Purpose To evaluate plasma levels of selected cytokines and investigate their correlation with choroidal thickness (CT) in patients with acute and chronic central serous chorioretinopathy (CSC). Methods We enrolled 30 patients with acute CSC, 30 patients with chronic CSC and 20 controls. Plasma concentrations of 12 cytokines, interleukins IL‐8, IL‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐10 and IL‐12 p70, granulocyte‐macrophage colony‐stimulating factor, interferon‐γ, tumour necrosis factor‐α (TNF‐α) and vascular endothelial growth factor (VEGF), were measured using multiplex immunoassays. Differences in cytokine levels between groups were assessed. We also investigated correlations between cytokine levels and CT using swept‐source optical coherence tomography, as well as an association between plasma cytokine profile and systemic hypertension. Results We noted differences in IL‐6 (p = 0.005), IL‐10 (p = 0.03), IL‐12 p70 (p = 0.028) and VEGF (p = 0.029) levels between groups. Pro‐inflammatory IL‐12 p70 and multidirectional IL‐10 cytokines were upregulated, while pro‐angiogenic VEGF was downregulated in chronic CSC as compared with controls (p = 0.005, p = 0.025 and p = 0.027, respectively). Interleukin‐6 (IL‐6) was upregulated in acute and chronic CSC (p = 0.030 and p = 0.005, respectively). Interleukin‐5 (IL‐5), IL‐6 and IL‐12 levels correlated with mean CT in acute CSC (p = 0.008, p = 0.003 and p = 0.044, respectively), while IL‐8, IL‐6 and TNF‐α plasma levels correlated with hypertension in chronic CSC (p = 0.005, p = 0.033 and p = 0.001, respectively). Conclusion We provided new evidence for the possible role of plasma cytokines in the pathogenesis of CSC. Our results suggest that IL‐6 may be important in the pathophysiology of acute and chronic CSC. The association between inflammatory response and hypertension in patients with CSC was also confirmed.

Purpose: We report here a unique case of a sudden loss of vision as the first symptom of an advanced chronic nephropathy. Methods and Results: A 25-year-old man was referred to the Department of Ophthalmology with sudden visual deterioration presumptively diagnosed as bilateral retinitis. The patient had never been under any medical care before and had never had any clinical signs of any chronic disease. He underwent an ophthalmic examination with optical coherence tomography (OCT). Based on the clinical features, OCT scans and systemic blood pressure (BP) assessment (225/145 mm Hg), the patient was definitely diagnosed with hypertensive retinopathy and choroidopathy due to hypertensive crisis. After urgent diagnostic procedures, the patient was diagnosed with a chronic kidney disease at stage 5 in the course of chronic glomerulonephritis. Immediately, a renal replacement therapy was started and the patient was qualified for renal transplantation. Conclusion: Adolescents with an unclear picture of retinal lesions, who have neither a history nor clinical signs of a systemic disease, should undergo careful systemic screening with BP assessment. A sudden deterioration of vision may be the first symptom of a previously undiagnosed severe systemic disease (very rare chronic) that requires immediate treatment.

Background: The pathogenesis of central serous chorioretinopathy (CSC) remains a subject of intensive research. We aimed to determine correlations between plasma levels of selected angiogenic factors and different forms of CSC. Methods: Eighty patients were enrolled in the study including 30 with a chronic form of CSC, 30 with acute CSC, and 20 controls. Presence of active CSC was determined by fluorescein angiography (FA), indocyanine green angiography (ICGA), and swept-source optical coherence tomography (SS-OCT). Plasma concentrations of angiopoietin-1, endostatin, fibroblast growth factor, placental growth factor (PlGF), platelet-derived growth factor (PDGF-AA), thrombospondin-2, vascular endothelial growth factor (VEGF), VEGF-D, and pigment epithelium–derived factor were measured, and the results were compared between groups. Additionally, mean choroidal thickness (CT) was measured in all patients. Results: Levels of angiopoietin-1 (p = 0.008), PlGF (p = 0.045), and PDGF-AA (p = 0.033) differed significantly between the three groups. Compared with the controls, VEGF (p = 0.024), PlGF (p = 0.013), and PDGF-AA (p = 0.012) were downregulated in the whole CSC group, specifically PDGF-AA (p = 0.002) in acute CSC and angiopoietin-1 (p = 0.007) in chronic CSC. An inverse correlation between mean CT and VEGF levels was noted in CSC patients (rho = −0.27, p = 0.044). Conclusions: Downregulated angiopoietin-1, VEGF, PDGF-AA, and PlGF levels may highlight the previously unknown role of the imbalanced levels of proangiogenic and antiangiogenic factors in the pathogenesis of CSC. Moreover, downregulated VEGF levels may suggest that choroidal neovascularization in CSC is associated with arteriogenesis rather than angiogenesis.

Ruthenium-106 plaque radiotherapy is an effective and safe treatment option for DCH associated with SWS. Brachytherapy led to tumor regression and resolution of serous retinal detachments, and visual stabilization was achieved in most cases.

Polimorfizmy genów HTRA1 rs11200638 oraz ARMS2 rs10490924 i ich wpływ na wyniki leczenia doszklistkowymi iniekcjami czynnika anty-VEGF u chorych na wysiękową postać zwyrodnienia plamki związanego z wiekiem HTRA1 rs11200638 and ARMS2 rs10490924 gene polymorphisms and response to intravitreal anti-VEGF treatment in patients with exudative age-related macular degeneration

Background/Aim: This study analysed the prevalence of the characteristics evaluated in dermatoscopy for melanocytic infiltrations of the conjunctiva with various degrees of malignancy. Patients and Methods: A total of 160 conjunctival pigmented lesions were studied. Each lesion was scored using dermatoscopic patterns and the characteristics of malignancy described by Kittler. Also, the Authors' own clues were added to the evaluation. Results: In melanomas, the following characteristics were identified: asymmetry of the pattern and colour, larger average number of colours, the presence of grey colour, structureless area, polymorphic vessels and feeder vessels. A pattern of black dots and a black colour was typical of malignant lesions and pre-cancerous (premalignant) lesions -primary acquired melanosis (PAM) with atypia. Cysts were observed only in the group of naevi. Conclusion: The patterns evaluated with dermatoscopy are present in pigmented lesions of the conjunctiva. There are, however, some characteristics which allow differentiation between melanoma and pigmented naevus and melanosis and also between PAM.There are several lesions that arise from the melanocytes of the conjunctiva. The most common are naevi, primary acquired melanosis (PAM) and malignant melanoma (MM). The predominant conjunctival pigmented tumour is naevus (1, 2). Naevus accounts for 28% of all conjunctival tumours and 52% of melanocytic lesions (3). It is a benign lesion, with a less than 1% (3, 4) tendency to malignant transformation. It is usually a unilateral, slightly elevated, variably pigmented lesion, with clear cysts, and feeder vessels, and is predominantly located in the bulbar conjunctiva (3). All naevi require serial observation using photographic documentation. Any changes in size, shape or colour are suspicious of malignant transformation and should be treated like melanoma. Some patients demand excision for cosmetic reasons (4, 5).PAM accounts for 11% of all conjunctival tumours and 21% of conjunctival pigmented lesions (2, 6, 7). It can be divided into melanosis with atypia and without atypia, depending on the nuclear features and growth pattern of melanocytes in the histopathological examination. The presence of atypia is associated with a very high risk (13-50%) of malignant transformation, while absence of atypia carries no risk for melanoma development (4-6). PAM with atypia is considered to be a form of melanoma in situ, similar to lentigo maligna of the skin (6, 8). PAM occurs as a flat, unilateral, brown, patchy or diffuse lesion usually in middleaged Caucasian individuals (9). It is thought that it is impossible to distinguish clinically PAM without atypia from PAM with atypia (4). PAM must be differentiated from racial melanosis, which is usually bilateral and symmetrical (6). The procedure proposed by Shields and co-workers in patients with PAM involves observation or surgical treatment in combination with cryotherapy and/or topical chemotherapy depending on the size of the lesion. In cases of very large tumours, ...

Background and Objectives: Retinal pigment epitheliopathy and hyperpermeability of choroidal vessels were postulated to be involved in the pathogenesis of central serous chorioretinopathy (CSC). Imbalanced levels of vascular endothelial growth factor (VEGF) and pigment-epithelium–derived factor (PEDF) were previously implicated in the development of chorioretinal diseases characterized by increased vascular permeability. We aimed to compare the plasma levels of proangiogenic VEGF and antiangiogenic PEDF for 26 patients with acute CSC, 26 patients with chronic CSC, and 19 controls. Materials and Methods: VEGF and PEDF levels were measured using a multiplex immunoassay or enzyme-linked immunosorbent assay. Correlations with disease duration were assessed. Results: VEGF levels differed between groups (p = 0.001). They were lower in patients with acute CSC (p = 0.042) and chronic CSC (p = 0.018) than in controls. PEDF levels were similar in all groups. The VEGF-to-PEDF ratio was lower in CSC patients than in controls (p = 0.04). A negative correlation with disease duration was noted only for PEDF levels in the group with chronic CSC (rho = −0.46, p = 0.017). Discussion: Our study confirmed that patients with CSC have imbalanced levels of VEGF and PEDF. This finding may have important implications for the pathogenesis of CSC. VEGF-independent arteriogenesis rather than angiogenesis may underlie vascular abnormalities in these patients.

Introduction: The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was designed to measure the vision-related quality of life (QoL). We aimed to assess the effect of disease duration, disease type (i.e., acute vs. chronic and unilateral vs. bilateral), and selected sociodemographic data on the QoL of patients with central serous chorioretinopathy (CSC). Material and methods: The study included 79 patients diagnosed with CSC. The QoL was assessed using the NEI VFQ-25. The statistical analysis was performed using IBM SPSS Statistics 24. Results: A significant positive correlation was found between deterioration in peripheral vision as assessed by the NEI VFQ-25 and duration of CSC (r =-0.22, p = 0.046). Compared with women, men obtained higher scores on the scales assessing general health, mental health, ocular pain and role limitations (p = 0.018, p = 0.027, p = 0.009 and p = 0.007, respectively). Patients with acute CSC reported higher levels of social functioning as compared with those with chronic CSC (p = 0.04). There were no differences in any of the scales between patients with unilateral and bilateral CSC. Elderly patients obtained lower scores on 9 of the 12 analyzed scales, as compared with younger patients (p < 0.05). Conclusions: Patients with CSC do not assess their QoL in negative terms, which may be related to the fact that the disease presents with transient symptoms. However, the QoL deteriorated with longer disease duration. Men with CSC have better vision-related QoL than women.