Ceska a Slovenska Oftalmologie最新文献

A corneal stromal lenticule (CSL) is a part of the corneal stroma that forms as a waste product during the refractive surgery ReLEx SMILE (Small Incision Lenticule Extraction) and is no longer used. With the increasing number of ReLEx SMILE procedures and the number of potentially available CSLs, two main aspects of their usage are currently being investigated. The first aspect includes the biological properties of CSLs and their proper preservation with respect to long-term storage. The second aspect is related to the potential clinical use of CSLs. As a high-quality biomaterial, CSLs have substantial potential to be used for alternative solutions in the treatment of specific eye diseases. In a number of studies it has been shown that RSL transplantation could be a safe and effective method that does not cause any serious complications, for example in terms of immune reaction. The aim of this article is to present an overview of the possibilities for using CSLs for transplantation purposes, and at the same time to discuss our methodology for processing and preserving CSLs with the protocol used at the Eye Tissue Bank of the Královské Vinohrady University Hospital.

Aims: To investigate the concordance between the corneal power determined by various approaches with two tomographers (MS-39® and Galilei G6®) and the clinical history method (CHM) in patients undergoing photorefractive surgery with excimer laser for myopic errors.

Material and methods: Prospective cohort study. Patients undergoing keratorefractive surgery, and having pre- and postoperative keratometries, and tomographies, were included.

Results: In 90 eyes, the differences in the power estimated by the CHM and the one determined by four approaches with the corneal tomographers, which included measurements of the posterior cornea, did not show statistically significant differences in their averages. However, the 95% limits of agreement were very wide. After obtaining regression formulas to adjust the values of these four variables, the results of the agreement analysis were similar.

Conclusion: Although certain values either directly determined or derived from measurements with the Galilei® and MS-39®corneal tomographers, approximated the estimated value of postoperative corneal power according to the CHM, due to the amplitude of their limits of agreement, these calculations must be taken with care, because they may not be accurate in a given eye.

Aim: to investigate the dynamics of the T-cell immune response in rabbits with experimental autoimmune uveitis (EAU) of varying severity.

Materials and methods: The experiment involved two groups of Chinchilla rabbits (15 rabbits in each group). The model of EAU was created. The clinical picture of intraocular inflammation of varying severity was assessed. The determination of the level of white blood cells (WBC), lymphocytes (Lymphs), CD3+, CD4+, CD8+, and CD16+ in the blood of rabbits was conducted.

Results: Group I - moderate and severe uveitis, Group II - uveitis of mild severity. WBC, Lymphs, CD3+, CD4+, CD16+ were elevated and statistically significant in both groups of animals compared to control parameters on all days of the experiment (3, 7, 10, 14, 21 days) (p.

Aims: To retrospectively evaluate the anatomical and functional success of surgical treatment for rhegmatogenous retinal detachment (RRD) in pediatric patients aged 18 years and younger.

Material and methods: The study includes 14 eyes of 14 patients, 9 (64%) of whom were males, with an average age of 12 years. All patients underwent surgery for rhegmatogenous retinal detachment (RRD) performed by a single surgeon at the Department of Ophthalmology, University Hospital Brno, and Masaryk University, from July 1, 2019, to June 30, 2024. The surgical techniques used included cryosurgery and 25G+ pars plana vitrectomy (PPV). In 3 patients a 25G+ PPV was combined with pre-equatorial scleral buckling. A history of blunt ocular trauma was permissible. The cause of RRD was retinal tear(s), regardless of their number or location. The transparency of the anterior segment enabled reliable visualization of the posterior segment. Preoperative proliferative vitreoretinopathy (PVR) grades A-D2 were acceptable. Patients with a history of penetrating ocular trauma were excluded. Anatomical success was defined as complete retinal reattachment. Each patient's final visual acuity (VA) was assessed using a Snellen chart. Numerical outcomes were expressed as arithmetic means and percentages. Since no comparative analysis was conducted between different groups, statistical tests were not required.

Results: In 13 patients (93%), complete retinal reattachment was achieved. In 1 patient (7%), the retina became detached again after silicone oil removal, with rapid progression of PVR, leading to anatomical treatment failure due to inoperability. A total of 11 patients (78%) achieved visual acuity (VA) of ≥ 4/40.

Conclusion: We consider cryosurgical techniques utilizing episclerally fixed encircling bands and buckles, 25G+ PPV, and potentially a combination thereof as appropriate methods for managing RRD in children.

Aims: To evaluate the prevalence of uveitis and ocular complications in children with juvenile idiopathic arthritis (JIA) and "JIA-like" form. To determine the onset of ocular symptoms in relation to the diagnosis of the underlying disease and identify the most common predictive factor preceding the onset of uveitis.

Materials and methods: Retrospective analysis of medical records of children with JIA and JIA-like uveitis monitored at the Pediatric Rheumatology and Ophthalmology Clinic at the University Hospital Ostrava between 2016-2024. Observed parameters included the child's age at the time of diagnosis of JIA or JIA-like uveitis, laboratory tests, ocular findings, age at the onset of uveitis symptoms, time correlation with the diagnosis of the underlying disease, ocular complications of recurrent uveitis attacks and overall treatment of the underlying disease.

Results: There were 27 children in the group with confirmed JIA, with an average age of 5 years. Ten patients were diagnosed with anterior or posterior uveitis. The average age at the time of JIA diagnosis was 6 years. The mean time interval from JIA diagnosis to the appearance of pathological ocular findings was 38 months. Ocular complications were recorded in 50% of children, most commonly cataracts (40%). All children with uveitis were laboratory positive for ANA antibodies. There were 8 patients with JIA-like uveitis, with an average age of 9 years. All children showed signs of anterior or posterior uveitis, which was manifested on average at 8.5 years of age. Exclusion of JIA diagnosis was established on average 6 months after the appearance of ocular pathology. Ocular complications were observed in 88% of children, most frequently posterior synechiae (63%). Laboratory findings showed ANA antibody positivity in 88% of children with uveitis.

Conclusion: Regular ophthalmological examinations in JIA patients are essential due to the potential occurrence of complications, which are more frequent in young females with JIA-like uveitis and ANA antibody positivity.

Purpose:  To compare the anatomical and functional outcomes, surgical duration, and complication rates between chandelier-assisted segmental scleral buckling (SB) and conventional SB in the treatment of primary rhegmatogenous retinal detachment (RRD).

Material and methods:  This retrospective comparative study included 19 phakic patients with primary RRD who underwent either conventional SB (Group 1, n = 9) or chandelier-assisted segmental SB (Group 2, n = 10). Patients were selected based on specific inclusion criteria including presence of anterior retinal breaks and PVR ≤ Grade C1. Group 1 underwent standard 360-degree SB with indirect ophthalmoscopy, while Group 2 underwent segmental SB with limited peritomy and chandelier-assisted wide-angle visualization under a surgical microscope. Primary outcomes included best-corrected visual acuity (BCVA) and anatomical reattachment at 1-year follow-up. Secondary outcomes included surgical duration and epiretinal membrane (ERM) formation.

Results:  Both groups demonstrate successful retinal reattachment in all cases and significant improvement in BCVA at one year, with no statistically significant intergroup difference. Mean surgical duration was significantly shorter in the chandelier-assisted group (35.1 ±21.2 minutes) compared to the conventional group (70.2 ±23.2 minutes, p.

Objective: The aim of this study was to evaluate the outcomes of Ozurdex® (DEX) implant in patients with diabetic macular edema (DME) in real-world clinical practice, and to determine the correlation between known OCT biomarkers and the effect of treatment.

Material and methods: This retrospective study included 42 eyes of 33 patients (16 women, 17 men) treated with DEX at the Department of Ophthalmology, Faculty of Medicine and Dentistry of Palacký University and University Hospital Olomouc for DME indication between 2020 and 2023. Follow-up examinations were conducted at 1, 3, and 6 months after the first DEX application. The main assessed parameters were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), OCT biomarkers. The results were subsequently statistically evaluated.

Results: At the first follow-up after DEX application, there was an average decrease in CRT of 186 ±146µm and a gain of 3 ±7 letters. Positive morphological and functional responses were observed in 39 eyes (92.9%) and 23 eyes (54.8%) respectively. The disorganization of retinal inner layers (DRIL) biomarker was initially present in 41 eyes (97.6%), with reduction or disappearance observed in 13 eyes (31%) post-application. Eyes with ellipsoid zone disruption (EZ disruption) had an average initial BCVA of 49.6 letters, compared to 57.8 letters in the group without this biomarker. The mean gain in BCVA was +8.7 letters in treatment-naive eyes and +2.1 letters in previously treated eyes. Chronic DME was less frequent in treatment-naive (n = 1, 14.3%) compared to previously treated eyes (n = 28, 84.8%). All these results were statistically significant (p < 0.05). An increase in IOP post-DEX application occurred in 9 patients (21.4%).

Conclusion: Our results confirm DEX as a safe and effective treatment option for DME. Treatment-naive patients achieved better functional outcomes. We confirmed ellipsoid zone disruption (EZ disruption) as a negative biomarker. Additionally, we demonstrated the capacity of DEX to reduce disorganization of the retinal inner layers (DRIL).

Aims: To demonstrate the relationship of dependency between the thickness of the retinal nerve fiber layer and the functional sensitivity of the retina in healthy young individuals. We also secondarily investigated the relationship between refractive error and mean retinal thickness in the macula.

Material and methods: The basic cohort contained 30 subjects with an average age of 23.4 ±4.2 years. These were young, generally healthy individuals without serious ocular pathologies. The average value of spherical equivalent in both eyes of all individuals was -1.2 ±2.5 D. We measured the thickness of the retinal nerve fiber layer (RNFL) in the papilla area and the average thickness of the retina in the area of the macula using the device OPKO Spectral OCT SLO Combination Imaging System (Opko Health, USA). We performed a functional examination of the retina within an area up to 30° using a perimeter with a stimulus with a Frequency Doubling Technology (FDT) from the company Humphrey (Carl Ziess Meditec, Inc., Dublin, CA). As a significant variable for comparison, we determined the mean value of retinal sensitivity deviation (MD).

Results: In our study, we did not demonstrate a statistically significant relationship between the average thickness of the retinal nerve fiber layer (RNFL) and the average value of retinal functional sensitivity (r = 0.18, p = 0.34) in either right eyes or the left eyes of the examined subjects (r = 0.20, p = 0.29). We also did not find a statistically significant relationship secondarily between the variable called the spherical equivalent of refractive error (SE) and the average retinal thickness in the macula in either the right eyes (r = 0.34, p = 0.06) or the left eyes (r = 0.18, p = 0.32).

Conclusion: When comparing the average thickness of the nerve fibers in the papilla with the help of OCT examination and the functional sensitivity of the retina measured on an FDT perimeter, we did not find a statistically significant dependence in the group of right eyes or in the group of left eyes. We also achieved a similar result when examining the interdependence of the variables of spherical equivalent of refractive error of the eye and the average thickness of the retina in the macula.

Aim: The aim of the article is to summarize observations on cytomegalovirus (CMV) anterior uveitis, and in short case reports present cases of patients treated at our Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague.

Material and methods: Retrospective analysis of patients at the Centre for diagnosis and treatment of uveitis from 2003 to 2024. Presentation of our experiences with CMV anterior uveitis confirmed by polymerase chain reaction (PCR) in aqueous humor in case reports.

Results: From a cohort of 3844 patients with uveitis, 3 patients were diagnosed with CMV anterior uveitis, confirmed by PCR in the aqueous humor. The clinical presentation was as acute recurrent hypertensive anterior uveitis in all patients, with a switch to chronic form with elevated intraocular pressure (IOP). Despite local anti-inflammatory and antiglaucomatous therapy, there was high recurrence of uveitis with decompensation of IOP when the medication was reduced. Patients underwent antiglaucoma surgery because of persistent high IOP despite maximal local antiglaucomatous therapy. An anterior chamber tap was taken for PCR analysis, with a CMV-positive result. After the initiation of antiviral therapy with local ganciclovir, patients manifested compensated IOP and a pronounced reduction of recurrences of uveitis and progression of glaucoma.

Conclusions: CMV anterior uveitis is a rare pathology in our geographic region, but it is important to consider this etiology in cases of recurrent anterior hypertensive uveitis with a low response to local anti-inflammatory medication. Timely verification of the etiological agent with prompt diagnosis and treatment is essential in order to achieve a favorable prognosis. Long-term, low maintenance doses of antiviral therapy with local ganciclovir for several months reduce relapses of uveitis and lead to compensation of IOP.

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.