient? 论坛眼科-如何控制黄斑OCT诊断数据的积累,使医生和患者都受益?
Pub Date : 2021-09-30 DOI: 10.24292/01.ot.300921.z
Dorota Kaczmarek
Wet age-related macular degeneration (wet AMD) is a disease which requires regular diagnostic tests such as macular optical coherent tomography which is extremely important both in diagnosis and disease monitoring. With constant aging of the population, we are dealing with an increasing incidence rate of AMD, which makes it even more important to have a tool allowing for quick and precise analysis of anatomical changes in macular region, particularly in the current complicated epidemiological situation when diagnostic time should be used most efficiently to plan the follow-up treatment. Forum® software allows for the precise analysis of many tests performed in a single patient and combining it with treatment effectiveness assessment which substantially accelerates the diagnostics.
湿性年龄相关性黄斑变性(Wet - aging -related macular degeneration, Wet AMD)是一种需要定期进行诊断检查的疾病,如黄斑光学相干断层扫描,这在诊断和疾病监测中都非常重要。随着人口的不断老龄化,AMD的发病率也在不断上升,这就使得有一种工具能够快速准确地分析黄斑区域的解剖变化变得更加重要,特别是在当前复杂的流行病学情况下,诊断时间最应该被有效地利用来计划后续治疗。Forum®软件允许对单个患者进行的许多测试进行精确分析,并将其与治疗效果评估相结合,从而大大加快了诊断。
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引用次数: 0
Diagnosis of type 3 macular neovascularization 3型黄斑新生血管的诊断
Pub Date : 2021-09-30 DOI: 10.24292/01.ot.300921.x
Justyna Mędrzycka, A. Piotrowicz, J. Gołębiewska, R. Różycki
Type 3 macular neovascularization is characterized by a complex of pathological vessels located in the sensory retina. Fundus oculi examination reveals intraretinal hemorrhages, macular edema, hard exudates and pigment epithelial detachments. Indocyanine and fluorescein angiography, OCT and angio-OCT are used for diagnosis and treatment monitoring. The treatment efficacy depends on the disease severity and the therapy applied.
3型黄斑新生血管的特点是病变血管位于感觉视网膜的复合体。眼底检查显示视网膜内出血、黄斑水肿、硬渗出物及色素上皮脱落。吲哚菁和荧光素血管造影,OCT和血管OCT用于诊断和治疗监测。治疗效果取决于疾病的严重程度和所采用的治疗方法。
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引用次数: 0
The role of epithelial thickness mapping in corneal refractive surgery 上皮厚度定位在角膜屈光手术中的作用
Pub Date : 2021-09-30 DOI: 10.24292/01.ot.300921.2
Aleksandra Wlaź, barbara czarnota-Nowakowska, J. Wierzbowska
Refractive surgery has stimulated significant progress in anterior segment imaging. Knowledge of epithelial thickness profile considerably increases the efficacy and safety of refractive procedures. This review aims to present new technologies evaluating corneal epithelial thickness and the most important clinical applications in the field of corneal refractive surgery.
屈光手术促进了前节成像的显著进步。了解上皮厚度剖面大大提高了屈光手术的有效性和安全性。本文就角膜屈光手术中评估角膜上皮厚度的新技术及最重要的临床应用进行综述。
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引用次数: 0
Current and new indications for corneal cross-linking in the therapy of corneal diseases 角膜交联治疗角膜疾病的新指征及现状
Pub Date : 2021-09-30 DOI: 10.24292/01.ot.300921.1
Katarzyna Przewłócka, P. Kanclerz
Corneal collagen cross-linking, a technique used in ophthalmology, involves the creation of new bonds between collagen fibers, thus leading to stabilization and corneal stiffening. The most common indication for corneal collagen cross-linking procedures is to prevent the progression of corneal ectasia, i.e., keratoconus, pellucid marginal degeneration, and ectasia after corneal refractive surgery. Clinical data also indicate that it is effective in the treatment of bacterial corneal infections and bullous keratopathy. Corneal collagen cross-linking was shown to inhibit the progression of corneal ectasia, and the treatment commonly leads to the improvement in visual acuity, decreases the maximum keratometry values, and improves the corneal topography image. In addition, it is possible to avoid or postpone the need for more complex and invasive surgery.
角膜胶原交联是一种用于眼科的技术,涉及在胶原纤维之间建立新的键,从而导致角膜稳定和硬化。角膜胶原交联手术最常见的适应症是防止角膜扩张的进展,即圆锥角膜、透明边缘变性和角膜屈光手术后的扩张。临床资料也表明,它是有效的治疗细菌性角膜感染和大疱性角膜病变。角膜胶原交联被证明可以抑制角膜扩张的进展,治疗通常会改善视力,降低最大角膜测量值,改善角膜地形图图像。此外,可以避免或推迟更复杂和侵入性手术的需要。
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引用次数: 0
The issue of preservatives in light of evidence based medicine 基于循证医学的防腐剂问题
Pub Date : 2021-09-06 DOI: 10.24292/01.ot.060921
M. Misiuk-Hojło, K. Pawłowska
Glaucoma is the leading cause of irreversible blindness worldwide. Most patients will require drug therapy for the rest of their lives. Preservatives play a key role in the development of topical medications whose primary role is to provide antimicrobial activity to maintain sterility. The most common preservative is benzalkonium chloride, which has antibacterial, antifungal, and antiviral properties. This article was written based on the latest research in MEDLINE and other major bibliographic databases for studies published in English by August 1st, 2021. Our meta-analyses confirm that eye drops side effects are not caused solely by the presence of preservatives, and the effectiveness of anti-glaucoma drugs containing benzalkonium chloride and those without preservatives is comparable. During the COVID-19 pandemic, studies showed the protective effect of preservatives against SARS-CoV-2.
青光眼是世界范围内导致不可逆失明的主要原因。大多数病人在他们的余生中都需要药物治疗。防腐剂在外用药物的开发中起着关键作用,其主要作用是提供抗菌活性以保持无菌。最常见的防腐剂是苯扎氯铵,它具有抗菌、抗真菌和抗病毒的特性。本文基于截至2021年8月1日的MEDLINE等主要文献数据库的最新研究成果编写而成。我们的荟萃分析证实,眼药水的副作用不仅仅是由防腐剂的存在引起的,含有苯扎氯铵的抗青光眼药物和不含防腐剂的药物的有效性是相当的。在COVID-19大流行期间,研究表明防腐剂对SARS-CoV-2具有保护作用。
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引用次数: 0
Switching Between Aflibercept and Ranibizumab in the Treatment of Refractory Exudative Age-related Macular Degeneration 阿非利塞普和雷尼单抗在难治性渗出性老年性黄斑变性治疗中的转换
Pub Date : 2021-08-27 DOI: 10.24292/01.OT.270821
M. Wichrowska, J. Kocięcki, W. Suda
Introduction: Aflibercept and ranibizumab have become the most used drugs in the treatment of wet age-related macular degeneration. Some patients; however, do not respond to aflibercept and ranibizumab treatment. Our aim was to determine whether the switch from aflibercept to ranibizumab, and then switchback, is effective in a group of patients poorly responding to aflibercept. We assessed best corrected visual acuity, central retinal thickness, and the presence of intra- and subretinal fluid (respectively). Material and methods: We conducted a retrospective comparative case series study. Twenty eyes of 20 patients, who had no inhibition of disease activity after at least one year of treatment with aflibercept, were included in the study. If after switch to ranibizumab the response to the drug was again inadequate, we returned to aflibercept. We divided the study population into two groups: treatment- naïve and patients who had received injections before entering the Drug Program for the Treatment of Age-Related Exudative Macular Degeneration. Results: We observed an improvement in both best corrected visual acuity and central retinal thickness parameters, but only in the treatment-naïve group. We did not observe any statistically credible effects for sub- and intraretinal fluid in the studied groups. Conclusions: Drug conversion may be beneficial for patients poorly responding to primary therapy. Greater improvement is seen in previously untreated patients.
简介:阿非利赛普和雷尼单抗已成为治疗湿性年龄相关性黄斑变性最常用的药物。有些病人;然而,对阿非利西普和雷尼单抗治疗无反应。我们的目的是确定从阿非利西普切换到雷尼单抗,然后切换,是否有效的一组患者对阿非利西普反应不良。我们分别评估了最佳矫正视力、视网膜中央厚度和视网膜内液和视网膜下液的存在。材料和方法:我们进行了回顾性比较病例系列研究。20例患者的20只眼睛,在使用阿伯西普治疗至少一年后,疾病活动没有受到抑制,被纳入研究。如果在切换到雷尼单抗后,对药物的反应再次不足,我们返回到阿伯西普。我们将研究人群分为两组:治疗组- naïve和在进入治疗年龄相关性渗出性黄斑变性药物计划之前接受注射的患者。结果:我们观察到最佳矫正视力和中央视网膜厚度参数的改善,但仅在treatment-naïve组。在研究组中,我们没有观察到任何统计学上可信的视网膜下液和视网膜内液的效果。结论:药物转换可能有利于对原治疗反应不佳的患者。先前未接受治疗的患者改善更大。
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引用次数: 0
Conjunctival herpetic ulcer in an immunosuppressed patient with birdshot chorioretinopathy 鸟射性脉络膜视网膜病变免疫抑制患者的结膜疱疹性溃疡
Pub Date : 2021-08-27 DOI: 10.24292/01.ot.160821
A. Fernández-Hortelano, E. Guzmán-Almagro, M. Castro-Rebollo, C. Izquierdo-Rodríguez, J. González Martín-Moro
Introduction: Herpes Simplex Virus (HSV) is a human herpesvirus responsible for systemic infections. Ocular involvement spans all ocular tissues. Corneal lesions, such as dendritic or geographic ulcers, are frequently found in HSV keratitis while conjunctival lesions have been described as infrequent. Clinical case: A 62-year-old man diagnosed with Birdshot chorioretinopathy presented a stye in his eyelid that was treated with oxytetracycline-hydrocortisone ointment. One week later he returned presenting several small dendritic corneal ulcers in both eyes and a conjunctival ulcer in one of them. All lesions healed completely after treatment with topical acyclovir ophthalmic ointment at 3%. Conclusions: We should pay attention to the conjunctiva and not merely focus on the cornea when examining patients with herpetic eye disease, especially if being treated with inmunosupressors.
简介:单纯疱疹病毒(HSV)是一种引起全身感染的人类疱疹病毒。眼部受累遍及所有眼部组织。角膜病变,如树突状或地域性溃疡,常见于HSV角膜炎,而结膜病变已被描述为罕见。临床病例:一名62岁的男性被诊断为Birdshot绒毛膜视网膜病变,他的眼睑有一种风格,用土环素-氢化可的松软膏治疗。一周后,他又来了,两只眼睛出现了几个小的树突状角膜溃疡,一只眼睛出现了结膜溃疡。用3%的阿昔洛韦眼膏治疗后,所有病变完全愈合。结论:在疱疹性眼病患者的检查中,尤其在使用免疫抑制剂治疗时,应注意结膜,而不仅仅是角膜。
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引用次数: 0
SMILE – charakterystyka zabiegu i jakość życia pacjentów
Pub Date : 2021-06-30 DOI: 10.24292/01.OT.150721.X
Marika Wolniewińska, Barbara Czarnota-Nowakowska, Jagoda Wolniewińska, Joanna Wierzbowska, J. Kocięcki
Zabieg laserowej korekcji wad wzroku ReLEx® SMILE jest stosunkowo nowym, bezpłatkowym zabiegiem refrakcyjnym, wykonywanym tylko przy użyciu lasera femtosekundowego. Zyskał on uznanie zarówno wśród okulistów, jak i pacjentów, stanowiąc alternatywę dla zabiegu LASIK, uważanego dotąd za złoty standard w korekcji krótkowzroczności i astygmatyzmu krótkowzrocznego. W niniejszym artykule przedstawiono charakterystykę zabiegu ReLEx® SMILE w porównaniu z innymi zabiegami laserowej korekcji wad wzroku oraz jego wpływ na jakość życia pacjentów po zabiegu.
ReLEx® SMILE 激光视力矫正手术是一种相对较新的免费屈光手术,仅使用飞秒激光进行。它为迄今为止被视为矫正近视和近视散光黄金标准的 LASIK 手术提供了一种替代方案,因而获得了眼科医生和患者的认可。本文介绍了ReLEx® SMILE手术与其他激光视力矫正手术相比的特点及其对患者术后生活质量的影响。
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引用次数: 1
The mechanism of intraocular pressure rise after keratoplasty 角膜移植术后眼压升高的机制
Pub Date : 2021-06-23 DOI: 10.24292/01.OT.210521
Diana Wyroślak-Bednarek, Zofia Pniakowska, P. Jurowski
Purpose: To determine the pathomechanism of increased intraocular pressure after penetrating and lamellar keratoplasty based on clinical observation and literature data. Materials and methods: Morphometric analysis of the anterior segment of the eye using spectroscopic optical coherence tomography, gonioscopy and biomicroscopy. Results: Pre- and postoperative spectroscopic optical coherence tomography scans in patients after keratoplasty reveal deformation of the peripheral cornea, narrowing of the iridocorneal angle, presence of anterior synechiae and various types of pupillary block. Conclusions: The mechanism of elevated intraocular pressure after corneal grafting is complex and depends on pre-, intra- and postoperative factors, such as anatomy changes of the iridocorneal angle, presence of anterior synechiae, as well as anterior and posterior pupillary block. Spectroscopic optical coherence tomography plays an important role in diagnosis and further treatment management.
目的:通过临床观察和文献资料,探讨穿透性板层角膜移植术后眼压升高的病理机制。材料和方法:使用光谱光学相干断层扫描、角镜和生物显微镜对眼前段进行形态计量学分析。结果:角膜移植术患者术前和术后光谱光学相干断层扫描显示周围角膜变形,虹膜角膜角变窄,存在前粘连和各种类型的瞳孔阻滞。结论:角膜移植术后眼压升高的机制复杂,与虹膜角膜角的解剖改变、前粘连的存在、前后瞳孔阻滞等术前、术中、术后因素有关。光谱光学相干层析成像在诊断和进一步治疗管理中发挥着重要作用。
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引用次数: 0
Vitrectomy in stage 5 ROP – surgical and functional results of 1000 vitrectomies 5期玻璃体切除术- 1000例玻璃体切除术的手术和功能结果
Pub Date : 2021-06-23 DOI: 10.24292/01.OT.080621
M. Prost
Despite improvements in neonatal care, retinopathy of prematurity is still leading cause of blindness in the world. The most treatment problems pose stage 4 and 5 of this disease. Performing vitrectomy in stage 5 is a subject of controversy among ophthalmologists due to unsatisfactory functional results after the surgery. Therefore, our aim was to present the results of 1000 vitrectomies performed by the author in years 1994–2019 in 1018 eyes of 692 children with stage 5 retinopathy of prematurity. In these children lens sparing vitrectomies and lensectomy-vitrectomy with limbal approach were performed. The results were compared with visual function of 127 untreated children with stage 5 retinopathy of prematurity. Visual acuity of treated patients ranged from 0.05 to no light perception in stage 5 and from no light perception to finger counting in the untreated group. Comparing the functional results of treated and untreated patients, it can be concluded that vitrectomy gives a better chance of gaining useful vision.
尽管新生儿护理有所改善,早产儿视网膜病变仍然是世界上致盲的主要原因。大多数治疗问题出现在该病的第4和第5阶段。由于手术后的功能效果不理想,在眼科医生中进行玻璃体切除术是一个有争议的话题。因此,我们的目的是介绍作者在1994-2019年间对692例5期早产儿视网膜病变患儿的1018只眼睛进行的1000例玻璃体切除术的结果。在这些儿童中进行了保留晶状体的玻璃体切除术和晶状体切除术结合晶状体缘入路的玻璃体切除术。结果与127例未经治疗的5期早产儿视网膜病变儿童的视觉功能进行了比较。治疗组5期视力从0.05到无光感,未治疗组5期视力从无光感到手指计数。比较治疗后和未治疗后的功能结果,玻璃体切除术能更好地获得有用的视力。
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引用次数: 0
期刊
OphthaTherapy. Therapies in Ophthalmology
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