AIM: To report the clinical results of treatment of patients with retinal tears or holes, including rhegmatogenous retinal detachment, who were treated primarily with laser retinopexy. MATERIAL AND METHODS: The effect and results of the therapy of patients with one or more retinal tears who underwent therapy with the green laser IQ 532 IRIDEX between December 2019 and August 2022 at our center with a follow-up observation period of at least 3 months were retrospectively evaluated. RESULTS: A total of 14 eyes of 14 patients were treated by this method during the monitored period. All the tears found were primarily successfully repaired. The overall success rate of prophylaxis of rhegmatogenous retinal detachment was 93% in our cohort. In one patient, subsequent pars plana vitrectomy was required due to the progression of retinal detachment from another biomicroscopically inaccessible hole, which was part of lattice degeneration in the peripheral part of the retina. This pathology was only verified during intraocular surgery. Postoperatively, the retina was attached with a very good anatomical and functional effect. The other patients did not require any adjuvant therapy. Visual functions improved or remained stable in all patients in the cohort. The follow-up observation period ranged from 3 to 36 months. CONCLUSION: Laser retinopexy is a sparing, safe and effective method of retinal tear therapy. From our clinical experience, the technique is also applicable in the case of partial vitreous hemorrhage or incipient rhegmatogenous detachment. We did not record any complications of perioperative or postoperative treatment among our patients.
- Klíčová slova
- IRIDEX, Retinal detachment, hemovitreus, laser, photocoagulation, retinal tear,
- MeSH
- laserová terapie * škodlivé účinky MeSH
- lidé MeSH
- odchlípení sítnice * chirurgie etiologie MeSH
- perforace sítnice * chirurgie MeSH
- retina chirurgie MeSH
- retrospektivní studie MeSH
- vitrektomie škodlivé účinky metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
AIM: To report the clinical results of chelation of band keratopathy in long-term follow-up. MATERIAL AND METHODS: The long-term results of 5 patients (5 eyes) with symptomatic band keratopathy with a follow-up period of at least 6 months, in whom 2% EDTA was chelated on the affected eye in the study period from April 2018 to March 2021, were retrospectively evaluated. The follow-up period was 9-37 months. RESULTS: In all patients, there was a significant improvement in the local findings and an increase in the transparency of the cornea. The effect of therapy was verified on a color photograph of the anterior segment and on AS-OCT by the disappearance of subepithelial hyperreflective foci and accompanying optical shadows. Postoperatively, this enabled a more detailed visualization of the deeper layers of the cornea and other structures of the anterior segment. In a patient with the potential to improve vision, it was also possible to significantly improve visual functions. In the other three patients with pain in the affected eye, the pain subsided, and they also benefited cosmetically from the operation. CONCLUSION: Based on our experience and previously published reports, EDTA corneal chelation is able to causally resolve the pathology and improve vision in eyes with visual potential. At the same time, it reduces discomfort and has an analgesic effect in long-term irritated eyes. The operation is also suitable for amaurotic, cosmetically unsightly bulbs, as a successful intervention preserving the eye and improving the appearance of such eyes leads to satisfaction and a subjective increase in the quality of life of the patients.
- Klíčová slova
- EDTA, OCT, anterior segment optical coherence tomography, band keratopathy, chelation, ethylenediaminetetraacetic acid, surgical treatment,
- MeSH
- analgetika terapeutické užití MeSH
- bolest farmakoterapie patologie MeSH
- dědičné dystrofie rohovky MeSH
- EDTA terapeutické užití MeSH
- kvalita života * MeSH
- lidé MeSH
- retrospektivní studie MeSH
- rohovka * patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- analgetika MeSH
- EDTA MeSH
PURPOSE: Evaluation of the incidence of pseudoexfoliation (PEX) syndrome and glaucoma in cataract patients operated at our Clinic, with an analysis of possible complications. METHODOLOGY: Retrospective evaluation of medical records of PEX syndrome patients who have undergone cataract surgery at the Gemini Eye Clinic Ostrava-Hrusov was undertaken. The study period was from November 2016 to April 2021. The evaluated parameters were the incidence of PEX syndrome, age and gender of patients, intraocular pressure (IOP) before the surgery, pre-existing therapy of previously diagnosed secondary glaucoma and the occurrence of perioperative complications. RESULTS: In the study period of 4.5 years, out of the total number of 14 167 operated eyes with cataracts there were 852 eyes of 689 patients with PEX syndrome diagnosed at our Clinic, i.e. 6.0 %. The mean age was 76.9 years, the median 77 years, range 54-100 years. The observed pathology was more common in women at a ratio of 1.84: 1 (552: 300). Elevation of IOP above 21 mmHg was recorded in 118 eyes, in 14 of them IOP reached values over 30 mmHg. Diagnosed and long-term treated secondary glaucoma was confirmed by 153 patients (204 eyes), out of which 22 eyes have undergone antiglaucoma laser (19 eyes) and / or surgery (5 eyes) in the anamnesis. Perioperatively, we recorded the following pathological findings accompanying the occurrence of PEX syndrome in 231 eyes. Most often it was poor artificial mydriasis (189 eyes), then subluxation of the lens (31 eyes) or zonular fragility (17 eyes). To reduce the risk of perioperative and postoperative complications, implantation of a capsular tension ring was indicated in 20 eyes. Complications during the procedure occurred in 11 eyes, of which 8 eyes were diagnosed with advanced cataract. CONCLUSION: PEX syndrome and glaucoma are relatively common diseases that can complicate the lives of patients and eye surgeons. The incidence of PEX syndrome in our cataract patients was 6 %. Proper diagnosis of this disease is important not only for the possible occurrence of numerous complications during and after cataract surgery, but also for the possible presence of secondary glaucoma. It also serves to detect possible involvement of the contralateral eye. In addition, due to the involvement of practically all tissues in the body, the patient is endangered by numerous, especially vascular comorbidities. For these reasons, we find it appropriate that these patients are observed by other healthcare specialists. In our experience, early indication of cataract surgery is important to achieve a lower degree of zonular fragility and a softer lens core. In addition, lower levels of proinflammatory pseudoexfoliation material occur in the anterior segment of the eye in the early stages, which may have a beneficial effect on the postoperative healing.
- Klíčová slova
- Phacoemulsification, cataract, complications, plasmapheresis, pseudoexfoliation glaucoma, pseudoexfoliation syndrome, secondary glaucoma,
- MeSH
- exfoliativní oční syndrom * komplikace diagnóza epidemiologie MeSH
- glaukom * komplikace epidemiologie MeSH
- incidence MeSH
- katarakta * komplikace epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Describe the clinical finding and course of treatment in patients with a sudden decrease in visual function due to an acute occlusion of the arteria centralis retinae. Patients were primarily indicated for selective angiography with thrombolysis of the ophthalmic artery. MATERIALS AND METHODS: Medical documentation of two patients with acute central retinal artery occlusion with a time duration of up to 5 hours was evaluated retrospectively. The diagnosis of central retinal artery occlusion was determined on the basis of a detailed ophthalmological examination in arteficial mydriasis. The initial best-corrected visual acuity (BCVA) were hand movement in front of the eye with uncertain light projection in first patient and no light perception in the second patient. In both cases a relative afferent pupillary defect of the 4th degree was present with the onset of the ischemic macular edema and an incipient development of the cherry red spot. After evaluation of the overall condition, laboratory findings, exclusion of cancer and surgery in the last three months, a selective angiography of ophthalmic artery and thrombolysis in collaboration with the intervention radiologist were performed. Results: First patient with a better initial visual acuity, selective angiography demonstrated a decrease in flow in the central retinal artery with subsequent improvement in haemodynamic ratios after application of 12 ml of recombinant tissue plasminogen activator (Alteplase). The BCVA improved to 1/ 60 after interventional procedure. We did not experience any serious treatment side effects during or after intervention. In the second patient, selective angiography of the intracranial arteries and internal carotids revealed the presence of an aneurysm before the ophthalmic artery. Due to the normal flow of the contralateral carotid and the filling of the intracranial vessels on the affected side via the circle of Willis, the internal carotid ligation was performed under the aneurysm. Three months after the surgery BCVA was no light perception and patient had no neurological symptomatology. CONCLUSION: Selective angiography in combination with thrombolysis appears to be a useful imaging as well as therapeutic method for acute central retinal artery occlusion. This technique allows not only to confirm the diagnosis but it can also solve problem causally and improve the visual acuity of the affected person. Sometimes it also helps to clear the cause of the closure and prevent next potential embolization into the intracranial space and possible fatal consequences of CNS involvement or even death.
- Klíčová slova
- CRAO, Selective angiography, aneurysm of the internal carotid artery, central retinal artery occlusion, recombinant tissue plasminogen activator, thrombolysis,
- MeSH
- angiografie * MeSH
- lidé MeSH
- okluze retinální arterie * diagnostické zobrazování farmakoterapie MeSH
- retrospektivní studie MeSH
- tkáňový aktivátor plazminogenu * MeSH
- trombolytická terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- tkáňový aktivátor plazminogenu * MeSH
AIM: To describe clinical findings in patients with sudden decrease of visual functions according to the solar maculopathy appearance after watching the partial solar eclipse and results of the changes follow-up after 7 weeks. MATERIAL AND METHODS: Medical records of five women (6 eyes) with solar maculopathy associated with watching partial solar eclipse on March 20th, 2015 were retrospectively evaluated. The diagnosis of solar maculopathy was established according to the medical history, ophthalmologic examination of the fundus in artificial mydriasis, and confirmed by means of spectral domain optic coherence tomography examination of the macula. The follow-up period of the patients in the study group was 7 weeks. RESULTS: All patients described the presence of relative central scotoma and decrease of the central visual acuity (VA) of different extension in the involved eye. The average best-corrected visual acuity (BCVA) of women in our group was 6/9 (range, 6/6 partially - 6/18). In one patient, the involvement was bilateral, in the other cases the involvement was unilateral. The biomicroscopic examination of the fundus revealed yellowish to yellow-whitish lesions with brightness of the pigment layer in the center of the foveola in all patients. The optic coherence tomography examination of the macula confirmed the irregularities of the retinal pigment layer and photoreceptors outer segment with hyper-reflective focus of the neuroretina in the center of the foveola. CONCLUSION: During the follow-up period, we recorded improvement of the central visual acuity in all women with unilateral involvement. In the woman with bilateral retinal involvement, the best-corrected visual acuity of the right eye remains without any improvement. The optic coherence tomography examination after 7 weeks shows regression of the findings in three eyes. In all other cases, slight structural changes in the center of the macula persist.
- MeSH
- dospělí MeSH
- fluoresceinová angiografie MeSH
- fundus oculi MeSH
- lidé MeSH
- macula lutea patologie účinky záření MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci retiny diagnóza etiologie MeSH
- optická koherentní tomografie MeSH
- popálení oka komplikace diagnóza MeSH
- retrospektivní studie MeSH
- sluneční záření škodlivé účinky MeSH
- zraková ostrost * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
We present a rare case of combined fungal infection in a critically ill 47 year-old patient with chronic hepatitis C at the stage of liver cirrhosis. The patient was admitted for signs of decompensated cirrhosis caused by hepatitis C and increased alcohol consumption. After 2 week hospital stay, his condition was complicated by a pulmonary infiltrate and rapid deterioration followed. Despite intensive care, the patient died. Autopsy findings showed invasive pulmonary aspergillosis. The aim of this case report is to point to a broad differential diagnosis of jaundice and pulmonary infiltrates, thus stressing the value of interdisciplinary cooperation and the need to consider the possibility of invasive fungal infections when caring for liver cirrhosis patients. In addition, several risk factors contributing to the development of fungal diseases in these patients are discussed in the article.
- MeSH
- alkoholická cirhóza jater komplikace MeSH
- chronická hepatitida C komplikace MeSH
- invazivní plicní aspergilóza komplikace MeSH
- kandidóza komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci jícnu komplikace MeSH
- oportunní infekce komplikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: The study objective was to evaluate epidemiological aspects in patients with hepatitis C treated at the Clinic of Infectology and Travel Medicine in Kosice. MATERIAL AND METHODS: A retrospective analysis was performed of 232 patients (132 males and 100 females, mean age 43.8 years) followed up and treated with the diagnosis of hepatitis C (HC) in 2003 through 2007. RESULTS: The probable sources of infection were most often blood transfusion (in 31% of patients), injecting drug use (9%) and invasive medical procedures (6%). Tattooing and piercing procedures were a potential route of infection in 4% of HC cases, while other risk factors were less common. None of the HC risk factors was identified in 41% of HC patients. HCV genotype was determined in 198 patients. HCV genotype 1 was detected in nearly 90% of the tested HC patients, HCV genotype 3 in 36.6%, HCV genotype 2 in 3 patients and HCV genotypes 4 and 6 in one patient each. Two HC cases were coinfections with HCV genotypes 1 and 3 or 1 and 4. The mean time interval from the first detection of elevated aminotransferase activity to the diagnosis and therapy institution was 6.3 years. CONCLUSION: The most common source of infection was blood transfusion, followed by injecting drug use and surgery. The prevailing HCV genotype is 1. In the future, it would be necessary to reduce the time interval from the detection of liver damage to the etiological diagnosis of HC, which has been too long.
- MeSH
- dospělí MeSH
- Hepacivirus klasifikace genetika MeSH
- hepatitida C epidemiologie přenos virologie MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
OBJECTIVE: To assess the prevalence of hepatitis C in the general Slovak population without any further evaluation or risk group stratification. MATERIAL AND METHODS: A total of 3,608 remnant serum specimens from epidemiological surveys in 1997 (1,484 specimens) and 2002 (2,124) were analyzed. These were from randomly selected persons over 15 years of age from all over Slovakia. The anti-HCV antibodies were detected using the 4th generation ELISA test. In case of positive or borderline results, the presence of HCV RNA was determined qualitatively. RESULTS: Of the 3,608 analyzed specimens, 55 (1.52 %) were anti-HCV-positive and 10 (0.28 %) were borderline positive. HCV RNA was detected in 24 cases (0.67 %). A comparison of the 1997 and 2002 results showed a statistically significant (p < 0.01) increase of anti-HCV-positive specimens. A similar--but not significant--increase was noted in HCV RNA-positive cases. Despite a slightly higher prevalence of HCV infection in females, no statistically significant gender differences were found. Whereas anti-HCV positivity increased slightly with age, most HCV RNA patients were from the middle age group, i.e. between 36 and 45 years of age. The geographic distribution of HCV cases across Slovakia was relatively even. CONCLUSIONS: The prevalence of anti-HCV antibodies in subjects representing the general population of Slovakia older than 15 years was 1.52 %; chronic HCV infection was confirmed in 0.67 % of cases.
- MeSH
- dospělí MeSH
- Hepacivirus izolace a purifikace MeSH
- hepatitida C - protilátky krev MeSH
- hepatitida C epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- prevalence MeSH
- RNA virová analýza MeSH
- senioři MeSH
- séroepidemiologické studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
- Názvy látek
- hepatitida C - protilátky MeSH
- RNA virová MeSH
Sera of 426 adult persons were examined to assess the prevalence of SEN virus (SENV) infection in Slovakia and to determine the importance of different risk factors for parenteral transmission. SENV prevalence was determined by the PCR method using primers of SENV-D and SENV-H strains. Positive results were found in 10 of 37 patients with acute hepatitis of unknown etiology, 7 of 38 with acute hepatitis B, 17 of 44 with chronic hepatitis B, 29 of 102 with chronic hepatitis C, 36 of 72 hemodialysis patients, 2 of 33 health care workers and 24 of 100 persons from the control group. The highest prevalence of SENV was among hemodialysis patients, significantly higher than in the groups of health care workers, acute hepatitis B and controls. The lowest prevalence was in health care workers group, significantly lower also in comparison with groups of chronic hepatitis B and C. Among the possible risk factors of virus transmission the average duration of hemodialysis (1.15 vs. 0.50 years), number of surgeries (1.60 vs. 1.10) and transfusions (1.34 vs. 0.94) showed notable differences in terms of SENV infection. Bilirubin and aminotransferase levels did not differ between SENV-positive and -negative groups. No pathogenetic role of SEN virus in liver injury was confirmed.
- MeSH
- chirurgie operační škodlivé účinky MeSH
- dialýza ledvin škodlivé účinky MeSH
- DNA virů analýza MeSH
- dospělí MeSH
- infekce DNA virem epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci jater epidemiologie virologie MeSH
- neparametrická statistika MeSH
- polymerázová řetězová reakce MeSH
- potransfuzní reakce MeSH
- rizikové faktory MeSH
- senioři MeSH
- Torque teno virus * genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
- Názvy látek
- DNA virů MeSH
Anticoagulant treatment with coumarins is due to it unequivocal benefit and relatively low risk increasingly used for prevention of sudden cerebrovascular attacks, in atrial fibrillation, in the treatment of thromboembolic disease, as part of treatment after replacement of cardiac valves and other diseases. With the increasing number of indications and patients treated with oral anticoagulants the number of haemorrhagic complications is increasing. The submitted case-history demonstrates an uncommon haemorrhagic complication, retroperitoneal haematoma associated with a neurological symptomatology in a 59-year-old patient who had prolonged anticoagulant treatment with monocoumarin with permanent non-rheumatic atrial fibrillation, a history of an anteroseptal myocardial infarction with an aneurysm and apical thrombus, polycythemia and chronic venous insufficiency. In addition to anamnestic data and the clinical picture the final establishment of the diagnosis was significantly assisted by ultrasonography and CT.
- MeSH
- antikoagulancia škodlivé účinky terapeutické užití MeSH
- bérec inervace MeSH
- cerebrovaskulární poruchy prevence a kontrola MeSH
- fibrilace síní komplikace MeSH
- hematom chemicky indukované komplikace MeSH
- infarkt myokardu komplikace MeSH
- krvácení chemicky indukované MeSH
- kumariny škodlivé účinky terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- retroperitoneální prostor * MeSH
- rizikové faktory MeSH
- úžinové syndromy etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antikoagulancia MeSH
- coumarin MeSH Prohlížeč
- kumariny MeSH