Ceska a Slovenska Oftalmologie最新文献

Aim:  To evaluate RNFL (Retinal Nerve Fiber Layer) and GCC (Ganglion Cell Complex) thickness, using SD-OCT in treatment-naive patients of primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG) and normal-tension glaucoma (NTG) and to compare these findings with healthy controls.

Material and methods:  The study included 150 eyes of 75 glaucoma patients (25 each of POAG, PACG, NTG) and 200 eyes of 100 controls. In this cross-sectional observational study, patients meeting the inclusion criteria underwent comprehensive ophthalmic examinations, including best-corrected visual acuity, intraocular pressure (IOP) by Goldmann applanation tonometry (GAT), gonioscopy to differentiate between open and closed angle and visual field analysis (VFA). GCC-IPL and RNFL thickness were measured using SD-OCT.

Results:  Significant thinning of RNFL was noted in all glaucoma subtypes, especially in inferior and superior quadrants (p.

Purpose:  The aim of this retrospective study was to evaluate the outcomes of refractive lens exchange (RLE) with implantation of extended depth of focus (EDOF) and trifocal intraocular lenses (IOLs) in presbyopic hyperopic patients diagnosed with Fuchs endothelial corneal dystrophy (FECD), and to retrospectively assess preoperative criteria suitable for RLE indication.

Materials and methods:  The study included 17 patients (34 eyes) with hyperopia and FECD who underwent RLE with implantation of EDOF or trifocal IOLs at Lexum Eye Clinics between 2022 and 2024. The mean follow-up period was 13 months, and the mean patient age was 56 ±5 years. Evaluated parameters included preoperative and postoperative refraction, visual acuity, endothelial microscopy, central pachymetry, and posterior corneal backscatter.

Results:  The mean preoperative uncorrected distance visual acuity was 0.68 logMAR, improving postoperatively to 0.01 logMAR. The mean corrected distance visual acuity improved from 0.01 logMAR preoperatively to -0.01 logMAR postoperatively. Postoperative uncorrected intermediate and near visual acuities were 0.07 logMAR and 0.10 logMAR, respectively. According to Krachmer's classification of endothelial microscopy, 14 patients had grade 1, one patient grade 2, and two patients grade 3 FECD. The mean postoperative endothelial cell density was 2595 cells/mm², with a coefficient of variation of 30 % and hexagonality of 50 %. No statistically significant difference was found between preoperative and postoperative pachymetry values (p = 0.184). The mean posterior corneal backscatter was 14.7 GSU preoperatively and 16.8 GSU postoperatively.

Conclusion:  Fuchs endothelial corneal dystrophy has long been considered a contraindication for refractive lens exchange. In our cohort of motivated patients, the outcomes were highly satisfactory. Key parameters - central pachymetry, endothelial microscopy, and posterior corneal backscatter remained stable over time. When properly indicated, carefully performed RLE may be a viable option for presbyopia correction in patients with early-stage FECD.

Introduction: Retinal artery occlusion (RAO) is a vascular occlusive disorder and an acute condition in ophthalmological practice.

Purpose: To evaluate the effectiveness of treatment approaches used at our department in patients with RAO, particularly their impact on the resulting central visual acuity of the affected eye. Furthermore, to determine how many patients would meet the time window for intravenous thrombolysis (IVT) administration in the case of central retinal artery occlusion (CRAO).

Material and methods: This retrospective study included all the patients diagnosed with CRAO and BRAO (branch retinal artery occlusion) who received systemic treatment with intravenously administered vasodilators (Procaine®) at our department between 01/2020 and 08/2025. We monitored the time delay to examination, the type of healthcare facility upon first contact, the type of therapy, the duration of symptoms before the initiation of treatment, and risk factors. We evaluated the change in central visual acuity (CVA) before treatment and immediately after completion of therapy upon discharge from hospital.

Results: The study sample consisted of 73 eyes (51 with CRAO and 22 with BRAO). No significant improvement in CVA was observed after the administration of 0.2% procaine hydrochloride (Procaine®): the mean change in CVA before and after treatment was 0.045 in the BRAO group and 0.078 in the CRAO group. No significant association was found between CVA change and the number of administered Procaine doses. The average time from the onset of symptoms to examination at our ophthalmology clinic was 33.5 hours in the BRAO group and 28.4 hours in the CRAO group. The time window for potential IVT administration was met by 2 patients with BRAO (9%) and 14 patients with CRAO (27%).

Conclusion:  We did not demonstrate any potential therapeutic effect of intravenously administered 0.2% procaine hydrochloride. Our results confirmed the need to establish a protocol for IVT administration.

Purpose: Presentation of a  case report demonstrating the complexity of care for a  patient with atopic keratoconjunctivitis (AKC), including the management of complications such as corneal ulceration, development of keratoconus, corticosteroid-induced intraocular pressure elevation, and cataract formation.

Material and methods: We describe a case of a 52-year-old male with a marginal corneal ulcer within the context of atopic blepharokeratoconjunctivitis, focusing on complications and the need for intensive local and systemic therapy to stabilize the disease.

Results:  Intensive therapy led to a gradual improvement of the disease. Corneal cross-linking stabilized keratoconus, intraocular pressure elevation was successfully managed with anti-glaucoma medication, and cataract surgery resulted in a significant improvement of visual function.

Conclusion:  This case report highlights the importance of early diagnosis and the need for long-term, multidisciplinary care in patients with AKC. Regular follow-up examinations, patient education, and a  combination of local, systemic, and surgical therapy are essential in order to prevent complications and stabilize the disease.

Aim:  To evaluate the efficacy of a customized cryotherapy technique in enhancing ocular salvage and reducing evisceration rates in patients with descemetocele and iris prolapse.

Material and methods:  A retrospective, observational study was conducted at SMEC Eye Hospital, Medan, including 467 eyes from 467 patients treated with customized cryotherapy between January 2008 and July 2025. The procedure integrated standardized cryotherapy with adjunctive perioperative protocols, including antiseptic preparation, postoperative antibiotic, anti-inflammatory, and beta-blocker eyedrops, as well as strict environmental precautions and protective eyewear. Outcomes assessed were the need for repeated cryotherapy and evisceration.

Results:  Of the 467 treated eyes, 454 (97.2%) were successfully preserved without requiring evisceration. Repeated cryotherapy was required in 11 eyes (2.2%), of which 10 achieved ocular preservation. Evisceration was ultimately required in 13 eyes (2.8%), primarily due to spontaneous ocular content prolapse. Most treated eyes demonstrated corneal wall thickening and scarring, with regression of iris prolapse, thereby restoring ocular contour.

Conclusion:  Customized cryotherapy is a highly effective intervention for preventing evisceration in eyes with descemetocele and iris prolapse. By stabilizing the corneal wall and mitigating the risk of spontaneous ocular prolapse, this technique represents a valuable strategy for ocular salvage. Further prospective and controlled studies are warranted to validate long-term outcomes and to optimize treatment protocols.

Purpose: To evaluate the clinical outcomes following the implantation of a new toric intraocular lens (TIOL) with extended depth of focus (EDOF) Bi-Flex ELON Toric POB-MA 877PETY (Elon®, Medicontur Medical Engineering Ltd., Zsámbék, Hungary), including analysis of lens rotational stability and assessment of patient satisfaction.

Material and methods: In a retrospective, monocentric clinical study, 29 eyes of 18 patients (11 men and 7 women) with presbyopia, cataracts, and corneal astigmatism were evaluated. These patients underwent uncomplicated cataract surgery with Bi-Flex ELON Toric TIOL implantation. Postoperative assessments included measurements of monocular uncorrected and corrected distance visual acuity (UDVA, CDVA) and near visual acuity (UNVA, CNVA), rotational stability of the TIOL, and subjective evaluation of visual quality using a questionnaire. Follow-up examinations were conducted 6 months postoperatively (ranging from 3 to 9 months).

Results: The mean postoperative monocular UDVA improved from 0.4 ±0.2 to 0.90 ±0.1 (p.

Aims: This systematic review aimed to investigate whether quantitative metrics derived from gaze tracking (GT) outputs during visual field (VF) testing with an automated perimeter could enhance the evaluation of test reliability.

Materials and methods: A systematic search of PubMed, Cochrane, LILACS, and IBECS databases, from inception to August 31, 2024, was conducted.

Results: Eight studies - four cross-sectional and four cohort - met the inclusion criteria, comprising 8,181 visual field tests from 3,687 patients. The studies were categorized based on testing strategy: SITA Standard, Fast, and Faster. In the SITA Standard group, GT parameters were associated with visual field result reproducibility and the structure-function relationship in glaucoma, but were influenced by ocular surface variables. In the SITA Fast and Faster group, results were mixed: some studies suggested GT metrics could complement conventional reliability parameters, while others concluded that GT quantitative metrics did not offer clinically meaningful insights beyond existing methods.

Conclusion: GT trace quantification shows promise as an objective reliability parameter for VF testing, particularly within the SITA Standard framework. Advanced image analysis techniques, including artificial intelligence, could facilitate automated GT parameter quantification, streamlining processes and supporting further studies to evaluate their impact on VF data reliability and clinical decision-making.

Aim: To evaluate changes in the vascular density of the deep and superficial capillary plexus of the retina, the area of the foveal avascular zone, central retinal thickness, and best corrected visual acuity in patients with diabetic macular edema treated with anti-VEGF agents.

Material and methods: In a prospective study at the Ophthalmology Clinic of FNHK, we evaluated a group of 41 eyes of 30 patients (19 men and 11 women) with diabetic macular edema treated with Lucentis or Eylea. The average age of the patients was 61.7 ±11.3 years. Average initial visual acuity was 64.4 ±9.1 letters on ETDRS optotypes. During the one-year follow-up period we monitored the density of the deep and superficial retinal capillary plexus using OCTA. We evaluated OCTA scans with the ImageJ program at 3, 6, 9, and 12 months. Additionally, the area of the foveal avascular zone, central retinal thickness, and best-corrected visual acuity were measured.

Results: During the one-year follow-up period there was a statistically significant change in both retinal capillary plexuses, with the density of the deep capillary plexus increasing (p.