Seroprevalence of Bartonella Species in Patients with Ocular Inflammation.

Bartonella species, vector-borne etiologic agents of many systemic or self-limited infections, are responsible for a widening spectrum of diseases in humans, including inflammatory conditions of the eye. The aim of this study was to determine whether there is any relationship between uveitis and the evidence of Bartonella spp. infection in the serum, ocular fluid, and cataract mass in patients with intraocular inflammation. Polymerase chain reaction (PCR)-based tests and DNA sequencing were performed on surgery-extracted specimens of intraocular fluid and lens mass of 33 patients. Sera from 51 patients and 101 control subjects were tested for the presence of specific antibodies against Bartonella spp. Neither IgM-class antibodies against Bartonella spp. nor Bartonella spp. DNA were detected. A specific IgG-class antibody was found in 33.3% of the patients with uveitis. The rate of positive Bartonella serology was higher among the uveitis patients than that in control subjects. This high rate may in part result from unrecognized indirect mechanisms rather than the immediate presence and multiplication of Bartonella spp. in the eyeball. Nonetheless we believe that screening for Bartonella spp. should become part of the diagnostic workup in uveitis.

Macular assessment using Optical Coherence Tomography in patients after uneventful phacoemulsification treated postoperatively with bromfenac, diclofenac or dexamethasone.

Aim: To assess macular thickness and volume using optical coherence tomography in patients treated with different anti-inflammatory agents after uneventful phacoemulsification. Material and methods: We analysed macular parameters using optical coherence tomography in 50 consecutive patients (mean age 70.5 years) who underwent uneventful phacoemulsification cataract surgery at the Ophthalmology Department, Medical University of Warsaw between March 2012 and January 2013. Patients were divided into 3 groups, according to 3 different anti- -inflammatory agents used during the postoperative period: group T receiving dexamethasone 0.1% (n=17), group Y receiving bromfenac sodium 0.09% (n=16) and group D receiving diclofenac sodium (n=17). We evaluated macular scans obtained the day before surgery and on days 1., 7., 30. and 90. postoperatively. Central subfield thickness, cube volume and cube average thickness were measured during the optical coherent tomography. The data was analysed statistically using the SAS 9.2 software. The graphs were prepared using the STATISTICA 12 software. Results: A significant increase in central subfield thickness was observed on day 30. postoperatively. However, there were no statistically significant differences in macular thickness between the study groups. Conclusions: Central retinal thickness increases after uneventful phacoemulsification despite active anti-inflammatory treatment and irrespective of the drug class used.

Bacterial tick-borne diseases caused by Bartonella spp., Borrelia burgdorferi sensu lato, Coxiella burnetii, and Rickettsia spp. among patients with cataract surgery.

BACKGROUND: Clinical data have shown that tick-borne diseases caused by Borrelia burgdorferi sensu lato, Bartonella spp., Coxiella burnetii, and Rickettsia spp. can affect the central nervous system, including the eye. The aim of this study was to establish a relationship between the incidence of cataract and evidence of bacterial infections transmitted by ticks. MATERIAL AND METHODS: Fluid with lenticular masses from inside of the eye and blood from 109 patients were tested by PCR and sequencing. Sera from patients and the control group were subjected to serological tests to search specific antibodies to the bacteria. RESULTS: Microbiological analysis revealed the presence of Bartonella sp. DNA in intraoperative specimens from the eye in 1.8% of patients. Serological studies have shown that infections caused by B. burgdorferi sensu lato and Bartonella sp. were detected in 34.8% and 4.6% of patients with cataract surgery, respectively. CONCLUSIONS: Presence of DNA of yet uncultured and undescribed species of Bartonella in eye liquid indicates past infection with this pathogen. Specific antibodies to B. burgdorferi sensu lato and Bartonella sp. are detected more frequently in patients with cataract compared to the control group. This could indicate a possible role of these organisms in the pathological processes within the eyeball, leading to changes in the lens. Further studies are needed to identify Bartonella species, as well as to recognize the infectious mechanisms involved in cataract development.

Evaluation of macular thickness after uneventful phacoemulsification in selected patient populations using optical coherence tomography.

PURPOSE: To quantitatively evaluate the effect of uneventful phacoemulsification on central retinal thickness and foveal volume with regard to the following factors: age, gender, systemic diseases: diabetes mellitus, arterial hypertension, coronary heart disease, phacoemulsification parameters (power and time); and to identify patient population at high risk of postoperative changes in macular thickness. MATERIAL AND METHODS: 87 eyes of 87 patients were examined. Foveal volume and central retinal thickness were measured using optical coherence tomography on postoperative days 1, 7, 30, 90 and 180. 10 patients did not complete the study, because of independent factors, these were excluded from the analysis. The results were analyzed within the predefined patient groups. RESULTS: There was a significant increase of central retinal thickness and foveal volume values on postoperative days 7, 30, 90 and 180, as compared to baseline (1st day after surgery). These values were higher in males and in patients with coronary heart disease. The presence of diabetes and hypertension was associated with the increased central retinal thickness, especially when both considered factors were present. No significant relation was found between the patient age and central retinal thickness during the 6-month's follow up. However, a significant association was observed between the age and the risk of retinal thickening. Higher phaco power (over 40.0%) settings increased both central retinal thickness and the risk of retinal thickening during the follow-up period. CONCLUSION: There is a significant increase in macular parameters after uneventful phacoemulsification. Despite downward trend, they remain elevated throughout the 6-month observation period. Diabetes and hypertension increase the risk of post-operative changes in macular thickness, especially if they coexist. Higher phaco power increases the risk of retinal thickening after cataract surgery. Early macular evaluation using the optical coherence tomography identifies patients at high risk of complications, who might benefit from additional anti-inflammatory treatment.

Pupil diameter during cataract surgery after intracameral injection of the first ready-to-use combination of mydriatics and anaesthetic at the beginning of surgery in patients with a preoperative pupil diameter <6 mm.

PURPOSE: We evaluated, in a real-life setting, the effect of Mydrane® (ready-to-use combination of tropicamide, phenylephrine hydrochloride and lidocaine, injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anaesthesia) on the pupil diameter during cataract surgery in patients with a preoperative pupil diameter <6 mm after the use of topical mydriatics. METHODS: We collected and analysed the data of 59 consecutive patients whose pupils dilated to a diameter <6 mm after the administration of mydriatic eye drops during the preoperative visit and who received Mydrane® during cataract surgery. RESULTS: In the group of 59 patients with a preoperative pupil diameter <6 mm after topical mydriatics, cataract surgery was performed in 36 patients (61.0%) using only Mydrane® to obtain mydriasis, with no additional drug or medical device. The mean pupil diameters in this group (36 of 59) during the preoperative assessment after topical mydriatics and just before capsulorhexis when Mydrane® was injected during surgery were 5.1 ± 0.74 and 6.15 ± 1.14 mm. Additional drugs were used in 23 patients (39%). In this group, the mean pupil diameters after topical mydriatics and just before capsulorhexis using Mydrane® were 4.58 ± 1.06 and 5.6 ± 1.26 mm, respectively. CONCLUSION: In a real-life setting, the mean pupil diameter achieved during cataract surgery after the intracameral injection of Mydrane® in patients with a preoperative pupil diameter <6 mm was over 1 mm larger than the mean pupil diameter after topical mydriatics, despite the trauma caused by the operation.

[IThe use of Pentacam for keratoconus diagnosis and progress evaluation]. / Zastosowanie aparatu Pentacam w diagnostyce i ocenie progresji stozka rogówki.

The authors present possibilities of Pentacam examination for keratoconus diagnosis and progress evalutaion. They describe meaning of data comming from Pentacam 3D model measurements; indexes for corneal surface disturbances, analysis of anterior and posterior corneal surface, sense of connection data from keratometric and pachymetric measurements for keratoconus detection.

Stable Mydriasis After Intracameral Injection of a Combination of Mydriatics and Anesthetic During Cataract Surgery: A Real-Life, Multicenter Study.

Purpose: To evaluate the effect of Mydrane (contains tropicamide, phenylephrine hydrochloride, and lidocaine hydrochloride) on time needed to induce mydriasis and mydriasis stability during cataract surgery. Methods: This was an observational, non-interventional, multicenter study of patients undergoing cataract surgery who received Mydrane for mydriasis and intraocular anesthesia. The study was conducted at seven ophthalmology departments at university hospitals in Poland. Patients admitted for cataract surgery within a 2-week period were asked to participate in the study. Patients whose pupils dilated to a diameter ≥6 mm after topical mydriatic administration during preoperative examinations were scheduled to receive Mydrane and included in the registry. No additional inclusion criteria were used. Patients' medical histories, examination results, and operative details were recorded. Pupil diameter was measured during surgery. Surgeons were asked to complete a Likert-based survey in parallel. Results: A total of 307 patients were enrolled. The mean pupil diameter was 7.0 ± 1.0 mm before capsulorhexis and 6.9 ± 1.2 mm before lens implementation. A pupil diameter ≥6 mm was achieved in 91.9% and 87.6% of patients before capsulorhexis and lens implantation, respectively. We asked 58 surgeons whether they agreed with the statement "Mydriasis was obtained in a short time after the administration of Mydrane"; the surgeons agreed with this statement after 92.2% (283/307) of surgeries. In addition, after 88.2% of surgeries, the surgeons agreed with the statement "Mydriasis was stable after the administration of Mydrane." Conclusions: Mydriasis was rapidly and stably obtained after Mydrane injection, as demonstrated by pupil diameter measurements during surgery and surgeons' feedback.

[Louis Braille (1809-1852)--inventor of raised dots system]. / Louis Braille (1809-1852)--twórca pisma dla niewidomych.

Louis Braille was born on January 4th 1809 in Coupvray, France. An injury to his eye at the age of three, resulted in total loss of vision. In 1819 he entered the Institute for Blind Youth in Paris. There he would live, study, and later teach. When he was fifteen, he developed system of reading and writing by means of raised dots, which is known today as Braille. The basis of the Braille system is known as a Braille cell. The cell is comprised of six dots numbered in a specific order. Each dot or combination of dots represents a letter of the alphabet. This Braille system has established itself internationally and formed the basic Braille for all languages.

[Pentacam--the new way for anterior eye segment imaging and mapping]. / Pentacam--nowe mozliwosci obrazowania przedniego odcinka galki ocznej.

Accurate preoperative measurements are required for refractive and cataract surgery. Pentacam is a new imaging system for anterior eye segment study. The authors present technique and the range of measurements; topography of both anterior and posterior corneal surface from limbus to limbus, densitometry, anterior chamber angle, volume and depth, lens densitometry and 3D-virtual model of the anterior eye segment are taken. All those structures are shown thanks to rotating Scheimpflug camera, which generates three-dimension images. Any eye movements are detected by a second camera and corrected for, in the process. All results are written down on PC and are available for the prospective studies.

[The visual acuity impairment as the only sign of cerebral aneurysms--case report]. / Obnizenie ostrosci wzroku jako jedyny objaw tetniaków tetnic mózgowych--opis przypadku.

Cerebral aneurysms are the most common reason of subarachnoid haemorrhage at the age of 50-60. Though the results of such haemorrhage are severe (high morbidity and mortality), it is quite often, the first noticeable sign of the problem. Previous symptoms i. e. headache, ophthalmic disturbances, temporary neurological symptoms are often passed over. The authors present the case of a young woman with cerebral aneurysms, in which the visual acuity impairment was the only symptom of the disease.