Basal cell carcinoma in an eyelid of a farmer with Sturge-Weber syndrome.

The paper presents the coexistence of a nevus flammeus and basal cell carcinoma affecting the left upper lid of 61-year-old farmer with Sturge-Weber syndrome. The occurrence of basal cell carcinoma in nevus flammeus is extremely rare. The etiology of the malignancy in this situation is unknown. It is difficult to diagnose neoplastic transformations that could arise in the nevus flammeus. Radiotherapy followed by complete surgical excision were used as a treatment in the described patient.

Management of bilateral ectopia lentis et pupillae syndrome.

A 52-year-old patient presented with signs clinically consistent with ectopia lentis et pupillae syndrome. The patient was treated successfully with vitrectomy, dislocated lens removal using perfluorocarbon liquid and phacofragmentation in the vitreous cavity, pupil reconstruction, and scleral-fixated intraocular lens implantation in both eyes. Despite the fact that the surgery was successful in technical terms, the final visual outcome was not as good as expected. This was caused by the optic nerve atrophy resulting from long-lasting glaucoma. Nevertheless, the described surgical techniques may be considered an effective method of treatment in cases of ectopia lentis et pupillae syndrome.

[Application of polymerase chain reaction method (PCR) in diagnosis of endophthalmitis]. / Zastosowanie metody lancuchowej reakcji polimerazy (PCR) w diagnostyce zakazen wnetrza galki ocznej.

PURPOSE: The goal of this study is to determine the usefulness of the PCR method in the diagnosis of endophthalmitis. MATERIALS AND METHODS: 30 clinical specimens 18 AH and 12 VF were obtained from 20 eyes with the clinical diagnosis of endophthalmitis. These included: 14 cases after cataract surgery, 1 case post trabeculectomy, 2 cases after penetrating traumas, and 3 cases after endogenous endophthalmitis. The same samples were analysed using 2 different methods: 1. conventional microbiological techniques (microscopy and diagnostic culture) and 2. PCR directed at 16S rDNA using universal primers. RESULTS: In the aqueous humor the causative pathogen was identified in one case (5.2%) by using diagnostic culture compared with seven cases (39%) by using PCR methods. In the vitreous samples the pathogen was identified in one case (9%) by using conventional method compared with five cases (50%) by using PCR. Microscopic preparation was difficult to evaluate in all samples. CONCLUSIONS: PCR performed on aqueous humor and vitreous fluid is a reliable tool for diagnosis of causative organism particularly in smear and culture negative specimens. By using universal primers we are able to detect the presence of pathogen in case of endophthalmitis and than potentially by using DNA probe hybridization to determine the species of the bacteria. The discrimination between infection or non-infection endophthalmitis plays the main role in a succesful therapy.

[Systemic diseases in patients with central retinal artery occlusion or its branches in the material of Department of Ophthalmology of Medical University of Lublin]. / Schorzenia ogólnoustrojowe u pacjentów z zamknieciem tetnicy srodkowej siatkówki lub jej galezi w materiale Kliniki Okulistyki Akademii Medycznej w Lublinie.

Patients with central retinal artery occlusion usually suffer from serious systemic diseases that could be potentially threatening life. Retinal emboli are associated with the presence of hypertension and other cardiovascular diseases, diabetes mellitus, hematological disturbances or infections. The goal of this study is the assessment of the most common coexisting systemic diseases in patients with the occlusion of retinal arteries. We retrospectively studied 51 patients with symptomatic retinal artery occlusion treated in The Department of Ophthalmology, Medical University of Lublin from 1990 to 2003. The most common concomitant diseases were hypertension, cardiovascular diseases and brain stroke. Eight of 51 patients died. The most frequent reason of death was cerebral stroke. Cardiovascular and cerebovascular examinations should be recommended for patients with retinal emboli.

[Identification of bacterial flora of conjunctival sac in congenital nasolacrimal duct obstruction in children]. / Identyfikacja flory bakteryjnej spojówek towarzyszqcej wrodzonej niedroznosci przewodu nosowo-lzowego u dzieci.

PURPOSE: The aim of the study was to evaluate the species of the microorganisms and their susceptibility to antibiotics in congenital nasolacrimal duct obstruction in children. MATERIAL AND METHODS: The pus secretion after lacrimal sac massage was obtained from 81 children with congenital nasolacrimal duct obstruction. The laboratory diagnostics was performed using typical microbiological procedures. The modification of these procedures was 24-hour pre-incubation in sugar boullion. RESULTS: The most frequently isolated bacteria were Staphylococcus epidermidis (28%) and Staphylococcus aureus (22%). The isolated staphylococci (only coagulase-negative species MRSE) were resistant to methicillin in 2 cases. Streptococci were obtained in 20% isolations: Streptococcus pneumoniae (14%), Streptococcus viridans (6%). Gram-negative bacilli Pseudomonas aeruginosa and Moraxella spp. and Candida albicans were isolated in a few cases. Negative results of the cultures were obtained in 25% cases. CONCLUSIONS: The microorganisms typically constituting physiological flora of conjunctival sac may become the pathogens in the complications of congenital nasolacrimal duct obstruction in children.

[Antiphospholipid syndrome and changes in the eye]. / Zespót antyfosfolipidowy a zmiany w narzadzie wzroku.

Antiphospholipid syndrome (APS) is one of the most often secondary thrombophilic state, characterized by recurrent arterial and venous thrombosis, recurrent pregnancy loss, and the presence of circulating antiphospholipid antibodies. Ophthalmologic features are present in 15-88% of the patient with primary APS. In this article pathogenesis and clinical picture, especially ocular complications are presented.

[Chronic blepharitis caused by mite Demodex folliculorum]. / Przewlekle zapalenie brzegów powiek wywolane przez nuzenca Demodex folliculorum.

Two cases of the very long term observation and clinical findings of chronic blepharitis caused by mite Demodex folliculorum are presented. Both patients were treated for over ten years for inflammation of the margin of the eyelid with antibiotics and steroids administered locally. A significant thickening of the blood vessels in the eyelid and numerous cylindrical cuffs of dry discharge around the base of the eyelashes persuaded us to carry out microbiological tests on the suspect eyelashes. In both cases we received additional test results from the epilated eyelashes. Demodex folliculorum should be taken into consideration as an etiological factor in cases of chronic blepharitis.

[Bee sting of the cornea--a case report]. / Uzadlenie rogówki przez pszczole--opis przypadku.

Published reports on bee stings of the cornea are rare, especially when it occurs in the winter season. have the potential for causing serious ophthalmologic problems. The venom in the sting can produce toxic and immunologic reactions. The result is acute ocular inflammation, which is usually confined to the anterior segment of the eye. The aim of our work is to present a 84-year-old man who was stung by a bee on the left cornea, while taking care of a swarm of bees. The main symptoms were pain, oedema of eyelids, conjunctival injection, keratitis and iritis. The sing was present in the cornea. After the removal of retained stinger and pharmacological treatment we observed rapid improvement.

[Value of conjunctival biopsy in the diagnosis of sarcoidosis]. / Przydatnosc biopsji spojówki w diagnostyce sarkoidozy.

The eye signs of sarcoidosis may be observed in patients with no evidence of any other symptoms. In this paper a patient with diagnosis of sarcoidosis was presented. The proper diagnosis and treatment were possible after results of conjunctival biopsy. Conjunctival biopsy could be a useful method in the diagnosis of many systemic diseases, including sarcoidosis.

[Changes in bacterial flora of conjunctival sac in patients prophylacticaly treated with antibiotic before cataract operation]. / Zmiany flory bakteryjnej worka spojówkowego pacjentów, u których stosowano profilaktycznie antybiotyk przed operacja zacmy.

PURPOSE: The aim of the study was to estimate changes in bacterial flora of conjunctival sac changes in patients prophylacticaly treated with different antibiotics (chloramphenicol, gentamycin, ofloxacin, norfloxacin) before cataract operation. MATERIAL AND METHODS: The studied group consisted of 166 patients hospitalized for cataract surgery. The control group consisted of 33 persons, neither treated topically with antimicrobial drugs nor suffering from infectious or inflammatory diseases. On the first day and on the operation day conjunctival swabs were obtained and typical microbiological diagnosis was performed. During hospitalization only one antimicrobial drug was administrated topically (chloramphenicol, gentamycin, ofloxacin or norfloxacin) in the studied group. RESULTS: Prophylaxis with antibiotics before cataract surgery changes bacterial flora of conjunctival sac: quantitative changes were observed most frequently, but also hospital antibiotic resistant strains were detected. None of tested antibiotics caused total elimination of conjunctival flora in all patients. CONCLUSIONS: None of the antibiotics used in our study could cause total elimination of conjunctival flora. According to our results, the most effective antibiotics in prophylaxis before eye surgery are fluoroquinolones. Some patients before eye surgery have the pathogenetic conjunctival flora not causing the disease, yet increasing the risk of postoperative endophthalmitis.

[Role of nitric oxide in ophthalmic diseases]. / Rola tlenku azotu w chorobach oka.

Nitric oxide is a unique molecule with simple chemical structure and sophisticated and heterogeneous functions in human organism. In this article, we reviewed possible participations of nitric oxide in physiological and pathological states inside the eye (eg. glaucoma, cataract, uveitis and retinal disorders).

[Nitric oxide level in aqueous humor in patients with glaucoma]. / Poziom tlenku azotu w cieczy wodnistej u pacjentów z jaskra.

PURPOSE: There is increasing evidence suggesting, that nitric oxide may be implicated in the pathogenesis of glaucoma. The aim of the study was to evaluate nitric oxide level in aqueous humor of glaucoma patients. MATERIAL AND METHODS: The examined group was constituted by 26 persons (13 women and 13 men), aged 60-86 (mean age 70) suffering from glaucoma. In 14 patients glaucoma was classified as POAG and in 12 as PACG. All patients have undergone trabeculectomia. The 14 patients was operated because of age-related cataract (8 women and 6 men), aged 47-82 (mean age 65), constituted a control group. All patients agreed to samples collection. Level of nitric oxide in anterior chamber fluid was assessed using commercial kits based on Griess reaction (R&D) according to manufacturer's instruction. Statistical analysis was performed using U Mann-Whitney test. RESULTS: The mean level of nitric oxide in aqueous humor was not significantly different between glaucoma and cataract group (p=0.535). The level of NO in humor aqueous was statistically significantly lower in patients with primary open angle glaucoma than in patients with primary angle closure (p=0.022), and than in control group (p=0.053). No statistically significant differences in the level of nitric oxide in humor aqueous between PACG and cataract patients were observed (p=0.365).

[Antibodies to beta-2 glycoprotein I in serum and aqueous humor of patients with glaucoma and their influence on the static perimetry]. / Poziom przeciwcial skierowanych przeciwko beta-2 glikoproteinie I w surowicy i cieczy wodnistej pacjentów z jaskra i ich wplyw na wystepowanie zmian w perymetrii statycznej.

PURPOSE: The evaluation of the relationships between the antibodies anti beta-2 glycoprotein I in serum and aqueous humor of the glaucoma patients to the visual field defects. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. In plasma and anterior chamber fluid the level of antibodies to beta-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. The visual field defects were examined with Humphrey static perimetry. Statistical analysis was performed using Spearman test. RESULTS: There were no significant correlations between antibodies anti beta-2 glycoprotein I, static perimetry, age and duration of the disease. CONCLUSIONS: There have not been stated any relationships between the static perimetry to antiphospholipid antibodies level in serum and aqueous humor in patients with glaucoma. It is the preliminary communication.

[Serum and aqueous humor antibodies to beta-2 glycoprotein I in patients with glaucoma and cataract]. / Przeciwciala przeciwko beta-2 glikoproteinie I w surowicy i cieczy wodnistej chorych na jaskre i zacme.

PURPOSE: Evaluation of the serum and aqueous humor antibodies to beta-2 glycoprotein I in patients with glaucoma. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. The group of 20 operated patients, because of age-related cataracta (7 men and 13 women), aged 47-82 (mean age 65), constituted a control group. All patients agreed with samples collection. In plasma and anterior chamber fluid, the level of antibodies to b-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. Statistical analysis was performed using U Mann-Whitney test when both groups were compared and Spearman test to comparisons concerning single group. RESULTS: Significant changes between glaucoma and cataract patients were observed in anti-b-2 glycoprotein I antibodies class IgA in aqueous humour (p=0.04) and in serum (p=0.03). CONCLUSIONS: Knowledge of the immunological pathogenesis in the glaucomatous nerve damage can be curtailed or even prevented with the use of proper agents. Indeed, there are many intriguing new therapeutic possibilities on the horizon. To determine the clinical potential of serum antibodies in glaucoma patients, a randomized clinical trial would be necessary. It is the preliminary communication.

[Levels of antiphospholipid antibodies in the serum and aqueous humor of glaucoma patients]. / Poziom przeciwcial antyfosfolipidowych w surowicy i cieczy wodnistej pacjentów z jaskra.

PURPOSE: Evaluation of antiphospholipid antibodies in the serum and aqueous humor in patients with glaucoma. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomia. The group of 20 operated, because of age-related cataracta patients (7 men and 13 women), aged 47-82 (mean age 65) constituted a control group. All patients agreed to samples collection. In plasma and anterior chamber fluid the level of antiphospholipids antibodies classes IgM and IgG were measured, using ELISA method (commercial kits produced by Euroimmun) according to producent's instruction. Statistical analysis was performed using U Mann-Whitney test. RESULTS: The mean values of antiphospholipids in both group are put in the table. The significant differences between glaucoma and no-glaucoma patients were observed in levels of IgG in serum (p=0.014) and in levels of IgM antibodies in aqueous humor (p=0.013). CONCLUSIONS: The presence of elevated levels of antiphospholipid antibodies in aqueous humor and serum may be a risk factor in progression of glaucomatous neuropathy.

[The prognostic significance of shape of demarcation line and ridge in clinical course of active phase of retinopathy of prematurity]. / Znaczenie prognostyczne ksztaltu linii demarkacyjnej i walu w przebiegu klinicznym fazy czynnej retinopatii wczesniaków.

PURPOSE: We planed out a comparison of clinic significance between eyes with acute ROP with "bays" and ROP without "bays". Retinopathy of prematurity (ROP) is a main reason of blindness in premature babies. There are no studies about shape of demarcation line and ridge in acute retinopathy of prematurity and its influence for clinical significance of ROP. In 11.42% of eyes with acute ROP we observed irregularities of demarcation line and ridge, which we called "bays". MATERIAL AND METHODS: We observed 140 premature babies (280 eyes) with acute ROP. In 32 eyes (11.42%) we stated "bays". We compared progression to stage ROP3c between group I (eyes with acute ROP and "bays") and group II (eyes with ROP without "bays). RESULTS: In 87.5% eyes with "bays" we observed progression to stage 3 c retinopathy of prematurity. In group without "bays" progression to stage 3c was observed only in 33.47%. CONCLUSIONS: We suppose, that presence of "bays" of demarcation line and ridge brings about worse prognosis at the course of acute retinopathy of prematurity.

[Evaluations of ophthalmological care expectation in the opinion of countryside dwellers in the example of the Wola Uhruska region]. / Ocena potrzeb zdrowotnych w zakresie narzadu wzroku i ich realizacji w opinii mieszkanców terenów wiejskich na przykladzie gminy Wola Uhruska.

PURPOSE: The aim of the study was the evaluations of ophthalmological care expectation in opinion of countryside inhabitants and their knowledge of eye diseases. MATERIALS AND METHODS: The analysis was performed based on the results of a survey, which covered 198 rural inhabitants living in Wola Uhruska region. The study was carried out during training arranged by Medical University of Lublin in July 2002. RESULTS: The obtained material was analysed and presented in the form of diagrams and written report. The results of the study showed, that 77% of patients was dissatisfied with the ophthalmologic health care access, despite, that the nearest ophthalmologic practice was in the distance of 30 km. Unfortunately, only 25% of persons could indicate the cause of their eye problems. It is important, to provide more information of eye condition for all patients.

The use of the radioisotope method in studies of pesticide penetration into the eyeball.

The studies concerning the effects of pesticides on the human body focused mainly on their local action or chronic poisoning of the organism. In this study we examine the pesticide penetration into the eyeball resulting from direct contact with the eye. We used an isotope-labelled carbamate pesticide -- carbaryl. The determinations of the amount and concentration of this substance in the cornea, aqueous humour, vitreous humour and retina were performed using the method measuring beta radiation emitted by radioactive carbon. The results revealed measurable concentrations of labelled carbamate in the cornea and aqueous humour 10 and 30 min after application. The levels of this pesticide in the vitreous humour and retina were very low and difficult to analyse statistically. The described method appears to be useful in determining the range and rate of eye penetration by environmental toxins having direct contact with the eyeball.