AIM: To introduce the topic of pediatric keratoconus, highlighting the importance of routine corneal topography and tomography in children and adolescents from predisposed groups. To attempt to ensure the early detection of keratoconus and its subclinical form, enabling early treatment, which brings better expected postoperative results. Material and methods: Using the corneal tomograph Pentacam AXL we examined children and adolescents with astigmatism equal or greater than 2 diopters (in at least one eye) and patients with at least one risk factor such as eye rubbing in the case of allergic pathologies, positive family history of keratoconus or certain forms of retinal dystrophy. In total, we included 231 eyes (116 patients), of which 54 were girls and 62 were boys. RESULTS: The Belin-Ambrósio deviation index parameter was evaluated, in which we classified a total of 41 eyes as subclinical keratoconus and 12 eyes as clinical keratoconus. Next, the corneal maps were evaluated individually, in which we included a total of 15 eyes as subclinical keratoconus and 6 eyes as clinical keratoconus. In our group, compared to the control group, subclinical and clinical keratoconus occurred most often in the group of patients with astigmatism and in the group of so-called "eye rubbers". After individual evaluation, keratoconus occurred more frequently in boys than in girls in our cohort. CONCLUSION: Most patients with keratoconus are diagnosed when there is a deterioration of visual acuity and changes on the anterior surface of the cornea. Corneal topography and tomography allows us to monitor the initial changes on the posterior surface of the cornea, and helps us to detect the subclinical form of keratoconus and the possibility of its early treatment. Therefore, it is important to determine which groups are at risk and groups in which corneal topography and tomography should be performed routinely.

• Klíčová slova
• astigmatism, eye-rubbing, keratoconus, topography and tomography,
• MeSH
• astigmatismus * MeSH
• dítě MeSH
• keratokonus * diagnóza   MeSH
• lidé MeSH
• mladiství MeSH
• oftalmologie * MeSH
• pachymetrie rohovky MeSH
• rohovka patologie   MeSH
• rohovková topografie metody   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the efficacy of epithelium-on photorefractive intrastromal crosslinking (PiXL), a noninvasive procedure to reduce refractive error in patients with low hyperopia. SETTING: Gemini Eye Clinic, Zlin, Czech Republic. DESIGN: Prospective single-center study. METHODS: Twenty-two low hyperopic eyes were enrolled and underwent PiXL treatment according to a standardized treatment protocol. Visual acuity, subjective distance refraction, keratometry, topography, pachymetry, subjective discomfort, and endothelial cell density (ECD) were recorded during 12-month follow-up. RESULTS: In 22 eyes, the median manifest refraction decreased significantly (P < .0001) from +0.75 diopters (D) (interquartile range [IQR], +0.63 to +1.06 D), median and IQR) diopters (D) preoperatively to +0.25 D (IQR, 0.0 to +0.50 D) at 12-month follow-up and remained stable. Seventy-seven percent of eyes achieved refraction within ± 0.50 D of emmetropia by 1 month postoperatively and was stable through 12-month follow-up. ECD was stable and did not show significant changes. There was low incidence of postoperative pain and dry eye. CONCLUSIONS: PiXL is a promising alternative to conventional laser refractive surgeries for low hyperopia. Further studies are warranted to optimize treatment parameters for a wider range of refractive errors and to evaluate the potential to improve precision.

• MeSH
• fotochemoterapie metody   MeSH
• fotosenzibilizující látky terapeutické užití   MeSH
• hypermetropie farmakoterapie   metabolismus   patofyziologie   MeSH
• kolagen metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• pachymetrie rohovky MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• reagencia zkříženě vázaná * MeSH
• refrakce oka fyziologie   MeSH
• riboflavin terapeutické užití   MeSH
• senioři MeSH
• stroma rohovky účinky léků   metabolismus   MeSH
• ultrafialové záření MeSH
• výsledek terapie MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fotosenzibilizující látky MeSH
• kolagen MeSH
• reagencia zkříženě vázaná * MeSH
• riboflavin MeSH

The thesis deals with comparison of topographic corneal indexes and their importance for the diagnosis of corneal ectatic disease. The corneas with different stages of keratoconus, forme fruste keratoconus, pellucid marginal degeneration, corneal warpage syndrome, and physiological cornea with varying values of regular astigmatism were included in the tested group. The study was conducted in 2015-2018 at the European Eye Clinic Lexum Brno. The study group contained 208 eyes, 111 eyes with keratoconus, 31 eyes with forme fruste keratoconus, 23 eyes with pellucid marginal degeneration, 10 eyes with corneal warpage syndrome and 33 physiological eyes. 19 corneal parameters and indexes were monitored for these ectatic diseases, which were compared with healthy corneas with regular astigmatism. A single-factor ANOVA test, a Student t-test were used for statistical analysis. Pearson's coefficients were used to assess the correlation. In all the observed tomographic parameters a statistically significant difference was found between the physiological and ectatic group of corneas. The parameters with the highest statistical difference were BEThLo, ISV, IHD, D, Rmin. Statistically significant indices were also found between the forme fruste keratoconus and physiological corneas. The best parameters for detecting the subclinical keratoconus were the back elevation at the thinniest point of the cornea (BEThLo), the difference between the thinniest and the central point of cornea (CP-TL), the maximum pachymetic progression index and the Db and D indexes (p 0.6) according to Pearson's correlation coefficient. Statistically significant differences in the KK and PMD groups were found in the index of relative pachymetry, central pachymetry, CKI and Dp. Key words: Pentacam, corneal ectasia, keratoconus, pellucid marginal degeneration, corneal warpage syndrome, forme fruste keratoconus.

• Klíčová slova
• Pentacam, corneal ectasia, corneal warpage syndrome, forme fruste keratoconus, keratoconus, pellucid marginal degeneration,
• MeSH
• časná diagnóza MeSH
• dilatace patologická MeSH
• keratokonus * diagnóza   MeSH
• lidé MeSH
• pachymetrie rohovky MeSH
• ROC křivka MeSH
• rohovka * MeSH
• rohovková topografie * MeSH
• tomografie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the effect of accelerated corneal crosslinking (CXL) with a "higher peripheral intensity" profile setting compared with a standard "top hat" profile setting performed using different CXL systems. SETTING: Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany. DESIGN: Retrospective case series. METHODS: Eyes from patients with progressive keratoconus were included. Group 1 included eyes treated with the higher peripheral intensity profile. Group 2 included eyes treated with the top hat profile. Accelerated CXL was performed based on the modified Dresden protocol (9 mW/cm2, 10 minutes). Corneal-topography and tomography are characterized using the Pentacam Scheimpflug system. RESULTS: The study comprised 45 eyes (25 eyes in Group 1, 20 eyes in Group 2) from 45 patients. The keratometry (K) at the apex (maximum K) decreased significantly from 54.95 diopters (D) ± 6.73 (SD) to 53.21 ± 6.05 D for Group 1 (P < .001) and from 57.29 ± 7.16 D to 56.48 ± 6.88 D for Group 2 (P = .01). In Group 1, flat K (K1) and steep K (K2) decreased significantly after treatment (P < .05). The thinnest corneal thickness decreased significantly by -17.5 ± 21.9 μm (P = .001) in Group 1. In Group 2, no significant flattening was observed in K1 and K2 (P > .05), and the thinnest corneal thickness showed a slight but not significant thinning (P = .097). CONCLUSIONS: In Group 1 (the higher peripheral intensity group), the corneal topographic and tomographic parameters improved significantly after accelerated CXL. The higher peripheral intensity profile effect on keratoconic cornea flattening seemed to be more pronounced compared with the top hat profile.

• MeSH
• časové faktory MeSH
• dospělí MeSH
• fotochemoterapie metody   MeSH
• fotosenzibilizující látky terapeutické užití   MeSH
• keratokonus diagnóza   farmakoterapie   MeSH
• kolagen terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• pachymetrie rohovky metody   MeSH
• reagencia zkříženě vázaná terapeutické užití   MeSH
• retrospektivní studie MeSH
• riboflavin terapeutické užití   MeSH
• rohovka patologie   MeSH
• rohovková topografie metody   MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fotosenzibilizující látky MeSH
• kolagen MeSH
• reagencia zkříženě vázaná MeSH
• riboflavin MeSH

The aim of this study was to examine whether mesenchymal stem cells (MSCs) and/or corneal limbal epithelial stem cells (LSCs) influence restoration of an antioxidant protective mechanism in the corneal epithelium and renewal of corneal optical properties changed after alkali burns. The injured rabbit corneas (with 0.25 N NaOH) were untreated or treated with nanofiber scaffolds free of stem cells, with nanofiber scaffolds seeded with bone marrow MSCs (BM-MSCs), with adipose tissue MSCs (Ad-MSCs), or with LSCs. On day 15 following the injury, after BM-MSCs or LSCs nanofiber treatment (less after Ad-MSCs treatment) the expression of antioxidant enzymes was restored in the regenerated corneal epithelium and the expressions of matrix metalloproteinase 9 (MMP9), inducible nitric oxide synthase (iNOS), α-smooth muscle actin (α-SMA), transforming growth factor-β1 (TGF-β1), and vascular endothelial factor (VEGF) were low. The central corneal thickness (taken as an index of corneal hydration) increased after the injury and returned to levels before the injury. In injured untreated corneas the epithelium was absent and numerous cells revealed the expressions of iNOS, MMP9, α-SMA, TGF-β1, and VEGF. In conclusion, stem cell treatment accelerated regeneration of the corneal epithelium, restored the antioxidant protective mechanism, and renewed corneal optical properties.

• MeSH
• alkálie MeSH
• antioxidancia terapeutické užití   MeSH
• buněčná diferenciace účinky léků   MeSH
• chemické popálení enzymologie   genetika   patologie   terapie   MeSH
• imunohistochemie MeSH
• králíci MeSH
• limbus corneae cytologie   MeSH
• matrixová metaloproteinasa 9 metabolismus   MeSH
• mezenchymální kmenové buňky cytologie   účinky léků   MeSH
• ochranné látky farmakologie   terapeutické užití   MeSH
• pachymetrie rohovky MeSH
• regulace genové exprese účinky léků   MeSH
• rohovkový epitel patologie   MeSH
• superoxiddismutasa metabolismus   MeSH
• synthasa oxidu dusnatého, typ II metabolismus   MeSH
• transformující růstový faktor beta genetika   metabolismus   MeSH
• transplantace mezenchymálních kmenových buněk * MeSH
• tukové buňky cytologie   účinky léků   MeSH
• vaskulární endoteliální růstový faktor A metabolismus   MeSH
• zákal rohovky komplikace   terapie   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• publikace stažené z tisku MeSH
• Názvy látek
• alkálie MeSH
• antioxidancia MeSH
• matrixová metaloproteinasa 9 MeSH
• ochranné látky MeSH
• superoxiddismutasa MeSH
• synthasa oxidu dusnatého, typ II MeSH
• transformující růstový faktor beta MeSH
• vaskulární endoteliální růstový faktor A MeSH

BACKGROUND/AIMS: To identify the underlying molecular genetic cause of disease in a patient with Harboyan syndrome and to perform a detailed assessment of her renal function. We also assessed the influence of the SLC4A11 mutation identified on the corneal endothelium in the heterozygous state. METHODS: A 55-year-old female was examined ophthalmologically, audiologically and nephrologically including 24-hour urine collection. The coding region of SLC4A11 was directly sequenced. Specular microscopy was performed in the proband's 21-year-old daughter. RESULTS: The proband had bilateral iridectomy at the age of 3 months because of an initial diagnosis of congenital glaucoma and since the age of 12 years she underwent several keratoplasties in each eye. Nephrological examination did not reveal any abnormalities. Moderate bilateral sensorineural hearing loss was confirmed by audiometry. A novel homozygous mutation predicted to lead to a premature stop codon at the protein level, c.2188C>T; p.(Arg730*), was identified in SLC4A11. No changes in corneal endothelial cell morphology or density were observed in the heterozygous daughter. CONCLUSION: In contrast to the Slc4a11(-/-) mouse, no abnormalities in daily renal ion excretion or polyuria were observed in the Harboyan syndrome patient. The mutation identified does not affect corneal endothelial cell morphology or density in the heterozygous state.

• MeSH
• antiportéry genetika   MeSH
• audiometrie MeSH
• dědičné dystrofie rohovky diagnóza   genetika   patofyziologie   MeSH
• jaterní testy MeSH
• ledviny fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mutační analýza DNA MeSH
• nesmyslný kodon * MeSH
• pachymetrie rohovky MeSH
• percepční nedoslýchavost diagnóza   genetika   patofyziologie   MeSH
• polymerázová řetězová reakce MeSH
• proteiny přenášející anionty genetika   MeSH
• rohovkový endotel patologie   MeSH
• vyšetření funkce ledvin MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antiportéry MeSH
• nesmyslný kodon * MeSH
• proteiny přenášející anionty MeSH
• SLC4A11 protein, human MeSH Prohlížeč

PURPOSE: To evaluate obtained data by using a relatively novel devices and their results which are important eg. in refractive and cataract surgery. MATERIAL AND METHODS: The study included 66 eyes (n = 66). Subjects were represented by 32 women and 1 man whose age was 22.5 years ± 1.2 years (min. 21, max. 26 years) without any signs of potential eye disease. Duration of the study was 3 months. Results were compared with the measurements using the auto-refract-keratro-tono-pachymeter (TRK 1P, Topcon, Japan), Keratograph 5M (Oculus, Germany) and aberrometer iTRACE (Hoya, Japan). RESULTS: After 3 months were statistically compared keratometry values of ​​ corneal anterior surface detected by all devices. They provided to be comparable. Furthermore the values ​​of objective refraction and pachymetry were detected. CONCLUSION: Results of this study show a statistically significant correlation values ​​of objective refraction using devices TRK and iTRACE (r = 0.66 at p = 0.05) and showed a significant relationship between the keratometric data for all the devices. All used methods and devices are possible to reliably and use for valid evaluation parameters of the eye. KEY WORDS: aberrometry, low and high orders abberations, keratometry, topography, pachymetry.

• MeSH
• aberometrie přístrojové vybavení   MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• pachymetrie rohovky MeSH
• refrakce oka fyziologie   MeSH
• rohovka fyziologie   MeSH
• rohovková topografie MeSH
• zrakové testy MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVE: The objective of the study was to assessment of changes of monitored parameters after CXL. Incidence of complications were assessed in the whole group and in groups of patients divided according to the selected criteria. Evaluated parameters were also relations between them and in time. METHODS: The 86 eyes of patients with progressive keratoconus who underwent CXL according to the Dresden protocol in the years 2007-2009 at the Ophthalmic clinic FN Brno Bohunice were included in this study. RESULTS: There was observed significant increase of BCVA (letters--before CXL 42,30±10,35, 1st year after CXL (1Y) 44,68±10,04, p<0,01, 2nd year after CXL (2Y) 44,44±10,57, p<0,01) and SE (-5,95±3,98D, -5,27±3,84D, p<0,01, -4,94±3,68D, p<0,01), and decrease of maximum curvature of the cornea (MAX--before CXL 50,39±4,17D, 1Y 49,46±4,13D, p<0,01, 2Y 49,42±4,14D, p<0,01). Change of ultrasound CCT, polymegatisms, pleomorfisms and corneal endothelial cell density was not significant. The value of MAX is the most important parameter in estimating the effect of CXL. The highest incidence of corneal opacity after CXL was observed in the eyes of patients with III. stage of keratoconus over 40 years old, carrying hard contact lenses and with biomikroskopic symptom of keratoconus on the cornea. We found that corneal thickness measurement with Orbscan II and the mesurement of IOP with noncontact method is incorrect by patients after CXL. CONCLUSION: Corneal cross-linking of the cornea is safe and effective procedure of stopping the progression of keratoconus in 97% of eyes in the period up to 2 years after CXL.

• MeSH
• časové faktory MeSH
• dospělí MeSH
• fotochemoterapie metody   MeSH
• fotosenzibilizující látky terapeutické užití   MeSH
• keratokonus diagnóza   farmakoterapie   MeSH
• kolagen * MeSH
• lidé MeSH
• následné studie MeSH
• pachymetrie rohovky MeSH
• progrese nemoci MeSH
• prospektivní studie MeSH
• reagencia zkříženě vázaná terapeutické užití   MeSH
• výsledek terapie MeSH
• zraková ostrost účinky léků   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• fotosenzibilizující látky MeSH
• kolagen * MeSH
• reagencia zkříženě vázaná MeSH

PURPOSE: To identify the molecular genetic cause of macular corneal dystrophy (MCD) in four probands, and characterize phenotypic similarities between MCD and keratoconus. METHODS: We performed ophthalmological examination, Scheimpflug imaging (Pentacam, Oculus Inc.), histopathological examination of excised corneal buttons, and direct sequencing of the CHST6 coding region. RESULTS: Pentacam measurements were taken in six eyes of three probands. All showed diffuse corneal thinning with paracentral steepening of the anterior corneal surface that was graded as keratoconus by the integrated software, but without associated ectasia of the posterior corneal surface or regional thinning. Homozygous or compound heterozygous CHST6 mutations were identified in all cases, including two novel mutations, c.13C>T; p.(Arg5Cys) and c.289C>T; p.(Arg97Cys). DISCUSSION: Localized elevation of the anterior corneal curvature can occur in MCD in the absence of other features of keratoconus. The identification of a further two Czech probands with the compound allele c.[484C>G; 599T>G] supports the enrichment of this allele in the study population.

• MeSH
• dědičné dystrofie rohovky genetika   patologie   MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mutace * MeSH
• pachymetrie rohovky MeSH
• rohovka patologie   MeSH
• rohovková topografie MeSH
• sulfotransferasy sacharidů MeSH
• sulfotransferasy genetika   MeSH
• velikost orgánu MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• sulfotransferasy MeSH

Solar UVB radiation evokes photokeratitis, accompanied by increased corneal hydration and changes in corneal transparency, resulting in increased light absorption. Corneal optical properties are disturbed and visual acuity decreased. The aim of this study was to investigate the reversibility of these UVB-induced changes. Rabbit corneas were irradiated with UVB doses of 0.5 J cm(-2) or 1.01 J cm(-2) during 4 days. Some rabbits were sacrificed after the last irradiation and some 2 months later. Corneas were investigated spectrophotometrically for light absorption, and corneal hydration was evaluated by central corneal thickness with an ultrasonic pachymeter. Corneal impression cytologies were examined immunohistochemically for proinflammatory cytokines and malondialdehyde. The increased corneal light absorption, hydration and the staining of immunohistochemical markers found in corneas after irradiation returned to normal values during 2 months in corneas irradiated with the lower UVB dose. In contrast, in corneas irradiated with the higher UVB dose, a moderate but statistically significant increase in corneal light absorption, hydration and positive immunohistochemical stainings remained as residual changes. This was in contrast to normal corneas, where the staining of proinflammatory cytokines as well as malondialdehyde was negative. In conclusion, the reversibility of UVB-induced disturbances was dependent on UVB dose.

• MeSH
• cytokiny biosyntéza   MeSH
• dávka záření MeSH
• experimentální radiační poranění * MeSH
• keratitida etiologie   metabolismus   patologie   MeSH
• králíci MeSH
• malondialdehyd metabolismus   MeSH
• obnova funkce fyziologie   účinky záření   MeSH
• oxidační stres MeSH
• pachymetrie rohovky MeSH
• peroxidace lipidů MeSH
• poranění rohovky * MeSH
• rohovka metabolismus   MeSH
• ultrafialové záření škodlivé účinky   MeSH
• voda metabolismus   MeSH
• vztah dávky záření a odpovědi MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• cytokiny MeSH
• malondialdehyd MeSH
• voda MeSH