Ceska a Slovenska Oftalmologie最新文献

Herpetic infections frequently cause diagnostic errors, which subsequently lead to mistakes in therapy. They affect all the ocular structures, although in everyday practice we most frequently encounter herpetic infections of the anterior segment of the eye. This review article focuses on infections of the anterior segment of the eye caused by the herpes simplex virus. It explains in further detail the specific pathophysiology and course of herpetic infection, which is closely related to the clinical manifestations of the disease. The various stages of primary and secondary infection are described in detail and documented with photographs from the 2nd Eye Clinic of the Slovak Medical University at F.D. Roosevelt Hospital in Banská Bystrica. The last two sections focus on the diagnosis and treatment of herpes simplex virus infections. Correct identification of the form of herpetic disease is crucial for proper therapeutic management.

Aim: To evaluate changes in the subjective perception of visual acuity in everyday life during intravitreal ranibizumab treatment in patients with diabetic macular edema using the Slovak version of the international NEI VFQ-25 questionnaire.

Material and methods: In a prospective study, 48 eyes of 30 treatment-naive patients were evaluated, and met the indication criteria. We determined best-corrected visual acuity in letter score (LS), intraocular pressure (IOP), central retinal thickness (CRT) and total macular volume (TMV). Patients received the NEI VFQ-25 questionnaire before the first and then after three, six and twelve months of treatment.

Results: Before treatment, LS averaged 68.1 letters, IOP 17.6 mmHg, CRT 480.5 μm, and TMV 11.2 mm3. After twelve months of intravitreal treatment, LS averaged 72.6 letters, IOP 17.0 mmHg, CRT 332.4 μm, and TMV 9.3 mm3. Comparison of data relating to subjective perception of vision before and after twelve months of treatment: perception of general health improved by 7%, vision in general improved by 15%, eye pain decreased by 8%, near vision improved by 12%, distance activities improved by 5%, social functioning improved by 4%, mental health improved by 6%, difficulties with functioning improved by 16%, dependency improved by 1%, driving improved by 2%, color vision improved by 7%, and peripheral vision improved by 9%.

Conclusion: We determined that anti-VEGF ranibizumab treatment improved objective parameters after one year of intravitreal therapy in LS, CRT and TMV. Subjective changes in visual perception improved in all the monitored parameters after one year of treatment.

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.

Aim: To evaluate the epidemiological data, etiology and clinical characteristics, and to assess the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in the treatment of choroidal neovascular membrane (CNV) in children and adolescents. The results are compared with data from previously published studies and case reports.

Material and methods: Retrospective analysis of medical records of patients treated for CNV at the Department of Pediatric Ophthalmology, University Hospital Brno, between January 2015 and April 2025. The cohort consisted of 12 patients, including 7 males and 5 females. All the cases involved unilateral disease; the right eye was affected in 7 patients and the left eye in 5. The mean age at onset was 11.8 years (range: 3-17 years). All underwent a comprehensive ophthalmological examination including optical coherence tomography (OCT); in 7 cases the diagnosis was confirmed by fluorescein angiography. The evaluated parameters included epidemiological data, clinical and morphological characteristics of CNV before and after anti-VEGF therapy. The etiology of CNV in our cohort was as follows: post-inflammatory/post-infectious in 6 cases, idiopathic in 3 cases, and one case each of myopic, post-traumatic, and neoplastic origin. The most common localization was subfoveal. All CNV lesions were classified as classic (type 2).

Results: All patients achieved either anatomical or functional improvement. No ocular or systemic adverse effects related to intravitreal anti-VEGF therapy were observed during the study period.

Conclusion: Early diagnosis and intervention with anti-VEGF therapy show favorable outcomes, including stabilization and remission of the disease. In our cohort, no adverse events or complications associated with intravitreal anti-VEGF administration were recorded. Continued research is essential in order to gain a further understanding of the pathogenesis of pediatric CNV and to optimize treatment strategies in children.

Aim: Retinal detachment is an acute sight-threatening condition that requires immediate surgical intervention. The aim of this study is to compare the outcomes of pars plana vitrectomy (PPV) for uncomplicated rhegmatogenous retinal detachment (RRD) between the different types of gases used, the position, and the number of tears.

Material and methods: This is a retrospective non-randomized comparative study of patients with uncomplicated RRD treated at the Department of Ophthalmology from March 2018 to April 2021 using PPV. A total of 494 evaluated eyes were included in the study. The anatomical success of the surgery was monitored with regard to the extent of retinal detachment, the number and position of tears, and the tamponade used.

Results: The success rate of retinal reattachment with a single operation was 90.7% (448 eyes), and the final anatomical success rate was 100%. A very weak paired relationship was found between the success of the surgery for tears in the 4-8 hours region and the 9-3 hours region (89.1% vs. 92%). Similarly, no significant differences were observed between procedures using SF6 and C3F8 gases for RRD with a tear in the 4-8 hours region (success rate 93.4% for SF6 vs. 89.1% for C3F8). The average postoperative improvement of best corrected visual acuity was 29.6 ETDRS letters, and a gain of 15 letters was recorded in 55.1% (272 eyes). Overall, the complication rate was very low.

Conclusion: PPV is a safe and effective method for treating RRD. Extensive experience with this method allows the use of short-acting tamponades in selected patients.

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.

Retinopathy of prematurity (ROP) is always a serious and sight-threatening condition, and its treatable stages require early detection and adequate treatment. It is necessary to focus on the principles of screening of ROP and recurrences thereof, which occur more often with the onset of intravitreal treatment using anti-vascular endothelial growth factor (anti-VEGF) agents. In this study, we evaluate the recurrence of ROP after primary treatment with intravitreally administered bevacizumab or ranibizumab, its frequency and timing of occurrence. Also discussed are the rules for screening of ROP, its recurrence and the need for long-term follow-up monitoring of children with any form of ROP.

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.

Aim: To evaluate the safety and efficacy outcomes of PRESERFLO™ MicroShunt implantation in patients with primary open-angle glaucoma.

Material and methods: Retrospective data analysis of 19 eyes of 12 patients, comprising 5 females and 7 males. The patients underwent surgery between August 2020 and February 2022. The follow-up period was 24 months after surgery. During the follow-up period, intraocular pressure (IOP), the need to apply topical antiglaucoma medication and its spectrum, visual field status, optic nerve target findings and postoperative complications were recorded. The indication for PRESERFLO™ MicroShunt implantation was primary open angle glaucoma (POAG), poorly controlled with maximum tolerated medical therapy.

Results: Average IOP was reduced from 19.05 ±5.58 mmHg preoperatively to 11.47 ±2.48 mmHg at 3 months postoperatively, 12.26 ±2.48 mmHg at 6 months postoperatively, 14.0 ±2.43 mmHg at 12 months postoperatively, 11.78 ±2.37 mmHg at 18 months postoperatively, and 12.73 ±2.51 mmHg at 24 months postoperatively (p.

Objective: To report a case of mitochondrial retinopathy, highlighting its clinical and imaging findings, the importance of genetic confirmation, and the possible implications of heteroplasmy in this disease.

Material and methods: Case report of a mitochondrial retinopathy secondary to m.3243A>G mutation in the MT-TL1 gene.

Results: A 32-year-old woman presented with bilateral vision loss, photophobia, and sensorineural hearing loss for more than 3 years. Best corrected visual acuity (BCVA) was 20/60 in the right eye (OD) and 20/25 in the left eye (OS). Fundus examination revealed multiple macular subretinal yellow-white deposits and central chorioretinal atrophy, without edema, hemorrhage, or subretinal fluid in the RE, and juxtafoveal atrophy with retinal pigment epithelium (RPE) metaplasia in the OS. Multimodal imaging raised suspicion of retinal dystrophy, and genetic testing confirmed a mitochondrial retinopathy secondary to the m.3243A>G mutation in the MT-TL1 gene.

Conclusions: Bilateral and symmetric RPE atrophic changes in young individuals, especially when associated with systemic symptoms, should prompt a comprehensive evaluation, including multimodal imaging and genetic testing. Identifying causative mutations and understanding the dynamics of mitochondrial DNA in the pathogenesis of these diseases is crucial for improving diagnosis and suggesting potential therapeutic strategies, including gene therapy.