Purpose To assess the occurrence of choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSCR) using optical coherence tomography angiography (OCTA) and correlate these findings with choroidal thickness (CT). Materials and Methods This retrospective study included 25 consecutive patients (43 eyes), mean age 48.12 ± 7.8 years, diagnosed with persistent CSCR. All patients underwent a complete ophthalmic examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography, and OCTA. Results CNV was confirmed in 18.6% of eyes using FA and ICGA and in 25.6% of eyes using OCTA. All cases of CNV were associated with irregular retinal pigment epithelial detachment. CT was increased in the affected eyes (mean 491.05 ± 91.98), but there were no statistically significant correlations between CT and CNV and PED occurrence (p = 0.661 and p = 0.614, resp.) and between CT and duration of the disease (p = 0.940). Conclusions OCTA detected CNV more frequently than other imaging modalities. CNV coexisted with irregular PED in all cases. CT was increased in eyes with chronic CSCR, but without any correlation with CNV occurrence; therefore, CT cannot be considered as a predictor of CNV occurrence. Further studies with a larger number of patients are needed to confirm these findings.
Introduction: To evaluate the effectiveness of methylprednisolone (MP) and surgical treatment in achieving complete reversal of dysthyroid optic neuropathy (DON) and predictive factors of this therapy. Material and methods: The group consisted of 10 patients (18 eyes) with DON. The diagnosis of DON was based on at least two criteria from the following: (i) deterioration of visual acuity (VA < 1.0), (ii) loss of colour vision, (iii) optic disc swelling, and/or (iv) signs of DON in magnetic resonance imaging (presence of apical crowding and/or optic nerve stretching). A complete recovery of DON was defined as the normalisation of VA (VA = 1.0), normal colour vision, and reversal of optic disc swelling. A significant improvement was defined as improvement of VA of at least 0.2. The consecutive steps of treatment of DON consisted of: (i) first-line treatment -intravenous MP pulse therapy (3 × 1 g); (ii) second-line treatment -endoscopic intranasal orbital decompression of medial wall; (iii) additional treatment -additional MP therapy and/or surgical decompression. Results: A significant improvement in VA could be achieved in the majority of patients; a complete recovery was noted in 22.2%, 33.3%, and 66.7% of eyes after first-line, second-line, and additional treatment, respectively. Positive predictive factors were: younger age (p = 0.049), shorter duration of DON (p = 0.035), and a higher Graves' orbitopathy clinical activity score (p = 0.035). Conclusions: By using combination therapy (intravenous MP pulse therapy and surgical decompression), a complete recovery can be achieved in the majority of patients with DON. (Endokrynol Pol 2016; 67 (2): 166-173)
BackgroundThis study aimed to review the causes, presentation, and clinicopathological associations of uveitis in a single department of ophthalmology in Poland, and to compare the findings with previously published studies from other European countries.Material/MethodsReview of local patient records between 2005–2015 identified patients diagnosed with uveitis. Data obtained included age, gender, imaging findings, and laboratory diagnostic findings. A literature review identified 24 publications from 1976–2017 that reported observational data from patients with uveitis in Europe. Statistical analysis compared the findings.ResultsBetween 2005–2015, 279 patients were diagnosed with uveitis (mean age, 38.3±15.3 years) (61.6% women) including unilateral uveitis (60.5%), with posterior uveitis (48.4%), anterior uveitis (26.5%), and intermediate uveitis (12.9%). A general etiology was established in 76.3% and included ocular-specific syndromes (31.8%), infection (27.9%), and an association with systemic disease (16.8%), but 23.6% were unclassifiable. Specific causes of uveitis included toxoplasmosis (17.9%), Fuchs uveitis (12.2%), white dot syndromes (WDS) (10.4%), sarcoidosis (6.1%), toxocariasis (6.1%), HLA-B27-associated acute anterior uveitis (AAU) (5.7%), multiple sclerosis (4.7%), ankylosing spondylitis (3.6%) and herpesvirus infection (2.5%). Data from 26 published studies (24,126 patients with uveitis) from 12 European countries showed that idiopathic uveitis was most common (36.6%); the identified causes included toxoplasmosis (9.4%), WDS (7.2%), and Fuchs uveitis (6.1%).ConclusionsIn a single ophthalmic center in Poland, and throughout Europe, the causes of uveitis are varied. Genetic, geographic, social and environmental factors are likely to affect the cause of uveitis in different populations.
. Purpose: This study aimed to compare the safety and effect on intraocular pressure (IOP) of latanoprost given every evening versus pilocarpine/timolol maleate fixed combination (PTFC) given twice daily in patients with primary open‐angle glaucoma (POAG) or ocular hypertension (OH). Methods: Following a 6‐week, medicine‐free period, qualified patients were randomized for Period 1 to either placebo administered every morning and latanoprost every evening or to PTFC administered twice daily. After 8 weeks of treatment, IOP was measured at 08.00, 10.00, 16.00 and 18.00 hours. Patients were then switched to the opposite treatment and underwent a second diurnal evaluation at the end of Period 2. Results: Thirty‐two patients completed this study. They demonstrated diurnal baseline IOP of 24.1 ± 2.4 mmHg. Mean diurnal pressure was 16.8 ± 2.1 mmHg on PTFC and 16.9 ± 2.5 mmHg on latanoprost (p = 0.60). No statistical difference between treatments was observed at any individual time‐point except at 10.00 hours, when the PTFC group demonstrated an IOP of 15.9 ± 2.3 mmHg and latanoprost 16.8 ± 2.7 mmHg (p = 0.02). There were no statistical differences between groups in unsolicited systemic or ocular adverse events (p > 0.05). However, the PTFC group showed a narrower pupil diameter (2.3 mm) than the latanoprost group (3.7 mm). Additionally, a solicited symptom survey demonstrated mild blurred vision, stinging and ocular pain with PTFC (p < 0.001). Conclusions: Both PTFC and latanoprost are efficacious in reducing diurnal IOP in POAG or OH. However, PTFC may be more effective in the late morning and may have a greater incidence of mild ocular side‐effects.
The physiology of pregnancy is a curious issue for specialists from different branches of medicine and science. In this systematic review, the attention was focused on changes in eyes during pregnancy and confinement. To summarise and systematize actual knowledge in eyes' changes during pregnancy, publications from years 2011-2017 were analysed. Stud-ies about parameters of corneal endothelial cells, corneal biomechanical parameters, keratometric variables, intraocular pressure and biometry of the anterior chamber were compared. The conducted studies demonstrated the unambiguous character of changes only in case of intraocular pressure, which decreased during the II and III trimesters of pregnancy. Inconsistent study methods and low number of examined patients did not enable to draw explicit conclusions in context of other parameters of the anterior segment of the eye in pregnant women. It is indicated to perform further studies on a representative and homogeneous group of female patients.
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