Cíl: Analýza souboru pacientů s drúzami zrakového nervu (DZN) se zaměřením na možnosti jejich diagnostiky pomocí moderních zobrazovacích metod. Metodika: Přehled literatury a retrospektivní statistická analýza pacientů s podezřením na DZN. Do souboru byli zařazeni pacienti, u nichž byly prokázány drúzy zrakového nervu alespoň jednou ze zobrazovacích metod (ultrazvuk – USG, optická koherenční tomografie – OCT, autofluorescence fundu – FAF). Výsledky: Soubor tvořilo 12 pacientů (23 očí), z nich bylo 7 žen a 5 mužů. Medián věku pacientů byl 25 let. Střední doba sledování byla 73 měsíců. U 11 pacientů (22 očí) se jednalo o oboustranný výskyt, v 1 případě (1 oko) o jednostranný nález. Na terči zrakového nervu 8 pacientů (16 očí) byly prokázány hluboké drúzy (69,6 %), u 4 pacientů (7 očí) se jednalo o drúzy povrchové (30,4 %). Střední hodnota nejlépe korigované zrakové ostrosti (NKZO) a nitroočního tlaku (NT) byla po celou sledovací dobu stabilní (NKZO p = 0,236, NT p = 0,855). Efektivita záchytu DZN pomocí paraklinických vyšetření (USG, FAF, OCT) byla rovnocenná (p = 0,768). U 11 pacientů (21 očí) byl zaznamenán pokles vrstvy retinálních nervových vláken (RNFL). Zaznamenali jsme statisticky významný pokles RNFL v čase vzhledem k normativní databázi v segmentech temporo – superiorním (p = 0,015), temporálním (p = 0,026) a nasálním (p = 0,011), po rozdělení dat na povrchové a hluboké drúzy v nasálním segmentu u povrchových drúz (p = 0,031). Nezaznamenali jsme statisticky signifikantní rozdíl změny RNFL v čase mezi povrchovými a hlubokými drúzami (p = 0,109–0,999 pro jednotlivé segmenty). Závěr: Drúzy zrakového nervu jsou časté, úroveň zrakových funkcí zůstává stabilní. Jejich diagnostika se v současnosti opírá zejména o moderní zobrazovací metody.
Purpose: To analyze patients with optic disc drusen (ODD), with emphasis on modern diagnostics. Materials and Methods: Research of the literature was conducted, together with a retrospective statistical analysis of patients with ODD. The group included individuals with ODD diagnosed using at least one of the following (ultrasound – USG, optical coherence tomography – OCT, fundus autofluorescence – FAF). Results: The group consisted of 12 patients (23 eyes), 7 women and 5 men. The mean age was 25 years. The mean observation period was 73 months. In total, 11 patients (22 eyes) had a bilateral finding and 1 patient (1 eye) had a unilateral finding. The mean age was 25 years. Buried drusen were confirmed in 69.6% of cases (8 patients, 16 eyes), superficial drusen were confirmed in 30.4% of cases (4 patients, 7 eyes). Mean best corrected visual acuity (BCVA) and mean intraocular pressure were stable over time (BCVA p = 0.236, IOP p = 0.855). The aforementioned diagnostic methods proved to be equally effective (p = 0.768). In 11 patients (21 eyes) a depression of the retinal nerve fiber layer (RNFL) was recorded. We found a statistically significant decrease of the RNFL over time in reference to the normative database in the superior temporal (p = 0.015), temporal (p = 0.026) and nasal segments (p = 0.011). After separation of superficial and buried drusen the same significant change was found in nasal segment in superficial drusen (p = 0,031). We found no statistically significant difference over time between superficial and buried drusen (p = 0.109–0.999 for individual segments). Conclusion: ODD are common and visual functions remain stable. Their presence can be confirmed using modern paraclinical methods.
PURPOSE: To assess the intraday repeatability of macular architecture measurements in glaucomatous and non-glaucomatous patients using spectral-domain optical coherence tomography (SD-OCT) and to evaluate the independence from intraindividual intraocular pressure (IOP) fluctuations. METHODS: In this single-center, time-point comparison study, 88 eyes with glaucoma, 53 eyes with ocular hypertension (OHT), and 253 healthy eyes underwent two standardized SD-OCT and intraocular pressure (IOP) measurements on the same day with a 5-h time gap. Bland-Altman plots, intraclass correlation coefficients (ICC), and random-effects model were used to analyze repeatability of entire retinal thickness, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, and inner nuclear layer measurements. RESULTS: Intraday measurements were highly reproducible in all 3 groups. ICC were greater than 0.90, respectively. The pairwise comparisons of morphometric parameters showed a statistically significant difference (P < 0.001, respectively) between groups (glaucoma vs. control, glaucoma vs. OHT) and a significant influence of time points. No correlation was found between IOP fluctuations and morphometric parameters (P > 0.05, respectively), except for a weak positive correlation with GCL (rho = 0.109, P = 0.031). CONCLUSIONS: The evaluation of macular morphometric parameters of SD-OCT showed a high intraday repeatability and an excellent degree of agreement in glaucoma, ocular hypertension, and healthy groups. The fixed effects of time points were statistically significant. Except for a weak positive correlation of ganglion cell layer, variability did not appear to be affected by intraday IOP changes. Additional research is required to fully understand the impact of IOP fluctuations on macular morphometric parameters, considering the small observed IOP changes.
- MeSH
- dospělí MeSH
- glaukom * diagnóza patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- macula lutea * patologie diagnostické zobrazování MeSH
- následné studie MeSH
- nervová vlákna * patologie MeSH
- nitrooční tlak * fyziologie MeSH
- oční hypertenze diagnóza patofyziologie MeSH
- optická koherentní tomografie * metody MeSH
- reprodukovatelnost výsledků MeSH
- retinální gangliové buňky * patologie MeSH
- senioři MeSH
- tonometrie oční MeSH
- zraková pole fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Cíl: Cílem tohoto kazuistického sdělení je referovat případ pacienta s iatrogenně vzniklým Kaposiho sarkomem s multiorgánovým postižením včetně oční manifestace. Kazuistika: U 74letého pacienta s transplantovanou ledvinou léčeného imunosupresivy došlo ke vzniku iatrogenního Kaposiho sarkomu (KS) obou dolních víček. Nález KS byl následně potvrzen i v oblasti levého předloktí a byla vyjádřena suspekce ložiska v plicích. Nádor v oční lokalizaci byl chirurgicky odstraněn, s negativními okraji dostatečné resekční šíře, bez nutnosti další terapie. Léze na levém předloktí byla kompletně odstraněna. Pacient podstoupil radioterapii ložiska v plicích a byla u něj snížena imunosupresivní terapie. Závěr: Případ poukazuje na důležitost časného rozpoznání KS, jeho bioptickou verifikaci, radikální resekci a multidisciplinární spolupráci. Znalost epidemiologie tohoto onemocnění je stěžejní na cestě ke správné diagnostice.
Aim: The aim of this case report is to present the case of a patient with iatrogenic Kaposi’s sarcoma afflicting several organs, ocular manifestation. Case report: In a 74-year-old kidney transplant patient receiving immunosuppressive therapy, iatrogenic Kaposi’s sarcoma (KS) developed in both lower eyelids. Subsequently, KS was confirmed in the region of the left forearm, with suspicion of lesions in the lungs. The ocular tumor was surgically removed with negative margins, requiring no further therapy. The lesion on the left forearm was completely excised. The patient underwent radiotherapy for the lung lesions, and immunosuppressive therapy was reduced. Conclusion: The case highlights the importance of early identification of KS, its histological verification, radical resection, and multidisciplinary collaboration. Knowledge of the epidemiology of this condition is a key factor in determining the correct diagnosis.
- MeSH
- časná diagnóza MeSH
- iatrogenní nemoci MeSH
- imunosupresivní léčba škodlivé účinky MeSH
- Kaposiho sarkom * diagnostické zobrazování diagnóza komplikace MeSH
- lidé MeSH
- nádory očního víčka diagnóza etiologie klasifikace MeSH
- oční nemoci diagnóza etiologie klasifikace MeSH
- senioři MeSH
- týmová péče o pacienty MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: In this study, we measured the volume of customized tumor models in the periocular area using three-dimensional (3D) stereophotogrammetry and evaluated the reproducibility of these measurements. METHODS: Five tumor models of different colors and sizes were placed in different periocular positions, and 3D facial images were obtained from 68 healthy adult volunteers. Subsequently, the volumes of the tumor models were measured, and the intra- and interrater reproducibility was assessed. RESULTS: The gray 6 mm model revealed the highest reliable measurements in both Caucasians (intra- and interrater intraclass correlation coefficients of 0.981 and 0.899, mean absolute difference of 1.446 and 3.327 mm3, relative error measurement of 3.497% and 8.120%, technical error of measurement of 1.450 and 3.105 mm3, and relative technical error of measurement of 3.506% and 7.580%) and Asians (0.968 and 0.844, 1.974 and 4.067 mm3, 4.772% and 9.526%, 2.100 and 4.302 mm3, and 5.076% and 10.076%, respectively). The highest reliability of measurements in the lateral upper eyelid (0.88 and 0.95, 4.042 and 3.626 mm3, 9.730% and 9.020%, 5.714 and 3.358 mm3, and 9.730% and 8.350%, respectively) and medial upper eyelid (0.81 and 0.89, 4.313 and 4.226 mm3, 9.730% and 9.020%, 6.098 and 4.069 mm3, and 9.730% and 8.350%, respectively) with eyes closed was evident in Caucasians, while the same trend (0.841 and 0.815, 2.828 and 3.757 mm3, 9.860% and 9.840%, 4.052 and 4.308 mm3, and 9.860% and 9.740%, respectively) was observed in Asians in the medial canthus with eyes closed. CONCLUSIONS: This study confirms, for the first time, the high reliability of periocular tumor volume measurements using 3D stereophotogrammetry, suggesting its feasibility for eyelid tumor measurement. Further trials are required to investigate its clinical use for documentation and follow-up of different eyelid tumors.
- Publikační typ
- časopisecké články MeSH
Skriptum
První vydání 73 stran : ilustrace (převážně barevné) ; 30 cm
Vysokoškolská učebnice, která se zaměřuje na oftalmologii.
- MeSH
- oftalmologie MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- oftalmologie
- NLK Publikační typ
- učebnice vysokých škol
- MeSH
- hasiči * MeSH
- lidé MeSH
- poranění oka * diagnóza MeSH
- sportovní úrazy * diagnóza MeSH
- sporty * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The possible complications of anophthalmic eye sockets can occur due to many different pathomechanisms. A differentiation is made between allergic, infectious, inflammatory or mechanical causes. This article gives an overview on the different etiologies of socket complications with their pathophysiology and treatment options.
- MeSH
- anoftalmie * MeSH
- enukleace oka MeSH
- lidé MeSH
- následná péče MeSH
- orbita MeSH
- orbitální implantáty * škodlivé účinky MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
This article aims to present the differential diagnostics of benign and malignant eyelid tumours. The most common malignant eyelid tumour is basal cell carcinoma, followed by squamous cell carcinoma. The common signs of malignity are loss of lashes, ulceration, and infiltration of the lesion. Often the clinical appearance is various and therefore only a histological analysis gives the proper diagnosis. For most tumours, surgical resection is the gold standard of therapy. The reconstruction of the defects should be performed by an experienced oculoplastic surgeon. In malignant tumours that require large safety margins, the defect can be easily very large, and the reconstruction must then be performed with advanced ophthalmic plastic reconstruction techniques.
INTRODUCTION: The aim of this study was to present the indications for a combined endoscopic transnasal and sublabial transantral approach for the surgical treatment of orbital lesions. MATERIAL AND METHODS: This case study enrolled 10 patients scheduled for endoscopic transnasal surgery for treating orbital lesions from 2009 to 2020. When the tumour was localised to the medial part of the orbit, patients underwent endoscopy with a transnasal mononostril approach. Alternatively, when the tumour was localised to the mediocaudal part of the orbit, and when instrument manoeuvreability was limited, the transnasal approach was combined with a sublabial transantral approach. Herein, we evaluate the indications, complications, and advantages of monoportal and combined two-portal approaches. RESULTS: 8/10 patients (80%) underwent surgery with the transnasal mononostril approach, and 2/10 (20%) underwent surgery with the combined transnasal mononostril and sublabial transantral approach. In the two latter cases, visualisation of the operation field was excellent, and there was adequate room for manipulating instruments. CONCLUSIONS: The combined mononostril-transantral approach provided the space necessary to manoeuvre instruments and to visualise the surgical field in treating mediocaudal orbital lesions. CLINICAL IMPLICATIONS: This two-portal approach enables extensive resections of intraconal lesions. It should be considered to be a suitable and safer alternative to the binostril approach.
- MeSH
- endoskopie * metody MeSH
- lidé MeSH
- nádory orbity * chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH