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Mapping of Changes in Oxygen Saturation in Retinal Vessels Related to the Extent of Periperal Nonperfusion in Patients with Retinal Vein Occlusion
Šínová, Irena ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Mapping of changes in oxygen saturation in retinal vessels related to the extent of peripheral nonperfusion in patients with retinal vein occlusion Purpose: The aim of this study was to evaluate the relationship between the ischemic index and the oxygen saturation in retinal vessels in patients with retinal vein occlusion. Methods: We performed a prospective, cross-sectional study. The cohort consisted of 43 eyes of 43patients with retinal vein occlusions (RVO), 23 of whom had central retinal vein occlusions (CRVO) and 20 who had branch retinal vein occlusions (BRVO). We evaluated the retinal vessel saturation using an automatic retinal oximetry device (Oxymap Inc., Reykjavik, Iceland). The retinal ischemic index (ISI) was determined using ultra-wide-field fluorescein angiography (Heidelberg Engineering GmbH, Heidelberg, Germany). Results: Mean arterial saturation (± SD) was 100 ± 11 %, mean vein saturation was 52 ±13 % and mean A-V difference was 48 ± 16 % in eyes with BRVO. The average ISI inthe same group was 0.48 (range 0-1). There was no statistically significant correlation between the retinal ischemic index and retinal saturation in the BRVO group. The affected eye in the CRVO group had a mean arterial saturation of 101 ± 6 %, vein saturation of 44 ± 11 % and A- V difference of 58 ± 10 %. The...
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Retinal nerve fiber layer measurement in patients with Alzheimer's disease
Kasl, Zdeněk ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Retinal nerve fiber layer measurement in patients with Alzheimer's disease The current ophthalmologist's possibilities in diagnostics of Alzheimer's disease Alzheimer disease (AD) is the most common cause of dementia syndrome and mild cognitive impairment. To enroll the disease most securely there are used so called biomarkers using evidence of changed brain metabolism by pozitron emission tomography (PET) and in cerebrospinal fluid or the brain's structure magnetic resonance imaging (MRI). These methods are expensive, organisationally and temporally challenging and burdening for the patients. According to that reasons we are still seeking for alternative attitudes suitable for early diagnosis. The evaluation of thickness of retinal nerve fiber layer (RNFL) which is well accessible to examination through optical aparatus of the eye could be one of the options. The aim of our work was to present current knowledges about Alzheimer's disease targeting relations of Alzheimer's disease and an ophthalmological finding. In the next part of this paper we introduce the retinal nerve fiber layer measurement by optical coherence tomography (OCT) as a potential diagnostics method by screening of patients with Alzheimer's disease and to present our results measured in our cohort of patients. The studied cohort...
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Research of the secondary cataract, the possibilities of it's prevention by the choice of surgical techniques and intraocular implants
Stepanov, Alexandr ; Jirásková, Naďa (advisor) ; Baráková, Drahomíra (referee) ; Těšínský, Pavel (referee)
Research of the secondary cataract, the possibilities of it's prevention by the choice of surgical techniques and intraocular implants Summary Aim: To compare the degree of posterior capsule opacification (PCO) in two groups of patients after cataract surgery using two types of software. Design: Prospective clinical trial. Methods: Best corrected visual acuity vas evaluated using Snellen optotypes, biomicroscopy of the eye on the slit lamp, keratometry and axial length was measured preoperatively. AquaLase was used in the right eye and NeoSoniX in the left eye of each patient in the first group. The same hydrophobic acrylic artificial intraocular lens AcrySof SA60 (Alcon Laboratories, Fort Worth, Texas, USA) was implanted in all eyes, and evaluation was conducted during eight-year follow-up. Torsional mode (OZil) phacoemulsification was used in the second group and hydrophobic-hydrophilic intraocular lens EriFlex FAB 877 (Videris, CZ) was implanted. Evaluation of the second group was performed 1 year after cataract surgery. PCO quantification was done using a subjective PCO software - EPCO 2000 (Evaluation of Posterior Capsule opacification) and objective system - OSCA (Open-Access Systematic Capsule Assessment) with open access. Results: Thirty seven patients were analyzed 8 years after cataract surgery in...
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Flaps transmissions in surgeries of basal cell carcinomas of eye lids
Zikmund, Lukáš ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Říčařová, Renata (referee)
Flaps transmissions in surgeries of basal cell carcinomas of eye lids Purpose: The main target of the dissertation is to evaluate our own sample of patients, and by analysis of the monitored parameters confirm the effectiveness and possibilities of the local skin flaps advance in dealing with defects after excisions of basal cell carcinomas of the eyelids and periorbital area. Specifically, in the case of defects for which it is not possible to use a range of simple suture wounds. The aim was to compare the results of surgical procedures performed either by the local rotary flaps or free flaps. Methods: The sample consisted of 133 patients with basal cell carcinoma, which claimed covering defect by skin flaps. In 108 cases, local rotary flap in defect has been used and in 25 cases transfer of the tissue into the defect by free flap. In the group of rotary flaps was in 6 cases simultaneously transplanted part of the tarsal plate cartilage of the ear auricle and in 2 patients a surgical procedure multi flap movements was used. The follow up period in both groups was 2 years. Results: Rate of recurrence within 2 years for excision 2 mm safety rim was 5.3%. Patients with recurrence have a significantly larger surface excision (p = 0.01) and lobe (P = 0.004). Recurrences are significantly more frequent...
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Possibilities of treatment of diplopia when suffering from paralitic strabismus with the use of conservative methods
Pražáková, Lenka ; Jirásková, Naďa (advisor) ; Těšínský, Pavel (referee) ; Baráková, Drahomíra (referee)
Summary: Possibilities of treatment of diplopia when suffering from paralitic strabismus with the use of conservative methods Purpose The aim of this thesis is to assess the effectiveness of ambulant pleoptic-ortoptic exercises complemented by domiciliary rehabilitation using specially adapted software - applied to patiens with suddenly occured eye movement disorder and diplopia. Methods Representative sample was composed od 86 adult patients suffering from sudden eye movement disorder and diplopia, containing 33 rehabilitating ones in treatment group and 53 not rehabilitating patients in control group. The eye movement disorder was caused by cerebrovascular accident, craniocerebral injury or vascular disease. All the patients underwent complex eye and ortoptic examination as well as objectification of the eye movement disorder and diplopia by Hess-Lancaster test. Both treatment and control group have been observed for 3 - 6 months. Results An average improvement of 96.8 % (P ≤ 0,01) was reached in the treatment group - in case of the extent of horizontal deviation of strabismus (for rehabilitating adults having the infliction n. VI of one eye). In the control group 28.1 % (P ≤ 0,00001) was noticed. The patients having the infliction n. III and n. IV of one eye improved of 73.7 % (P ≤ 0,0008) in the...
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Implantation of artificial corneas AlphaCor and KeraKlear in patients with severe corneal disorder: long-term outcomes
Burova, Mariya ; Jirásková, Naďa (advisor) ; Těšínský, Pavel (referee) ; Baráková, Drahomíra (referee)
Implantation of artificial corneas AlphaCor and KeraKlear in patients with severe corneal disorder: long-term outcomes. Purpose: To assess the long-term results of AlphaCor and KeraKlear implantation, to evaluate the main complications and risk factors. Methods: An artificial cornea AlphaCor was implanted in 15 eyes of 15 patients. KeraKlear has been used in 4 eyes of 4 patients. All patients before the surgery were examined in detail. The evaluation of best corrected visual acuity (BCVA) and slit-lamp examination of anterior segment of the eye were performed. The status of posterior segment of the eye was assessed with B-scan ocular ultrasaund examination. Corneal pachymetry was performed in patients before the KeraKlear implantation. Digital photographs of anterior segment of the eye in all cases were obtained. Intraocular pressure (IOP) was satisfactory controlled before AlphaCor and KeraKlear surgery in all eyes. Postoperatively evaluation of BCVA and IOP, slit-lamp examination with digital photography of anterior segment of the eye and B-scan ocular ultrasaund examination were regularly performed. Results: Best corrected visual acuity after AlphaCor surgery ranged from hand movement to 0.8. The survival rate of the AlphaCor at 1, 2, 3 and 4 years was 80%, 53%, 40% and 27%, respectively. The...
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Issues in local and systemic side effects of chemotherapeutics after their experimental intraocular and periocular delivery
Petrušková, Denisa ; Dotřelová, Dagmar (advisor) ; Baráková, Drahomíra (referee) ; Jirásková, Naďa (referee)
achieving control over retinoblastoma cells floating within the vitreous cavity in advanced retinoblastoma of grade C, D and E. Periocular and intravitreal drug injection is a promissing route for maximum bioavailability to the vitreous but it requires a well defined dose for achieving tumor control while limited toxicity to the ocular structures. Objective: 1. Experimentally evaluate local ocular toxicity of carboplatin and topotecan on the model of rabbit eye after periocular and intravitreal administration. 2. To evaluate the clinival applicability of the new method of intravitreal application of chemotherapeutics using transcorneal approach. Material and methods: In vivo experiment was conducted on the model of 54 New Zealand White rabbits, which were dividend into groups of six rabbits according to protocol. Only right eyes were applicated and received: 1. periocular carboplatin at a dose of 15 mg and 30 mg and periocular topotecan at a dose of 2 mg, 2. intravitreal carboplatin at a dose od 0,05 mg a 0,008 mg and intravitreal topotecan at a dose of 1 μg a 2 μg. Left eyes received the same amount of saline. Concentrations of carboplatin in the vitreous humor and plasma were determined by atomic absorption analysis, topotecan concentrations by high performance liquid chromatography and concentrations of...
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The evaluation of the effect in supression of the inflammatory reaction by oral intake Relifex (nabumeton) after photodynamic therapy in the treatment of exsudative age-related macular degeneration
Šín, Martin ; Jirásková, Naďa (advisor) ; Sosna, Tomáš (referee) ; Dotřelová, Dagmar (referee)
Purpose: To evaluate photodynamic therapy (PDT) combined with the preferential the cyclooxygenase-2 (COX-2) inhibitor, nabumetone in the treatment of the neovascular age-related macular degeneration (ARMD). Methods: A prospective, double-blind, randomized study on 60 patients with subfoveal CNV secondary to ARMD without any previous treatment. Patients were divided into a nabumetone or placebo group. The main endpoints were the change of best-corrected visual acuity (BCVA), central macular thickness (CRT) and number of required PDT treatments Results: In the nabumetone group, 27 patients (90%) and 28 (93%) in the placebo group completed the follow-up of 12 months. In the nabumetone group, the mean CRT decreased from 332 μm (SD 68 μm) to 220 μm (SD 46 μm). In the placebo group, CRT decreased from 331 μm (SD 72 μm) to 254 μm (SD 61 μm). The mean BCVA was 0.68 log MAR (SD 0.22 log MAR) in the nabumetone group and 0.62 log MAR (SD 0.23 log MAR) in the placebo group at baseline. This stabilised in the placebo group to 0.66 log MAR (SD 0.33) but deteriorated in the nabumetone group to 0.86 logMAR (SD 0.41 logMAR). There was a significant reduction in the number of required PDTs in the nabumetone group, but significant progression of the RPE atrophy area. Conclusion: Combined PDT with oral intake of the COX-2...
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Evaluation of posterior capsule opacification after cataract surgery
Kalfeřtová, Marie ; Jirásková, Naďa (advisor) ; Baráková, Drahomíra (referee) ; Těšínský, Pavel (referee)
Purpose: To study effect of AquaLase method used for final management of posterior capsule during cataract surgery on the posterior capsule opacification (PCO) creation and to verify safety of this method for the corneal endothelium. Methods: The prospective clinical study involving 56 patients with bilateral cataract having lens removal at the Department of Ophthalmology, University Hospital Hradec Králové in the period from September 2007 to March 2009. During the surgery lens was removed using torsional phacoemulsification and bimanual irigation/aspiration. Cleaning of the posterior capsule of the right eye was performed using AquaLase method (Alcon Laboratories, Forth Worth, Texas, USA) based on pulsed warm, naturally balanced surgical solution. Intraocular lens AcrySof SA60AT was implanted bilaterally to all patients. All patients were examined preoperatively and 3, 6, 12 and 24 months after surgery. Each examination covered best corrected visual acuity (BCVA), endothelial cell count (ECC) and corneal pachymetry. Moreover postoperatively digital retroillumination photographs of the anterior segment focused on the posterior capsule were always obtained. The Evaluation of Posterior Capsule Opacification (EPCO 2000) software and the Open-Access Systematic Capsule Assessment (OSCA) system were used...
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