[Uveitis in patients with multiple sclerosis]. / Zapalenie blony naczyniowej u chorych na stwardnienie rozsiane.

UNLABELLED: Multiple sclerosis (SM) is an idiopathic, demyelinating CNS disease, with often ocular manifestations. Besides the most common SM ocular manifestation-optic neuritis, particular attention should be paid to uveitis. It is estimated that uveitis is ten times more frequent in population with SM than on population without it. PURPOSE: The aim of this study is to present our own observation of clinical course of the uveitis in SM patients. MATERIAL AND METHODS: We studied 9 patients (7 women and 2 men), who had been treated in 2nd Department of Ophthalmology Lublin Medical School in 1993-2006. In I group (2 persons) uveitis was casually diagnosed during an ophthalmic examination in patients with SM. In II group (2 persons), first event of the uveitis was observed in patients with already diagnosed SM. In III group (2 persons), initial diagnose was uveitis, and subsequently SM was diagnosed. Group IV consisted of patients with uveitis, who developed SM several years later (3 persons). RESULTS: Clinical course of inflammatory process was bilateral, severe and chronic with exacerbation. Panuveitis, cystoid macular oedema, cataract formation, and glaucoma were the most often findings. All of patients were treated with corticosteroids. Therapy with corticosteroids caused improvement in all patients. CONCLUSIONS: The possibility of co-existence of SM and uveitis should be emphasized. Corticosteroids are efficient in the treatment of ocular complications in patients with SM.

[A severe case of sympathetic ophthalmia--case report]. / Zapalenie wspólczulne o ciezkim przebiegu--opis przypadku.

PURPOSE: The aim of our work is to present clinical and histological data of the case of severe sympathetic ophthalmia (SO). Sympathetic ophthalmia is a rare, bilateral, non-necrotizing granulomatous panuveitis that follows penetrating injury to one eye. SO is a potentially blinding condition. MATERIAL AND METHODS: A 40-year-old man sustained a penetrating injury to his right eye. He refused to be treated surgically. A few days later, he developed bacterial endophthalmitis. After 5 months the patient came to our hospital with clinical manifestations suggesting SO. His right eye was removed. Unfortunately, despite the intensive pharmacological treatment the uveitis of the left eye intensified. RESULTS: Generalized uveitis with optic nerve oedema, secondary cataract and glaucoma resulted in total blindness. CONCLUSIONS: Although, SO is a rare disease, ophthalmologists should be aware of its devastating effect on vision.

[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.

[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.

[Central serous choroidopathy in a 57 years old woman]. / Choroidopatia centralna surowicza u 57-letniej chorej.

A 57 years old patient with unilateral decrease of vision with accompanying micropsia and metamorphopsia is presented. After ophthalmological examination, fluorescein angiography and ultrasound examination we diagnosed idiopathic central serous choroidopathy. After photocoagulation the improvement of visual acuity was achieved.

TH1/TH2 balance in the subretinal fluid of patients with rhegmatogenous retinal detachment.

BACKGROUND: The pathogenesis of rhegmatogenous retinal detachments remains unclear, but some data suggest immune system involvement. Cytokines are substances secreted by cells in order to modulate the function of other cells. They exert primarily local effects. Because the TH1/TH2 balance is crucial in the immune response, the predominance of one cytokine profile in subretinal fluid may be of particular importance in understanding its pathogenesis. MATERIAL/METHODS: We measured the titres of IL-10 and tIL-12 in the subretinal fluid of 36 rhegmatogenous retinal detachment patients using ELISA assays. RESULTS: The mean level of IL-10 and tIL-12 in the subretinal fluid was 4.75 pg/ml and 106.5 pg/ml, respectively. CONCLUSIONS: It would appear that IL-10 and IL-12 are produced by cells in subretinal fluid, and their presence may be evidence for an existing inflammatory process. Despite the tendency to decreased cytokine concentration over time and the tendency to higher concentrations of IL-10 and tIL-12 when the detachment of the retina is more extensive, no predominance of TH1- or TH2-type response was observed.

The occurrence of primary open angle glaucoma in a family.

The occurrence of primary open glaucoma (POAG) in families proves the hypothesis that POAG is a disease with underlying genetic factors. This work describes a family of four generations, in which eight members suffered from POAG. In the 3rd and 4th generation members, the disease occurred at an early age (between the age of 20-40 years), i.e. at a much earlier age than it could be expected. Therefore, a need arises to keenly observe families in which POAG is present.

The level of alpha-antitrypsin and ceruloplasmin in the subretinal fluid of patients with rhegmatogenous retinal detachment.

UNLABELLED: The aim of the study was to determine alpha-antitrypsin (AAT) and ceruloplasmin (CER) level in the subretinal fluid of patients with rhegmatogenous retinal detachment (RRD). Investigation was performed in 41 patients (22 women, 19 men) operated on for RRD at the age from 24 to 81. The group of patients was divided with regard to the extent and duration of RRD. In 24 patients detachment involved 1 or 2 quadrants and in 17 patients--3 or 4 quadrants. In 16 subjects RRD lasted shorter than 2 weeks, in 6 patients--about one month and in 19 patients--from 1 to 3 months. The subretinal fluid was collected during operation. The levels of the examined substances were determined with the radial diffusion method on Nor-Partigen plates by Behring. The results were as follows: mean AAT concentration in the subretinal fluid of all the patients operated on for RRD was 0.739 +/- 0.475 g/l and CER was 0.186 +/- 0.122 g/l. Mean AAT concentrations did not differ statistically significantly between the group with bigger and smaller retinal detachments while CER level was higher in the group with a bigger RRD. Mean AAT and the CER concentration was statistically significantly higher in the group with RRD lasting from 1 to 3 months compared with the group with RRD lasting shorter than one month. CONCLUSIONS: the fact of finding acute phase proteins in subretinal fluid suggests that they may play a part in the pathogenesis of RRD by affecting the intensity of local inflammatory reaction.

The level of total sialic acid, alfa-antitrypsin, ceruloplasmin in the serum of patients with choroidal melanoma.

Melanoma of the choroid is a fatal disease because of its metastases. The quest is ongoing for more reliable serum markers for detecting and staging ocular melanoma. Total serum sialic acid and acute phase proteins are valuable adjuncts in the management of malignancies, including melanoma. The aim of the paper was to asses the level of total sialic acid (TSA), total sialic acid to total protein (TP) ratio (TSA/TP) and the level of alfa-antitrypsin (AAT) and ceruloplasmin (CER) in patients with choroidal melanoma. The concentrations of TSA, TP, AAT and CER were evaluated in 61 patients with choroidal melanoma and 84 healthy controls. 36 patients had larger tumors and 25 patients had smaller melanomas. 36 patients were treated with brachytherapy. The mean concentration of TSA in all intraocular melanoma patients was 84.86 +/- 19.37 mg/dl and was significantly higher than in control group 53.63 +/- 8.47 mg/dl (p < 0.001). TSA level was significantly higher in patients with large tumors than in those with smaller choroidal melanomas. There were not differences between groups of patients treated with brachy-therapy and those not treated. TSA/TP in melanoma patients was 11.88 +/- 2.97 and it was higher than in control group 7.32 +/- 1.21 (p < 0.001). AAT level was 236.56 +/- 141.53 mg/dl in the group of melanoma patients and in the control group was 226.42 +/- 46.74 mg/dl but the differences were not statistically significant. The concentration of CER in the study group was 28.25 +/- 11.01 mg/dl and in the control group it was 29.56 + 6.33 mg/dl but the differences were not statistically significant. The assessment of TSA in blood serum may be useful in evaluation of patients with choroidal melanoma.