The case report of a young myope (born in 1997) who was diagnosed with bilateral concentric narrowing of the visual field to 15-20 degrees in 2021 is presented. On eye fundus, the findings were normal with central excavation c/d=0.5 and 0.4, respectively. OCT showed loss of retinal nerve fiber layer - in both vertical quadrants, including a reduction in the ganglion cell complex. Electrophysiological examination (PERG) showed normal retinal responses. Visual evoked responses (PVEP) after stimulation squared a 1 degree decrease in amplitudes, with no prolongation of P100 latency. When stimulated with 15-minute squares, responses were normal (see Supplementary Figure). Magnetic resonance imaging of the brain showed a narrowing of the chiasm. In conclusion, optic chiasm hypoplasia may not always have distinct morphological and functional manifestations. In addition to imaging methods, electrophysiological examination of the visual analyser was of great help for its verification.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Cíl: Představit historii a současnost zrakových korových neuroprotéz a předložit novou metodu stimulace nepoškozených buněk zrakové kůry. Metody: Práce podává nejen přehled o historii a současném stavu stimulace zrakové kůry u těžkých poruch zraku, ale hlavně upozorňuje na jejich nedostatky. K nim se řadí hlavně stimulace právě poškozených korových buněk na malé ploše a z morfologického hlediska pak možné poškození stimulovaných neuronů elektrodami a jejich zapouzdření gliotickou tkání. Výsledky: Práce dále předkládá návrh nové technologie zpracování obrazu a jeho transformace do podoby neinvazivní transkraniální stimulace nepoškozených částí mozku, která je chráněna národním i mezinárodním patentem. Závěr: V práci je předložen ucelený přehled současných možností náhrady ztraceného zraku na úrovni mozkové kůry a návrh nové neinvazivní metody stimulace funkčních neuronů zrakové kůry.

Purpose: The purpose of the article is to present the history and current status of visual cortical neuroprostheses, and to present a new method of stimulating intact visual cortex cells. Methods: This paper contains an overview of the history and current status of visual cortex stimulation in severe visual impairment, but also highlights its shortcomings. These include mainly the stimulation of currently damaged cortical cells over a small area and, from a morphological point of view, possible damage to the stimulated neurons by the electrodes and their encapsulation by gliotic tissue. Results: The paper also presents a proposal for a new technology of image processing and its transformation into a form of non-invasive transcranial stimulation of undamaged parts of the brain, which is protected by a national and international patent. Conclusion: The paper presents a comprehensive review of the current options for compensating for lost vision at the level of the cerebral cortex and a proposal for a new non-invasive method of stimulating the functional neurons of the visual cortex.

• Klíčová slova
• zraková neuroprotéza,
• MeSH
• kvalita života MeSH
• lidé MeSH
• nemoci retiny klasifikace   terapie   MeSH
• oční protézy * klasifikace   MeSH
• primární vizuální kortex MeSH
• transkraniální magnetická stimulace * metody   přístrojové vybavení   MeSH
• zrak MeSH
• zrakově postižení MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

PURPOSE: The aim of this study was to compare changes in the conventionally undiagnosed distal nasal visual field with RNFL in patients with early primary open-angle glaucoma (POAG). MATERIAL AND METHODS: 59 eyes of 32 patients (18 women, 14 men) with early stage POAG were included. All eyes were found to have a normal visual field (fast threshold program of 50 degrees nasally and 22 degrees temporally) with the Medmont M700. Visual acuity was 1.0 (with a possible correction ±3 D), and they had no other ocular pathology except glaucoma. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli in a range of 0-120 degrees nasally. Nerve fiber layer (RNFL) and vessel density (VD) was measured using the in-built software of the Avanti RTVue XR instrument. Using Pearson's correlation coefficient, the results of visual field examination with RNFL without and after correction (by subtracting VD from total RNFL value) in the superior-nasal (SN-5) and inferior-nasal (IN-8) segments were compared. RESULTS: In all eyes, changes were found in the distal periphery of the nasal part of the visual field. No correlation was noted by comparison with RNFL. After adjusting RNFL for VD, we observed no correlation in the SN segment (5) (r=-0.03) and a very weak correlation in the IN segment (8) (r=-0.16). CONCLUSION: With a normal visual field tested by the rapid threshold glaucoma program, changes in the distal part of the nasal periphery of the visual field were found in the entire cohort and did not correlate with the RNFL and RNFL results after correction from VD.

• Publikační typ
• časopisecké články MeSH

Cíl: Cílem práce bylo zjistit hranice vzdálené nasální části zorného pole u pacientů s fyziologickým očním nálezem. Materiál a metody: Vyšetření zorného pole bylo provedeno u 15 zdravých osob (30 očí). U devíti žen ve věku 20–43 let a šesti mužů ve věku 22–35 let. U všech očí byl zjištěn fyziologický oční nález a zraková ostrost 1,0 s korekcí menší nebo rovnou 3 dioptrie. Zorné pole bylo vyšetřeno přístrojem Medmont M700 posunutím fixačního bodu o 40 stupňů temporálně a současného stočení hlavy nasálně, programem prostorové přizpůsobivosti. Celkem bylo zahrnuto 89 vyšetřovaných bodů pomocí flicker podnětů. Výsledky: Vzdálená nasální hranice zorného pole dosáhla u 13,3 % očí 100°, u 20 % očí 105° a u 66,7 % očí až 110°. Závěr: Hranice vzdálené nasální části zorného pole dosahovala 100–110 stupňů (při eliminaci stínění kořenem nosu).

Aims: The aim of the study was to determine the limits of the far nasal part of the visual field. Material and Methods: Visual field examination was performed in 15 healthy subjects (30 eyes), specifically nine women aged 20–43 years and six men aged 22–35 years. All eyes were found to have physiological ocular findings and visual acuity of 1.0 with correction less than or equal to 3 diopters. The visual field was examined with a Medmont M700 instrument by shifting the fixation point 40 degrees temporally and simultaneously turning the head nasally, with a spatial accommodation program. A total of 89 examination points were included using flicker stimuli. Results: The far nasal limit of the visual field reached 100° in 13.3% of eyes, 105° in 20% of eyes and up to 110° in 66.7% of eyes. Conclusion: The limit of the far nasal part of the field of vision reached 100–110 degrees (when nose shielding was eliminated).

• MeSH
• dospělí MeSH
• lidé MeSH
• testy zrakového pole metody   MeSH
• zraková ostrost MeSH
• zraková pole * fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH

Cíl: Cílem této studie bylo ověřit možné změny konvenčně nediagnostikované nasální části zorného pole u pacientů s diagnózou včasného primárního glaukomu s otevřeným úhlem (PGOÚ) s vysokou tenzí. Materiál a metody: Vyšetření vzdálené nasální části zorného pole bylo provedeno u 30 nemocných (60 očí) s počínajícím PGOÚ (preperimetrické stadium změn). Soubor tvořilo 16 žen (průměrného věku 46,5 let) a 14 mužů (průměrného věku 44,7 let). U všech očí bylo zjištěno glaukomovým programem (rychlý prahový program v rozsahu 50 stupňů nasálně a 22 stupňů temporálně) přístrojem Medmont M700 fyziologické zorné pole. Zraková ostrost byla 1,0 s případnou korekcí menší nebo rovnou ±3 dioptrie, a kromě glaukomového onemocnění neměli jinou oční vadu. Zorné pole bylo následně vyšetřeno stejným přístrojem posunutím fixačního bodu o 40 stupňů temporálně (prostorově adaptabilní program) a současným otočením hlavy o 10 stupňů nasálně. Celkem bylo zahrnuto 89 vyšetřovacích bodů s použitím flicker podnětů a rozsahem 0–120 stupňů nasálně. Výsledky: U všech očí byla zjištěna deprese vzdálené periferie nasální části zorného pole v rozsahu od 50 do 95 stupňů, při normální zorném poli vyšetřeným glaukomovým programem. Závěr: Při normálním zorném poli vyšetřeném rychlým prahovým glaukomovým programem byly u všech nemocných PGOÚ zjištěny změny v distální části nasální periferie zorného pole.

Aim: The aim of this study was to examine possible changes in the conventionally undiagnosed nasal visual field in patients diagnosed with early primary open angle glaucoma. Material and Methods: Examination of the far nasal part of the visual field was performed in 30 patients (60 eyes) with early stage of primary open angle glaucoma (preperimetric stage of changes). The cohort consisted of 16 women (mean age 46.5 years) and 14 men (mean age 44.7 years). In all eyes, the glaucoma program (rapid threshold program of 50 degrees nasally and 22 degrees temporally) was performed with the Medmont M700 instrument to determine the physiological visual field. Visual acuity was 1.0 with a possible correction less than or equal to ±3 diopters and they had no other ocular defect except glaucoma disease. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli and a range of 0–120 degrees nasally. Results: The far nasal limit of the visual field reached 100° in 13.33% of eyes, 105° in 20% of eyes and up to 110° in 66.67% of eyes. Conclusion: In all eyes, depression of the distal periphery of the nasal part of the visual field was found to range from 50 to 95 degrees, with a normal visual field examined by the glaucoma program.

• MeSH
• časná diagnóza MeSH
• glaukom s otevřeným úhlem diagnóza   MeSH
• glaukom * diagnóza   MeSH
• lidé MeSH
• optická koherentní tomografie MeSH
• testy zrakového pole metody   MeSH
• zraková pole MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• klinická studie MeSH

The present article describes a case of a 24-year-old patient who suffered from acute pancreatitis. The patient simultaneously developed visual acuity loss and changes in the visual field. When examined, the finding was physiological, including the fundoscopy. Neither fluorescein angiography or optical coherence tomography demonstrated any retinal abnormalities; electroretinography was physiological as well. The visual evoked potentials (VEP) showed abnormalities in amplitudes. Patient's visual field was reduced to 40 ̊. The follow-up examination 13 months after the first symptoms proved a progression of changes in the visual field and prolonged latency of P100 peak in VEP. The retinal nerve fibre layer stayed unchanged, but the vessel density on the optic nerve head decreased. Magnetic resonance brain imaging showed non-specific subcortical and paraventricular focuses in the white matter of both hemispheres. There were no other abnormalities detected by magnetic resonance imaging. Neurological examination was normal. In conclusion, the present study verified this decrease of visual functions as a lesion in the visual pathway using VEP, which was also confirmed by magnetic resonance brain imaging.

• Publikační typ
• kazuistiky MeSH

BACKGROUND: The authors present a case study which describes the development of bilateral optic neuropathy as a complication of allogeneic hematopoietic stem cell transplantation (HSCT) in a patient who underwent a transplant for B-cell acute lymphoblastic leukemia (B-ALL). The patient, who was in remission with regard to the underlying hematological disease, developed edema of both optic discs and maculas three months after transplantation. The morphological finding regressed after treatment with corticoids and comprehensive systemic anti-infective therapy. However, the loss of function was not entirely restored. CASE REPORT: One year after the healing, the atrophy of the optic discs persisted, with corresponding findings in vessel density (VD), retinal nerve fibre layer (RNFL) and visual field changes. Electrophysiological examination by pattern electroretinogram (PERG) showed an alteration in retinal ganglion cells in the left eye, but with significant damage to nerve fibres on both sides. Visual evoked potential (VEP) verified bilateral non-inflammatory neurogenic lesions. This finding was also confirmed by functional magnetic resonance imaging (fMRI). Examination by structural magnetic resonance imaging (MRI) showed inflammatory changes in the optic nerve sheaths over time and a consequent marked narrowing of them. CONCLUSION: The authors believe that edema of the optic discs and maculas was caused by a combination of several factors. Firstly, MRI showed inflammatory changes in the optic nerve sheaths, which led to a blockade of axoplasmic transport. Another factor that may have played a part in the outcome was endothelial damage to blood vessels with impaired microcirculation supplying the optic nerve fibres, which contributed to the occurrence of macular edema.

• MeSH
• lidé MeSH
• macula lutea * MeSH
• nemoci zrakového nervu * etiologie   patologie   MeSH
• nervus opticus MeSH
• optická koherentní tomografie MeSH
• transplantace hematopoetických kmenových buněk * škodlivé účinky   MeSH
• zrakové evokované potenciály MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• kazuistiky MeSH

PURPOSE: A case report of a 40-year-old patient with tuberculosis treated with ethambutol is described. Within six months of starting treatment, there was a painless sudden decline in visual function. Despite the known complications of ethambutol treatment, it was discontinued after another three months. METHODS: In the case report, we highlight the damage to the dominantly peripheral visual pathways. Using electrophysiological examinations, we showed a significant alteration in the optic nerves. Optical Coherence Tomography (OCT) showed progressive loss of vessel density and nerve fibre layer of retinal ganglion cells. Perimetric examination showed both a central decrease in sensitivity and mainly scotomas in the temporal parts of the visual fields. Although there was improvement in visual fields over time, OCT findings indicated progression of ethambutol-induced optic neuropathy (EON). Magnetic Resonance Imaging confirmed the alteration in the peripheral part of the visual pathway (intraorbital, intracranial parts of optic nerves, chiasma, and optic tracts). CONCLUSION: Even though EON is not an unknown complication, new cases still occur and, unfortunately, with an irreversible course. Therefore, it is important to draw attention constantly to this complication and to consider it not only in ophthalmologists' surgeries.

• MeSH
• antituberkulotika škodlivé účinky   MeSH
• dospělí MeSH
• ethambutol škodlivé účinky   MeSH
• lidé MeSH
• nemoci zrakového nervu * chemicky indukované   diagnóza   patologie   MeSH
• nervus opticus diagnostické zobrazování   patologie   MeSH
• optická koherentní tomografie metody   MeSH
• tuberkulóza * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• kazuistiky MeSH

The present study aimed to determine how the vascular density (VD) in each segment peripapillary influences the retinal nerve fiber layer (RNFL) and to eliminate its contribution to RNFL in pathological intraocular pressure (IOP). In a cohort of 69 subjects (mean age, 45±6 years old) with untreated ocular hypertension (122 eyes in total) enrolled in this study, Ocular Response Analyser IOP was measured during routine outpatient care. Its value was >21 (range, 21-36) mmHg in all eyes. Furthermore, peripapillary VD and RNFL were measured using optical coherence tomography in the following eight segments: Inferior temporal (segment 1); temporal inferior (segment 2); temporal superior (segment 3); superior temporal (segment 4); superior nasal (segment 5); nasal superior (segment 6); nasal inferior (segment 7); and inferior nasal (segment 8). The visual field examination was performed with the fast threshold glaucoma program using the Medmont M 700. The overall defect was evaluated. Person's correlation coefficient was used to assess the correlation between VD and IOP. The largest changes were observed in peripapillary segments 1, 4, 5, 6, 7 and 8. The second part of the work was to eliminate the contribution of VD to RNFL. The partial correlation coefficient r was used to adjust RNFL from VD to assess the dependence between the selected parameters. The largest changes in RNFL were in segments 5 and 8 after they had been 'cleaned' of peripapillary VD. In conclusion, the present study revealed that the largest changes in RNFL after VD adjustment were observed for the incipient hypertensive glaucoma in segments 5 and 8.

• Publikační typ
• časopisecké články MeSH

The aim of this study was to determine whether the values of vessel density (VD) and perfusion parameters in the ophthalmic artery (OA) and central retinal artery (CRA) of the same eye differ in patients with hypertensive glaucoma (HTG) from patients with normotensive glaucoma (NTG). The first group consisted of 20 HTG patients (40 eyes). Patients with HTG were verified to have primary open-angle glaucoma (POAG). The second group consisted of 20 HTG patients (40 eyes). VD was used to determine the Avanti RTVue XR from Optovue (USA). Peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) were measured in both the central retinal artery (CRA) and ophthalmic artery (OA) using Doppler sonography on the Affinity 70G from Philips (USA). The visual field (VF) was examined by a fast threshold glaucoma program using a Medmont M700 (Australia). We showed no differences in VF, VD, PSV-OA and EDV-CRA between the two groups. Statistically significant differences between the two groups were observed in PSV in CRA (p = 0.04), EDV in OA (p = 0.009) and in RI in both CRA and OA. Other values were without significant differences in both groups. In both HTG and NTG, we observed in PSV-CRA, EDV-OA, RI-CRA and RI-OA.

• Publikační typ
• časopisecké články MeSH