Ceska a Slovenska Oftalmologie最新文献

Aim: The study aimed to explore the association between duration of smartphone usage and tear film parameters in adolescents through a hospitalbased cross-sectional study.

Material and methods: A detailed history regarding smartphone usage was obtained, followed by tear film assessment for all the study participants. Tear meniscus height (TMH), Tear film break up time (TBUT), and Schirmer's I test were done for all participants. Then they were classified into four groups, based on daily smartphone usage: < 2 hours/day, 2-4 hours/day, 4-6 hours/day, and > 6 hours/day.

Results: 123 smartphone users of the adolescent age group aged 10-19 years (mean age: 16.6 ±2.8 years) were included. The mean values of tear film parameters were as follows: TMH was 0.25 ±0.1 mm, Schirmer's I was 17.7 ±9.2 mm, and TBUT was 10.5 ±5.7 seconds. Participants using smartphones for > 6 hours/day had a significantly higher prevalence of reduced TMH (< 0.25 mm) compared to those with lower usage durations (p < 0.0001). Similar trends were observed for Schirmer's I and TBUT values, indicating a statistically significant association between prolonged smartphone use and tear film dysfunction (p < 0.0001). Notably, 72.7% of eyes in the > 6 hours/day group exhibited tear film dysfunction, significantly higher than in other groups.

Conclusion: Prolonged smartphone use adversely affects tear film stability and ocular surface health in adolescents. Awareness and appropriate measures to limit excessive screen time are essential to prevent tear film dysfunction and associated ocular discomfort.

Aim: To evaluate the long-term impact of accelerated corneal cross-linking (A-CXL) on selected refractive and topographical parameters in eyes with progressive keratoconus.

Methods: 77 eyes with keratoconus in 54 patients treated with A-CXL (10 min "epi-off" protocol) were included in the analysis. Preoperative and postoperative (1, 3 and 5 years after A-CXL) values of the studied parameters were compared.

Results: In the cohort, there was an improvement in best corrected central visual acuity (BCCVA) 1 year (p = 0.004) and 3 years (p.

Aims:  The aim of the study was to describe a cohort of patients reoperated on for persistent primary macular hole, and to evaluate the anatomical and functional results of the reoperated patients.

Material and methods:  459 eyes of 390 patients were operated on for primary macular hole at Department of Ophthalmology, 3rd Faculty of Medicine, Charles University, Kralovske Vinohrady University Hospital between January 1, 2013, and December 31, 2023. We included 33 eyes of 33 patients in our retrospective case series, in which macular hole persisted after the primary surgery. Preoperative, perioperative and postoperative data of these patients were recorded, as well as initial and resulting best corrected visual acuity (BCVA), surgical technique, whether the first or second reoperation was successful. The minimum follow-up time was 90 days after the revision surgery. The statistical analysis included descriptive statistics to characterize the demographic and clinical parameters. Qualitative and quantitative variables were analyzed using means, medians and standard deviations.

Results:  Primary surgery for macular holes was successful in 426 eyes of 357 patients (92.8%). The surgery was unsuccessful in the remaining 33 eyes of 33 patients (7.2%), with persistent macular hole. These patients underwent reoperation, which led to closure of the hole in 27 of 33 eyes (reoperation success rate 81.8% and total success rate of primary surgery and reoperation altogether 98.7%). Reoperation was unsuccessful in 6 eyes (18.2% of reoperated eyes and 1.3% of all operated macular holes). In 4 eyes a second reoperation was performed; in 3 eyes the reoperation was successful and led to an improvement of BCVA. The average BCVA of the successfully reoperated eyes was 65.2 ± 11.9 letters (ETDRS ±SD). In the eyes of patients after a successful second reoperation, BCVA was 56.7 ±8.4 letters, while in the eyes of patients who did not undergo further surgery (n = 3), average BCVA was only 39.0 ±11.0 letters.

Conclusion:  Reoperation of macular holes has a very good success rate and usually leads to an improvement of visual acuity. Improvement of visual acuity can also be achieved in patients who only achieved success after a second reoperation.

Objective: To compare the incidence of postoperative complications after cataract surgery in current types of acrylic intraocular lenses (IOLs) in relation to the material used to manufacture the implant, published in the scientific literature.

Methodology: Search for publications in the Pubmed database, published in 2015-2024 (inclusive), without language restrictions, featuring the keywords Hydrophobic, Hydrophilic, Intraocular lens. Reviewing all abstracts and excluding publications that do not match the specified topic.

Results: A total of 220 works were published in the last 10 years that met the specified keywords. Of these, 92 publications were dedicated to the comparison of both types of IOLs. These were 4 meta-analyses, 10 reviews and 47 clinical studies, 21 laboratory and experimental studies and 10 studies of a different nature (editorials, considerations, chapters in textbooks).

Conclusion: Current types of soft acrylic intraocular lenses achieve excellent refractive results and high subjective patient satisfaction. This applies to lenses made of both hydrophilic and hydrophobic materials. The main disadvantage of hydrophilic implants is the higher risk of opacification of the posterior capsule of the lens, as well as the risk of opacification of the implant itself. Especially in patients who are expected to undergo subsequent surgery (corneal endothelial dystrophy, retinal pathology), as well as in patients with a higher risk of complications after Nd:YAG laser capsulotomy (patients with myopia, chronic uveitis or glaucoma), the use of hydrophobic material should be considered as a priority.

Aims:  To review the findings in the professional literature on unexplained loss of visual acuity (VA) in patients with silicone oil (SO) tamponade and post-removal, and assess the efficacy and safety of citicoline as a neuroprotective agent on anatomical changes and visual function in patients undergoing 25-gauge pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment with large/multiple tears (macula-on/off).

Materials and methods:  We studied 96 eyes, 64 receiving citicoline (5 ml orally 3x daily) after PPV with SO tamponade, performed from 01.01.2023 to 30.06.2023 at the Eye Clinic of SZU and UNB. Best corrected visual acuity (BCVA) was measured using ETDRS charts, and changes in the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were assessed using OCT at 1, 3 and 6 months. Complications were monitored and results analyzed statistically.

Results:  BCVA improved (citicoline: 19 to 48 letters; non-citicoline: 13 to 42 letters, p.

Stargardt disease (STGD1) is among the most prevalent inherited macular dystrophies, characterized by typical flavimaculatus flecks and varying degrees of macular atrophy. This case report highlights the importance of optical coherence tomography (OCT) to detect subtle OCT changes in an 8-year-old girl without any detectable fundus abnormalities.

Aim: The aim of the study was to determine the correlation between intraocular pressure (IOP) and thickness of the retinal nerve fiber layer (RNFL), and vascular density (VD) in the optic nerve.

Material and methodology: IOP was greater than 21 mmHg (21-36 mmHg) in all eyes and was measured as the result of an average of three measurements with the instrument Ocular Response Analyzer (ORA, Reichert). RNFL and VD thickness (in the papillary region of 4.5 x 4.5 mm) was measured with the instrument Avanti RTVue XR (Optovue). In the case of the VD, the scan area was further separated into individual anatomical segments. In the case of corrected RNFL (RNFLc), the VD value was subtracted from the total RNFL value. The relationship of IOP to VD, RNFL and RNFLc in each peripapillary segment was determined using a Pearson's correlation coefficient.

Results: The most significant correlation with IOP was observed for small vessel VD in a full scan (r = -0.48) and VD in the IT segment (r = -0.48). A similar correlation was observed for IOP and RNFL (r = -0.42). No statistically significant correlation was observed for RNFLc.

Conclusion: We demonstrated that VD values, specifically WI-VDs and peripapillary VDs in the IT segment, are significant markers for the early diagnosis of glaucoma.

Aim: This research was conducted to determine the normal values of choroidal thickness in healthy individuals and to evaluate the relationship between this thickness and age, gender, refraction, axial length and average macular thickness using OCT.

Material and method: In the study, the right eyes of 400 healthy individuals (234 women, 166 men) between the ages of 4 and 70 years, who applied to the Department of Ophthalmology outpatient clinic for examination, were evaluated.

Results: Macular thickness, macular volume, and foveal thickness were found to be 249.12 ±21.32 µm, 9.98 ±0.5 µm3 and 280 ±13.45 µm, respectively. According to linear regression analysis, a negative correlation was detected between age and subfoveal choroidal thickness (p < 0.05). It was determined that foveal thickness, retinal volume and average retinal thickness were higher in men, and foveal thickness increased with age (p < 0.05).

Conclusion: As a result of the research, it was determined that age is an important factor affecting choroidal thickness. It is thought that, in future, improving in vivo imaging of the choroid and measuring choroidal thickness using OCT will facilitate understanding of the pathophysiological basis of many ophthalmological diseases.

Aims: This scoping review was conducted to investigate whether nocturnal eye compression from inappropriate sleeping postures may contribute to the development or asymmetry of keratoconus (KC), by examining the association between sleeping positions and KC.

Material and methods: A systematic search of CENTRAL, MEDLINE, EMBASE, LILACS, ClinicalTrials.gov, gray literature, and selected journals from inception to January 18, 2023, was undertaken.

Results: Ten studies involving 2 322 participants met inclusion criteria. These studies were categorized into analytical and non-analytical designs to evaluate the relationship between prone, lateral, or supine sleeping positions and KC presence or asymmetry. Among the included studies, 50% were non-analytical, all indicating a correlation between KC parameters and nocturnal eye compression. In contrast, a statistically significant association between sleeping positions and KC risk was reported in 3 out of 5 analytical studies (60%).

Conclusion: Findings suggest a possible link between prone or lateral sleeping positions and KC development or asymmetry, implying that these positions may increase corneal biomechanical stress during sleep. However, the association was confirmed in only 60% of analytical studies. The review highlights the necessity for additional research to validate these findings and to explore potential causal mechanisms between sleeping positions and KC.

Purpose: To evaluate the potential use of a combination of subretinal triamcinolone acetonide (TA) injection with transpupillary thermotherapy (TTT) in the treatment of circumscribed choroidal hemangioma (CCH) with exudative retinal detachment.

Case report: The clinical case of a 27-year-old patient demonstrates the treatment of CCH with exudative retinal detachment. We used a combination of subretinal injection of 4 mg preservative-free TA with the simultaneous partial aspiration of subretinal fluid in the first stage. After one week, when the retina was fully attached, TTT of CCH was used in the second stage. At Month 12, visual acuity in the left eye increased from light perception with projection to 20/400. Ultrasonography did not reveal any signs of choroidal masses or retinal detachment. During the follow-up period, 3 sessions of TTT were performed.

Conclusion: A combination of subretinal TA injection with TTT can be an alternative treatment for CCH with exudative retinal detachment.