The assessment of multifocal ERG responses in school-age children with history of prematurity.

PURPOSE: The authors examined macular function in preterm-born children, using multifocal ERG (mfERG). Possible alterations in P1 amplitudes, P1 amplitudes density and P1 implicit time between school-age children with history of prematurity and their peers were researched. The correlations between parameters of mfERG responses and birth weight, gestational age, macular volume and central macular thickness were verified. METHODS: A group of 18 preterm-born school-age children were analyzed (mean age 10.18 ± 1.21 years). The study group was compared to the group of 15 peers born appropriate for gestational age (mean age 10.8 ± 1.52 years). The mfERG was evaluated in all children. RESULTS: There were statistically significant differences for P1 amplitudes from ring 1 (p = 0.0001) and P1 amplitudes density from ring 1 (p = 0.0001). Calculating the correlation coefficients, we receive significant results for P1 amplitudes from ring 1 versus gestational age (r = 0.54; p = 0.026), birth weight (r = 0.54; p = 0.026) and central macular thickness (r = -0.62; p = 0.008), and for P1 amplitudes density from ring 1 versus central macular thickness (r = -0.51; p = 0.034). CONCLUSIONS: The study suggests that P1 amplitudes and P1 amplitudes density vary in preterm-born children in comparison with their peers born appropriate for gestational age, which might suggest discreet macular dysfunction. The correlation between low birth weight, early gestational age, central macular thickness and mFERG components from ring 1 might evidence that decreased bipolar cells density caused by premature birth is the result of altered development of central retina reflecting in structural anomalies of the fovea.

The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia.

BACKGROUND: A significant increase in myopia among children and teenagers can be observed all over the world. Yet at the same time, there is still an insignificant number of studies concerning this health problem. The aim of this study was to assess the level of trait anxiety among myopic group of teenagers in comparison to teenagers with emmetropia, and to confirm whether the level of trait anxiety relates to age and gender. METHODS: Two hundred thirty-nine students aged 13-17 years were included in the study. The study group comprised 114 persons with myopia (81 girls and 33 boys), while the control group comprised 125 persons without refractive error (79 girls and 46 boys). Volunteers completed a set of questionnaires including: personal data, State-Trait Anxiety Inventory for Children (STAIC) (13-14 year-olds), or State-Trait Anxiety Inventory (STAI) (15-17 year-olds). The trait anxiety subscales were thus analyzed. RESULTS: Among younger adolescents (13-14 years of age) with myopia there was a significantly higher incidence of pathological intensification of anxiety as a constant trait. After taking into account the distribution of gender, there was a higher level of trait anxiety in the group of boys with myopia than in the control group aged 13-17 years and 13-14 years. There was also a higher level of trait anxiety detected in males than in females. CONCLUSIONS: Myopia may affect the level of trait anxiety among 13-14-year-olds. In both age groups of girls, a higher percentage of patients with high level of anxiety was discovered (≥7 sten), as compared to their peers without vision defects. Our results can contribute to a more accurate analysis of young teenagers' psychological problems, especially among boys diagnosed with myopia.

Traumatic hyphema in children and adolescents ­ aetiology and treatment.

Purpose: Retrospective analysis of patients with traumatic hyphema, including type of injury, treatment and visual outcome. Material and methods: We analysed a cohort of patients after blunt trauma, who were examined and treated between 2011­ ­2015. In each case, the baseline and ultimate visual acuity was determined, followed by slit lamp examination, intraocular pressure measurement, indirect binocular ophthalmoscopy of the fundus, ultrasound scan and OCT Visante. The type of treatment as well as duration of inpatient treatment and late complications were assessed for each case. Results: 45 patients (45 eyes) with traumatic hyphema due to blunt ocular trauma were enrolled. 42 of them were boys (93.3%), and 3 were girls (6.7%). The age range was 2.5­17.5 years (mean age of 11.92 ± 3.75 years). Upon admission, 10 (22.2%) children had full visual acuity (1.0). The most common injuries concomitant with hyphema included iridodialysis, corneal oedema, mydriasis and corneal erosion. Secondary hemorrhage occurred three days following injury in only one (2.2%) patient. The mean duration of inpatient admission was 4.3 days (ranged from 2 to 8 days). At the last follow-up visit, 36 (80%) patients had a full visual acuity of 1.0. Conclusions: Visual outcomes improve with earlier treatment commencement. Conservative management was sufficient to resolve traumatic hyphema in reported cases

Central nervous system tumour diagnosis in pediatric population ­ the role of an ophthalmologist and the utility of visual evoked potentials.

Objective: To determine possible alterations of P100 and P1 amplitudes and latencies in school-aged children with a history of a central nervous system tumour. Material and methods: The pattern visual evoked potential and flash visual evoked potential testing was performed in 42 school- -aged children: 15 patients with a history of the central nervous system tumour (mean age of 13.44 ± 2.41 years and 13.75 ± 2.29 years, respectively) and 27 healthy subjects as a control group (mean age 11.84 ± 1.44 years, and 14.78 ± 4.26 years, respectively). Results: P100 amplitudes of pattern visual evoked potentials were statistically decreased in the study group as compared to the control group. The only statistically signifcant difference between the study group and the controls was latencies recorded from O1 in 15-minute stimuli. P2 amplitudes of flash visual evoked potentials were decreased and latencies were increased in the study group, however, the differences were not statistically significant. Conclusions: Visual evoked potential alterations can be a sign of functional disturbances of the visual system in patients with any central nervous system tumour. Therefore, a diagnostic process of a central nervous system tumour should include a thorough ocular exam, even in patients with normal visual acuity.

An Influence of Birth Weight, Gestational Age, and Apgar Score on Pattern Visual Evoked Potentials in Children with History of Prematurity.

PURPOSE: The objective of our study was to examine a possible influence of gestational age, birth weight, and Apgar score on amplitudes and latencies of P100 wave in preterm born school-age children. MATERIALS AND METHODS: We examined the following group of school-age children: 28 with history of prematurity (mean age 10.56 ± 1.66 years) and 25 born at term (mean age 11.2 ± 1.94 years). The monocular PVEP was performed in all children. RESULTS: The P100 wave amplitudes and latencies significantly differ between preterm born school-age children and those born at term. There was an essential positive linear correlation of the P100 wave amplitudes with birth weight, gestational age, and Apgar score. There were the negative linear correlations of P100 latencies in 15-minute stimulation from O1 and Oz electrode with Apgar score and O1 and O2 electrode with gestational age. CONCLUSIONS: PVEP responses vary in preterm born children in comparison to term. Low birth weight, early gestational age, and poor baseline output seem to be the predicting factors for the developmental rate of a brain function in children with history of prematurity. Further investigations are necessary to determine perinatal factors that can affect the modified visual system function in preterm born children.

Immune recovery uveitis: pathogenesis, clinical symptoms, and treatment.

IRU is the most common form of immune reconstitution inflammatory syndrome in HIV-infected patients with cytomegalovirus retinitis who are receiving highly active antiretroviral therapy (HAART). Among patients with CMV in the HAART era, immune recovery may be associated with a greater number of inflammatory complications, including macular edema and epiretinal membrane formation. Given the range of ocular manifestations of HIV, routine ocular examinations and screening for visual loss are recommended in patients with CD4 counts <50 cells/µL. With the increasing longevity of these patients due to the use of HAART, treatment of IRU may become an issue in the future. The aim of this paper is to review the current literature concerning immune recovery uveitis. The definition, epidemiology, pathophysiology, clinical findings, complications, diagnosis, and treatment are presented.

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.

Evaluation of corneal endothelium in children and adolescents with type 1 diabetes mellitus.

PURPOSE: To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. MATERIALS AND METHODS: The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. RESULTS: The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm(2) and was significantly lower than in control group (2970.75 ± 270.1 cells/mm(2)). The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. CONCLUSIONS: ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT.

[Evaluation of anterior segment lesions in children and adolescents with ocular trauma using Visante OCT]. / Ocena zmian w przednim odcinku oka powstalych w nastepstwie urazów narzadu wzroku u dzieci i mlodziezy za pomoca OCT Visante.

AIM: To evaluate the anterior eye segment in children and adolescents after unilateral ocular trauma, using optical coherence tomography Visante OCT. MATERIAL AND METHODS: 19 patients (17 boys and 2 girls), hospitalized in Department of Pediatric Ophthalmology due to ocular trauma, were examined. Mean age was 12.6 years (6-17 years). 12 patients had blunt ocular trauma, and 7 patients had a penetrating injury. RESULTS: Hyphaema impeded the view in 5 eyes, so Visante OCT was helpful for the right treatment. The anterior chamber shallowing was diagnosed in 9 cases, and anterior chamber deepening in 5 cases. Lens pathology (subluxation, cataract) was recognized in 4 patients. OCT was useful in diagnosis of corneal wound (1 case) and in foreign body removal (1 case). CONCLUSIONS: Visante OCT provides easy visualization and high-resolution documentation. Its ability to image the anterior segment structures despite corneal opacification seems particularly important. This technique can be very useful in children and adolescents with ocular trauma.

[Evaluation of anterior chamber depth measurements in emmetropic, hypermetropic and myopic eyes in children and adolescents using OCT Visante]. / Ocena przedniego odcinka oczu normowzrocznych, nadwzrocznych i krótkowzrocznych u dzieci i mlodziezy za pomoca optycznej koherentnej tomografii OCT Visante.

PURPOSE: To evaluate the anterior chamber depth (ACD) measurements in emmetropic, hypermetropic and myopic eyes in children and adolescents using optical coherence tomography (OCT). MATERIAL AND METHODS: 86 patients at the age from 4 to 17 years were examined. 27 patients with mean age 14.0 +/- 2.94 years had myopia with spherical equivalent refraction (RE) from -0.50 to - 19.50 D (mean RE = -8.63 +/- 3.89 D). 29 patients with mean age 8.7 +/- 1.95 years had hypermetropia with RE from +0.50 to +9.00 D (mean RE = +4.49 +/- 2.11 D). 30 patients control group) with mean age 9.8 +/- 1.03 years had emmetropia. The anterior chamber depth was measured by OCT Visante. In myopic eyes measurements of axial length were obtained using ultrasound A scan. RESULTS: 172 eyes (86 subjects) were evaluated. The mean ACD measurement was 3.18 +/- 0.31 mm in myopic eyes, 2.73 +/- 0.2 mm in hypermetropic eyes, and 2.92 +/- 0.11 mm in emmetropic eyes. There were significant differences in ACD between these three groups of eyes (p<0.01). ACD was correlated with spherical equivalent refraction (Spearman correlation, r = -0.688, p<0.001), and axial length (r = 0.388, p = 0.003) in myopic eyes. There were no statistically significant differences in ACD between 30 eyes of 15 patients with anisometropia >3.00 D. CONCLUSIONS: There were significant differences in ACD between emmetropic, hypermetropic and myopic eyes in children and adolescents. ACD was associated with refractive error and axial length in the eyes with myopia. Further observations are necessary on larger number of patients.

The Effectiveness of Laser Peripheral Iridotomy in Adolescent Eyes with Ocular Hypertension and Concave Configuration of the Peripheral Iris.

Purpose: To evaluate the efficacy of laser peripheral iridotomy (LPI) in preventing deterioration in eyes with ocular hypertension (OHT) and concave configuration of the iris. Materials and Methods: This was a retrospective study, which was carried out within a period of 3-5 years. Twenty-four patients with OHT and concave irises were treated with LPI and followed up periodically. IOP, central corneal thickness (CCT), anterior chamber depth (ACD), scleral spur angle (SSA), global neuroretinal rim (NRR) thickness, and global retinal nerve fiber layer (RNFL) were examined before and after LPI. Results: The average age of the 24 patients was 14.21 ± 1.41 (13-17.5) years on admission. The initial IOP of the 48 eyes was 23.21 ± 1.56 mmHg in RE and 22.96 ± 2.1 mmHg in LE before LPI. All 48 eyes had concave irises in both eyes. All eyes treated with LPI have shown iris flattening, which has persisted during follow-up (mean 1.54 ± 0.9 years). At the last follow-up visit, the average IOP was 17.58 ± 2.63 (14-21) mmHg in RE and 17.58 ± 2.86 (14-21) mmHg in LE, which was statistically lower than that of the baseline (p < 0.001). There were significant changes in SSA in both eyes and global RNFL in RE after LPI. Conclusions: In the current study, LPI resulted in an IOP-lowering effect and iris flattening in adolescent eyes with a concave configuration of the peripheral iris.

[Glaucoma in the myopic patient--diagnostic problems]. / Jaskra u pacjenta z krótkowzrocznoscia--problemy diagnostyczne.

Myopic eyes represent a special problem in the diagnosis of glaucoma. First, glaucomatous changes of the optic disc can be masked by the usual myopic conus, tilting of the disc and circumpapillary atrophy. Second, the ocular rigidity is usually lower than in normal eyes, therefore intraocular pressure must be checked with applanation or contour tonometry. Third, glaucomatous changes in the visual field of myopic patient may be thought to be caused by the myopic conus, staphyloma or choroidal atrophy. The discerning clinician must be doubly on guard for glaucoma in myopic patients. This is especially important because glaucoma occurs more frequently in myopic patients.

Endothelin-1 Serum Concentration in Pediatric Chronic Idiopathic Uveitis.

PURPOSE: The aim of our study was to determine endothelin-1 (ET-1) concentration in chronic idiopathic uveitis in children and adolescents depending on anatomical location and grade of inflammation. METHODS: The cross-sectional study was conducted among 17 patients with chronic idiopathic uveitis and 22 healthy controls. Concentration of ET-1 in serum was determined using a commercially available ELISA kit. The concentration of C reactive protein (CRP) in serum was determined by immunoturbidimetric method using CRP4 reagent kit (Roche Diagnostics GmbH, Mannheim, Germany). RESULTS: Statistically significant difference between ET-1 concentration in patients with chronic idiopathic uveitis and controls was found 1.33 (1.22; 1.48) vs 1.93 (1.1; 3.11), p = 0.008). No correlations were found between ET-1 concentration and age, either in chronic idiopathic uveitis patients or controls. Nine out of 17 patients presented with anterior uveitis, 5 with posterior and 3 with panuveitis. There were no differences in ET-1 concentration between anterior, posterior and panuveitis (p = 0.634), and in terms of grade of inflammation. CONCLUSION: ET-1 expression is disturbed in pediatric chronic idiopathic uveitis irrespective of the anatomical location and grade of inflammation. Lower expression of ET-1 plays a crucial role in disturbed vascular tone control and can result in permanent visual impairment in chronic non-infectious uveitis.

Aphakic glaucoma after congenital cataract surgery with and without intraocular lens implantation.

PURPOSE: To evaluate the incidence and individual risk factors for the development of aphakic glaucoma after congenital cataract surgery. MATERIAL AND METHODS: We retrospectively reviewed the records of 113 eyes of children who underwent surgery for cataract between 1998 and 2002. Outcome variables studied included intraocular pressure, number of medication changes required over the course of the follow-up, and surgical interventions required. RESULTS: We enrolled 113 eyes who had cataract extraction with IOL (101 eyes), or lensectomy with anterior vitrectomy (12 eyes). Median age during cataract surgery was 11.5 months. The median time to development of postoperative glaucoma was 3.2 years (range, 6 months-10 years). Mean post cataract surgery follow-up was 6.2 years. Postoperative glaucoma developed in 9.7% of eyes of children with cataract. Postoperative open-angle glaucoma developed in 6 pseudophakic eyes and in 2 aphakic eyes; postoperative closed-angle glaucoma developed in 3 aphakic eyes. The mean follow-up period after the diagnosis of glaucoma was 3.8 years. During the course of follow-up, all of 11 eyes required 1-3 medication changes for controlling glaucoma and 3 of them (31.4%), required surgical intervention. CONCLUSIONS: Despite modern surgical techniques the incidence of aphakic glaucoma must be considered in all patients after pediatric cataract extraction. Our results show the importance of careful follow up of intraocular pressure after cataract surgery in children. Young patients undergoing cataract surgery should be monitored routinely for glaucoma.

[The evaluation of efficacy of Ahmed valve implantation in the surgical treatment of glaucoma in children and adolescents]. / Ocena skutecznosci zastawek Ahmeda w leczeniu operacyjnym jaskry u dzieci i mlodziezy.

PURPOSE: To report the safety and efficacy of Ahmed glaucoma valve implantation in the management of secondary glaucoma in children and adolescents. MATERIAL AND METHODS: 6 patients with secondary glaucoma underwent Ahmed valve implantation. 1 patient had aphakic glaucoma, 3 patients had traumatic glaucoma, 1 patient had aniridia and 1 patient had ectropion uveae. IOP values range from 35 to 51 mmHg (mean 41.3 mmHg), with maximal medical treatment by this time. Mean follow-up was 2.17 years. RESULTS: Mean pooperative IOP ranged from 2 to 8 mmHg (mean 6 mmHg), during the first week. 6 months later IOP increased to 15.2 (6-21) mmHg. The mean IOP at last follow-up was 15 mmHg and overall success rate was 83.3%. We observed one hypotony, one tube exposure and one Tenon's cyst formation. CONCLUSIONS: The Ahmed valve is effective treatment for secondary glaucoma in children. It can be useful to avoid enucleation of the eye with traumatic glaucoma.

Cataract surgery with primary intraocular lens implantation in children suffering from chronic uveitis.

PURPOSE: To evaluate the visual outcome of cataract surgery with intraocular lens (IOL) implantation in children with chronic uveitis. MATERIAL AND METHODS: The records of seven children (9 eyes), with chronic uveitis who had cataract extraction with IOL implantation between 2001 and 2007, were retrospectively examined. The mean follow-up was 47.9 months, respectively. The postoperative visual outcome and complications were analyzed. RESULTS: The mean age of 2 girls and 5 boys was 17.4 years (range from 12 to 21 years). 5 patients had unilateral cataract. 6 patients underwent cataract extraction with IOL implantation, one patient underwent combined cataract surgery with IOL implantation and trabeculectomy. Median age at surgery was 17.7 years. At the final follow-up examination 8 eyes (88.9%), had improved visual acuity. The visual acuity was 20/20 in one eye, 20/40 or better in 5 eyes and 20/50 in 3 eyes. Posterior capsule opacification was observed in 5 eyes, high intraocular pressure in 2 eyes and cystoid macular edema in 1 eye. CONCLUSIONS: The outcomes of cataract extraction with IOL implantation in children's eyes with chronic uveitis may be satisfactory. Correct time of surgery, adequate long-term preoperative and postoperative anti-inflammatory therapy may promote good results.

[Intraocular pressure in children and adolescents with myopia]. / Cisnienie wewnatrzgalkowe u dzieci i mlodziezy z krótkowzrocznoscia.

PURPOSE: To determine, whether intraocular pressure (IOP) is associated with myopia and axial length in children and adolescents. MATERIAL AND METHODS: 129 patients in age from 9 to 18 years (mean 14.5 years), were examined. They underwent dynamic contour tonometry, cycloplegic autorefraction, and A-scan biometry. For analyses, refractive error was split into three groups: low myopia (spherical equivalent refraction - SE < -3.00 D), moderate myopia (SE from -3,00 D to -6,00 D), and high myopia (SE > -6.00 D). RESULTS: There were no significant IOP differences between eyes with low (mean IOP = 15.15 mm Hg +/- 2.73), moderate (15.3 mmHg +/- 2.6) or high myopes (15.6 mmHg +/- 2.33). IOP was not correlated with spherical equivalent refraction (p = 0.49) or axial length (Spearman correlation, r = 0.04). There were also no statistically significant differences in IOP between the less myopic and more myopic eyes of 11 patients with anisometropia > 3,00 D. Neither spherical equivalent (p = 0.49) nor axial length (p = 0.51) were significantly associated with IOP in anisometropic patients. CONCLUSIONS: IOP was not associated with refractive error and axial length in the eyes of myopic children and adolescents. Further observations are necessary, because myopia can be a risk factor in developing juvenile glaucoma.

Effect of Repeated Intravitreal Ranibizumab and Aflibercept Injections on the Cornea in Patients with Age-Related Macular Degeneration.

PURPOSE: To assess the effect of repeated intravitreal ranibizumab injections (RI) and aflibercept injections (AI) on the corneal endothelium and central corneal thickness (CCT) in patients with age-related macular degeneration (AMD). MATERIALS AND METHODS: In the retrospective study, 110 eyes of 106 patients, aged 52 to 93 years, were analyzed. Fifty eyes were treated only with RI (I group), and 60 eyes were treated only with AI (II group). Every patient received one intravitreal injection of 0.5 mg of ranibizumab once a month or 2 mg of aflibercept for 3 subsequent months. Each patient received only 3 injections during the whole observation period. Corneal analysis was obtained with the specular microscope. Examinations were performed before initial treatment, after each injection, and 6 months after the first injection. Analysis included corneal endothelial cell density (ECD), hexagonal cell percentage (% Hex), coefficient of variation (CoV), and CCT. RESULTS: There was a statistically significant ECD loss, regardless of the type of the anti-VEGF agent. The mean ECD value in the I group was 2397 ± 459 cells/mm2 before RI, 2389 ± 459 cells/mm2 after the first RI, 2386 ± 467 cells/mm2 after the second RI, 2378 ± 475 cells/mm2 after the third RI, and 2357 ± 460 cells/mm2 6 months after the first RI. The mean ECD value in the II group was 2448 ± 493 cells/mm2 before treatment, 2456 ± 498 cells/mm2 after the first AI, 2426 ± 496 cells/mm2 after the second AI, 2402 ± 488 cells/mm2 after the third AI, and 2348 ± 473 cells/mm2 6 months after the first AI. In comparison with the group treated with RI, the group treated with AI presented a greater ECD loss at each measuring point. The percentage of hexagonal cells was decreased in both groups. There was a slight increase in polymegathism in both treated groups. Ranibizumab proved to cause a small increase in CCT, while CCT remained unchanged in the aflibercept group. CONCLUSIONS: Repeated intravitreal injections of 0.5 mg of ranibizumab or 2 mg of aflibercept can influence the morphology of the corneal endothelium but not CCT.

Endothelin-1 Serum Concentration is Lower in Children and Adolescents with High Myopia, a Preliminary Study.

The aim of this study is to evaluate the levels of enothelin-1 (ET-1) in children and adolescents with high myopia and its association with the axial length of the eye and the presence of myopic retinal degeneration. The cross-sectional study was carried out in 57 patients with high myopia and 29 control subjects. Serum concentrations of ET-1 were measured using enzyme-linked immunosorbent assay (ELISA) kit. A significantly lower concentration of ET-1 in highly myopic patients compared to controls was found (1.47 (0.91; 1.87) vs. 1.94 (1.1; 2.69) pg/mL, p = 0.005). In patients with high myopia, a weak negative correlation between ET-1 concentration and the longest axial length out of the two eyes was found (r = -0.255, p = 0.0558). Further analysis revealed statistically significant differences in ET-1 concentration between patients with the axial length of the eye > 26 and ≤ 26 mm (p < 0.041) and patients with the axial length of the eye > 26 mm and controls (p < 0.001). ET-1 expression is disturbed in highly myopic children and adolescents. Lower ET-1 concentration in patients with the axial length of the eye > 26 mm may co-occur with high myopia and should be considered a risk factor in the pathophysiology of high myopia progression.

[Impairment of optic nerves as the result of cerebral sinus venous thrombosis]. / Uszkodzenie nerwów wzrokowych w nastepstwie zakrzepowego zapalenia zatok zylnych podstawy czaszki.

UNLABELLED: Cerebral venous sinus thrombosis is a disease with potentially serious consequences and usually affecting young to middle aged people. Headache was the most frequent symptom. Diagnosis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given, taking into consideration parameters of coagulation system and the type of thrombus. Because of moderate to high mortality rate, patients should be closely monitored. PURPOSE: Presentation of the case of bilateral optic nerve atrophy after extensive thrombus of sigmoid and right transverse sinuses. MATERIAL AND METHODS: We present the case of a boy, who suffered inflammation of venous sinuses of cranial basis, when he was 6 years old. It happened 1 month after right mastoid bone injury. In the course of this disease, intracranial hypertension with bilateral optic disc swelling appeared. RESULTS: 5 years after thrombosinusitis, the child has pale optic discs, changes in the peripheral visual field, abnormal VEP and incorrect contrast sensitivity. CONCLUSIONS: Trauma in the region of the temporal bone may cause hard complications from thrombosinusitis, and lead to bilateral optic damage.