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Selected problems and challenges of ophthalmic care system in Poland 波兰眼科保健系统的选择问题和挑战
Pub Date : 2021-03-15 DOI: 10.24292/01.OT.300321.2
M. Osęka, A. Jamrozy-Witkowska, M. Mulak
In the perspective of 10–20 years, the ophthalmic care system in Poland will face numerous challenges, and the existing problems will increase. Due to the aging of the population, the incidence of refractive errors and chronic, age-related diseases such as presbyopia, AMD, diabetic retinopathy, glaucoma and cataracts will increase. Due to the change in lifestyle, the incidence of myopia is expected to increase among children and adolescents. The number of ophthalmologists and nurses will decrease and the average age of these professional groups will increase. The number of optometrists in Poland is low, and the legal aspects of practicing the profession of optometrists remain unregulated. Low social awareness contributes to late detection of eye diseases, which worsens the prognosis and increases the costs of treatment.
从10-20年的角度来看,波兰的眼科保健系统将面临众多挑战,现有的问题将会增加。由于人口老龄化,屈光不正和老花眼、黄斑变性、糖尿病视网膜病变、青光眼、白内障等慢性老年性疾病的发病率将会增加。由于生活方式的改变,儿童和青少年的近视发病率预计会增加。眼科医生和护士的人数将会减少,这些专业群体的平均年龄将会增加。波兰验光师的数量很少,验光师职业的法律方面仍然不受监管。社会意识低下导致眼病发现晚,从而使预后恶化并增加治疗费用。
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引用次数: 0
The role of balanced supplementation in diet of age-related macular degeneration patients 平衡补充剂在老年黄斑变性患者饮食中的作用
Pub Date : 2021-03-15 DOI: 10.24292/01.ot.300321.1
Iwona Kusz vel Sobczuk, Anna Święch
Aim: The aim of the article was to discuss the role of balanced supplementation in diet of age-related macular degeneration patients. Methods: This review was carried out using comprehensive and systematic literature reports on the role of supplementation of vitamin D, vitamin C, vitamin E, vitamin B6, vitamin B12, zinc, lutein, zeaxanthin, omega-3 acid and folic acid in the prevention of AMD. Results: Vitamins, minerals and carotenoids are essential for the proper retinal function over an inflammation and immune response modulation. Conclusions: Vitamins, minerals and carotenoids discussed in the article have anti-inflammatory and antioxidative properties in the management of AMD progression. Accordingly, it is relevant to assure the appropriate level of these nutrients in a diet of AMD patients.
目的:本文的目的是讨论平衡补充在年龄相关性黄斑变性患者饮食中的作用。方法:对补充维生素D、维生素C、维生素E、维生素B6、维生素B12、锌、叶黄素、玉米黄质、omega-3酸和叶酸在预防AMD中的作用进行全面系统的文献综述。结果:维生素、矿物质和类胡萝卜素对视网膜正常功能在炎症和免疫反应调节中是必不可少的。结论:本文讨论的维生素、矿物质和类胡萝卜素在AMD进展的管理中具有抗炎和抗氧化特性。因此,确保AMD患者饮食中这些营养素的适当水平是相关的。
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引用次数: 0
Program lekowy wysiękowego zwyrodnienia plamki związanego z wiekiem – efekty leczenia w oparciu o badania diagnostyczne i ocenę pacjentów
Pub Date : 2021-01-05 DOI: 10.24292/01.ot.311220.x
Urszula Michalik-Marcinkowska, Ilona Jas, Andrzej Misiak, D. Dobrowolski
Zwyrodnienie plamki związane z wiekiem (AMD, age-related macular degeneration) to obecnie główna przyczyna obniżenia ostrości wzroku, a nawet ślepoty w populacji osób powyżej 45. r.ż. Postępowanie lecznicze w wysiękowej postaci AMD polega na jak najszybszym włączeniu terapii anty-VEGF w postaci iniekcji doszklistkowych. Od 2015 r. w Polsce jest dostępny program lekowy dla pacjentów z wysiękową postacią AMD. W ramach programu zatwierdzono preparaty ranibizumab oraz aflibercept. Celem badań była ocena skuteczności stosowania programu lekowego wśród pacjentów z wysiękową postacią AMD. Z zastosowaniem badań diagnostycznych oraz sondażu diagnostycznego przebadano 98 pacjentów biorących udział w programie lekowym.
年龄相关性黄斑变性(AMD)是目前导致 45 岁以上人群视力下降甚至失明的主要原因。对渗出型老年黄斑变性的治疗方法是尽快采用玻璃体内注射抗血管内皮生长因子疗法。自2015年起,波兰推出了针对渗出型AMD患者的药物计划。该计划已批准了雷珠单抗和阿弗利百普。这项研究旨在评估药物计划在渗出性AMD患者中的有效性。通过诊断测试和诊断调查,对98名参与药物计划的患者进行了调查。
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引用次数: 1
Laser trabeculoplasty and subthreshold transscleral cyclophotocoagulation – the new therapeutic options are modifying therapeutic algorithm in glaucoma 激光小梁成形术和阈下经巩膜光凝术-新的治疗选择正在改变青光眼的治疗算法
Pub Date : 2020-12-31 DOI: 10.24292/01.OT.311220.11
J. Wasyluk, Ilona A Kaczmarek, R. Różycki
Selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT) are well established, non-invasive laser procedures in glaucoma, but their place in the therapeutic algorithm still evolves. Lately published multicenter randomized clinical trials indicate the need to consider laser trabeculoplasty as the first-line treatment before medications in primary open-angle glaucoma an ocular hypertension due to its favorable safety profile, efficacy and cost-effectiveness. Subthreshold transscleral cyclophotocoagulation (present on the market under different brand names: SubCyclo® TS-CPC [Quantel, France] or Cyclo G6® mTS-CPC [Iridex, USA]) is an antiglaucomatous laser procedure, recently arousing more and more interest in ophthalmologists as a new non-invasive method in our therapeutic portfolio. This new device utilizes 810 nm diode laser beam, fractionated into ultra-short pulses, resulting in low energy spots without causing ciliary body coagulation. Subthreshold (or subliminal) energy delivered during the session spares the tissue due to very limited local heat accumulation zone and therefore this procedure may be repeated. Laser energy partially disables aqueous producing ciliary epithelium and opens supraciliary space thus activating the additional outflow facility. Subthreshold TS-CPC in several clinical trials proved to be effective in lowering the intraocular pressure and devoid of significant sight threatening side effects, comparing to the classical thermal diode cyclophotocoagulation method.
选择性激光小梁成形术(SLT)和微脉冲激光小梁成形术(MLT)是青光眼的非侵入性激光治疗方法,但它们在治疗算法中的地位仍在发展。最近发表的多中心随机临床试验表明,由于激光小梁成形术具有良好的安全性、有效性和成本效益,因此需要考虑将其作为原发性开角型青光眼和高眼压的一线治疗方法。阈下经巩膜睫状体光凝(市场上有不同的品牌名称:SubCyclo®TS-CPC [Quantel, France]或Cyclo G6®mTS-CPC [Iridex, USA])是一种抗青光眼的激光手术,最近作为一种新的非侵入性治疗方法引起了眼科医生越来越多的兴趣。这种新装置利用810 nm二极管激光束,分割成超短脉冲,产生低能量斑点,而不会引起纤毛体凝固。由于非常有限的局部热积聚区,在会话期间传递的阈下(或阈下)能量可以保护组织,因此该过程可以重复。激光能量部分使产水睫状体上皮失活,打开睫状体上间隙,从而激活额外的流出设施。与经典的热二极管光凝法相比,阈下TS-CPC在多项临床试验中被证明能有效降低眼压,且无明显的视力威胁副作用。
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引用次数: 0
Prof. dr hab. n. med. Ariadna Gierek-Łapińska (1938–2020)
Pub Date : 2020-12-31 DOI: 10.24292/01.ot.311220.z
Marek E. Prost
Prof. dr hab. n. med. Ariadna Gierek-Łapińska (1938–2020)
阿里亚德娜-吉雷克-罗皮恩斯卡教授(1938-2020)博士
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引用次数: 0
The influence of soft multifocal contact lenses with high additions on the eye–hand coordination 高附加值软性多焦隐形眼镜对手眼协调能力的影响
Pub Date : 2019-12-31 DOI: 10.24292/01.ot.311219.07
Katarzyna Przekoracka, K. Michalak, A. Michalski, Jan Olszewski, Joanna Paluch, A. Przekoracka-Krawczyk
The aim of the present study was to assess whether soft multifocal contact lens (SMFCLs) with high addition powers, designed for myopia control, may have an impact on eye movements and eye–hand coordination. A total of 24 young adults used SMFCLs (Relax, SwissLens) with high additions: +2D (Add2) and +4D (Add4). Single vision (Add0) contact lenses were used as controls (Orbis, SwissLens). In the eye–hand coordination task, the study participants were asked to point out the small circle displayed on a touch screen. Reaction time and accuracy of pointing, as well as latency of eye movements were measured. Results showed that SMFCLs had no significant impact on the latency of eye movements (135, 136, 139 ms, for Add0, Add2 and Add4, p = 0.171), reaction time (732, 730, 727 ms for Add0, Add2 and Add4, p = 0.932) or percent error (17%, 13%, 18% for Add0, Add2 and Add4, p = 0.386).
本研究的目的是评估用于近视控制的高附加倍率软多焦隐形眼镜(SMFCLs)是否会影响眼球运动和眼手协调。共有24名年轻人使用了高添加量的smfcl (Relax, SwissLens): +2D (Add2)和+4D (Add4)。单视力(Add0)隐形眼镜作为对照(Orbis, SwissLens)。在手眼协调任务中,研究参与者被要求指出触摸屏上显示的小圆圈。测量了反应时间、指向的准确性以及眼球运动的潜伏期。结果表明,SMFCLs对眼球运动潜伏期(Add0、Add2和Add4分别为135、136、139 ms, p = 0.171)、反应时间(Add0、Add2和Add4分别为732、730、727 ms, p = 0.932)和误差百分比(Add0、Add2和Add4分别为17%、13%、18%,p = 0.386)均无显著影响。
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引用次数: 2
The role of topical antibiotics in perioperative endophthalmitis prevention in cataract surgery 外用抗生素在白内障手术围术期预防眼内炎中的作用
Pub Date : 2019-09-30 DOI: 10.24292/01.ot.300919.01
A. Grzybowski, K. Kupidura-Majewski
Postoperative endophthalmitis after cataract surgery, although very rare, remains an important cause of blindness. Practice patterns vary in many European countries. They include topical antibiotics before surgery, use of povidone-iodine, intracameral antibiotics at the end of the procedure, subconjunctival injection, use of topical antibiotics after surgery, and also emerging ideas such as dropless cataract surgery. The purpose of this article is to present the current management strategy and the role of local antibiotic therapy used in the prevention of endophthalmitis.
白内障术后眼内炎虽然非常罕见,但仍是导致失明的重要原因。许多欧洲国家的实践模式各不相同。它们包括术前使用局部抗生素,手术结束时使用聚维酮碘,结膜下注射,手术后使用局部抗生素,以及新兴的想法,如无水滴白内障手术。本文的目的是介绍目前的管理策略和局部抗生素治疗在预防眼内炎中的作用。
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引用次数: 0
Zastosowanie generatora plazmowego w zabiegach okuloplastycznych – doświadczenia własne 在眼部整形手术中使用等离子发生器--亲身经历
Pub Date : 2019-09-30 DOI: 10.24292/01.ot.300919.05
J. Wasyluk, I. Kaczmarek, M. Strąk, M. Myślińska, Marta Dubisz
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引用次数: 0
Visual function after bilateral implantation of multifocal versus monofocal IOLs in children below 5 years of age 5岁以下儿童双侧多焦点与单焦点人工晶体植入术后视觉功能的比较
Pub Date : 2019-09-30 DOI: 10.24292/01.ot.300919.06
M. Prost
Background: Since pediatric ophthalmologists still prefer to implant monofocal IOL and experience with multifocal IOL implantation in children is limited. Therefore, the aim of the study was to evaluate visual results after bilateral implantation of multifocal versus monofocal IOLs in children aged 1–5 years with congenital cataract. Methods: Children between 1 and 5 years of age with bilateral cataract who underwent cataract removal implantation of an multifocal IOL – Lentis Mplusx, Oculentis GmbH, Germany (55 children – group A) or monofocal IOL – C-flex Aspheric Monofocal, Rayner Intraocular Lenses Limited, UK (55 children – group B). The distance corrected visual acuity, distance corrected near visual acuity, binocular function using the Worth 4-dot test, stereopsis using the TNO test were evaluated. Results: At the final follow-up visit after 12 months, the mean best corrected distant visual acuity was not significantly different between groups A and B but the best corrected near visual acuity, binocular vision and stereopsis were significantly better in patients from group A as compared to group B. Conclusion: Implantation of a multifocal IOL in children aged 1–5 years with bilateral cataract provides a better level of near vision and considerably improves the development of stereopsis in comparison with children after monofocal IOL implantation.
背景:由于儿童眼科医生仍然倾向于单焦点人工晶状体植入术,儿童多焦点人工晶状体植入术的经验有限。因此,本研究的目的是评估1-5岁先天性白内障患儿双侧植入多焦点与单焦点人工晶体后的视力效果。方法:1 ~ 5岁双侧白内障患儿,分别行多焦点IOL - Lentis Mplusx,德国Oculentis GmbH(55例A组)或单焦点IOL - C-flex非球面单焦点,Rayner Intraocular Lenses Limited,英国(55例B组)。采用Worth 4点测试评估矫正距离视力、矫正距离近视力、双眼功能、TNO测试评估立体视觉。结果:在12个月后的最后一次随访中,A组和B组患者的平均最佳矫正远视力无显著差异,但A组患者的最佳矫正近视力、双眼视力和立体视觉明显优于B组。1-5岁双侧白内障儿童多焦点人工晶体植入术与单焦点人工晶体植入术相比,可提供更好的近视力水平,并显著改善立体视发育。
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引用次数: 1
Nystagmus vision therapy 眼球震颤视力治疗
Pub Date : 2019-09-30 DOI: 10.24292/01.ot.300919.04
M. Gwara
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引用次数: 0
期刊
OphthaTherapy. Therapies in Ophthalmology
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