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Analysis of the retinal nerve fiber layer in hiv positive patients in era of combination antiretroviral treatment
Kožner, Pavel ; Filouš, Aleš (advisor) ; Kalvodová, Bohdana (referee) ; Sedláček, Dalibor (referee)
The aim of the study was to evaluate the effect of human immunodeficiency virus infection (HIV) and antiretroviral treatment on the retinal nerve fibre layer (RNFL). The RNFL hickness defined by standard parameters(TSNIT average, Superior average and Inferior average) was assessed in 48 HIV positive patients using scanning laser polarimeter, GDx VCC device. Results were compared to normal values and tested against factors suspected to affect the RNFL thickness. The mean values of the RNFL standard parameters were for TSNIT average, Superior average and Inferior average, 57,65 ± 6,18 m, 69,38 ± 8,34 m, 68,89 ± 9,50 m respectively, in our cohort. The RNFL thinning was not confirmed in our HIV positive group compared to values on healthy population. No significant correlation between the RNFL thickness and the immune profile or antiretroviral therapy was detected. However, a significant negative correlation between the RNFL thickness with increasing duration of HIV infection was foundin our study that is hypothesized to be possibly on an immune pathological basis. Powered by TCPDF (www.tcpdf.org)
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Some molecular mechanisms of calcium phosphate metabolism in diabetes mellitus
Vedralová, Marcela ; Černá, Marie (advisor) ; Kalvodová, Bohdana (referee) ; Brunerová, Ludmila (referee)
We chose to study polymorphisms of vitamin D receptor gene (VDR), parathyroid hormone gene (PTH) and CASR gene whose protein products significantly affect calcium phosphate metabolism and are implicated in the pathogenesis of diabetes, which may also involve kidney damage. The aim of this study was to find out whether the VDR, PTH and CASR polymorphisms are associated with the risk of developing diabetes mellitus and its renal complications. The frequencies of alleles and genotypes were studied in the groups of diabetic patients a with and without kidney complications using either TaqMan probes or PCR-RFLP. Comparison of patients with diabetic nephropathy (DN) and healthy subjects identified statistically significant difference for the FokI polymorphism in VDR gene (P<10-4) and also for the BstBI polymorphism in PTH gene (P=0,023). DraII polymorphism in PTH gene is associated with the risk of developing diabetes and its renal complications. In DN patients, the BBFFAATt haplotype of VDR gene was more frequent than in healthy subjects (P=0,046), and the BbFFAaTt variant was more frequent than in DM2 patients (P=0,018). The BBDD haplotype of PTH gene seems to be a predisposing factor for diabetes itself (P=0,019). The allele frequencies and genotype distribution for rs3804594 and rs1042636...
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Changes in eye tissues in patients with diabetes mellitus, with emphasis on the tissue surface of the eye
Česká Burdová, Marie ; Mahelková, Gabriela (advisor) ; Kalvodová, Bohdana (referee) ; Kvapil, Milan (referee)
Introduction: Relation of diabetes mellitus (DM) to the diabetic keratopathy and various stages of corneal nerve fiber damage has been well accepted. A possible association between changes in the cornea of diabetic patients and diabetic retinopathy (DR), DM duration, and age at the time of DM diagnosis were evaluated. Neuropathies are among the most common long-term complications of diabetes mellitus. Good glycemic control is essential in prevention of this complication. DM patients with similar mean glucose levels or glycated hemoglobin (HbA1c) levels often exhibit differences in evaluation of diabetic complications. One reason for these differences may be the differences in glucose variability. DM patients with similar mean glucose levels or HbA1c levels often exhibit differences in glucose variability Hypothesis: Diabetes mellitus damages the subbasal nerve fibers of the corneal and affects the density of epithelial, endothelial and stromal cells. Corneal changes in patients with DM are dependent on the degree of diabetic retinopathy (DR), age at diagnosis, duration of DM, and compensation parameters. Purpose: To compare changes in cell density in individual layers of cornea and status of subbasal nerve fibers in patients with type 1 DM (DM 1) and in healthy subjects. To evaluate the dependence...
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Analysis of the retinal nerve fiber layer in hiv positive patients in era of combination antiretroviral treatment
Kožner, Pavel ; Filouš, Aleš (advisor) ; Kalvodová, Bohdana (referee) ; Sedláček, Dalibor (referee)
The aim of the study was to evaluate the effect of human immunodeficiency virus infection (HIV) and antiretroviral treatment on the retinal nerve fibre layer (RNFL). The RNFL hickness defined by standard parameters(TSNIT average, Superior average and Inferior average) was assessed in 48 HIV positive patients using scanning laser polarimeter, GDx VCC device. Results were compared to normal values and tested against factors suspected to affect the RNFL thickness. The mean values of the RNFL standard parameters were for TSNIT average, Superior average and Inferior average, 57,65 ± 6,18 m, 69,38 ± 8,34 m, 68,89 ± 9,50 m respectively, in our cohort. The RNFL thinning was not confirmed in our HIV positive group compared to values on healthy population. No significant correlation between the RNFL thickness and the immune profile or antiretroviral therapy was detected. However, a significant negative correlation between the RNFL thickness with increasing duration of HIV infection was foundin our study that is hypothesized to be possibly on an immune pathological basis. Powered by TCPDF (www.tcpdf.org)
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New approaches in the treatment of macular edema. (Intravitreal triamcinolone acxetonide application)
Dusová, Jaroslava ; Hejcmanová, Dagmar (advisor) ; Boguszaková, Jarmila (referee) ; Kalvodová, Bohdana (referee)
New approaches in the treatment of macular edema. Intravitreal triamcinolone acetonide application. We evaluate the efficacy of 4 mg intravitreal triamcinolone injection (IVTA) in patients with macular edema (ME) of various etiology. This prospective study included 54 eyes. Group I consisted of 30 eyes with diabetic macular edema (DME), group II included 16 eyes with ME after retinal vein occlusion and group III contained 8 eyes with cystoid macular edema (CME) after standard cataract surgery. All patients were examined prior to injection and at the 1, 3, 6, 9 and 12 months as followed: the best corrected visual acuity (BCVA) using ETDRS charts, intraocular pressure (IOP) by applanation tonometry, anterior segment and macula biomicroscopy at the slit lamp. Colour fundusphotography was done and macular thickness (MT) was measured by optical coherence tomography (OCT). In all groups of ME, the reduction of MT and improvement of BCVA was observed during and at the end of the study. Mean BCVA in group I improved from 0.19 to 0.23 and MT decreased from 518µm to 375µm. Statistically significant improvement of BCVA (p<0,05) was demonstrated for 1, 3, 6 and 9 months after IVTA. At the 12th month follow up improvement of BCVA was not significant (p=0,057). Reduction of ME was significant in all follow up...
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Surgical treatment of diabetic macular edema
Aboutable, Tarek ; Kalvodová, Bohdana (advisor) ; Korda, Vladimír (referee) ; Boguszaková, Jarmila (referee)
Diabetic macular edema is the most common cause of visual impairment in diabetic patients. Precise pathophysiology of diabetic macular edema is unclear and seems to be multifactorial and includes pericyte loss, microaneurysm formation, basement membrane thickening and focal closure of the capillary bed, vitreomacular traction, and ultimately breakdown of the blood-retinal barrier with increased vascular permeability. Risk factors for clinical significant diabetic macular edema are hyperglycemia, hypertension, hyperlipidemia, duration of diabetes, and pregnancy. The increasing number of individuals with diabetes worldwide suggests that diabetic macular edema will continue to be major contributors to vision loss and associated functional impairment in the working-age population of most developed countries. Although eyes with diffuse macular edema carry a particularly poor prognosis despite laser photocoagulation, laser treatment is still the first choice of treatment for diabetic macular edema as it is safety and less invasive that other surgical options. Diffuse diabetic macular edema is characterized by diffuse leakage from extensive areas of the posterior retinal capillary bed, a scarcity of hard exudates, and often the formation of cystoid spaces. Focal macular edema, in contrast, is characterized by...
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