AIMS: To investigate the efficacy and safety of intravitreal Dexamethasone implant (DEX-I) therapy in the treatment of diabetic macular edema (DME) refractory to intravitreal bevacizumab (IVB). MATERIAL AND METHODS: This retrospective and cross-sectional study included 37 eyes of 37 patients who received 3 loading doses of IVB injections for DME with no response and underwent DEX-I implant. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurements and central foveal thickness (CFT) measured by spectral domain optical coherence tomography (SD-OCT) were recorded and compared before DEX-I, at the first week, first, second, third and sixth months. Duration of DME, glycated hemoglobin (HbA1c) levels, DME types and lens status (phakic, pseudophakic) were also recorded. RESULTS: The mean age of the patients was 61.14 ±8.69 years (59.5% male, 40.5% female). 35.1% of the patients had cystoid macular edema, 64.9% had diffuse macular edema and 73 % were phakic and 27% were pseudophakic. BCVA, CFT and IOP values before DEX-I injection were 0.78 ±0.16 LogMAR, 493.73 ±107.6 µm and 13.05 ±2.59 mmHg, respectively. At 6 months after DEX-I, BCVA, CFT and IOP values were 0.64 ±0.11 LogMAR, 397.35 ±59.72 µm and 16.3 ±2.51 mmHg, respectively. In all follow-ups, there was a significant improvement in BCVA, a significant decrease in CFT and a significant increase in IOP compared to pre-injection. Ocular hypertension was observed in 0.8 % of patients and progression of cataract progression in 1% of patients after treatment. CONCLUSION: DEX-I therapy is an effective and safe treatment option for DME refractory to IVB treatment.

• Klíčová slova
• Dexamethasone implant, bevacizumab, cataract, diabetic macular edema, intraocular pressure,
• MeSH
• bevacizumab aplikace a dávkování   škodlivé účinky   MeSH
• dexamethason * aplikace a dávkování   škodlivé účinky   MeSH
• diabetická retinopatie * farmakoterapie   MeSH
• glukokortikoidy aplikace a dávkování   škodlivé účinky   MeSH
• injekce intravitreální * MeSH
• léky implantované * MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém * farmakoterapie   etiologie   diagnostické zobrazování   MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• bevacizumab MeSH
• dexamethason * MeSH
• glukokortikoidy MeSH
• léky implantované * MeSH

AIMS: This scoping review was conducted to investigate whether nocturnal eye compression from inappropriate sleeping postures may contribute to the development or asymmetry of keratoconus (KC), by examining the association between sleeping positions and KC. MATERIAL AND METHODS: A systematic search of CENTRAL, MEDLINE, EMBASE, LILACS, ClinicalTrials.gov, gray literature, and selected journals from inception to January 18, 2023, was undertaken. RESULTS: Ten studies involving 2 322 participants met inclusion criteria. These studies were categorized into analytical and non-analytical designs to evaluate the relationship between prone, lateral, or supine sleeping positions and KC presence or asymmetry. Among the included studies, 50% were non-analytical, all indicating a correlation between KC parameters and nocturnal eye compression. In contrast, a statistically significant association between sleeping positions and KC risk was reported in 3 out of 5 analytical studies (60%). CONCLUSION: Findings suggest a possible link between prone or lateral sleeping positions and KC development or asymmetry, implying that these positions may increase corneal biomechanical stress during sleep. However, the association was confirmed in only 60% of analytical studies. The review highlights the necessity for additional research to validate these findings and to explore potential causal mechanisms between sleeping positions and KC.

• Klíčová slova
• Cornea, asymmetric keratoconus, keratoconus, sleep, sleeping behavior,
• MeSH
• autologní transplantace MeSH
• keratokonus * chirurgie   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pterygium * chirurgie   MeSH
• retrospektivní studie MeSH
• spánek MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• přehledy MeSH

AIM: This research was conducted to determine the normal values of choroidal thickness in healthy individuals and to evaluate the relationship between this thickness and age, gender, refraction, axial length and average macular thickness using OCT. MATERIAL AND METHOD: In the study, the right eyes of 400 healthy individuals (234 women, 166 men) between the ages of 4 and 70 years, who applied to the Department of Ophthalmology outpatient clinic for examination, were evaluated. RESULTS: Macular thickness, macular volume, and foveal thickness were found to be 249.12 ±21.32 µm, 9.98 ±0.5 µm3 and 280 ±13.45 µm, respectively. According to linear regression analysis, a negative correlation was detected between age and subfoveal choroidal thickness (p < 0.05). It was determined that foveal thickness, retinal volume and average retinal thickness were higher in men, and foveal thickness increased with age (p < 0.05). CONCLUSION: As a result of the research, it was determined that age is an important factor affecting choroidal thickness. It is thought that, in future, improving in vivo imaging of the choroid and measuring choroidal thickness using OCT will facilitate understanding of the pathophysiological basis of many ophthalmological diseases.

• Klíčová slova
• Cirrus HD-OCT, choroidal thickness, central macular thickness, age,
• MeSH
• choroidea * diagnostické zobrazování   anatomie a histologie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• macula lutea * diagnostické zobrazování   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• optická koherentní tomografie * MeSH
• předškolní dítě MeSH
• referenční hodnoty MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

A corneal stromal lenticule (CSL) is a part of the corneal stroma that forms as a waste product during the refractive surgery ReLEx SMILE (Small Incision Lenticule Extraction) and is no longer used. With the increasing number of ReLEx SMILE procedures and the number of potentially available CSLs, two main aspects of their usage are currently being investigated. The first aspect includes the biological properties of CSLs and their proper preservation with respect to long-term storage. The second aspect is related to the potential clinical use of CSLs. As a high-quality biomaterial, CSLs have substantial potential to be used for alternative solutions in the treatment of specific eye diseases. In a number of studies it has been shown that RSL transplantation could be a safe and effective method that does not cause any serious complications, for example in terms of immune reaction. The aim of this article is to present an overview of the possibilities for using CSLs for transplantation purposes, and at the same time to discuss our methodology for processing and preserving CSLs with the protocol used at the Eye Tissue Bank of the Královské Vinohrady University Hospital.

• Klíčová slova
• Cryopreservation, ReLEx SMILE, corneal stromal lenticule (CSL),
• MeSH
• laserová chirurgie rohovky metody   MeSH
• lidé MeSH
• refrakční chirurgické výkony metody   MeSH
• stroma rohovky * chirurgie   MeSH
• transplantace rohovky * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Adult-onset foveomacular vitelliform dystrophy (AOFVD) is a rare disease characterized by accumulation of yellowish deposits in the macula. Rarely, it may be complicated by choroidal neovascularization (CNV). Cases with CNV may be confused with occult CNV in age-related macular degeneration. In our case, we will present the visual and anatomical results of a patient with AOVF-related CNV, in which we administered 3 doses of intravitreal ranibizumab (IVR). A 59-year-old female patient, who attended our clinic with the complaint of decreased vision in both eyes, was diagnosed with AOVF-related CNV in both eyes and was treated with 3 doses of IVR for 3 months. Despite the improvement in visual and anatomical functions 1 month after the first dose, vision decreased, and anatomical functions regressed to the pre-injection state in continued injections. IVR therapy is not an appropriate treatment option in the treatment of AOVF-associated CNV.

• Klíčová slova
• adult onset vitelliform dystrophy, anti-VEGF, optic coherence tomography, retinal dystrophy, subretinal deposits,
• MeSH
• Bestova nemoc * farmakoterapie   diagnostické zobrazování   diagnóza   MeSH
• humanizované monoklonální protilátky aplikace a dávkování   MeSH
• inhibitory angiogeneze * aplikace a dávkování   MeSH
• injekce intravitreální * MeSH
• lidé středního věku MeSH
• lidé MeSH
• neovaskularizace choroidey farmakoterapie   diagnostické zobrazování   MeSH
• ranibizumab * aplikace a dávkování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• humanizované monoklonální protilátky MeSH
• inhibitory angiogeneze * MeSH
• ranibizumab * MeSH

AIM: To determine risk factors associated with keratoconus in Bucaramanga, Colombia. MATERIAL AND METHODS: A paired case-control study was conducted at Bucaramanga, Colombia, between November 2022 and December 2023. The controls were age- and sex-matched. Patients answered a questionnaire designed for this study regarding their family history of keratoconus, eye rubbing, atopy, sun exposure, and sleeping habits. Information from medical records was also obtained. Univariate and multivariate conditional analyses were used to test the significance of associations. RESULTS: One hundred fifty-six patients with a diagnosis of keratoconus and 312 controls were included. Univariate analyses revealed significant differences between cases and controls in the following factors: very frequent eye rubbing (OR = 20.9, 95% CI 6.2-70.1), a positive family history of keratoconus (OR = 13.0, 95% CI 5.5-30.8), a personal history of atopy (OR = 2.2), and nocturnal eye compression (OR = 1.7, 95% CI 1.0-2.7). Multivariate analysis showed a statistical significance for eye rubbing (OR = 6.9, 95% CI 3.8-12.5), and family history of keratoconus (OR = 10.3, 95% CI 2.3-44.9). There was a significant mild interaction between both, since when the two coincided the OR increased up to 74.1 times. CONCLUSION: Eye rubbing and family history of keratoconus were the most important risk factors for keratoconus in our population. Although it is impossible to establish causal relationships, our results suggest that controlling eye rubbing could be a potentially useful preventive measure, particularly in individuals with a family history of keratoconus. Other factors, such as sun exposure, sleeping position, and atopy, may play a role in the pathophysiology of the disease.

• Klíčová slova
• Case-control studies, Latin America, keratoconus, risk factors,
• MeSH
• dospělí MeSH
• genetická predispozice k nemoci * MeSH
• keratokonus * genetika   etiologie   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• studie případů a kontrol 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
• Geografické názvy
• Kolumbie MeSH

A 70-year-old woman was examined with a 10-day history of photopsia and floaters in her left eye. Her best-corrected visual acuity was 20/25 in both eyes, with a normal intraocular pressure and some nuclear sclerosis. Spectral-domain optical coherence tomography revealed a separated posterior vitreous, with a rolled internal limiting membrane flap and inner retinal dimples in the left eye. Optical coherence tomography angiography demonstrated reduced vessel density in both the superficial and deep capillary plexuses of the left fundus. Sixteen months earlier, she had received a single intravitreal Dexamethasone implant injection, due to inferotemporal branch retinal vein occlusion-related macular edema. A diagnosis of internal limiting membrane tear following an uneventful posterior vitreous detachment was reached and no treatment was recommended.

• Klíčová slova
• Dexamethasone implant, inner retinal dimples, internal limiting membrane tear, intravitreal injection, macular edema, optical coherence tomography, posterior vitreous detachment, retinal vein occlusion,
• MeSH
• dexamethason * aplikace a dávkování   MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• léky implantované * MeSH
• lidé MeSH
• makulární edém * farmakoterapie   diagnostické zobrazování   etiologie   MeSH
• okluze retinální žíly * komplikace   farmakoterapie   diagnóza   diagnostické zobrazování   MeSH
• optická koherentní tomografie MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• dexamethason * MeSH
• glukokortikoidy MeSH
• léky implantované * MeSH

UNLABELLED: Patients with dry eye syndrome form a significant proportion of those treated in everyday ophthalmology practice. Diabetes mellitus is a major risk factor for the development of dry eye syndrome. Changes in tear film homeostasis, chronic inflammation and subsequent corneal nerve fiber pathology play a key role in its progression. The aim of this study was to describe the status of modern biomarkers of ocular surface damage in patients with type 1 diabetes and asses their utility in early diagnosis of dry eye syndrome. MATERIAL AND METHODS: In total the pilot study included 19 patients with type 1 diabetes (T1D) and 15 patients in the control group. All patients underwent a detailed ocular surface examination, sample collection for matrix metalloproteinase-9 (MMP-9) laboratory analysis and epithelial HLA-DR expression evaluation, and in-vivo corneal confocal microscopy. RESULTS: T1D patients showed statistically significantly reduced corneal nerve fiber length (p = 0.0482). The differences between the groups in terms of osmolarity, corneal sensitivity, Oxford score, tear break-up time and MMP-9 level were not statistically significant (p = 0.8272, p = 0.6029, p = 0.3507, p = 0.7561 and p = 0.0826 respectively). HLA-DR expression was examined in 10 T1D patients and 8 patients in the control group. Both groups showed minimal or no expression (p > 0.9999). CONCLUSION: The previously published literature supports our finding of corneal nerve fiber length reduction in T1D patients compared to controls. However, we did not find any significant changes in standard or modern ocular surface markers (MMP-9 levels, HLA-DR expression) measured in patients with dry eye syndrome.

• Klíčová slova
• Confocal microscopy, HLA-DR, MMP-9, biomarker, cardiovascular disease, diabetes mellitus, dry eye disease,
• MeSH
• biologické markery * analýza   metabolismus   MeSH
• časná diagnóza * MeSH
• diabetes mellitus 1. typu * komplikace   metabolismus   MeSH
• dospělí MeSH
• HLA-DR antigeny metabolismus   analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• matrixová metaloproteinasa 9 * metabolismus   analýza   MeSH
• pilotní projekty MeSH
• rohovka metabolismus   patologie   MeSH
• slzy metabolismus   MeSH
• syndromy suchého oka * diagnóza   metabolismus   etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery * MeSH
• HLA-DR antigeny MeSH
• matrixová metaloproteinasa 9 * MeSH

OBJECTIVE: The aim of this study was to evaluate the outcomes of Ozurdex® (DEX) implant in patients with diabetic macular edema (DME) in real-world clinical practice, and to determine the correlation between known OCT biomarkers and the effect of treatment. MATERIAL AND METHODS: This retrospective study included 42 eyes of 33 patients (16 women, 17 men) treated with DEX at the Department of Ophthalmology, Faculty of Medicine and Dentistry of Palacký University and University Hospital Olomouc for DME indication between 2020 and 2023. Follow-up examinations were conducted at 1, 3, and 6 months after the first DEX application. The main assessed parameters were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), OCT biomarkers. The results were subsequently statistically evaluated. RESULTS: At the first follow-up after DEX application, there was an average decrease in CRT of 186 ±146µm and a gain of 3 ±7 letters. Positive morphological and functional responses were observed in 39 eyes (92.9%) and 23 eyes (54.8%) respectively. The disorganization of retinal inner layers (DRIL) biomarker was initially present in 41 eyes (97.6%), with reduction or disappearance observed in 13 eyes (31%) post-application. Eyes with ellipsoid zone disruption (EZ disruption) had an average initial BCVA of 49.6 letters, compared to 57.8 letters in the group without this biomarker. The mean gain in BCVA was +8.7 letters in treatment-naive eyes and +2.1 letters in previously treated eyes. Chronic DME was less frequent in treatment-naive (n = 1, 14.3%) compared to previously treated eyes (n = 28, 84.8%). All these results were statistically significant (p < 0.05). An increase in IOP post-DEX application occurred in 9 patients (21.4%). CONCLUSION: Our results confirm DEX as a safe and effective treatment option for DME. Treatment-naive patients achieved better functional outcomes. We confirmed ellipsoid zone disruption (EZ disruption) as a negative biomarker. Additionally, we demonstrated the capacity of DEX to reduce disorganization of the retinal inner layers (DRIL).

• Klíčová slova
• OCT biomarkers, Ozurdex, dexamethasone, diabetic macular edema,
• MeSH
• dexamethason * aplikace a dávkování   MeSH
• diabetická retinopatie * farmakoterapie   MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• injekce intravitreální * MeSH
• léky implantované * MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém * farmakoterapie   MeSH
• optická koherentní tomografie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dexamethason * MeSH
• glukokortikoidy MeSH
• léky implantované * MeSH

AIM: To retrospectively evaluate the anatomical and functional success of surgical treatment of rhegmatogenous retinal detachment (RRD) in the only remaining seeing eye. MATERIAL AND METHODS: The study included 28 eyes of 28 patients, 19 (68%) of whom were men, with an average age of 46 years. They were operated on by a single surgeon for RRD at the Eye Clinic of the University Hospital and Faculty of Medicine, Masaryk University in Brno, from July 1, 2019, to April 30, 2023, using cryosurgical techniques and/or 25G+ pars plana vitrectomy (PPV). In 11 patients, 25G+ PPV was performed with the application of a pre-equatorial cerclage. The Blunt ocular trauma and uncomplicated cataract surgery with implantation of a posterior chamber intraocular lens were admissible within the patient histories. The cause of RRD was retinal tear(s) regardless of their number and location. The transparency of the anterior segment of the eye enabled reliable visualization of the posterior segment. Preoperative proliferative vitreoretinopathy (PVR) grades A-D2 were acceptable. Patients with a history of penetrating eye injury were excluded. Patients were evaluated 1-3 months after the performance of PPV. The surgery was considered anatomically successful if the retina was completely reattached. Each patient's final visual acuity (VA) was assessed using a Snellen chart. Numerical results were expressed as arithmetic means and percentages. Since the different groups were not compared, no statistical tests were needed. RESULTS: Retinal reattachment was achieved in 27 patients (97%), while 1 patient (3%) experienced retinal detachment, resulting in anatomical failure of the treatment. 9 patients (32%) achieved VA ≥ 4/8. CONCLUSION: We consider cryosurgical techniques using episclerally fixed cerclage bands and buckles, 25G+ PPV, and possibly a combination thereof, to be suitable methods for treating RRD in the only remaining seeing eye.

• Klíčová slova
• Visual acuity, rhegmatogenous retinal detachment,
• MeSH
• dospělí MeSH
• kryochirurgie MeSH
• lidé středního věku MeSH
• lidé MeSH
• odchlípení sítnice * chirurgie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• vitrektomie * metody   MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH