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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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Posterior lamellar keratoplasty
Studený, Pavel ; Dotřelová, Dagmar (advisor) ; Pašta, Jiří (referee) ; Filipec, Martin (referee)
110 9. SUMMARY Introduction The endothelial dysfunction and related corneal oedema with decreased transparency id still the main indication for keratoplasty. Method of posterior lamellar keratoplasty, which is popular in oftalmology in last few years, is suitable method because we exchange just the affected part of the cornea. Nowadays there are more surgical ways and modalities of the technique, but the best way has not been established yet. Purpose Purpose of our study was: to evaluate and analyze the efficacy of new technique of lamella preparation, to evaluate new method of lamela implantation and to analyse anatomical outcomes in experiment and clinical outcomes in practice. Materials and methods Group 1 involves 71 eyes of 55 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using a hydroimplantation. In group 2 were enrolled 27 eyes of 22 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using glide. In the postoperative period, we evaluated corrected and uncorrected visual acuity and corneal endothelial density. We analyzed and compared clinical outcomes of both groups and we focused especially on the method of implantation. Student t test and Bonferroni test were used for all statistical analysis....
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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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Vitreoretinal interface in relation to surgery on macular disorders
Kalvoda, Jan ; Dušková, Jaroslava (advisor) ; Dotřelová, Dagmar (referee) ; Rozsíval, Pavel (referee)
1 Abstract Introduction The vitreoretinal (VR) interface of the eye is a dynamically evolving environment which significantly influences and indicates the course of macular disorders. The main topic of the presented paper is research on the VR interface in relation to surgery on diabetic macular edema (ME), partial macular defects (PMD) and idiopathic macular holes (IMH). Aims The aims of the research were to find out new knowledge about specific characteristics of and changes in the VR interface in eyes with diabetic ME, PMD and IMH, namely with main attention focused on the internal limiting membrane (ILM) of the retina and the epimacular membrane (EMM). Methods Histopathologic and morphometric analyses were carried out on samples of the ILM of the retina and the EMM which were taken during pars plana vitrectomy (PPV) of eyes of sets of patients with diabetic ME, PMD and IMH. The analytic results were statistically evaluated and interpreted in relation to clinical factors and anatomical results of the PPV. Results Treatment of diabetic ME with removal of the ILM resulted in improved visual acuity (VA), at minimum 2 lines on the ETDRS table, in 51.8% surgically treated eyes and remained the same in 33.9% of eyes. A comparison study confirmed that PPV with preserving of the ILM achieved a long-term...
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Posterior lamellar keratoplasty
Studený, Pavel ; Dotřelová, Dagmar (advisor) ; Pašta, Jiří (referee) ; Filipec, Martin (referee)
110 9. SUMMARY Introduction The endothelial dysfunction and related corneal oedema with decreased transparency id still the main indication for keratoplasty. Method of posterior lamellar keratoplasty, which is popular in oftalmology in last few years, is suitable method because we exchange just the affected part of the cornea. Nowadays there are more surgical ways and modalities of the technique, but the best way has not been established yet. Purpose Purpose of our study was: to evaluate and analyze the efficacy of new technique of lamella preparation, to evaluate new method of lamela implantation and to analyse anatomical outcomes in experiment and clinical outcomes in practice. Materials and methods Group 1 involves 71 eyes of 55 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using a hydroimplantation. In group 2 were enrolled 27 eyes of 22 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using glide. In the postoperative period, we evaluated corrected and uncorrected visual acuity and corneal endothelial density. We analyzed and compared clinical outcomes of both groups and we focused especially on the method of implantation. Student t test and Bonferroni test were used for all statistical analysis....
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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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Vitreoretinal interface in relation to surgery on macular disorders
Kalvoda, Jan ; Dušková, Jaroslava (advisor) ; Dotřelová, Dagmar (referee) ; Rozsíval, Pavel (referee)
1 Abstract Introduction The vitreoretinal (VR) interface of the eye is a dynamically evolving environment which significantly influences and indicates the course of macular disorders. The main topic of the presented paper is research on the VR interface in relation to surgery on diabetic macular edema (ME), partial macular defects (PMD) and idiopathic macular holes (IMH). Aims The aims of the research were to find out new knowledge about specific characteristics of and changes in the VR interface in eyes with diabetic ME, PMD and IMH, namely with main attention focused on the internal limiting membrane (ILM) of the retina and the epimacular membrane (EMM). Methods Histopathologic and morphometric analyses were carried out on samples of the ILM of the retina and the EMM which were taken during pars plana vitrectomy (PPV) of eyes of sets of patients with diabetic ME, PMD and IMH. The analytic results were statistically evaluated and interpreted in relation to clinical factors and anatomical results of the PPV. Results Treatment of diabetic ME with removal of the ILM resulted in improved visual acuity (VA), at minimum 2 lines on the ETDRS table, in 51.8% surgically treated eyes and remained the same in 33.9% of eyes. A comparison study confirmed that PPV with preserving of the ILM achieved a long-term...
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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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