Optical coherence tomography in diagnosis and monitoring multiple sclerosis

This paper presents application of optical coherence tomography (OCT) for diagnosis and monitoring of multiple sclerosis (MS). The peripapillary retinal nerve fibre layer thinning and the reduced total macular volume analysis are shown. With the course of the MS, the severity of these abnormalities increases which reflects the progressive degeneration of retinal ganglion cells and nerve fibres. The OCT parameters are sensitive, non-invasive indicators useful in assessing the progression of inflammation and neurodegeneration in MS

Pseudophakic cystoid macular edema: update 2016

Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery, leading in some cases to a decrease in vision. Although the pathogenesis of PCME is not completely understood, the contribution of postsurgical inflammation is generally accepted. Consequently, anti-inflammatory medicines, including steroids and nonsteroidal anti-inflammatory drugs, have been postulated as having a role in both the prophylaxis and treatment of PCME. However, the lack of a uniformly accepted PCME definition, conflicting data on some risk factors, and the scarcity of studies comparing the role of nonsteroidal anti-inflammatory drugs to steroids in PCME prevention make the problem of PCME one of the puzzles of ophthalmology. This paper presents an updated review on the pathogenesis, risk factors, and use of anti-inflammatory drugs in PCME that reflect current research and practice

Comparison of Advanced Threshold and SITA Fast Perimetric Strategies

Purpose. To compare the results obtained with two threshold strategies of visual field assessment: Humphrey SITA Fast (SFA) (Carl Zeiss Meditec) and PTS 2000 Advanced Threshold (ADV) (Optopol Technology) in healthy subjects and patients with glaucoma. Methods. The study sample comprised of 53 healthy volunteers and 69 patients with glaucoma. One eye of each patient was examined with the SFA and ADV strategies. The quantitative comparisons of test duration and global indices were made using correlation coefficients. The sensitivity and specificity of the algorithms were evaluated based on the GHT results and the adjusted Anderson–Patella (A&P) criteria. Results. The ADV test duration was shorter both in healthy subjects (by 5%) and patients with glaucoma (by 18%). The mean differences in MS values between the SFA and the ADV strategies were 1.06 ± 1.13 dB (MSSFA-MSADV) in healthy subjects and 1.00 ± 1.92 dB (MSSFA-MSADV) in patients with glaucoma. The MD index of ADV tests was lower than the SFA in the healthy (−0.74 ± 1.09 dB) (MSSFA-MSADV) and glaucoma group (−0.85 ± 2.19 dB) (MSSFA-MSADV). The mean differences in PSD values determined using both methods were −0.86 ± 0.67 dB (PSDSFA-PSDADV) and −0.53 ± 1.48 dB (PSDSFA-PSDADV) in healthy subjects and patients with glaucoma, respectively. Analysis of receiver operating characteristic curves built from MD and PSD indices show bigger area under curve in SFA than in ADV (0.983 vs.0.968 and 0.986 vs. 0.938, respectively). The GHT-based sensitivity and specificity for the ADV strategy were 92.75% and 77.36%, respectively, as compared to 92.75% and 90.57%, respectively, for the SFA strategy. Conclusions. Both SFA and ADV enable effective identification of glaucomatous defects within 5 minutes. The ADV strategy, however, is significantly faster. The correlation between the global indices of SFA and ADV is very high. Both strategies offer very high sensitivity when using both GHT and A&P criteria

Current Trends in the Monitoring and Treatment of Diabetic Retinopathy in Young Adults

The diagnosis and treatment of diabetic retinopathy (DR) in young adults have significantly improved in recent years. Research methods have widened significantly, for example, by introducing spectral optical tomography of the eye. Invasive diagnostics, for example, fluorescein angiography, are done less frequently. The early introduction of an insulin pump to improve the administration of insulin is likely to delay the development of diabetic retinopathy, which is particularly important for young patients with type 1 diabetes mellitus (T1DM). The first years of diabetes occurring during childhood and youth are the most appropriate to introduce proper therapeutic intervention before any irreversible changes in the eyes appear. The treatment of DR includes increased metabolic control, laserotherapy, pharmacological treatment (antiangiogenic and anti-inflammatory treatment, enzymatic vitreolysis, and intravitreal injections), and surgery. This paper summarizes the up-to-date developments in the diagnostics and treatment of DR. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual ophthalmology journals, books, and leading pharmaceutical company websites

Role of Advanced Glycation End Products in Assessment of Diabetes Mellitus as a Risk Factor for Retinal Vein Occlusion

Aim: In this study, we aimed to assess the correlation between diabetes mellitus (DM) and the retinal vein occlusion (RVO) based on skin autofluorescence (SAF) measurement, which reflects the accumulation of advanced glycation end products (AGE) in patients who have undergone an episode of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Material and methods: In total, 23 patients (16 males, 7 females) with RVO were included in this study. Among these 23 participants, 12 (52%) had been diagnosed with CRVO and 11 (48%) with BRVO. The control group consisted of 14 healthy volunteers (11 females, 3 males). To calculate the risk of cardiovascular diseases (CVD) and DM, we conducted SAF examinations. We compared the SAF levels in three groups of patients: (1) with CRVO, (2) with BRVO, and (3) the control group. Basic demographic and clinical information and detailed history of the concurrent diagnoses of systemic diseases, such as systemic hypertension (HTN), DM, hyperlipidemia (HL), and heart diseases, were obtained. Results: In total, 10 (43.5%) patients were diagnosed with DM, 6 (55%) in the BRVO group and 4 (33%) in the CRVO group. The mean SAF value was significantly higher in the BRVO group than in the control group (2.64 a.u. and 2.35 a.u., respectively) (p = 0.023). More patients with risk of DM were identified in the CRVO group than in the BRVO group (p = 0.024). Conclusions: The advanced glycation end products (AGE) in the skin autofluorescence (SAF) is a viable method of evaluating the risk of DM in patients with RVO. We confirmed a correlation between RVO and DM, which was significantly pronounced in the CRVO form, although further carefully devised studies on the relationship between RVO and DM with a larger number of responders should be conducted in the future