[Retinal antigens in eye diseases--clinical value of diagnostic tests]. / Antygeny siatkówkowe w schorzeniach narzadu wzroku--znaczenie kliniczne testów diagnostycznych.

Current review of data concerning the role of antigen S, IRBP and antigen CAR in various ocular diseases, including, uveitis of unknown etiology, birdshot choroid retinopathy, vasculitis, diabetic retinopathy and retinitis pigmentosa.

[Diagnostic difficulties in cases of opticochiasmatic arachnoiditis]. / Trudnosci diagnostyczne w przypadkach arachnoiditis optochiasmatica.

Clinical signs and the methods of radiological diagnosis in optochiasmatic arachnoiditis are discussed. Difficulties in the interpretation of results of examinations may stem from the physiological fluctuations of the size and the form of the region and the situation of the chiasma and also from an insufficient precision of orientation of the tomographical cross-section. In spite of coordination of the angiography of carotis artery, of pneumocysternoencephalography and computer tomography one may receive faulty negative results. Presentation by means of a magnetic resonance seems to open quite new perspectives.

[Postoperative complications with the use of implants for treatment of retinal detachment]. / Powiklania operacji z uzyciem wszczepów w leczeniu odwarstwien siatkówki.

Complications of the retinal detachment surgery with the use of episcleral and intrascleral implants are presented. The authors are using biological materials (fascia lata, dura mater) as well as alloplastic materials (Lincoff's sponge). Among the postoperative complications following were seen: protracted reactions from the side of the ocular adnexa, intraocular haemorrhages, intravitreal exudates. The most severe from the observed complications was the atrophy of the sclera at the spot of implantation of the silicon sponge.

[Cataract surgery in adults and children with chronic uveitis]. / Chirurgia zacmy u doroslych i dzieci z przewleklym zapaleniem blony naczyniowej.

PURPOSE: To present preoperative strategies and results of cataract surgery in patients with different types of uveitis. PATIENTS AND METHODS: The results of 18 cases of extracapsular cataract extraction with or without intraocular lens implantation were retrospectively analysed. Age of patients ranged from 10 to 71 years (mean age: 35 years). Etiology of uveitis was determined in 10 cases (63%). Preoperative management was determined by the diagnosis of uveitis. The postoperative observation time ranged from 3 years to 6 months (mean: 25 months). RESULTS: Visual acuity improved postoperatively in 17 eyes (96%), and was better than 0.5 in 10 eyes (63%). The reasons for lower visual acuity were: cystoid macular edema in 6 cases (33%), band keratopathy, amblyopia and floaters in the vitreous. CONCLUSIONS: Establishing the diagnosis and controlling the inflammation pre- and postoperatively are the basic conditions for the surgical outcomes in cataract surgery in patients with history of uveitis.

[Management in preretinal macular hemorrhage. Case report]. / Postepowanie w przedsiatkówkowym krwotoku w okolicy plamkowej. Opis przypadku.

The report presents a method of management in case of clotted premacular haemorrhage in a 46 year-old woman. The used method of treatment proceeded in 2 stages: 1) pars plana, intravitreal injection of 50 mg tissue plasminogen activator (tPA-Actilise), 2) after 24 hours intravitreal 0.5 cc SF6 with air mixture (1:5). Fibrinolytic tPA action and mechanic action of expanding gas caused after argon laser puncture intravitreal haemorrhage dislocation and following its resorption. The almost full visual acuity persisted for over 2 years.

[Retinal detachment of unknown etiology]. / Odwarstwienie siatkówki o nieustalonej etiologii.

Cases of retinal detachment of undetermined aetiology were analyzed on the material of the Ophthalmological Department in Wroclaw. Presented were the results of the surgical procedures taking into account the actual classification of the detachments. A positive anatomical result of the operation was achieved in 80 p.c. of patients, instead the improvement of the visual function was observed in only 56.5 p.c. of cases.

[Occurrence of nocturnal arterial hypotension in patients with primary open-angle glaucoma and normal tension glaucoma]. / Wystepowanie nocnej hipotonii tetniczej u chorych na jaskre pierwotna otwartego kata i jaskre z normalnym cisnieniem.

PURPOSE: To investigate the nocturnal blood pressure "dip" in patients with primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG). MATERIAL AND METHODS: 46 patients (36 women and 10 men), including 15 patients with POAG (mean age 49.6 +/- 6.8), 20 patients with NTG (mean age 54.5 +/- 14.1) and 11 control subjects (mean age 43.4 +/- 16.3), were studied. Arterial systolic and diastolic blood pressure and heart rate were measured with automated blood pressure monitor MEDILOG DX in 15 minutes intervals during the day and 30 minutes intervals at night. RESULTS: 30.4% of all examined patients showed the nocturnal "dip" of less than 10% (non-dippers). In 41.4% of patients the blood pressure fell at night by 10-20% (dippers) and in 28.2% of patients by more than 20% (big dippers). The percentage distribution of patients with POAG, NTG and control subjects in non-dippers group was 35%, 36% and 29%; in dippers group: 21%, 53% and 26%; in big dippers group: 46%, 46% and 8% respectively. The nocturnal "dip" was significantly larger in NTG group (max. systolic dip 28% +/- 2.9%, mean systolic dip 17% +/- 4.3%, alpha = 0.05) in comparison with POAG and control group. CONCLUSIONS: Large blood pressure "dips" are observed more frequently in patients with glaucoma than in healthy control subjects. The degree of reduction in blood pressure is significantly larger in NTG patients in comparison with POAG patients and control group.

[Correlations between morphologic measurements of the optic disc using planimetric tests and changes in the visual field in patients with glaucoma]. / Wspólzaleznosc pomiedzy cechami morfologicznymi tarczy nerwu wzrokowego badanymi planimetrycznie a zmianami w polu widzenia u chorych na jaskre.

PURPOSE: To evaluate the relationships between planimetrical measurements of the optic disc and visual field indices in primary open-angle glaucoma patients and glaucoma suspects. MATERIALS AND METHODS: Materials consisted of 64 patients (128 eyes) divided into two groups: glaucoma suspects without any treatment (30 patients, 60 eyes) and early open-angle glaucoma patients already medically treated (34 patients, 68 eyes). All the patients underwent the full, computerized, planimetrical analysis of the optic disc. A special attention was paid to the neuroretinal rim measurements. Visual field examination was performed with automated perimeter Octopus 101 using test dG2. Results were analysed with the use of "Interzeag Peridata" software. RESULTS: We found the statistically significant correlations between neuroretinal rim area and visual field parameters in the glaucoma group. The highest relationship concerned mean defect and compound index of the field. There were no such correlations in glaucoma suspects. Cup/disc ratio correlated more weakly with visual field than neuroretinal rim area. We also analysed mean and extreme values of the neuroretinal rim area in groups of different depth and configuration of visual field defects. CONCLUSIONS: Neuroretinal rim area is a more valuable planimetrical parameter in optic disc analysis than cup/disc ratio. It is also an important factor affecting the visual field, but probably not the only one. There is a significant correlation between visual field quantitative parameters and neuroretinal rim area in primary open-angle glaucoma patients, but in glaucoma suspects that is not true. Digital planimetry proved to be a valuable tool for optic disc biomorphometry and it seems to be an objective method for detecting development of structural changes in glaucoma.

[Pars plana vitrectomy in cases of endophthalmitis non-responding to antibiotic therapy]. / Witrektomia w stanach zapalnych wnetrza galki ocznej opornych na leczenie zachowawcze.

UNLABELLED: The aim of the study is the evaluation of the results of pars plana vitrectomy in the cases of endophthalmitis unresponding to antibiotictherapy. MATERIAL AND METHODS: The procedure of pars plana vitrectomy was carried out in 7 patients treated preoperatively by intraocular injections of antibiotics because of endophthalmitis at Ophthalmological Department of Medical University in Wroclaw in the years 1996-1998. The age of patients was 33-88 years (mean 67). The postoperative follow up was 6 to 28 months. RESULTS: Endophthalmitis resulted in all cases from cataract surgery. The positive microbiological traces were in 4 cases. In 3 cases pathogenic microbes were Staphylococcus epidermidis, in 1 Staphylococcus aureus and Micrococcus. In all patients the symptoms of inflammatory process disappeared after vitrectomy. In 5 patients we achieved the full visual acuity (0.8-1.0), in 1 patient bullous kerathopathy developed and in 1 phthisis bulbi. CONCLUSIONS: Vitrectomy may lead to good functional outcome in 70% of postoperative endophthalmitis.

[Bilateral isolated posterior scleritis]. / Obustronne, izolowane zapalenie tylnej czesci twardówki.

A case of 44-year-old man is presented with no simultaneous bilateral posterior scleritis with amelanotic chorioidal mass initially diagnosed as intraocular tumor. The patient showed the features of nodular posterior scleritis without associated systemic disease. The case presented symptoms of severe eye pain, unilateral proptosis, hyperemia and dilatation of scleral, episcleral and conjunctival vessels. Diagnosis was made on the basis of B-scan ultrasonography. Differential diagnosis excluded melanoma malignum chorioideae, orbital cellulitis, Graves ophthalmopathy, orbital cellulitis, cavernous sinus thrombosis and carotid-cavernous fistula. The patient did not respond well to systemic steroids given in high doses and during slow tapering at the dosage of 30 mg prednisone once per day the symptom of uveal effusion syndrome occurred. After 10 months of steroid therapy the signs of disease like mild hyperemia and tenderness were still present. The adjunction of cyclosporin improved the disease and caused the remission.

[Comparative analysis of changes in the visual field in primary open-angle glaucoma and glaucoma with normal tension]. / Porównawcza analiza zmian w polu widzenia w jaskrze pierwotnej otwartego kata oraz w jaskrze z normalnym cisnieniem.

PURPOSE: To compare the pattern and the depth of visual field defects of POAG and NTG patients. MATERIALS AND METHODS: The visual fields in two groups of POAG and NTG patients, each counting 25 eyes, were analysed statistically. All eyes were tested at least twice, employing full threshold G2 test of Octopus 101 (Interzeag) automatic perimeter. The tests with the highest reliability level were included. The analysis was performed using Peridata (Interzeag) statistical package. Mean values of mean defect (MD), corrected loss variance (CLV) and compound index (CI) for each group were acquired. Furthermore, main values of MD for upper and lower hemifield, quadrants and 10 degrees concentric rings, were obtained. The differences between the two groups were tested for the statistical significance. RESULTS: Values of all three above parameters (MD, CLV i CI) were significantly lower in the group of eyes with POAG as compared with those with NTG. In both groups mean MD was higher in the upper hemifield, but the upper/lower hemifield ratio was significantly higher in the POAG group (1.50) as compared with NTG group (1.05). In POAG group the highest mean MD was found in the upper-temporal quadrant whereas in NTG group the lower-nasal quadrant was the most affected. In both groups the highest values of mean MD were found in the outer ring between 20 degrees and 30 degrees of visual field but the difference between the centre and periphery was considerably lower in NTG group. CONCLUSIONS: The results support the opinion that there exist differences between the patterns of visual field changes in POAG and NTG. The loss tends to be more diffuse in POAG, showing deeper defects in the periphery and stronger tendency to affect the upper hemifield.

[Use of soft contact lenses in the Riley-Day syndrome in a small child]. / Zastosowanie miekkich soczewek kontaktowych w zespole Riley-Day u malego dziecka.

We present the observation of a boy treated in our Ophthalmological Department in Wroclaw from the age of 6 months up to 6 years for the serious keratitis with ulceration. We diagnosed Riley-Day syndrome with regard to many associated pathological features. The efficacy of the local treatment improved after application of soft contact lenses.

[Tissue plasminogen activator in treatment of fibrinous membranes after cataract surgery]. / Tkankowy aktywator plazminogenu w leczeniu blon wlóknikowych po operacji zacmy.

UNLABELLED: The aim of our study is estimation of the efficacy of recombinant tissue plasminogen activator for the treatment of fibrinous membranes following cataract extraction. PATIENTS AND METHODS: The fibrinous membranes were formed, despite conventional antiinflammatory therapy, in 17 eyes after ECCE with IOL and in 3 eyes after ECCE without IOL. We injected the solution of recombinant tissue plasminogen activator-Actilyse (Boehringer Ingelheim) into the anterior chamber of 20 eyes after cataract surgery. Simultaneously, topical corticosteroid and cycloplegic therapy was continued. Routine follow-up included slit lamp examination, ophthalmoscopy and intraocular pressure measurement. RESULTS: Injection of the solution of tissue plasminogen activator into anterior chamber of 20 eyes resulted in complete dissolution of the fibrinous membranes in 18 eyes within 1 day. In 7 eyes, within a few days after injection, fibrinous membrane recurred. In four of this cases durable effect of fibrin dissolution was obtained after multiple tPA injections. Finally, expectable stable result was obtained in 15 of 20 eyes. CONCLUSIONS: Results of our study confirm high efficacy of recombinant tissue plasminogen activator in the treatment of fibrinous membranes after cataract surgery. Short term follow-up and small number of cases motivates further continuation of observation.

[Flash electroretinography and pattern-type visual evoked potentials in early glaucoma]. / Elektroretinogram blyskowy i wzrokowe potencjaly wywolane typu pattern we wczesnej neuropatii jaskrowej.

PURPOSE: The aim of this prospective study was to evaluate diagnostic sensitivity of flash-erg, oscillatory potentials (OPs), and pattern-visual evoked potentials (pVEP) in early glaucoma. MATERIAL AND METHODS: Erg, OPs and pVEP were registered in 416 eyes primary open angle glaucoma (120 eyes), normal tension glaucoma (137), ocular hypertension (74), glaucoma-like discs (86) in age-matched groups, by Tomey 400. RESULTS: There were no statistically significant differences between parameters of flash-erg and pVEP of examined population and control group. Significant reduction in OPs amplitude in NTG patients were found. CONCLUSIONS: Flash erg and pVEP have low diagnostic value in early glaucoma. OPs could be useful in scientific research on pathogenesis of glaucomatous neuropathy.