[Spontaneous RPE tear in high myopia]. / Samoistne przedarcie warstwy barwnikowej siatkówki (RPE) w przebiegu wysokiej krótkowzrocznosci.

PURPOSE: The aim of this study is to present the case of a spontaneous retinal pigment epithelial tear in high myopia. MATERIAL AND METHODS: A 56 years old woman with high myopia (refractive error -10.0D) in both eyes and amblyopia in right eye since childhood, complained of a decrease in left eye vision for one and a half month. Full ophthalmic examination, fundus photography, ultrasound examination and indocyanine green angiography were performed. RESULTS: At first visit BCVA was 5/25 in her left eye. A subretinal hemorrhage accompanied by retinal pigment epithelial tear inferotemporal to the fovea was found in ocular examination. B-scan ultrasound did not revealed any traction at the fovea. 3 months later BCVA was 5/16 OS. The area of the atrophy of RPE--Bruch's membrane--choriocapillaris complex expanded and hyperpigmentation occured above the RPE tear. 3 months later BCVA was 2/50 OS, we observed a dark brown pigment spot surrounded with a subretinal hemorrhage somewhat above the RPE tear. Indocyanine green angiography demonstrated an initial choroidal neovascularization at superotemporal edge of hypertrophic pigment epithelium (Fuch's spot). CONCLUSIONS: A spontaneous RPE tear might be the beginning of Fuchs' spot. A mechanical stress associated with eye movement is transmitted through the thin sclera and Bruch's membrane onto RPE and may cause a tear in its most vulnerable place i.e. at the margin of posterior staphyloma.

[Accuracy of the SRK II, SRK/T, Holladay and Hoffer Q IOL power calculation formulas in hyperopic patients after phacoemulsification]. / Porównanie dokladnosci kalkulacji mocy soczewki wewnatrzgalkowej metodami SRK II, SRK/T, Holladay i Hoffer Q u pacjentów z nadwzrocznoscia, operowanych metoda fakoemulsyfikacji.

PURPOSE: Comparison of the SRK II, SRK/T, Holladay and Hoffer Q formulas accuracy, in calculating IOL power in hyperopic patients. MATERIAL AND METHODS: 34 eyes of 22 hyperopic patients, 15 women and 7 men, at the age from 19 to 85 years old, after phacoemulsification with PCIOL implantation, operated between 1998 and 2004 were analysed retrospectively. The power of IOL was calculated using the SRK/T formula and ranged from 28.5 to 35.0 D. The axial length ranged from 19.6 mm to 21.99 mm. The obtained refraction was measured with autorefractometer from 9 days to 37 month after operation, mean 6 month. In addition, the theoretical target refraction for the implanted IOL was calculated using the SRK II, Holladay and Hoffer Q formulas and the differences between the target and obtained refraction for all the formulas were compared. RESULTS: The best accuracy of IOL power calculation was obtained with the Hoffer Q formula. The Holladay, SRK/T and SRK II formulas gave worse results respectively. CONCLUSIONS: For the purpose of IOL power calculation in hyperopic patients the Hoffer Q or Holladay formula should be chosen from those mentioned above. Nevertheless, miscalculation exceeding 3D also happens in case of using them. The use of SRK II and SRK/T is not recommended. To improve the results other formulas utilising precise measurements of the anterior segment should be applied. If it is impossible then attention should be paid to improving traditional biometry measurements.

[The reasons for the false positive diagnosis of glaucoma]. / Przyczyny falszywie dodatniego rozpoznania jaskry.

Glaucoma, if left untreated, leads to blindness, but if detected early, disease progression can be stopped or slowed with drugs or surgical treatment. The development of existing and new diagnostic methods has allowed substantial improvement in the clinical detection of possible glaucoma. But in some cases false positive diagnoses can be undertaken. In this paper we discussed reasons for the wrong evaluation of factors suggesting the diagnosis of glaucoma, with special interest for mistakes in applanation tonometry results caused by thick cornea.