BACKGROUND AND AIMS: Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS: We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS: The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION: The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.

• MeSH
• Glaucoma * MeSH
• Hyperlipidemias * complications   epidemiology   MeSH
• Hypertension * complications   epidemiology   MeSH
• Cardiovascular Diseases * MeSH
• Humans MeSH
• Sleep Apnea, Obstructive * MeSH
• Retinal Vein Occlusion * epidemiology   etiology   MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Thrombophilia * complications   MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Východiska: Uveální melanom je velmi vzácným nádorem, který asi v polovině případů metastazuje. V případě rozvoje metastatického onemocnění je jeho prognóza krajně nepříznivá a medián přežití nepřesahuje 6 měsíců. Možnosti účinné léčby byly doposud velmi limitované. Tebentafusp je bispecifickým fúzním proteinem, který jako první prokázal účinnost u uveálního melanomu. Případ: Pacientka odeslaná pro suspektní melanom levého oka byla dříve léčena pro Hodgkinovu nemoc. Primárně byl nádor ošetřen radiochirurgicky s radioterapií drobného ložiska obratlového těla. Následně však pacientka musela podstoupit enukleaci bulbu s nálezem rozsáhlého tumoru pT4b. PET/CT prokázala metastázy skeletu a jater, zároveň byl prokázán haplotyp A*02: 01. Pacientka absolvovala radioterapii sterna a následně – po schválení léku na základě žádosti na §16 – zahájila léčbu preparátem tebentafusp. Lék byl v prvních třech dávkách podáván za hospitalizace s nutností léčby cytokine release syndromu kortikosteroidy. Následně probíhala aplikace týdně ambulantní formou bez komplikací krom tranzitorní elevace transamináz. První restaging CT po 3 měsících prokázala stabilní nemoc, zatímco druhé restaging CT prokázala novou osteolytickou lézi ve výběžku Th11. Z důvodu progrese byla léčba tebentafuspem po 6 měsících ukončena. Ložisko bohužel nebylo možno ošetřit radioterapií. Po 2 měsících byla pacientka urgentně hospitalizována pro pravostrannou hemiplegii a MR prokázala prokrvácené metastatické ložisko v mozkovém kmeni. Závěr: V této kazuistice popisujeme případ první pacientky léčené tímto lékem v ČR.

Background: Uveal melanoma is a rare cancer, in which metastases occur in approximately one half of cases. In metastatic disease, the prognosis is unfavorable and the median of survival does not exceed 6 months. Effective treatment options were very limited up to date. Tebentafusp is a bispecific fusion protein, which as the first drug proved efficacy in uveal melanoma. Case: The patient was referred for suspected uveal melanoma of the left eye. She was treated for Hodgkin’s disease in the past. Primarily, the tumor was treated by radiosurgery with radiotherapy of a small lesion of the vertebral body. However, later the patient had to undergo bulbus enucleation with confirmation of a large tumor category pT4b. PET/CT revealed metastases of the bones and the liver; simultaneously, haplotype A*02: 01 was confirmed. The patient underwent radiotherapy of the sternum and later, after confirmation of payment from the health insurance company, she started treatment with tebentafusp. The first three doses were administered during admission to the hospital, with a need to treat cytokine release syndrome by corticosteroids. Later, the administration was performed in an out-patient regimen, without complications, except for a transient elevation of transaminases. The first CT restaging confirmed stable disease; however, the second restaging confirmed a new osteolytic lesion in the processus of Th11. Because of progression, the treatment with tebentafusp was withdrawn after 6 months. Unfortunately, the lesion could not be treated by radiotherapy. Two months later, the patient was urgently admitted to the hospital because of right-sided hemiplegia; MRI revealed bleeding metastatic lesion in the brain stem. Conclusion: In this case report, we present the case of the first patient treated with this drug in the Czech Republic.

• Keywords
• tebentafusp,
• MeSH
• Eye Enucleation MeSH
• Fatal Outcome MeSH
• Middle Aged MeSH
• Humans MeSH
• Neoplasm Metastasis diagnostic imaging   radiotherapy   MeSH
• Uveal Neoplasms * diagnostic imaging   complications   pathology   therapy   MeSH
• Treatment Failure MeSH
• Positron Emission Tomography Computed Tomography MeSH
• Disease Progression MeSH
• Recombinant Fusion Proteins * administration & dosage   economics   adverse effects   MeSH
• Neoplasms, Second Primary diagnostic imaging   therapy   MeSH
• Cytokine Release Syndrome chemically induced   drug therapy   MeSH
• Ultrasonography MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Diagnosis, Differential MeSH
• Optic Disk diagnostic imaging   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Small Cell Lung Carcinoma diagnosis   complications   MeSH
• Papilledema * diagnosis   pathology   MeSH
• Tomography, Optical Coherence methods   MeSH
• Paraneoplastic Syndromes, Nervous System * classification   complications   MeSH
• Vision Disorders etiology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Autoimmune Diseases MeSH
• Humans MeSH
• Medication Therapy Management MeSH
• Uveitis * drug therapy   classification   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

PURPOSE: To evaluate the relationship between the ischemic index and the oxygen saturation in retinal vessels in patients with retinal vein occlusion. DESIGN: Prospective, cross-sectional study. METHODS: We performed a prospective study. The cohort consisted of 43 eyes of 43 patients with retinal vein occlusions (RVO), 23 of whom had central retinal vein occlusions (CRVO) and 20 who had branch retinal vein occlusions (BRVO). We evaluated the retinal vessel saturation using an automatic retinal oximetry device. The retinal ischemic index (ISI) was determined using ultra-widefield fluorescein angiography. RESULTS: Mean arterial saturation (±SD) was 100% ± 11%, mean vein saturation was 52% ±13%, and mean A-V difference was 48% ± 16% in eyes with BRVO. The average ISI in the same group was 0.48 (range 0-1). There was no statistically significant correlation between the retinal ischemic index and retinal saturation in the BRVO group. The affected eye in the CRVO group had a mean arterial saturation of 101% ± 6%, vein saturation of 44% ± 11 % and A-V difference of 58% ± 10%. The average ISI in the CRVO group was 0.54 (range 0-1). A statistically significant negative correlation between ISI and vein saturation was found in the CRVO group (r = -0.686; P =.0003). A significant positive correlation between ISI and the A-V difference was found in the CRVO group (r = 0.893; P <.0001). CONCLUSIONS: Oxygen saturation in the retinal vein and the arteriovenous difference correlated with the ischemic index in CRVO patients. No correlation was found for BRVO patients.

• MeSH
• Fluorescein Angiography MeSH
• Ischemia physiopathology   MeSH
• Oxygen blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Retinal Vein Occlusion physiopathology   MeSH
• Tomography, Optical Coherence MeSH
• Oximetry MeSH
• Prospective Studies MeSH
• Cross-Sectional Studies MeSH
• Aged MeSH
• Oxygen Consumption physiology   MeSH
• Retinal Vein physiology   MeSH
• Visual Acuity MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

AIM: To evaluate the final best corrected visual acuity (BCVA) in patients with branch retinal vein occlusion (BRVO) treated with either (1) laser arteriolar constriction (ACo) or (2) the standard treatment recommended by the Branch Vein Occlusion Study Group (grid laser photocoagulation (GLP) or only observation (if indication criteria for GLP were not met). METHODS: 358 BRVOs were treated in three different ways: early ACo (n=133) performed ≤9 weeks after onset of BRVO, late ACo (n=62) performed >9 weeks after onset and controls which included GLP and observation (n=163). The groups were further divided according to initial BCVA into: ≤0.1; 0.16-0.3 and ≥0.4. RESULTS: Based on the proportion of 1 year BCVA≤0.1 as a risk category, the results of early ACo (3.8%) were significantly better than for the controls (22.7%, P<0.001) and late ACo (16.1%, P=0.006). The greatest difference in final BCVA was in patients with the worst initial VA (≤0.1). In the intermediate initial BCVA group 0.16-0.3, a significant difference was only found between the early ACo group and controls (P=0.007). There was no significant difference between any treatment group and prevalence of a final BCVA≤0.1 for patients with an initial BCVA≥0.4. CONCLUSIONS: Early ACo significantly reduces the prevalence of a final BCVA≤0.1 in patients with BRVO and an initial BCVA≤0.3 compared to controls (standard treatment treated with GLP or observed).

• MeSH
• Arterioles MeSH
• Adult MeSH
• Laser Coagulation methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Retinal Vein Occlusion therapy   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Visual Acuity * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Spojení opakujících se optických neuritid a následného rozvoje roztroušené sklerózy u dětí je časté a dostatečně známé, proto je spolupráce oftalmologa a neurologa nezbytná. Autoři popisují rekurentní retrobulbární neuritidu s následným rozvojem roztroušené sklerózy u 14leté dívky.

Association of recurrent optic neuritis and subsequent development of multiple sclerosis in children are common and well known, close collaboration among ophtalmologists and neurologists is needful. We report on recurrent retrobulbar optic neuritis and subsequent multiple sclerosis in a 14-years old girl.

• Keywords
• adolescenti, retrobulbární neuritida,
• MeSH
• Patient Compliance MeSH
• Interferon-beta therapeutic use   MeSH
• Humans MeSH
• Magnetic Resonance Imaging utilization   MeSH
• Methylprednisolone therapeutic use   MeSH
• Adolescent MeSH
• Cerebrospinal Fluid chemistry   MeSH
• Myelin Sheath pathology   MeSH
• Paresthesia complications   MeSH
• Vision Disorders diagnosis   etiology   MeSH
• Disease Progression MeSH
• Recurrence MeSH
• Multiple Sclerosis diagnosis   etiology   drug therapy   MeSH
• Optic Neuritis diagnosis   drug therapy   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Amblyopia prevention & control   MeSH
• Blepharoptosis congenital   MeSH
• Child MeSH
• Humans MeSH
• Retrospective Studies MeSH
• Severity of Illness Index MeSH
• Plastic Surgery Procedures classification   methods   utilization   MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Okluze sítnicových vén (kmenové a větvové) představují multifaktoriálně podmíněné onemocnění postihující převážně starší pacienty, u kterých představují změny sítnicových cév podmíněné hypertenzí a aterosklerózou jedny z nejdůležitějších patofyziologických faktorů pro rozvoj tohoto onemocnění. V posledních letech se intenzivní vědecké bádání zaměřilo na objasnění role poruch koagulační kaskády. Zejména u mladších pacientů patří mezi nejčastěji zmiňované defekty koagulační kaskády stav označovaný jako APC-rezistence. Až 95 % všech pacientů s APC-rezistencí je nositelem takzvané Leidenské mutace. Cílem naší studie bylo zjistit prevalenci APC-rezistence u 92 pacientů s angiograficky potvrzenou kmenovou nebo větvovou okluzí sítnicové žíly ošetřených na Oční klinice FN Olomouc v letech 1999 až 2005. Kontrolní soubor představoval 40 pacientů, u kterých bylo vyloučeno jakékoliv oční vaskulární onemocnění. Prevalence APC-rezistence byla u pacientů s okluzí sítnicové vény 10,9 % a v kontrolním souboru pacientů 5 %. Ve skupině pacientů do 55 let činila prevalence APC-rezistence 14,3 %, u pacientů starších 55 let 5,6 %. Vzhledem k relativně malému souboru pacientů nedosáhl zjištěný rozdíl hladinu statistické signifikace. Výsledky naší studie potvrdily závěry doposud publikovaných prací, že prevalence APC-rezistence není u pacientů s okluzí sítnicové vény ve srovnání s prevalencí v kontrolní populaci signifikantně vyšší

Occlusions of retinal veins (central and branch) represent multifactorialy-conditioned disease involving presumably older patients, in whom the changes of retinal vessels caused by hypertension and atherosclerosis present the most important pathophysiological factors for development of this disease. In last years, the intensive scientific research is focused to the explanation of the role of the defects of the coagulations cascade. Especially in younger patients, the most often mentioned defect of the coagulations cascade is called as APC-resistance. Up to 95 % of all patients with APC-resistance are carriers of so called Leiden mutation. The aim of our study was to establish the prevalence of the ACP-resistance in 92 patients with central or branch occlusion of the retinal vein verified by means of angiography treated at the Department of Ophthalmology, Faculty Hospital, Olomouc, Czech Republic, EU, during the period 1999–2005.The control group consisted of 40 patients without any vascular, eye-related disease. In the group of patients with occlusion of the retinal vein, the prevalence of the APC-resistance was 10.9 % and in the control group 5 %. In the group of patients 55 years old and younger the prevalence of the ACP-resistance was 14.3 %, in patients older than 55 years it was 5.6 %. According to the relatively small groups of patients, the established difference did not reach the level of statistical evidence. Results of our study confirmed the conclusions of previously published papers that the prevalence of the APC-resistance is not significantly higher in patients with retinal vein occlusion according to the prevalence in controls.

• MeSH
• Humans MeSH
• Retinal Vein Occlusion etiology   blood   pathology   MeSH
• Activated Protein C Resistance complications   blood   therapy   MeSH
• Thrombophilia diagnosis   etiology   blood   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Comparative Study MeSH

• Publication type
• Abstracts MeSH