OBJECTIVES: To describe the pattern and mutual relationships between basic biometric characteristics of the eye in a Central European Caucasian population. METHODS: A single-centre retrospective study of 2340 patients (965 males, 1375 females) scheduled for cataract surgery between 2014 and 2016. Measurements using laser interferometry included AL (axial length), K (average corneal curvature), ACD (anterior chamber depth), LT (lens thickness), CCT (central corneal thickness), AST (astigmatism) and WTW (white to white). Subjects were stratified by gender and controlled for age. Descriptive, correlation and regression analyses were performed on the data. RESULTS: The mean AL was 23.33 ± 1.01 mm - higher in males (23.59 ± 0.99 mm), in comparison to females (23.15 ± 0.99 mm). The elderly had lower ACD and higher LT, while males had higher AL independent of age. Furthermore, LT and K decreased with AL, while ACD decreased with LT and increased with AL independent of age and gender. CONCLUSIONS: The estimates of the biometrics are obtained on a large sample of subjects and can serve as normative values for Lenstar LS900 in the Central European Caucasian population.

• MeSH
• axiální délka oka MeSH
• biometrie MeSH
• katarakta * diagnóza   MeSH
• lidé MeSH
• oční čočka * MeSH
• optická koherentní tomografie MeSH
• přední komora oční MeSH
• retrospektivní studie MeSH
• rohovka MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Diabetický edém makuly je hlavnou príčinou poklesu zrakovej ostrosti u pacientov s diabetom v rozvinutých krajinách. Etiopatogeneticky ide o multifaktoriálne ochorenie, v ktorom zohráva úlohu zvýšená produkcia cievneho endotelového rastového faktoru, oxidačný stres, zápal a rôzne metabolické pochody, čo v konečnom dôsledku vedie k zrúteniu hematoretinálnej bariéry, strate pericytov, narušeniu tesných spojení endotelových buniek a vzniku edému makuly. Po dobu viac ako 30 rokov bola zlatým štandardom v liečbe diabetického edému makuly laserkoagulácia. V posledných rokoch sa do prvej línii liečby diabetického edému makuly dostali antirastové faktory, ale kortikosteroidy majú dôležité postavenie u určitej skupiny pacientov. Využívajú sa pre svoj protizápalový, antiapoptotický, antiedematózny a antiangiogénny účinok. Táto liečba môže byť efektívna u pseudofakických očí refraktérnych na liečbu blokátormi cievneho endotelového rastového faktoru alebo u recidivujúcich edémov, je metódou voľby u tehotných a kojacich žien alebo u pacientov, ktorí nie sú schopní z rôznych dôvodov podstúpiť početné mesačné intravitreálne aplikácie. V súčasnosti sa používa triamcinolon acetonid, intravitreálny implantát dexametazónu a intravitreálny implantát fluocinolónu. Dlhodobo používaný triamcinolon acetonid intravitreálne je tzv. off-label liečba v tejto indikácii. Vedľajšie účinky používania intravitreálnych steroidov sú vznik a progresia katarakty a zvýšenie vnútroočného tlaku, nežiadúcim účinkom intravitreálnej liečby, našťastie zriedkavým, je endoftalmitída, odlúčenie sietnice a krvácanie. Pomaly uvoľňujúce intravitreálne implantáty dexametazónu a fluocinolónu redukujú výskyt vedľajších účinkov a znižujú počet aplikácií v manažmente pacienta s diabetickým edémom makuly.

Diabetic macular edema is the main cause of decreased vision in diabetic patients in developing countries. Pathogenesis is multifactorial, upregulation of vascular endothelial growing factor, oxidative stress, inflammation and different metabolic pathways lead to breakdown of hematoretinal barrier, loss of pericytes, endothelial cells tight junction disruption and formation of macular edema. For more than 30 years, lasercoagulation has been the gold standard in the treatment of diabetic macular edema. Although antivascular endothelial growing factors are the first – line treatment option in eyes with DME, corticosteroids have the important role as well. The main advantage of corticosteroids is their antiinflammatory, antiapoptotic, antiedematous and antiangiogenic effects. This treatment could be especially effective in pseudophakic patients poorly responsive or refractive to antiVEGF treatment, as well as method of choice in pregnant and lactating women or in patients unwilling to come for numerous monthly injections. Currently available triamcinolone acetonide has been used for many years, but is not approved for this indication yet. Intravitreal-steroid-related side effects are cataract and elevation of intraocular pressure corticosteroids are triamcinolon acetonide, dexamethasone and fluocinolone acetonide intravitreal implants, injection – related side effects are endophthalmitis, retinal detachment and bleeding. Sustained release of intravitreal implants of dexamethasone and fluocinolon reduce complications and decreased number of injections in the management of patients with diabetic macular edema.

• MeSH
• dexamethason terapeutické užití   MeSH
• diabetická retinopatie terapie   MeSH
• fluocinolonacetonid terapeutické užití   MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• komplikace diabetu terapie   MeSH
• laserová koagulace metody   MeSH
• lidé MeSH
• makulární edém * terapie   MeSH
• randomizované kontrolované studie jako téma MeSH
• triamcinolon terapeutické užití   MeSH
• vaskulární endoteliální růstové faktory účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Diabetický edém makuly (DEM) je multifaktoriálne ochorenie, v ktorého patogenéze účinkuje množstvo angiogénnych, cievnych a zápalových procesov s následným vznikom charakteristických zmien v makule. V liečbe DEM sú účinné blokátory cievneho endotelového faktoru (VEGF) – bevacizumab, ranibizumab a aflibercept a predstavujú liečbu 1. voľby. Mechanizmus účinku blokátorov VEGF je však zameraný iba na jednu zložku komplexnej patológie DEM, a preto približne 50 % pacientov s DEM odpovedá na blokátory VEGF nedostatočne. Pre týchto pacientov môžu byť účinnou alternatívou liečby intravitreálne aplikované steroidy, ktoré fungujú odlišným patomechanizmom. Podávanie steroidov môže znížiť expresiu VEGF, potlačiť leukostázu, presakovanie z ciev a znížiť produkciu prozápalových cytokínov. Táto kazuistika pacienta, ktorý po nielkoľkoročnej liečbe antiVEGF-preparátmi prestal na liečbu odpovedať (pokles NKCOZ a nárast opuchu na OCT), ale po zmene preparátu na depotný kortikosteroid dexametazónu intravitreálne došlo k zlepšeniu anatomických a funkčných parametrov, to dokladá.

Diabetic macular edema (DME) is a multifactorial disease the pathogenesis of which is affected by a number of angiogenic, vascular and inflammatory processes with the subsequent development of characteristic changes in the macula. Vascular endothelial growth factor (VEGF) blockers – bevacizumab, ranibizumab and aflibercept – are effective in the treatment of DME and they are first-line drugs. However, the mechanism of action of VEGF blockers is focused on only one component of the complex pathology of DEM, and therefore approximately 50% of patients with DEM do not respond adequately to VEGF blockers. For these patients, intravitreal steroids that have different pathomechanisms may be an effective treatment alternative. Administration of steroids may reduce VEGF expression, suppress leukostasis, vascular leakage and reduce pro-inflammatory cytokine production. The evidence of this is the case report of a patient who stopped responding to treatment after several years of treatment with antiVEGF drugs (decrease in central visual acuity after the best correction and increase in swelling shown in OCT), but his anatomical and functional parameters improved after switching to intravitreally administered depot dexamethasone corticosteroid.

• MeSH
• bevacizumab farmakologie   terapeutické užití   MeSH
• dexamethason farmakologie   terapeutické užití   MeSH
• diabetes mellitus 1. typu komplikace   MeSH
• komplikace diabetu MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém * diagnóza   farmakoterapie   MeSH
• vaskulární endoteliální růstové faktory antagonisté a inhibitory   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

PURPOSE: The aim of this work was to study the association of serum ionized calcium with retinal photoreceptor apoptosis on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR). METHODS: Sixty consecutive cases with Type 2 diabetes mellitus were categorized into three groups: no diabetic retinopathy; non-proliferative DR; proliferative DR. The eye with more severe form of the disease was considered. Twenty healthy controls were also included. Best corrected visual acuity (BCVA) was measured on logMAR scale. Retinal photoreceptor apoptosis was defined as disruption of retinal photoreceptor ellipsoid zone (EZ). Ellipsoid zone disruption was assessed using SD-OCT. Serum levels of total and ionized calcium were measured using standard protocol. RESULTS: EZ disruption was found to be positively associated with serum total calcium and ionized calcium. Also, EZ disruption was found to be positively associated with logMAR BCVA. CONCLUSION: Increased serum ionized calcium induces retinal photoreceptor apoptosis resulting in increased EZ disruption in DR.

• MeSH
• apoptóza * MeSH
• diabetická retinopatie krev   patologie   MeSH
• fotoreceptory obratlovců patologie   MeSH
• homeostáza MeSH
• lidé středního věku MeSH
• lidé MeSH
• optická koherentní tomografie MeSH
• vápník krev   MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To study the correlation between disorganization of inner retinal layer (DRIL) and macular thickness parameters, ellipsoid zone (EZ) disruption and retinal nerve fiber layer (RNFL) thickness on spectral domain optical coherence tomography (SD-OCT) in diabetic retinopathy (DR), for the first time. METHODS: A tertiary care center-based cross-sectional study was undertaken. One hundred and four consecutive study subjects of type 2 diabetes mellitus were included: diabetes mellitus with no retinopathy (No DR) (n = 26); non-proliferative DR (NPDR) (n = 26); proliferative DR (PDR) (n = 26) and healthy controls (n = 26). Best Corrected Visual Acuity (BCVA) was measured on the logarithm of the minimum angle of resolution (logMAR) scale. Clinician-friendly, SD-OCT based, grading systems were created for DRIL and EZ disruption, within the macular cube. DRIL was graded as: grade 0, DRIL absent; and grade 1, DRIL present. EZ disruption was graded as; Grade 0: Intact EZ; Grade 1: Focal disruption and Grade 2: Global disruption. Every study subject underwent RNFL thickness analysis. RESULTS: DRIL was significantly associated with increase in severity of DR.Pearson correlation analysis showed significant positive correlation between DRIL and CST CAT and grades of EZ disruption . However, a significant negative correlation was found between DRIL and RNFL thickness . CONCLUSION: Presence of DRIL correlates with severity of DR, EZ disruption and RNFL thinning.

• MeSH
• diabetes mellitus 2. typu komplikace   MeSH
• diabetická retinopatie patologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• macula lutea patologie   MeSH
• nervová vlákna fyziologie   MeSH
• optická koherentní tomografie MeSH
• průřezové studie MeSH
• retina patologie   patofyziologie   MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To study the association of serum ionic calcium and glycated hemoglobin (HbA1c) with retinal photoreceptor ellipsoid zone (EZ) disruption in diabetic retinopathy (DR). METHODS: This is a tertiary care center-based observational cross-sectional study. Sixty-three consecutive cases, divided into 21 cases each with no diabetic retinopathy, non-proliferative diabetic retinopathy and proliferative diabetic retinopathy were included. Twenty-one healthy controls were also included. Ellipsoid zone disruption was assessed using spectral-domain optical coherence tomography. Serum ionic calcium and HbA1c were measured using standard protocol. Patient data from cases were divided into two groups according to their HbA1c levels: group 1 (HbA1c < 7, n = 26) and group 2 (HbA1c > 7, n = 37). Data were analyzed statistically. RESULTS: Mean ionic calcium levels in group 1 and group 2 were 1.131 ± 0.073 mmol/dL and 1.170 ± 0.070 mmol/dL, respectively. In group 1, 11 out of 26 had EZ disruption (42.3%). Similarly, in group 2, 29 out of 37 had EZ disruption (78.4%). On logistic regression analysis, as compared to group 1, ellipsoid zone disruption was found to be positively associated with serum ionic calcium (p = 0.01) in group 2 cases. CONCLUSION: Increased levels of serum ionic calcium are associated with increased EZ disruption in patients with HbA1c > 7 in DR.

• MeSH
• analýza rozptylu MeSH
• diabetická retinopatie patofyziologie   MeSH
• dospělí MeSH
• fotoreceptory obratlovců patologie   MeSH
• glykovaný hemoglobin analýza   MeSH
• hyperglykemie patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• vápník krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

PURPOSE: Age-related macular degeneration (AMD) is one of the leading causes of blindness in the elderly population. Although there are prevalence studies for AMD in Europe, data are scarce for the Slovakian population. METHODS: This was a prospective, multicenter, non-interventional, mobile clinic-based cross-sectional study that assessed age-specific prevalence of AMD in the Slovakian population and risk factors associated with AMD. The type of AMD was graded based on the international age-related maculopathy grading system; optical coherence tomography (OCT) was used for the differential diagnosis. Overall, 3,278 patients were screened; the fundus photographs, OCT scans, and self-reports were collected at the mobile clinic in a single visit. RESULTS: The prevalence of AMD in the study population was 8.99% (wet AMD 1.01%; dry AMD 7.85%), whereas the extrapolated estimate in the entire Slovakian population was 3.3% (wet AMD 0.3%; dry AMD 3.0%). Age, smoking, and hypertension were risk factors associated with AMD; however, contrary to reports in the literature, no gender-specific association was observed. CONCLUSION: Based on the results of this study, mobile clinics may be an effective way to extend health care access to a larger population. Early diagnosis of AMD will assist in early treatment and effective disease management of the population at risk.

• MeSH
• hodnocení rizik metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární degenerace diagnóza   epidemiologie   MeSH
• mobilní zdravotnické jednotky statistika a číselné údaje   MeSH
• optická koherentní tomografie MeSH
• prevalence MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• surveillance populace metody   MeSH
• věkové faktory MeSH
• věkové rozložení MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

BACKGROUND: Diabetic retinopathy is a serious sight-threatening complication which is manifested by excessive angiogenesis in diabetic patients. AIM: We hypothesize that cultured Rhesus monkey retinal endothelial cells (RhRECs) respond to high glucose with a change in cell proliferation and vascular endothelial growth factor (VEGF) secretion. MATERIALS AND METHODS: In our study, 20 000 cells per well were treated without glucose or with 5.5 mM, 18.5 mM and 30 mM glucose for 24 hours. Viable cells were counted using trypan blue dye exclusion method. VEGF concentrations were measured in cell media by ELISA method. RESULTS: The number of viable cells incubated with 5.5 mM glucose increased significantly by 53.7% after 24 hours. In comparison, the number of viable cells decreased by 2.8% at 18.5 mM of glucose and by 20.4% at 30 mM of glucose after 24 hours of incubation. In contrast to this effect of glucose on the number of viable cells, a significant increase in VEGF levels (pg/mL) in the cell media with a glucose concentration of 0 mM compared to 5.5 mM of glucose was found. VEGF secretion in cell medium with 18.5 and 30 mM of glucose increased non-significantly in comparison with euglycemic levels. CONCLUSION: Our results show that viability of retinal endothelial cells and VEGF release are highly responsive to changes in glucose concentration. Such glucose-induced changes in retinal endothelial cells may negatively impact the integrity of the microvasculature in the diabetic retina leading to angiogenesis and microaneursym.

• MeSH
• diabetická retinopatie patologie   patofyziologie   MeSH
• ELISA MeSH
• endoteliální buňky cytologie   MeSH
• glukosa metabolismus   farmakologie   MeSH
• Haplorrhini MeSH
• hyperglykemie komplikace   MeSH
• kultivované buňky MeSH
• lidé MeSH
• proliferace buněk účinky léků   fyziologie   MeSH
• referenční hodnoty MeSH
• retina cytologie   MeSH
• senzitivita a specificita MeSH
• vaskulární endoteliální růstový faktor A analýza   MeSH
• viabilita buněk MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Purpose: Large part of the population suffers of some kind of refractive errors. It is supposed that their prevalence could change with the development of the society. The aim of this study is to determine the prevalence of refractive errors using calculations based on the Gullstrand schematic eye. Methods: We used Gullstrand schematic eye to calculate refraction retrospectively. Refraction was presented as needed glasses correction in vertex distance 12 mm. Necessary data was obtained with the optical biometer Lenstar LS900. Data which could not be obtained due to the device limitation were substituted by theoretical data from the Gullstrand schematic eye. Only analyses from the right eyes were presented. Data were interpreted using descriptive statistics, Pearson correlation and t-test. Statistical tests were conducted at significance level of 5 %. Results: In our sample were 1663 patients (665 males, 998 females) in age from 19 to 96 years. Average age was 70,8 ± 9,53 years. Average refraction of the eye was 2,73 ± 2,13D (males 2,49 ± 2,34, females 2,90 ± 2,76). Mean absolute error from emmetropia was 3,01 ± 1,58 (males 2,83 ± 2,95, female 3,25 ± 3,35). 89,06 % of the sample was hyperopic, 6,61 % was myopic and 4,33 % emmetropic. We did not find correlation between refraction and the age. Conclusion: Females were more hyperopic than males. We did not find any statistically significant hypermetopic shift of the refraction with the age. According to our estimation the calculations of refractive errors showed hypermetropic shift of more than +2D from reality. Our results could be used in future for comparing prevalence of refractive errors using same methods as we used.

• Klíčová slova
• Gullstrandův model oka, Gullstrand schematic eye,
• MeSH
• biologické modely * MeSH
• biometrie MeSH
• emetropie MeSH
• interpretace statistických dat MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prevalence MeSH
• refrakce oka fyziologie   MeSH
• refrakční vady * epidemiologie   MeSH
• refraktometrie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• statistika jako téma MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Geografické názvy
• Slovenská republika MeSH

• Publikační typ
• recenze MeSH