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Optical coherence tomography in multiple sclerosis.
Lízrová-Preiningerová, Jana ; Kubala Havrdová, Eva (advisor) ; Vymazal, Josef (referee) ; Taláb, Radomír (referee)
Spectral domain optical coherence tomography (SD-OCT), a non-invasive imaging method, is based on an analysis of a near-infrared light deflected from tisssue layers, that provides detailed images of retinal structures. Nerve cells of the retina, that originate from neuroectoderm, reflect neurodegeneration of the central nervous system (CNS), as well as acute damage of nerve structures caused by optic neuritis. The dissertation first presents established imaging protocol and quality standards for SD-OCT imaging in multiple sclerosis (MS). In the following section we introduce SD-OCT as a biomarker in MS. In a multicentric cross-sectional study, we had shown, that a single time measurement of peripapillary retinal nerve fiber layer thickness (RNFL) has a predictive value for a risk of disease progression in the next five years. Patients with a thickness of RNFL in the lowest tercile of the studied population had a relative risk of disease progression 2x higher than patients in the highest tercile. The second presented study tests whether the history of optic neuritis (ON) in MS is a risk factor for neurodegeneration of RNFL in later years. The study confirmed that long term changes of RNFL thickness in eyes post-ON and in eyes with no history of ON are not different. Therefore, we conclude that both,...
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The effect of multiple sclerosis on psychical health of people suffering from multiple sclerosis
CHROUSTOVSKÁ, Petra
In my thesis, I focused on people with multiple sclerosis and their kin. I followed the issues how this disease affects the psychological perception of people with this disease and how to change the perception of their kin. Sclerosis comes from latin word "skleros" that means "stiff, tough" and multiple stands for the fact that lesions can be formed anywhere in the central nervous system. Multiple sclerosis is an autoimmune inflammatory disease. The cause of this disease is still unknown and there are currently no drugs that would be able to completely stop the disease and cure it. It is a disease of mainly young people between 20 - 40 years. The myelin sheaths disintegrate and the nerve impulses consequently interrupt or slow down in the organism. This process leads to progressive disability of such ill people. The work is divided into two parts, theoretical and practical. The theoretical part is mainly deals with the fundamental issues of multiple sclerosis. There are stated and described the symptoms of the disease and its treatment, diagnostics of disease and the impact on family, social or work life. The practical part is focused on qualitative research where I addressed two groups of people. The first group consists of people with multiple sclerosis disease. Data was collected by narrative interviews. The second group is formed by kin, where a semi standardized questionnaire was applied. Respondents were selected using the "snowball". The survey conducted among patients resulted in basic finding. For people with good family backgrounds the knowledge of their diagnosis caused decrease of their mental health and mild depression that was usually subsided after treatment with antidepressants and the patient was able to return to active life. For people with impaired family background mental and physical health deteriorated. Immediate family members understand the changes in life values of their loved ones and support them in every new activity. I chose this topic because the number of people with multiple sclerosis is increasing. In this work, I would like to contribute to greater awareness, both patients and company, also support patients and show that even with multiple sclerosis they can live a full life.
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