Correlation of spectral optical coherence tomography with fluorescein and indocyanine green angiography in multiple evanescent white dot syndrome.

AIMS: To determine the spatial location of lesions in multiple evanescent white dot syndrome (MEWDS) with the aid of spectral optical coherence topography (SOCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA). METHODS: A novel method of three-dimensional SOCT data analysis called reflectivity maps was introduced. The reflectivity maps display the distribution of a back-reflected intensity taken only from individual retinal layers located at specific distance from the reference plane. Reflectivity maps of the inner retina, the junction between photoreceptor inner and outer segments (IS/OS), retinal pigment epithelium and choroid of the patient with MEWDS were created and correlated with FA and ICGA. RESULTS: During the acute stage of MEWDS, the reflectivity map of the IS/OS junction displayed areas of reduced reflectivity that showed a strong positive correlation with hypofluorescent ICGA spots and a weaker but positive correlation with hyperfluorescent FA dots. SOCT examination did not reveal any pathological changes involving either any other retinal layers or the inner choroid. CONCLUSION: Disseminated disruptions of the IS/OS junction seen on SOCT cross-sectional images in the acute stage of MEWDS form the pattern of spots that can be correlated with those revealed by ICGA. This suggests that hypofluorescent ICGA spots indicate alternations in the retinal pigment epithelium-photoreceptor complex and do not represent inflammatory choroidal lesions.

Retinal imaging by spectral optical coherence tomography.

PURPOSE: To demonstrate applicability of high speed spectral optical coherence tomography (SOCT) method for imaging retinal pathologies in clinical conditions. METHODS: SOCT was performed in 67 eyes with different macular diseases. Examinations were carried out with the prototype SOCT instrument constructed in the Institute of Physics, Nicolaus Copernicus University, Torun, Poland. A broadband superluminescent diode was used as a light source. RESULTS: The disturbances of retinal layer structure concerning mainly outer segments of photoreceptors were observed in case of central serous chorioretinopathy and choroidal neovascularization in age-related macular degeneration. Large drusen were often related to significant changes of outer nuclear layer thickness and reflectivity. CONCLUSIONS: SOCT detects small disturbances of the retinal structure and helps to precisely determine layers involved in different pathologies.

[Evaluation of the surface of the new intraocular lenses in the scanning electron microscope]. / Ocena powierzchni nowych soczewek wewnatrzgalkowych w elektronowym mikroskopie skaningowym.

PURPOSE: To evaluate the surface of the new PC IOLs commercially available in Poland in 2000. MATERIAL AND METHODS: Representative samples of new posterior chamber IOLs produced by 6 different companies (Alcon, Lensita, Medicontur, Opsia, Rayner, Storz), 5 of each, underwent surface examination with Novoscan 30 scanning electron microscope. RESULTS: Although, in general, smooth surface of optic and haptic parts were observed, three samples with irregularities were found. CONCLUSIONS: Comparing to previous evaluation performed in 1994, significant improvement in quality of IOLs surface was noted. No considerable differences in this field between above mentioned producers were observed.

[Retrospective evaluation of PC IOL power after extracapsular cataract extraction]. / Retrospektywna ocena mocy soczewki wszczepionej podczas zewnatrztorebkowego wydobycia zacmy.

PURPOSE: Retrospective evaluation of PC IOL power calculation accuracy and comparison of the refractive errors after ECCE resulted from different methods of calculation. MATERIAL AND METHODS: The PC IOL power in 100 eyes with senile cataract without significant refractive errors, was calculated using SRK II formula with two different biometers and based on primary refraction. The final IOL power was established by surgeon based on all mentioned calculations (surgeon choice). Half a year after surgery the refractive error was measured. The proper IOL power, which did not require additional correction, was calculated (ideal lens). RESULTS: 48 eyes did not require any distance correction. In 44 eyes small hyperopia (to +2.0 D) appeared and in 8 eyes myopia (to -1.5 D). The smallest error was made in cases where we implanted lenses according to surgeon choice. The average power of ideal lens was 20.32 D. We observed statistically significant difference between both ultrasound biometers. CONCLUSIONS: The most accurate results were achieved in cases where IOL power was chosen by the surgeon based on SRK II formula and primary refraction. Possible source of errors can be inadequate indications of biometers.

[Optic disc drusen--case report]. / Druzy tarczy nerwu wzrokowego--opis przypadku.

A case of giant optic disc drusen is presented. Diagnostic difficulties and a role of fluorescein angiography, CT and static perimetry in diagnosing these alterations are described.

[Clear lens extraction in high myopia]. / Usuniecie soczewki przezroczystej w wysokiej krótkowzrocznosci.

PURPOSE: To evaluate effectiveness and safety of clear lens extraction in high myopia. MATERIAL AND METHODS: 39 eyes of 26 patients had clear lens extraction and implantation of PC IOL. The mean preoperative spherical equivalent was -17.0 D sph, mean follow-up was 19.4 months. IOL calculations were performed using SRK II formula for target refraction -2.0 or -3.0 D sph. RESULTS: The mean postoperative spherical equivalent was -3.3 D sph. The best corrected visual acuity improved in 84.6% of eyes. The percentage of eyes achieving BCVA 0.5 or better increased from 23% preoperatively to 59% postoperatively. In 7 eyes (18%) posterior capsule opacification occurred. Two years after the surgery in one eye retinal detachment appeared, which was successfully treated. CONCLUSION: Clear lens extraction with PC IOL implantation in high myopia gives good results with low number of complications.

[Tuberous sclerosis--case report]. / Stwardnienie guzowate--opis przypadku.

A case of 37-year-old man with tuberous sclerosis is presented. Classic triad (Vogt) which consists of mental handicap, epilepsy and adenoma sebaceum around a nose and cheeks was observed. Ophthalmoscopy showed bilateral retinal astrocytomas with mulberrylike appearance. During 6 years follow-up small progression of ocular changes (findings) was noticed. CT and NMR of the head, ultrasound of the eye fluorescein and ICG angiography are presented.

[Secondary posterior chamber intraocular lens implantation without scleral fixation]. / Wtórne wszczepy tylnokomorowe bez fiksacji twardówkowej.

AIM: Retrospective evaluation of results of secondary PC IOL implantation without scleral fixation. MATERIAL AND METHODS: 29 eyes of 21 patients including 8 children underwent secondary PC IOL implantation into the sulcus. In all these eyes there was partially or completely preserved posterior capsule. RESULTS: Final postoperative visual acuity of 20/40 or better was achieved in 82.7% of the eyes with PC IOL. CONCLUSION: Secondary PC IOL implants give good anatomical and functional results.

[Intraocular refractive surgery]. / Wewnatrzgalkowa chirurgia refrakcyjna.

The aim of this paper was presentation of current opinions about intraocular refractive surgery. The implantation of Baikoff and Worst-Fechner lenses to anterior chamber and usage of refractive PC IOL is described. The extraction of clear lens in high ametropia and implantation of PC IOLs of adequate power was also presented. The paper is illustrated by own material.

[Post-steroid elevations of intraocular pressure in patient after radial keratotomy]. / Posteroidowe zwyzki cisnienia wewnatrzgalkowego u osób po keratotomii radialnej.

PURPOSE: The evaluation of frequency and amplitude of IOP elevations in patients after RK who were administrated topically dexamethasone. MATERIAL AND METHODS: RK was carried out in 90 eyes (55 patients). All these patients had been treated topically with 0.1% dexamethasone (Maxitrol, Alcon) since the first day after surgery till the period of 3 months in lowering doses. IOP was measured using air-puff tonometer (Reichert, USA) before surgery and on 1, 2, 3, 14, 30, 50, 90 day after RK. In case of IOP elevations the measurements were made more often. RESULTS: The mean IOP before surgery was 14.88 +/- 2.86 mm Hg for women and 16.14 +/- 2.83 mm Hg for men. In the period of 3 months after RK maximum IOP increased significantly both for women (mean: 21.46 +/- 7.51 mm Hg) and men (mean: 26.14 +/- 8.87 mm Hg). IOP higher than 25 mm Hg was observed in 35 eyes (37.7%). These IOP elevations were observed more often in men than women but this difference was not statistically significant. There was no correlation between frequency of IOP elevations and preoperative refractive error or the age of patients. CONCLUSIONS: The usage of steroids after RK requires careful monitoring of IOP. This subject needs further studies to answer if these IOP elevations can damage eye functions.

[The use of indocyanine green angiography in diagnosis of occult choroidal neovascularization in age-related macular degeneration]. / Zastosowanie angiografii indocyjaninowej do wykrywania ukrytej neowaskularyzacji podsiatkówkowej w starczym zwyrodnieniu plamki.

PURPOSE: To determine whether scanning laser ophthalmoscopy (SLO) indocyanine green (ICG) angiography may be useful in detecting occult or ill-defined choroidal neovascularization (CNV). MATERIAL AND METHODS: ICG angiography using SLO was performed in 28 patients (29 eyes). Indication for this examination was occult or ill-defined CNV on fluorescein angiography. RESULTS: Well-defined hyperfluorescent lesions on ICG angiography were found in 16 eyes (55.2%). Three morphological types of CNV were noted: plaque (82.8%), focal spots (10.4%), combination lesions (3.4%). In one case no manifestations of CNV were observed in ICG angiography (3.4%). In 4 eyes (13.8%) we performed successful laseroterapy of CNV. CONCLUSIONS: ICG angiography performed using SLO is a valuable tool in determining borders of occult and ill-defined CNV.

[Results of radial keratotomy and photorefractive keratectomy in patients' assessment]. / Wyniki keratotomii radialnej i fotokeratektomii refrakcyjnej w ocenie pacjentów.

PURPOSE: The aim of the study is the presentation of RK and PRK results in patients' assessment. MATERIAL AND METHODS: Questionnaire forms were sent to 100 patients after RK and 120 after PRK between 12 and 24 months after surgery. Preoperative refractive error in both groups was similar: -6.76 D sph in RK group and(--)-6.25 D sph in PRK group. Questionnaire forms consisted of 12 questions about the decision of operation, its course, possible complications and results. RESULTS: 76 (76%) patients after RK and 94 (78.25%) after PRK answered the questionnaires. 96% of patients after RK and 98.9% after PRK were satisfied with achieved results. 56.4% of PRK and 29% of RK patients answered that healing was painful and very painful. 57% of patients after RK and 49% after PRK complained of complications after surgery (fluctuations of vision, glares). Majority of patients in both groups would accept the procedure again. CONCLUSIONS: Both RK and PRK were positively assessed by the patients, however slightly higher level of satisfaction was in PRK group. There were also fewer complications in this group.

[The evaluation of surface deposits on frequent replacement lenses by scanning electron microscopy (SEM)]. / Badanie w mikroskopie skaningowym zlogów na powierzchni soczewek kontaktowych systematycznej wymiany.

PURPOSE: The aim of our study was to find the method of preparation of soft contact lenses for examination by SEM and next evaluation of deposits on the surfaces of frequent replacement lenses. MATERIAL AND METHODS: Frequent replacement contact lenses (Acuvue) stored in physiological saline, distilled water and sterile, dry container were prepared for examination by SEM (Novoscan 30). The best quality preparations were made from contact lenses stored in sterile, dry container and dried at room temperature. Acuvue contact lenses were taken from five young, healthy persons after one, two, three and four weeks of wearing. All the lenses were examined by SEM. RESULTS: We observed nearly all the components of tear film on the surfaces of the lenses. Flat, amorphic protein, crystalline deposits, fibrinous structures were usually observed. Sometimes the nectrotic cell were seen. In one preparation we found bacteria. The amount of deposits was not high and did not increase with four weeks time of lens usage. The quality and quantity of deposits were individually variable. CONCLUSIONS: The methods we choose let us to prepare good quality preparations of soft contact lenses for examination by SEM. On the surfaces of the frequent replacement contact lenses we found only a small quantity of deposits.

[Contemporary views on the pathogenesis and possible prophylaxis of age related cataracts]. / Wspólczesne poglady na patogeneze i mozliwosci profilaktyki zacmy starczej.

In this review the role of UVB/290-320 nm/ and visible light radiation in generating of free radicals in the lens is described, which is the main factor leading to development of senile cataract. Also the mechanisms of antioxidant defence are presented especially glutathione and ascorbic acid. We review the literature connected with diet supplementation of antioxidants /vit. E, C, selenium/. According to actual theories the use of sun-glasses with UVB-filters, and antioxidant diet supplementation seems to be useful in prevention of age-related cataract.

[Personal observations with the use of soft contact lenses after radial keratotomy]. / Obserwacje wlasne stosowania soczewek kontaktowych miekkich po keratotomii radialnej.

PURPOSE: The evaluation of conjunctiva and cornea of patients wearing soft contact lenses after RK. MATERIAL AND METHODS: Between the years 1991-1995 RK was performed in 88 patients. Nine of them (10.2%) used soft contact lenses for correction of residual refractive error. All these people were carefully examined. RESULTS: The only complication was superficial neovascularisation concerning mainly peripheral parts of the corneal incisions. The long incisions reaching limbus and early application of contact lenses after RK promote peripheral neovascularisation of the cornea. CONCLUSIONS: Soft contact lenses should not be recommended after RK if corneal incisions reach the limbus. However, in other cases they can be used with careful ophthalmological supervision.

[Personal results of cataract phacoemulsification with tunnel incision without sutures]. / Wyniki wlasne fakoemulsyfikacji zacmy z cieciem tunelowym bez zakladania szwów.

PURPOSE: Early and late evaluation of no-stitch cataract phacoemulsification with tunnel incision. SETTING: Department of Ophthalmology, Bydgoszcz. MATERIAL AND METHODS: No-stitch phacoemulsification of cataract with sclero-corneal tunnel incision. Foldable PC IOL were implanted in 40 eyes of patients between 30-67 years of age. Observation period: 1-5 years. RESULTS: Very good anatomical and functional results. Fast visual rehabilitation. CONCLUSIONS: No-stitch cataract surgery: phacoemulsification with implantation of foldable PC IOL through tunnel incision is a method worth wide recommendation.

[Reactive oxygen forms in pathogenesis of selected eye diseases]. / Udzial reaktywnych form tlenu w patogenezie wybranych chorób oczu.

The paper presents mechanisms by which reactive oxygen forms appear in the eyeball and their effects on the tissues. They play an important role in pathogenesis of many eye diseases, especially in cataract, age-related macular degeneration and retinopathy of prematurity.

[Level of uric acid in aqueous and vitreous humor of man]. / Poziom kwasu moczowego w cieczy wodnistej i w ciele szklistym u czlowieka.

Uric acid-a potent endogenous antioxidant-may play a certain role in some eye diseases. However, its content in intraocular humors has not been examined so far. Samples of aqueous and vitreous humor were collected from 32 dead persons for examination. Uric acid was marked by indirect method with uricase. Uric acid level in aqueous humor ranges from 166.67 to 446.4 mumol/l (mean 309.34), whereas in vitreous humor from 77.38 to 452.00 mumol/l (mean 220.80).

[Level of uric acid in aqueous humor of patients with cataract]. / Poziom kwasu moczowego w cieczy wodnistej u chorych z zacma.

Aqueous humor was taken from 32 patients with senile and presenile cataract at the operation by means of anterior chamber puncture. Uric acid was marked by indirect method with uricase. The mean content of uric acid in aqueous humor of patients with cataract was 187.13 mumol/l and in the control group 309.34 mumol/l. The difference between the groups is statistically significant. The results suggest that uric acid as strong endogenous antioxidant may play an important role in pathogenesis of cataract.

[Uric acid level in human aqueous and vitreous humor]. / Poziom kwasu moczowego w cieczy wodnistej i w ciele szklistym u czlowieka.

Uric acid--a potent endogenous antioxidant--may play a certain role in some eye diseases. However, its content in intraocular humors has not been examined so far. Samples of aqueous and vitreous humor were collected from 32 dead persons for examination. Uric acid was marked by indirect method with uricase. Uric acid level in aqueous humor ranges from 166.67 to 446.4 mumol/l (mean 309.34), whereas in vitreous humor from 77.38 to 452.00 mumol/l (mean 220.80).