[Central serous choroidoretinopathy--the characteristics of the clinical picture and the evaluation of the influence of general conditions at the prognosis and the course of the disease. Metaanalysis]. / Centralna surowicza choroidoretinopatia--charakterystyka obrazu klinicznego i ocena wplywu stanu ogólnego na rokowanie i przebieg schorzenia. Przeglad pismiennictwa.

Central serous choroidoretinopathy (CSCR)--recurrent disorder characterized by the detachment of neurosensory retina and/or detachment of the RPE in the posterior pole, caused by fluid leakage from choroidal vessels, coming through retinal pigment epithelium layer. The aim of the following paper was to create a historic revue of examinations of CSCR and modern description of signs and symptoms of this disease. CSCR may be present in various clinical forms with different prognosis, and therefore also all kind of retina and choroidea lesions were described. The role of hypertension, steroid treatment and stress in course of CSCR was shown in many studies during past years and for that reason the correlation between those factors and the incidence and the course of CSCR, was analysed. It is important to stress, that in contrast to current opinion, steroids can evoke CSCR and intensificate its symptoms and are contraindicated in the treatment of this disease. To addition CSCR is not always a benign disease, and may cause significant impairment of the visual acuity and colour vision, therefore, it should be carefully followed-up.

The co-occurrence of Toxocara ocular and visceral larva migrans syndrome: a case series.

INTRODUCTION: Ocular toxocarosis associated with high peripheral eosinophilia and together with systemic signs of visceral damage has been reported sporadically. Eye infections caused by numerous migrating larvae of Toxocara parasites, probably due to re-invasion or delayed reactivation, and leading to a progressive loss of vision is relatively rare. We report three atypical cases of toxocarosis with the co-existence of ocular larva migrans syndrome and generalized signs of Toxocara infection in schoolboys. CASE PRESENTATION: Two children aged 8 and 14 years respectively, with symptomatic ocular and visceral larva migrans syndromes, and one 16-year-old adolescent with chronic multifocal eye invasion, characterized by severe granulomatous retinochoroiditis with unilateral blindness, chronic abdominal pain and generalized synthesis of total immunoglobulin E antibody are described. The three patients, heavily infected with Toxocara species were boys of Polish origin. Ocular location of the parasite was confirmed by the detection of intraocular synthesis of specific anti-Toxocara immunoglobulin G antibody in aqueous humour samples from the affected eyes. Immunological parameters of tissue eosinophilia, allergy or hypersensitivity reactions to the presence of the migrating Toxocara parasites were analysed. Irreversible eye complications were observed in the patients with high level of exposure to Toxocara species in a contaminated environment, with a suggestion of possible re-activation or re-infection by different species or strains of the parasite. CONCLUSIONS: Wide promotion of sanitary education is strongly justified in children and adolescents in Toxocara endemic areas in order to reduce the potential risk of primary invasion or re-infection with the parasites, which can lead to a severe course or progression of the disease. A long-term clinical follow-up and more intensive anti-parasitic treatment is recommended in patients with subclinical and overt forms of toxocarosis to prevent later reactivation of the migrating larvae in tissues.

[Central serous choroidoretinopathy (CSCR)--the diagnostics, monitoring and treatment]. / Centralna surowicza choroidoretinopatia--diagnostyka, monitorowanie i leczenie.

There are many clinical forms of central serous choroidoretinopathy (CSCR) with different prognosis. Although fluoresceine angiography still plays the most important role in the diagnosis of CSCR, it should be pointed out, that examination with retinal thickness analyser and optical coherent tomography is a modern and non-invasive method of retinal examination, which can provide with some significant and reliable observations helping in objective monitoring of CSCR. The aim of this paper was the description of diagnostic methods and analysis of optimal methods used for monitoring of CSCR. Because the research of the literature suggests, that local: nonsteroid anti-inflammatory drugs, beta-blockers and systemic or local carbonic anhydrase inhibitors may be helpful in therapeutic choice, the treatment options of CSCR were also analysed.

[An analysis of the fundus changes in families with high myopia]. / Analiza zmian dna oka w rodzinach obciazonych wysoka krótkowzrocznoscia.

PURPOSE: Of this study is to present fundus changes in members of families with high myopia. MATERIAL AND METHODS: Detailed clinical examination of the enrolled subjects have been performed in the high myopia families. Both affected (presented with high myopia) and unaffected individuals (without high myopia) are given an ophthalmologic examination: best-corrected visual acuity testing, intraocular pressure examination, fundoscopy, axial length determination (using ultrasonography), refractometry. RESULTS: In the 19 high myopia families, 152 individuals were carefully examined. In 11 individuals retinal detachment have been observed. Additionally, myopic degeneration of the central retina (15 cases), degeneration of the peripherial retina (20 subjects), AMD (4 subjects), hypertrophy of the RPE (2 subjects), CNV (1 case), striae medullares (1 case) and macular foramen (1 case), have been identified. CONCLUSIONS: In the affected individuals (presented with high myopia) changes of the eye fundus and retinal detachment were more frequently observed comparing to unaffected members of the families without high myopia. In unaffected individuals genetic factor seems to play insignificant role in apperance of fundus. Changes within central retina in the high myopia individuals may conduce to severe visual impairment.

[Retinal changes in patients with familial adenomatous polyposis]. / Zmiany barwnikowe siatkówki u osób z polipowatosciq rodzinna gruczolakowata.

PURPOSE: The aim of study was to evaluate retinal changes in patients diagnosed with familial adenomatous polyposis (FAP) and in patients with family history of FAP. MATERIAL AND METHODS: The study was conducted on 51 patients diagnosed with FAP and 35 subjects with family history of FAP. RESULTS: In 44 patients diagnosed with FAP (86.2%), typical pigmentation of fundus lesions were observed, in 1 patient atypical fundus changes were evident. However, in the group of patients with family history of FAP, the presence of typical fundus lesions was observed in 9 patients (25.7%). In the period of at least 6 month observation, no changes in fundus lesions were present in both groups. CONCLUSIONS: The occurrence of retinal changes typical for FAP, especially in patients with family history of the disease, should imply the higher risk of FAP.

[Non-Hodgkin lymphoma located in supraorbital skin region]. / Przypadek chloniaka nieziarniczego zlokalizowanego w okolicy nadoczodolowej.

PURPOSE: Periorbital skin alterations can be of inflammatory and neoplastic origin. In very rare cases Non-Hodgkin lymphomas occur in this region. We describe a patient with a rare subtype of the Non-Hodgkin lymphoma, which was diagnosed by ophthalmologists. MATERIAL AND METHODS: A 65 years old female patient visited an ophthalmologist because of a tumor within the left supraorbital skin area. She complained about subjective deterioration of vision. During the ophthalmologic examination we found a full visual acuity in both eyes with no bulbar pathology. Tumor biopsy and an immunocytochemical examination determined the diagnosis of an NK blastic lymphoma. The patient was treated with CHOP chemotherapy. RESULTS AND CONCLUSIONS: It is believed that the rare NK blastic lymphoma develops from NK progenitor cells. When the periorbital skin is involved, the secondary edema can lead to narrowing of the palpebral fissure and to subjective vision deterioration. In these cases ophthalmologists can be the first medical specialists visited.

[Is the method of localizing intraocular foreign bodies according to Madroszkiewicz still outstanding?]. / Czy metoda lokalizacji cial obcych w galce ocznej wedlug Madroszkiewicza jest nadal aktualna?

Nowadays, in available methods of visualizing and localizing intraocular foreign bodies, apart from ultrasonography, a special stress is laid on computed tomography. Classic radiological method of Madroszkiewicz - in which the X-rays of the orbit is made after putting up the special indicators under the conjunctiva - seems to be neglected considering those more advanced diagnostic methods. The aim of this study is to prove the undoubtful novelty of this method together with ultrasonography, in comparison with computed tomography on the grounds of 2 cases, presenting the patients successfully treated at the Department of Ophthalmology, University of Medical Sciences, Poznan, Poland.

[Central corneal thickness measurement in normal tension glaucoma]. / Centralna grubosc rogówki w jaskrze normalnego cisnienia.

PURPOSE: To evaluate corneal thickness in eyes with normal tension glaucoma. MATERIAL AND METHODS: CCT (measured by specular microscope Topcon SP2000P) was evaluated in 70 eyes of 39 patients with diagnosed NTG, 35 women and 4 men in age 31-78 years (mean 68 years). RESULTS: Mean central corneal thickness measured by the specular microscope (between 11 and 1), was 523.7 microm in range 465-575 microm. Impact of CCT on results of Goldman aplanation tonometry was detected in 55.7% of NTG eyes--overestimated in 20% and underestimated in 35% of them. Corrected maximal IOP > 21 mmHg, was found in 14% of NTG eyes. CONCLUSIONS: Central corneal thickness measurement should be part of routine ophthalmological examination in glaucomatous patients (especially in NTG), being helpful in choice of optimal therapeutic strategy.

Only neutral polymorphisms found in the TIGR/myocilin gene of 45 Polish patients with primary open-angle glaucoma.

The aim of the study was to identify mutations of the TIGR gene in Polish patients with primary open-angle glaucoma (POAG) and to define possible genotype-phenotype correlations. The study included 45 patients with a verified diagnosis of POAG. The PCR amplification of all three exons of the TIGR gene and screening for the sequence changes by CSGE analysis was done for every patient. The probes with identified heteroduplexes were sequenced. Altogether 315 PCR products were obtained. The CSGE analysis detected 60 possible changes of the sequence in 28 patients. 34 heteroduplexes were chosen for sequencing, including 29 unique changes and 5 changes representative of identical heteroduplexes. Direct sequencing enabled detection of only four different changes in the TIGR gene sequence. Three of them: 5'UTR -83G-->A (in 14 patients), +227 exon 1 G-->A, Arg76Lys (in 14 patients) and +311 exon 3 T-->C, Tyr347Tyr (in 4 patients) have already been described in the literature as neutral polymorphisms of the gene. Only one change in the promoter, 5'UTR -126T-->C (in 2 patients), has not been described in the literature to date. However, this change does not alter directly the sequence of amino acids in myocilin, so it is difficult to conclude on its pathogenetic role. Thus our study showed only neutral polymorphisms of the TIGR gene. This suggests that the patients probably have mutations in other genes, so other loci that predispose to POAG must be analyzed.

[Study of TIGR gene in patients with primary open angle glaucoma]. / Badania genu TIGR u pacjentów z pierwotna jaskra otwartego kata.

PURPOSE: The aim of the study was to identify the mutations of TIGR gene in Polish patients with primary open angle glaucoma (POAG), and to define the genotype-phenotype correlation, between the type of mutation and the clinical picture of POAG. MATERIAL AND METHODS: The study included 45 patients with verified and proved diagnosis of POAG. DNA was isolated from peripheral blood lymphocytes of patients. The PCR amplification of all three exons of TIGR gene was done for every patient. The screening for the sequence changes in the PCR products of TIGR gene was done using conformation sensitive gel electrophoresis (CSGE). The probes with identified heteroduplexes were sequenced using an automatic DNA sequencer. RESULTS: During amplification of the coding regions of TIGR gene and the promoter sequences and flanking sequences of introns, 315 PCR products were obtained. The CSGE analysis of these PCR products allowed to detect 60 possible changes of sequence in 28 patients. 34 heteroduplexes were chosen for sequencing, including 29 unique changes and 5 changes representative for repeated, identical heteroduplexes. Direct sequencing allowed to detect only four different changes in TIGR gene sequence. Three of them: 5'UTR -83G-->A (present in 14 patients), +227 exon 1 G-->A, Arg76Lys (present in 14 patient) and +311 exon 3 T-->C, Tyr347Tyr (present in 4 patients) were already described in literature as neutral polymorphisms of TIGR gene. Only one change in promoter: 5'UTR 126T-->C (present in 2 patients) was not described in the literature to date. However, because this change doesn't alter directly the sequence of aminoacids in protein product of TIGR gene, it is very difficult to conclude its pathogenetic role. CONCLUSIONS: Our studies have shown no TIGR gene changes that can be recognized as causative mutations in development of POAG. Thus, the definition of any genotype-phenotype correlation was impossible. The study on the role of the change in promoter sequence that was not yet described, will be continued. Exclusion of TIGR gene mutations in Polish patients with POAG means that they probably have mutations in other genes, what paves the way to the studies on other loci that predispose to POAG.

[Influence of Eqb 761 on the function of the retina in children and adolescent with long lasting diabetes mellitus--preliminary report]. / (146)Wplyw preparatu Egb 761 na czynnosc siatkówki u dzieci i mlodziezy z dlugo trwajaca cukrzyca insulinozalezna--doniesienie wstepne.

PURPOSE: Early detection of patological function of the retina, before anatomical changes, plays very important role in monitoring of visual complications in patients with diabetes mellitus. The aim of the study was the evaluation of anatomical and functional changes in visual organ in children and adolescents with long lasting diabetes mellitus type 1 and taking Egb 761 (Tanakan Beaufour Ipsen) as an adjuvant. MATERIALS AND METHODS: Group consists of 15 patients, age between 11 and 19 years, with diabetes mellitus lasting 6-12 years. All patients had full ophthalmologic examination and color vision tests (Panel D 15 saturated and desaturated). The examination was done 3 times, every 3 months. Egb 761 was given: 1 tablet - 3 times a day, during 3 months. RESULTS: No diabetic retinopathy was found. The results of color vision test were better after therapy (25% of pathological results) and 3 months later (only 4 % of patients). CONCLUSIONS: 1. Egb 761 seems to be good adjuvant in patient with long lasting diabetes mellitus. 2. Color vision tests are sensitive tests of the retinal function and are easy to perform.

[The evaluation of macular thickness in patients with retinal detachment treated with conventional surgery--preliminary report]. / Ocena grubosci siatkówki w plamce u chorych operowanych metoda konwencjonalna z powodu odwarstwienia siatkówki--doniesienie wstepne.

The aim of the study was to evaluate retinal thickness in macular area (before and after surgery), and its correlation with visual acuity in patients with retinal detachment treated conventional surgery. Twenty eyes of 20 patients, treated in our clinic and eyes of 20 healthy subjects without any ocular pathology were evaluated. Retinal thickness in macular area (obtained with retinal thickness analyzer RTA - TALIA Technology) and visual acuity achieved after surgery compared with ocular pathology before and after surgery were analyzed. The correlation between visual acuity changes after successful surgery and macular thickness was evaluated. Retinal thickening in macula in patients with detached retina (even if macula was attached), and immediately after successful surgery in comparison to control group was observed. In selected cases, withdrawal of subclinical macular edema correlated with improvement of visual acuity. RTA allows for quantitative evaluation of retinal thickness in macula and its correlation with visual rehabilitation in patients with retinal detachment treated conventional surgery. Therefore RTA can be a useful tool in monitoring and determining visual acuity improvement.

[Usefulness of new vitreous substitutes (F6H6, F6H8) in the vitreoretinal surgery]. / Wykorzystanie nowych substytutów ciala szklistego--semifluoranów (F6H6, F6H8)--w chirurgii witreoretinalnej.

The authors present a short review of the news from Polish and foreign medical literature on the subject of a new vitreous substitutes. They present mainly a modern vitreous substitute F6H6 and F6H8, which can be used for a long-term tamponade for complicated retinal detachment.

[Radial optic neurotomy (RON) in central retinal vein occlusion (CRVO)--preliminary report]. / Neurotomia radialna nerwu wzrokowego w zakrzepie zyly srodkowej siatkówki--doniesienie wstepne.

PURPOSE: Practical application of radial optic neurotomy for patients with central retinal vein occlusion, based on our initial experience. MATERIAL AND METHODS: Three patients with central retinal vein occlusion underwent pars plana vitrectomy with radial optic neurotomy at the nasal site of the optic disc. RESULTS: Improvement of visual acuity by one or three lines in two of three patients who underwent RON. Partial clearing of retinal haemorrhages and retinal oedema occurred in all cases. No serious complications developed intra- and postoperatively. CONCLUSIONS: Radial optic neurotomy remains a controversial but also promising treatment for eyes with CRVO. Further study is necessary to establish RON as a standard therapy for CRVO.

[Evaluation of effectiveness of Catalin eyedrops in patients with presenile and senile cataract]. / Ocena skutecznosci preparatu Catalin--kropli ocznych u pacjentów z zacma przedstarcza i starcza.

AIM OF THE STUDY: Evaluation of effectiveness of Catalin eye drops in inhibition of cataract or eventual influence on regression of actually present opacities. PATIENTS AND METHOD: 72 patients in age over 40 years with initial cortical cataract and visual acuity better than 0.5 were evaluated. 35 patients were treated with anticataracous drug Catalin, and 37 received placebo. All patients were evaluated with a slit-lamp and modern equipment EAS-1000 (Nidek) before starting research and after 3, 6, 12, 18 and 24 months of treatment. RESULTS: Catalin-eye drops in patients with cortical cataract showed its effectiveness in inhibition of lens opacification and its progression especially in group of patients in age up to 59 years. The increase of lens opacification in this group was only 1.425% (Catalin), and in older group (placebo) even 9.228%. Appropriate, raising effect of the drug can be observed after 18 months of treatment. Catalin-eye drops did not cause any complications during the study. CONCLUSIONS: 1. Catalin-eye drops used in patients with senile and presenile cortical cataract is effective drug in inhibiting lens opacification. 2. The function of the drug is more obvious in group of younger patients (up to 59 years of age) in comparison with older ones. 3. Appropriate, raising effect of the drug can be observed after 18 months of treatment. 4. Catalin-eye drops is well tolerated by the patients even after prolonged application.

[Analysis of comparative immunological profiles of intraocular fluid and serum samples in patients suspected of ocular toxoplasmosis or toxocarosis]. / Ocena porównawczego profilu immunologicznego swoistych przeciwcial w plynie sródocznym i krwi obwodowej pacjentów podejrzanych o toksoplazmoze lub toksokaroze oczna.

High seroprevalence of Toxoplasma and Toxocara spp. in populations of children and adults in Poland constitutes a significant risk of supradiagnosed parasitic eye infections. We described the clinical characteristics in relation to the analysis of comparative immunological profiles of T. gondii-specific antibodies in aqueous humour and serum samples in patients with reactivated retinochoroiditis, and of Toxocara spp. ones in cases with posterior granuloma, fibrotic and calcified tumor-like masses simulating retinoblastoma, detected by ophthalmoscopy and echography. Intraocular synthesis of specific IgG antibodies was detected in anterior eye chamber fluid in 1/2 and 2/3 of patients respectively, strongly suspected of ocular toxoplasmosis or toxocarosis. The evidence of a local production of specific antibodies in intraocular fluid shown by the Western blot seems to be a valuable immunodiagnostic method for a final confirmation of eye lesions of parasitic origin and crucial in the choice of an appropriate treatment regimen.

[Treatment results of treatment for congenital, unilateral microcoria and pupil displacement--case report]. / Wyniki leczenia wrodzonego jednostronnego zwezenia i przemieszczenia zrenicy--opis przypadku.

The purpose of this report was to present rarely occurring developmental anomaly of congenital unilateral microcoria and pupil displacement. We present a case of a boy, who underwent a plastic surgery of pupil at age of 3 year. Despite of relatively tardy onset of treatment and existing profound amblyopia (light perception with projection), a full vision recovery was achieved after 4 years of occlusion therapy.

[Use of enzyme in vitreoretinal surgery]. / Zastosowanie enzymów w chirurgii witreoretinalnej.

The aim of using enzymes in vitreoretinal surgery is to facility PVD and create pharmacological vitrectomy. It can be achieved by liquefying the gel structure of the vitreous (synchisis) and weakening of adherence of the posterior vitreous cortex to retina (syneresis). The article reviews currently used enzymes in vitreoretinal surgery (plasmin, hyaluronidase, dispase, chondroitinase, collagenase, urokinase, TPA--tissue plasminogen activator) and presents potential profits and side-effects related to their use. Although the day when vitreous surgery is replaced by pharmacological vitreolisis remains still as a future, these enzymes hold great promise. Additionally it has been proved that enzymes can be used successfully as an intraoperative adjuvant in vitrectomy.