The 25-G PPV with peeling of the ILM and air tamponade is an effective technique and presents no increased risks in comparison with routine procedures. The main benefit of the intervention is its good tolerance by the patient, particularly with respect to painfulness and postoperative irritation.

Pseudophakic patients, with a history of vitrectomy, even those with a basal iridectomy (Ando), are at high risk for migration of the Ozurdex® into the anterior chamber and development of corneal edema.

Background. Persistent idiopathic macular hole (IMH) after initial pars plana vitrectomy (PPV) appears in approx. 12% of cases. It is, therefore, one of the most common complications. IMH re-operation results tend to be better in eyes where IMH had been closed, while IMH re-operations in cases when the initial surgery had failed tend to be less successful: IMH often becomes even larger and visual acuity decreases, anatomical success rate of closure is about 60% and the resulting postoperative visual acuity is about 20/100. Aims. To establish anatomical and functional success rate of repeated operations of recurrent idiopathic macular hole. Materials and Methods. We evaluated the retrospective results of re-operations of persisting IMH that is cases in which the initial surgery did not result in closure: 6 eyes in 6 patients out of the overall 55 operated on IMH (primary PPV failed in almost 11% of cases). The follow-up period was 18 months (since the first surgery). Results and Conclusion. After the second PPV, the IMH was closed in 100% of operated eyes. It was not necessary to perform a third PPV during the follow-up period. In all cases the visual acuity improved. Anatomical and functional results of IMH treatment can be considered satisfactory. We consider the following combination of factors significant for the anatomical success rate of PPV: IMH size and stage, technical precision of the ILM peeling and the suction of the IMH contents, strict adherence to the recommended head positioning in early postoperative period, and IMH duration.

Purpose To evaluate the clinical efficiency, safety and painfulness of retinal laser photocoagulation employing a pattern scanning laser system Pascal given in a single-session versus conventional laser multiple-session treatment of the same patient with diabetic retinopathy during 12-month follow-up. Methods The cohort included 60 eyes in 30 patients treated at the Ophthalmology Clinic, Faculty Hospital Ostrava, from 2008 to 2013. Panretinal laser coagulation was performed on one eye using the multispot panretinal photocoagulation given in a single-session system Pascal (OptiMedica, Santa Clara, California). On the other eye laser treatment was carried out by the classic conventional multiple-session method. Results The performance of Pascal panretinal laser coagulation was evaluated as significantly less painful (visual scale of pain was 3.28 ± 1.9) than the performance of conventional photocoagulation (visual scale of pain was 3.93 ± 1.88) with similar efficiency. Distribution of progression of diabetic retinopathy in individual patients was very similar in both groups under comparison, and was strictly paired in 24 of the 30 patients at the end of 1-year follow-up. Conclusion Laser photocoagulation of the retina with the use of short impulse durations and patterns in patients with diabetic retinopathy given in one session possesses similar efficiency to that of conventional retinal photocoagulation in multiple sessions. The single session treatment is also better tolerated by patients and in addition to this, it shortens the performance of the whole therapy, which potentially saves considerable funds of all subjects participating in the process of treatment. Trial registration ClinicalTrials.gov NCT03672656 .

Cíl: Vyhodnotit charakter a četnost výskytu očních projevů u pacientů s nově diagnostikovanou HIV infekcí (z angl. Human Immunodeficiency Virus, virus lidské imunitní nedostatečnosti) před zahájením celkové terapie základního onemocnění. Metodika: Retrospektivní hodnocení vstupních lékařských záznamů 147 pacientů (22 žen a 125 mužů) s HIV infekcí průměrného věku 41 let (v rozmezí 22-79) vyšetřených na Oční klinice Fakultní nemocnice Ostrava v letech 1987-2015. Výsledky: Oční projevy HIV infekce byly nalezeny u 16 pacientů z celkového souboru (11,9 %). U primoinfekce a asymptomatického stadia nebylo oční postižení zaznamenáno. U pacientů v symptomatickém stadiu HIV infekce byly oční projevy pozorované v jednom případě (0,7 %). Ve stadiu rozvinutého AIDS (z angl. Acquired Immune Deficiency Syndrome, syndrom získané imunitní nedostatečnosti) bylo oční postižení nalezeno v 15 případech (10,2 %). Převážnou část z celkového počtu tvořily projevy vyvolané vlastním působením viru (HIV retinopatie, mikroangiopatie), které se vyskytly u 13 nakažených (76,5 %). Oportunní infekce byly zastoupeny u 3 nemocných (17,6 %). Na následky základního onemocnění zemřelo během sledování 5 pacientů. Oční komplikace HIV byly přítomné u dvou těchto nemocných (40,0 %). Závěr: Oční projevy jsou častým nálezem u HIV pozitivních pacientů ve stadiu hlubokého imunodeficitu. Oftalmologické vyšetření je nedílnou součástí vyšetřovacího algoritmu nemocných s diagnózou HIV infekce. Největší procento očních komplikací bylo přítomno u pacientů v našem souboru v pokročilém stadiu nemoci, které souvisí s výrazným poklesem imunitní obranyschopnosti organismu, a tedy i s vyšší úmrtností.

Background. Retinal artery occlusion is an extremely rare diagnosis in the pediatric population and the etiology with risk factors of retinal artery occlusion are poorly understood in younger individuals. Methods and Results. This case report a rare case of transient branch retinal artery occlusion (BRAO) in a healthy young girl. A fifteen-year-old girl presented with painless decreased vision in her right eye. Fundus examination revealed in the right eye intensive edema of the part of superior half of the retina, but the vessels were absolutely normal. She was hospitalized for diagnosis and treatment. A thorough workup was performed to determine any etiologic factor. Her physical examination was normal, but from anamnesis has been found that patient began use oral contraception at the time of occurrence eye problems. The condition is evaluated as transient branch retinal artery occlusion by the course of the disease. The paper includes the review of the literature also. Conclusion. Though retinal arterial obstruction is rare in the pediatric population, this case highlights the importance of including this in the differential diagnosis of acute vision loss.

Aim To evaluate the incidence of ocular adverse events after loading phase of the brolucizumab therapy in patients with neovascular age-related macular degeneration (nAMD) in real-life clinical practice – in treatment-naive patients and in patients after switching from another anti-VEGF agent. Another aim was to evaluate treatment outcomes in patients with adverse events. Methods This is a multicentre, retrospective, observational study from 16 application centres in the Czech Republic. Patients diagnosed with nAMD were treated with brolucizumab in a fixed regimen of loading phase (3 injections administered at one-month intervals) and the mean follow-up period was 120 ± 10 days after the first injection. The incidence of adverse events and the development of best corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients with complications were evaluated. A total of 1,098 eyes were followed up, of which 783 were treatment-naive and 315 eyes were after switching from another anti-VEGF agent. Results Adverse events were recorded in 42 eyes (3.83%), of which 30 eyes were treatment-naive (2.7%) and 12 eyes were post-switch (1.09%). The mean baseline BCVA ± SD was 56.7 ± 10.7 ETDRS chart letters in the group of patients with adverse events, 58.8 ± 10.1 letters in treatment-naive patients, and 51.4 ± 10.2 letters in patients after switch from another anti-VEGF agent. The mean baseline CRT ± SD was 432.2 ± 154.7 μm, being 435.8 ± 137.3 μm in treatment-naive patients and 424.5 ± 186.6 μm in patients after switch from another anti-VEGF agent. At the end of the follow-up, the mean BCVA ± SD was 53.4 ± 9.5 ETDRS charts letters in patients with adverse events, 55.6 ± 10 letters in treatment-naive patients, and 47.6 ± 10 letters in patients after switching from another anti-VEGF agent. The mean CRT ± SD at the end of the follow-up was 300.7 ± 115.7 μm in the total patient cohort, 285.2 ± 78.8 μm in treatment-naive patients and 334.5 ± 165.4 μm in patients after switching from another anti-VEGF agent. Conclusion We observed the development of adverse events in the form of intraocular inflammation or vasculitis with subsequent decrease in BCVA in 3.83% of cases after loading phase of the brolucizumab therapy. The decrease in BCVA was reversible in most cases after initiation of anti-inflammatory steroid treatment. From a functional and morphological point of view, we did not demonstrate any statistically significant difference between the groups of treatment-naive patients and patients after switching from another anti-VEGF agent.

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