AIM: The aim of the present study was to measure macular thickness in healthy eyes and find whether it changes with age. MATERIAL AND METHODS: We examined 163 healthy eyes of 84 healthy volunteers. In order to measure their macular thickness the patients were examined using spectral-domain optical coherent tomography (SD-ОСТ - iVue, Optovue). They were allocated into 6 age groups. RESULTS: The mean central macular thickness (inner circle - fovea centralis) was 248.9 ± 17.9 μm (mean ± SD), and the mean total macular thickness (an area including 9 subfields as defined by ETDRS) was 286.2 ± 13.9 μm (mean ± SD). We found that it correlated negatively with age (r = - 0.18; p = 0.03; Pearson correlation). CONCLUSION: We found a statistically significant decrease of mean macular thickness as age increased.

In the present study we have made a review of the relevant literature on pathogenesis and modern diagnostic methods for macular edema (ME) in uveitis. Macular edema is a typical non-specifi c complication of uveitis, one of the common causes of visual impairment. ME can be found in all types of uveitis. In 85% of cases of intermediate uveitis, the visual impairment is due to the development of cystoid macular edema. The macula is more rarely affected in panuveitis (35%), anterior (20-26%) and posterior (20%) uveitis. The etiological agent is of great importance for the course and treatment of infl ammatory diseases. Among the imaging diagnostic methods that are capable of detecting macular edema with fl uid accumulation in the retina (either diffuse or distributed in cysts) are the fl uorescein angiography (FA) and the optical coherence tomography (ОСТ). OCT allows a quantitative assessment of retinal thickening and how it changes throughout therapy. FA can be used to determine very precisely the site of a vascular leakage and assess how badly the vascular wall has been affected by the infl ammatory process. CONCLUSION: Macular edema occurring during an infl ammatory process is one of the causes for visual acuity loss in uveitis. OCT and FA are useful complementary imaging methods for investigation of structural changes in retinal architecture in uveitis patients.

Aim: To establish the correlation between intraocular pressure (IOP) and thickness of extraocular muscles (EOM), the severity and activity of thyroid-associated orbitopathy (TAO). Materials and methods: 50 patients with TAO were included in the study. They all underwent a thorough ophthalmic examination, Goldmann tonometry (mm Hg) and computer tomography of the orbits, the muscle thickness sum (MTS) of each eye being measured in millimeters. According to the activity of TAO, the patients were divided into two groups – with and without activity, and according to the severity of the disease – into 6 groups: Group 1 (‘O’) had only subjective symptoms, group 2 (‘S’) had soft tissue symptoms, group 3 (‘P’) – proptosis, group 4 (‘E’) – ocular motility disorders, group 5 (‘C’) – corneal damage, and group 6 (‘Si’) – visual impairment; Results: TAO activity was registered in 21 patients (42 eyes, 42%) with MTS 23.39±3.81 and IOP 18.43±4.16. Twenty-nine patients (58 eyes, 58%) with MTS 19±3.21 and IOP 15.98±4.59 showed no TAO activity. The IOP within the groups, in terms of severity, was as follows: group 1 – 19.92+4.05; group 2 – 14.5±2.55; group 3 – 18.04±4.51; group 4 – 18.2±5.05; group 5 – 20.5±4.5; group 6 – 21.5±4.95. A correlation between the IOP and MTS was found. Conclusions: The IOP in patients with TAO depends on the thickness of the EOM, as well as on the activity and severity of the disease.

Fluorescein angiography and spectral domain optical coherence tomography are highly sensitive methods used in detecting macular edema in patients with uveitis, but they might fail to be efficient in this if used independently. Optical coherence tomography is a more informative method, especially in diagnosing diffuse macular edema.

Acute retinal necrosis (ARN) is a devastating viral infection commonly associated with varicella zoster virus (VZV) and herpes simplex virus types 1 and 2 (HSV-1, HSV-2). Typically, ARN affects individuals without immune status disorders between the ages of 50-70. In two-thirds of the cases, one-eye involvement is observed and the inflammation can be presented as panuveitis. The most characteristic clinical manifestations are vitreitis, occlusion of the retinal arterioles, and peripheral necrotizing retinitis. Retinitis presents with the appearance of deep, multifocal, yellowish-white foci, typically localized in the peripheral retina. Systemic antivirals are the first treatment of choice for ARN. The goal of the therapy is to stop the viral replication and disease progression in the affected eye, as well as to prevent involvement of the healthy eye. The other eye can be attacked in an interval of 5 days to 30 years. The visual prognosis after illness is poor. Early diagnosis and timely initiation of treatment play an important role in maintaining visual acuity and preventing the other eye from being affected.

Confocal microscopy is a method which has been increasingly used over the last decade in the study of the anterior ocular surface. The method allows testing and in vivo high resolution imaging of the structures of the anterior eye segment, at a cellular level, which is close to the histological examination of tissues. The data provided by this method allow for a better understanding of both the functional and pathological processes occurring in the anterior ocular surface not only for scientific purposes but also in clinical practice. The aim of the present work is to summarize the current knowledge and applications of confocal microscopy of the anterior ocular surface.

Introduction: Severe cases of thyroid eye disease with high intraocular pressure and visual field defects are a real diagnostic challenge requiring the exclusion of dysthyroid optic neuropathy and differential diagnosis with glaucoma. Aim: To report а case of a patient with active thyroid eye disease (TED), decreased visual acuity and elevated intraocular pressure. Materials and methods: We present a 52-year-old woman with TED in both eyes, class 2c3c4a6a (NOSPECS), with 6 points (by CAS) activity, who received corticosteroid therapy to a maximum cumulative dose of 5750 mg, with non-insulin-dependent diabetes mellitus and topical antihypertensive treatment with tapticom, brizadopt, and luxfen. The patient received full ophthalmological exam, tonometry, exophthalmometry, computer perimetry, optical coherence tomography (OCT) and computed tomography (CT) scan of orbits. Results: The following results were obtained: BCVA of right eye = 0.6, BCVA of left eye = 0.3; TOD = 26 mm Hg and ТОS = 21 mm Hg; exophthalmometry: 30 mm for the right eye and 31 mm for the left one; diplopia in all directions, edema and hyperemia of the eyelids and conjunctiva, eyelids retraction, sluggish pupil reactions, normal color vision, transparent ocular media, indistinct borders of the optic nerve disc, without glaucomatous excavation, tortuosity and dilation of the venules, retina - without diabetic changes, maculas - with normal reflex; CP datа for a localized inferotemporal visual field defect, CT data for thickening of all extraocular muscles, soft tissue orbital edema, and optic nerves compression. Conclusion: Our results confirmed the presence of dysthyroid optic neuropathy based on the decreased visual acuity, ophthalmo­scopic evaluation of the optic nerve head, lack of glaucomatous OCT changes, atypical perimetric changes and the CT data. The optic neuropathy is the most severe complication in patients with TED which develops due to the compression of the optic nerve and/or its blood supply from the enlarged extraocular muscles and soft tissues in the orbital apex and due to the mechanical tension of the optic nerve in cases moderate or severe proptosis is present.

Introduction: Ischemic retinal vasculitis is an inflammatory disease affecting the retinal vessels. Visual acuity decreases due to macular ischemia, macular edema, neovascularization leading to vitreous hemorrhage, fibrovascular proliferation or tractional retinal detachment. Purpose: To present the case of a patient with ischemic retinal vasculitis. Material and Methods: The case involves a 34-year-old woman. The following tests were performed: complete blood count, biochemistry, coagulogram, rheumatological tests, serum calcium level, angiotensin-converting enzyme, CT of the lungs, MRI of the brain and spine, serological tests for: cytomegalovirus, herpes simplex virus (type 1 and 2), varicella-zoster virus, toxoplasmosis, tuberculosis, syphilis, as well as fluorescein angiography and optical coherence tomography. Results and Discussion: The patient was admitted to the hospital with visual acuity of the right eye, 0.8/0.9, and of the left eye, 1.0. The intraocular pressure in both eyes was normal: 14 mmHg in the right eye and 15 mmHg in the left eye. The following pathological finding was detected in the right eye fundus: an old chorioretinal cicatrix under the inferior temporal vascular arch with an ischemic exudate next to it, occlusion of the inferior temporal retinal arterial and venous branches, neovascularization and a preretinal hemorrhage. Fluorescein angiography showed delayed filling of the affected vessels, neovascularization, and major ischemia in the lower temporal part of the retina. The results of the serological tests for varicella zoster virus, herpes simplex virus type 1 and toxoplasmosis were outside the reference ranges. The patient was treated with Clindamycin and Acyclovir. Emergency laser therapy was performed in the ischemic retina area. Previous toxoplasma chorioretinitis was diagnosed, which had led to ischemic retinal vasculitis with sectoral involvement of the retinal vessels. The patient has been monitored over 3 -4 month periods, showing high visual acuity and stable ocular condition. Conclusion: Patients with ischemic retinal vasculitis are a challenge when it comes to cla-