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1.
Reumatologia ; 61(3): 161-168, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37522138

RESUMO

Introduction: The aim was to detect subclinical structural retinal abnormalities in optical coherence tomography (OCT) in ophthalmologically asymptomatic systemic lupus erythematosus (SLE) patients without signs of lupus retinopathy or drug toxicity in fundus examination and in OCT and to assess the relationship between OCT parameters and disease activity, therapy type and burden on other organs to demonstrate the utility of OCT in early retinal impairment in SLE patients. Material and methods: Cross-sectional study. Thirty-three SLE patients (57 eyes) and 31 healthy individuals (56 eyes) were enrolled in the study. We excluded patients with evidence of lupus retinopathy or hydroxychloroquine (HCQ) toxicity on OCT or fundus examination to reveal any subclinical changes. All patients underwent full ophthalmologic examination in the slit lamp including best corrected visual acuity, tonometry, and OCT. The Kolmogorov-Smirnov distribution test was used to assess the normal distribution in quantitative values. The differences between the individual measured parameters in the groups were analyzed using the Mann-Whitney U test. Spearman's rank correlation test was used to assess the correlation between the measured parameters and quantitative clinical data. Results: There was no difference in the OCT findings between SLE and healthy control groups. Among the study group a negative correlation was found between disease duration and age and retinal nerve fiber layer thickness in the inferior quadrant (p = 0.0063, p = 0.0036). No correlations were observed between examined retinal parameters and duration of hydroxychloroquine therapy, hydroxychloroquine as well as chloroquine cumulative dose and disease activity indices. Conclusions: Optical coherence tomography is a widespread ophthalmic modality used for SLE retinopathy and HCQ toxicity screening. Our study did not demonstrate its clinical potency in diagnosis of subclinical retinal involvement. An optical coherence tomography device seems to be less sensitive in subclinical retinal impairment detection than optical coherence tomography angiography.

2.
Medicina (Kaunas) ; 58(5)2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35630106

RESUMO

Radial keratotomy was a popular surgical procedure used to treat myopia. Patients who underwent radial keratotomy several years ago, are currently reporting to the ophthalmologist due to worsening of vision associated with age-related cataracts. In this case report we present a case of a 60-year-old woman who underwent radial keratotomy with 16 incisions in the right eye and 12 incisions in the left eye. The patient reported to an ophthalmologist due to a deterioration of vision caused by a cataract. We described, in detail, the difficulties encountered during the diagnostic procedures, differences in the calculation of intraocular lens, and intraoperative difficulties as compared to patients who had not undergone radial keratotomy. We also present the obtained postoperative results.


Assuntos
Extração de Catarata , Catarata , Ceratotomia Radial , Lentes Intraoculares , Miopia , Catarata/complicações , Extração de Catarata/efeitos adversos , Feminino , Humanos , Ceratotomia Radial/efeitos adversos , Lentes Intraoculares/efeitos adversos , Pessoa de Meia-Idade , Miopia/complicações , Miopia/cirurgia
3.
Mediators Inflamm ; 2020: 9175083, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32801998

RESUMO

RESULTS: In patients, an increase in the population of Th17-secreting cells negatively correlated with the abundance of both IFN-γ-producing and T regulatory as well as suppressor cells, regarding all the phenotypes studied. Although a strong dependence of the PB Th1 cell compartment on the duration of the disease was observed, it was limited to the subgroup of patients with macular edema only. The frequency of B regulatory cells was unchanged compared to controls. CONCLUSIONS: In pars planitis, the alterations in lymphocyte cell distribution affect primarily the T cell repertoire. The imbalance in PB Th1/Th17/Treg cells creates proinflammatory conditions, strengthening the suggestion that the immune background may play a role in pars planitis pathogenesis. Also, circulating Th1 level may be of potential clinical relevance in terms of prediction of a more severe course of the disease.


Assuntos
Interleucina-17/metabolismo , Pars Planite/metabolismo , Linfócitos T Reguladores/metabolismo , Células Th1/metabolismo , Adolescente , Adulto , Idoso , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Feminino , Citometria de Fluxo , Humanos , Interferon gama/metabolismo , Masculino , Pessoa de Meia-Idade , Células Th17/metabolismo , Adulto Jovem
4.
Int Ophthalmol ; 40(1): 235-246, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31578662

RESUMO

PURPOSE: To evaluate the efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation. METHODS: Prospective real-world evidence study included 39 eyes (of 36 patients) with primary open-angle glaucoma without previous glaucoma surgery and with uncontrolled intraocular pressure (IOP), glaucoma progression, or intolerance to IOP-lowering therapy. Patients underwent mitomycin C-augmented XEN implantation either as a stand-alone procedure or combined with cataract extraction. 5-Fluorouracil subconjunctival injections were a first-choice therapy for bleb failure and were administered according to predetermined criteria (analogous to pro re nata regimen in age-related macular degeneration treatment). Primary outcome was unqualified success, defined as postoperative IOP < 18 mmHg and > 20% reduction from medicated baseline without any antiglaucoma medications and no detected glaucoma progression. RESULTS: At median follow-up of 8 months (range 3-24 months), IOP decreased from a medicated baseline value of 23 mmHg (95% CI 21-24 mmHg) to 13 mmHg (95% CI 12-15 mmHg) and number of medications decreased from 3 (95% CI 2-3) to 0 (p < 0.0001 for both). Median number of 5-fluorouracil injections per eye was 3 (95% CI 2-3), and median time to first injection was 0.5 months (95% CI 0.25-3 months) after surgery. Thirteen eyes (33.3%) underwent ≥ 1 needling, and surgical revision was performed in three cases (7.7%). The primary outcome measure, which allows performing additional procedures, was achieved in 27 eyes (69%). CONCLUSIONS: 5-Fluorouracil subconjunctival injections are safe and effective in postoperative management of bleb failure after XEN implantation and represent a viable alternative to other methods.


Assuntos
Fluoruracila/administração & dosagem , Implantes para Drenagem de Glaucoma , Glaucoma de Ângulo Aberto/cirurgia , Pressão Intraocular/fisiologia , Cuidados Pós-Operatórios/métodos , Stents , Idoso , Túnica Conjuntiva , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Imunossupressores/administração & dosagem , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Reoperação , Resultado do Tratamento
5.
Polim Med ; 48(1): 47-51, 2018.
Artigo em Polonês | MEDLINE | ID: mdl-30712333

RESUMO

BACKGROUND: An increasing number of patients with refractive visual impairments, in whom the correction using spectacles or contact lenses does not meet expectations, consider the possibility of undergoing refractive surgery. Phakic implants are an alternative for patients who are not eligible for laser correction. OBJECTIVES: The aim of the study is to assess the safety of using collamer phakic implants in the correction of vision defects during the annual follow-up. MATERIAL AND METHODS: The study included 24 eyes in 12 patients who were implanted with Visian ICL phakic posterior chamber lenses in order to correct myopia. The examinations carried out before the surgery were as follows: objective refractometry, the assessment of distant visual acuity with the best correction, intraocular pressure measurement, evaluation of the endothelium, corneal topography, and depth of the anterior chamber measurement. The final examinations included visual acuity, refraction, intraocular pressure, implant placement, endothelial microscopy, and funduscopic examination. RESULTS: Mean objective refraction was: sphere -7.77 ±3.55 diopters and cylinder 1.18 ±0.87 diopters. Spectacle correction produced the mean visual acuity of 0.91 ±0.20 (Snellen). During the period of 1-year follow-up, the mean spherical power was 0.475 ±0.39 diopters, cylinder 0.46 ±0.27 diopters and the visual acuity after the procedure 1.05 ±0.22 (Snellen). The results of the 12-month evaluation showed a statistically significant greater improvement in patients using phakic implants compared to those subjected to spectacle correction (p < 0.05). The preand post-operative evaluation demonstrated no significant differences in endothelial cell density (p < 0.05). No complications were reported both during the surgery and the entire follow-up period. CONCLUSIONS: The results of the safety assessment of using properly implanted ICL phakic lenses show good tolerance of collomer implants in the posterior chamber. They do not have a negative effect on the structures located in the anterior segment of the eye, including the corneal endothelium and the lens.


Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Miopia , Humanos , Lentes Intraoculares/efeitos adversos , Refração Ocular , Resultado do Tratamento , Acuidade Visual
6.
Polim Med ; 46(1): 89-94, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28397423

RESUMO

The cornea is one of the principal refractive elements in the human eye and plays a crucial role in the process of vision. Keratoconus is the most common corneal dystrophy, found mostly among young adults. It is characterized by a reduced number of collagen cross-links in the corneal stroma, resulting in reduced biomechanical stability and an abnormal shape of the cornea. These changes lead to progressive myopia, corneal thinning, central scarring and irregular astigmatism, causing severely impaired vision. Hard contact lenses, photorefractive keratectomy or intracorneal rings are the most common treatment options for refractive error caused by keratoconus. However, these techniques do not treat the underlying cause of the corneal ectasia and therefore are not able to stop the progression of the disease. Riboflavin photoinduced polymerization of corneal collagen, also known as corneal cross-linking (CXL), has been introduced as the first therapy which, by stabilizing the structure of the cornea, prevents the progression of keratoconus. It stiffens the cornea using the photo-sensitizer riboflavin in combination with ultraviolet irradiation. This is a current review of the CXL procedure as a therapy for keratoconus, which relies on photoinduced polymerization of human tissue. We have focused on its biomechanical and physiological influences on the human cornea and have reviewed the previous and current biochemical theories behind cross-linking reactions in the cornea.


Assuntos
Colágeno/efeitos dos fármacos , Substância Própria/efeitos dos fármacos , Ceratocone/tratamento farmacológico , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Raios Ultravioleta , Fenômenos Biomecânicos , Colágeno/química , Colágeno/efeitos da radiação , Substância Própria/metabolismo , Substância Própria/efeitos da radiação , Humanos , Ceratocone/metabolismo , Ceratocone/prevenção & controle , Fármacos Fotossensibilizantes/farmacologia , Polimerização , Riboflavina/farmacologia
7.
Klin Oczna ; 118(3): 235-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-30088389

RESUMO

Corneal melting is a rare ocular complication of rheumatoid arthritis, associated with poor prognosis. Rapid course of the disease and unpredicted treatment response, which depends on a patient general state and disease severity, make every case a challenge and requires a cooperation between ophthalmologists and rheumatologists. We present a case of a 58-year-old woman with corneal melting, who was successfully treated with systemic corticosteroids and methotrexate, along with ocular surgery.


Assuntos
Artrite Reumatoide/complicações , Úlcera da Córnea/etiologia , Úlcera da Córnea/terapia , Transplante de Córnea/métodos , Feminino , Humanos , Metotrexato/uso terapêutico , Pessoa de Meia-Idade
8.
Klin Oczna ; 118(2): 155-60, 2016.
Artigo em Polonês | MEDLINE | ID: mdl-29912514

RESUMO

Nepafenac is an innovative non-steroidal anti-inflammatory drug used in ophthalmology for the prevention of macular edema after cataract surgery. Along with its anti-inflammatory effect, nepafenac has some unique properties which distinguish it from other non-steroidal anti-inflammatory drugs. It is a prodrug activated to amfenac after it penetrates through the corneal layers to the aqueous humour and the ciliary body. Having electrically neutral molecules of lipophilic properties, nepafenac does not accumulate in the cornea and does not cause its degeneration. Additionally, it quickly achieves higher concentrations in the aqueous humour as compared to other non-steroidal anti-inflammatory drugs. Nepafenac shows high selectivity and activity against COX-2 isoform, the key enzyme implicated in inducing inflammation, which is the main cause of macular edema. Furthermore, nepafenac has the unique scleral and suprachoroidal distribution pathways. Finally, its effect on the intraocular pressure is none to negligible. Nepafenac treatment should be initiated prior to cataract surgery and continued long enough to reduce the risk of late-onset macular edema. The Expert Group of the Polish Society of Ophthalmology consider using nepafenac in the prevention of post­operative macular edema in diabetic patients undergoing cataract surgery as expedient and reasonable. The proposed optimum pre- and postoperative treatment regimen can be modified for individualised therapy.


Assuntos
Benzenoacetamidas/uso terapêutico , Extração de Catarata/efeitos adversos , Edema Macular/prevenção & controle , Oftalmologia , Fenilacetatos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Catarata/complicações , Complicações do Diabetes , Humanos , Edema Macular/etiologia , Polônia
9.
Polim Med ; 45(2): 95-102, 2015.
Artigo em Polonês | MEDLINE | ID: mdl-26994891

RESUMO

According to the World Health Organization, cataract remains the leading cause of the curable visual impairment worldwide. Cataract can only be cured by surgery during which the cloudy lens is replaced with an artificial intraocular lens. It is one of the most common surgeries being performed worldwide. There are age-related, congenital, traumatic and metabolic types of cataract which have been distinguished. Age-related cataract is the most common one and it affects people over 60 with the greatest frequency. In reference to patients whose cornea does not fulfill the requirements for a standard refractive surgery, the number of refractive intraocular lens replacement is increasing. Manufacturers aim to enhance materials in order to minimize surgical complication while increasing the patient's eyesight. The increase in average lifespan along with patients' expectations stimulate competition among manufacturers who bring new products and solutions into to the market. There is an augmented demand for premium lenses such as toric, multifocal or accommodating. These lenses bring patients the promise of life without the need for wearing glasses. As far as the main materials used in the production of intraocular lens are concerned, there are hydrophobic, hydrophilic, acrylic and silicone lenses in use. In this paper the author discusses characteristics as well as advantages and disadvantages of the above-mentioned materials. The associated surgical complications and the new areas of development regarding the materials used in lenses manufacturing are also examined.


Assuntos
Extração de Catarata , Lentes Intraoculares , Polímeros/química , Acomodação Ocular , Idoso , Idoso de 80 Anos ou mais , Humanos , Interações Hidrofóbicas e Hidrofílicas
10.
Klin Oczna ; 117(2): 96-100, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26638546

RESUMO

Acute retinal necrosis (ARN) is a rare but very severe form of retinitis. In contrast to progressive outer retinal necrosis acute retinal necrosis typically affects immunocompetent individuals. Herpes Simplex and Varicella-zoster viruses play the main role in the development of the disease. We report a case study of a healthy, young male who presented to the ophthalmologist with unilateral visual acuity decrease and eye irritation. The acute retinal necrosis was diagnosed and a therapy was started including both systemic and local anti-viral agents, as well as an oral anticoagulant. Additional systemic steroid therapy was introduced a week later. The regression of retinal inflammatory changes and the improvement of visual acuity were observed. The polymerase chain reaction assay for the presence of viral DNA in serum was negative. The IgM antibody assay for potential causal pathogens was negative, but the level of Varicella-zoster virus IgG antibodies was markedly elevated. During the follow-up, the patient developed retinal detachment and pars plana vitrectomy with silicone oil endotamponade was performed. Although the surgery resulted in the successful retinal reattachment, the final visual acuity remained decreased. Six months after the surgery, the eye was free of the intraocular inflammation and the visual acuity slightly improved.


Assuntos
Herpes Zoster Oftálmico/diagnóstico , Herpesvirus Humano 3/isolamento & purificação , Síndrome de Necrose Retiniana Aguda/virologia , Anticoagulantes/administração & dosagem , Antivirais/administração & dosagem , Herpes Zoster Oftálmico/complicações , Herpes Zoster Oftálmico/terapia , Humanos , Masculino , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/terapia , Resultado do Tratamento , Acuidade Visual/efeitos dos fármacos , Vitrectomia , Adulto Jovem
11.
Biomed Eng Online ; 13: 69, 2014 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-24899167

RESUMO

BACKGROUND: An objective and noninvasive examination of pupil size variability can be used to assess the activity of the autonomous nervous system. We designed a system that enables binocular, fast, and accurate recordings of different types of pupil variabilities, which are synchronous with other biosignals. This type of measurement system is needed to extend the scope of pupillometry applications. METHODS: In the proposed system, the left and right eyes are independently and interchangeably illuminated to generate alternating images, which are successively acquired by a single camera. The system is composed of four functional modules: the image acquisition module, the image processing unit, the light stimulator, and the controller. The proposed image processing algorithm approximates the shape of the pupil using the best-fit ellipse. The user control panel (controller) precisely sets the stimuli parameters and controls the entire measurement procedure. RESULTS: The computer-based binocular system records the pupil size during the pupil light reflexes (direct and indirect) and spontaneous pupil size fluctuations, at a sampling rate up to 75 Hz, with a resolution better than 0.02 mm. Our initial laboratory tests confirmed that the new system is fast and precise (system accuracy better than 0.5% and repeatability better than 4%). CONCLUSIONS: The proposed system's unique geometry and construction, and the method it uses to detect images from each eye, allows us to monitor the right and left eyes using a single camera with no overlap between the images. The system does not require a very experienced operator, because it is relatively simple and easy to use. Importantly, it is comfortable for the subjects. Additionally, the presented system can operate with other bio-measurement systems using a synchronous signal. These system capabilities can expand the scope of pupillometry research applications.


Assuntos
Luz , Imagem Óptica/métodos , Pupila , Humanos , Processamento de Imagem Assistida por Computador , Imagem Óptica/instrumentação
12.
Klin Oczna ; 116(3): 205-9, 2014.
Artigo em Polonês | MEDLINE | ID: mdl-25799786

RESUMO

The authors focus on the assessment of ocular manifestation in patients with primary Sjögren's syndrome using the Ocular Staining Score. The method offers the possibility to stain different ocular structures separately: cornea with fluorescein and conjunctiva with lissamine green dye and provides for separate evaluation of abnormalities, unlike the current system assessing ocular damage where ocular tissues are stained either with bengal rose or lissamine green dye. The paper presents new criteria for the diagnosis of dry eye secondary to the autoimmune Sjögren's syndrome and their high specificity (94.7% and 93.3%)ö based on the results of clinical trials in 1618 patients, conducted by an international research team.


Assuntos
Fluoresceína , Corantes Verde de Lissamina , Soluções Oftálmicas , Rosa Bengala , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/fisiopatologia , Coloração e Rotulagem/métodos , Humanos , Campos Visuais/efeitos dos fármacos
13.
J Clin Med ; 13(6)2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38542021

RESUMO

Background: The aim of this study is to compare the effect of sodium-glucose cotransporter-2 inhibitors (SGLT-2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and dipeptidyl peptidase-4 inhibitors (DPP-4i) on the risk of diabetic retinopathy (DR) in patients with type 2 diabetes (DM2). Methods: We systematically searched the databases Pubmed, Embase, and Clinicaltrials up to October 2, 2023, for randomized clinical trials (RCTs) of drugs from the GLP-1RA, SGLT-2i, and DPP-4i groups, with at least 24 weeks duration, including adult patients with DM2 and reported ocular complications. A pairwise meta-analysis was performed to calculate the odds ratio (OR) of DR incidents. Results: Our study included 61 RCTs with a total of 188,463 patients and 2773 DR events. Pairwise meta-analysis showed that included drug groups did not differ in the risk of DR events: GLP1-RA vs. placebo (OR 1.08; CI 95% 0.94, 1.23), DPP-4i vs. placebo (OR 1.10; CI 95% 0.84, 1.42), SGLT2i vs. placebo (OR 1.02; CI 95% 0.76, 1.37). Empagliflozin may be associated with a lower risk of DR, but this sub-analysis included only three RCTs (OR 0.38; 95% CI 0.17, 0.88, p = 0.02). Conclusions: Based on currently available knowledge, it is challenging to conclude that the new antidiabetic drugs significantly differ in their effect on DR complications.

14.
Sci Rep ; 14(1): 14752, 2024 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926553

RESUMO

To compare the efficacy and safety of the proposed aflibercept biosimilar SCD411 and reference aflibercept in patients with neovascular age-related macular degeneration, this randomized, double-masked, parallel-group, multicenter study was conducted in 14 countries from 13 August 2020 to 8 September 2022. Patients with neovascular age-related macular degeneration. With subfoveal, juxtafoveal, or extrafoveal choroidal neovascularization were aged 50 years or older. Intravitreal injection of SCD411 or aflibercept (2.0 mg) were administered every 4 weeks for the first three injections and every 8 weeks until week 48. The primary efficacy endpoint was the change in best-corrected visual acuity from baseline to week 8 with an adjusted equivalence margin of ± 3.0 letters. Patients were randomly assigned to receive either SCD411 (n = 288) or reference aflibercept (n = 288). A total of 566 participants (98.3%) completed week 8 of the study. The least-squares mean difference of change in best-corrected visual acuity from baseline to week 8 (SCD411-aflibercept) was - 0.4 letters (90% confidence interval = - 1.6 to 0.9). The incidence of ocular (69 of 287 [24.0%] vs. 71 of 286 [24.8%]) and serious ocular (5 of 287 [1.7%] vs. 3 of 286 [1.0%]) treatment-emergent adverse effects were similar between the SCD411 and aflibercept groups. Immunogenicity analysis revealed a low incidence of neutralizing antibody formation in both groups. In conclusion, SCD411 has equivalent efficacy compared with reference aflibercept in patients with neovascular age-related macular degeneration and has a comparable safety profile. The results support the potential use of SCD411 for the treatment of neovascular age-related macular degeneration.


Assuntos
Injeções Intravítreas , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão , Acuidade Visual , Humanos , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/efeitos adversos , Proteínas Recombinantes de Fusão/uso terapêutico , Proteínas Recombinantes de Fusão/administração & dosagem , Masculino , Feminino , Idoso , Acuidade Visual/efeitos dos fármacos , Resultado do Tratamento , Degeneração Macular/tratamento farmacológico , Pessoa de Meia-Idade , Método Duplo-Cego , Idoso de 80 Anos ou mais , Neovascularização de Coroide/tratamento farmacológico , Medicamentos Biossimilares/uso terapêutico , Medicamentos Biossimilares/efeitos adversos , Medicamentos Biossimilares/administração & dosagem , Inibidores da Angiogênese/uso terapêutico , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/administração & dosagem
15.
Nutrients ; 16(7)2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38612968

RESUMO

Presbyopia is a global problem with an estimated 1.3 billion patients worldwide. In the area of functional food applications, dietary supplements or herbs, there are very few reports describing the positive effects of their use. In the available literature, there is a lack of studies in humans as well as on an animal model of extracts containing, simultaneously, compounds from the polyphenol group (in particular, anthocyanins) and iridoids, so we undertook a study of the effects of a preparation composed of these compounds on a condition of the organ of vision. Our previous experience on a rabbit model proved the positive effect of taking an oral extract of Cornus mas in stabilizing the intraocular pressure of the eye. The purpose of this study was to evaluate the effect of an orally administered ternary compound preparation on the status of physiological parameters of the ocular organ. The preparation contained an extract of the chokeberry Aronia melanocarpa, the honeysuckle berry Lonicera caerulea L., and the bilberry Vaccinium myrtillus (hereafter AKB) standardized for anthocyanins and iridoids, as bioactive compounds known from the literature. A randomized, double-blind, cross-over study lasting with a "wash-out" period of 17 weeks evaluated a group of 23 people over the age of 50, who were subjects with presbyopia and burdened by prolonged work in front of screen monitors. The group of volunteers was recruited from people who perform white-collar jobs on a daily basis. The effects of the test substances contained in the preparation on visual acuity for distance and near, sense of contrast for distance and near, intraocular pressure, and conjunctival lubrication, tested by Schirmer test, LIPCOF index and TBUT test, and visual field test were evaluated. Anthocyanins (including cyanidin 3-O-galactoside, delphinidin 3-O-arabinoside, cyanidin 3-O-glucoside, cyanidin 3-O-rutinoside, cyanidin 3-O-arabinoside) and iridoids (including loganin, sweroside, loganic acid) were identified as substances present in the extract obtained by HPLC-MS. The preliminary results showed that the composition of AKB applied orally does not change visual acuity in the first 6 weeks of administration. Only in the next cycle of the study was an improvement in near visual acuity observed in 92.3% of the patients. This may indicate potential to correct near vision in presbyopic patients. On the other hand, an improvement in conjunctival wetting was observed in the Schirmer test at the beginning of week 6 of administration in 80% of patients. This effect was weakened in subsequent weeks of conducting the experiment to 61.5%. The improvement in conjunctival hydration in the Schirmer test shows the potential beneficial effect of the AKB formulation in a group of patients with dry eye syndrome. This is the first study of a preparation based on natural, standardized extracts of chokeberry, honeysuckle berry, and bilberry. Preliminary studies show an improvement in near visual acuity and conjunctival hydration on the Schirmer test, but this needs to be confirmed in further studies.


Assuntos
Lonicera , Photinia , Presbiopia , Vaccinium myrtillus , Animais , Humanos , Coelhos , Presbiopia/tratamento farmacológico , Antocianinas , Estudos Cross-Over , Acuidade Visual , Túnica Conjuntiva , Iridoides
16.
Eur J Ophthalmol ; : 11206721231222939, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38385355

RESUMO

OBJECTIVES: To evaluate the validity and reliability of the new Fast Assessment of the Ocular Surface Trouble (FAST®) questionnaire for identifying glaucoma or ocular hypertension (OHT) patients at risk of ocular surface disease (OSD). METHODS: A multicenter, international, cross-sectional, epidemiological survey evaluated the most accurate interview items and ocular signs on the initial 14-item version of FAST® to develop a shorter version for routine, quick clinical use. Rasch analysis and least absolute shrinkage and selection operator (LASSO) method was used to reduce the number of items on the questionnaire. Sensitivity and specificity of FAST® were assessed with receiver operating characteristic (ROC) curves for the detection of OSD with the questionnaire and ophthalmic assessment. RESULTS: A total of 2308 eyes (1154 patients) were analyzed in this study by 92 ophthalmologists. The initial version of the FAST® indicated 60% of the subjects had OSD. Rasch analysis allowed removal of some clinical signs. The LASSO method allowed elimination of some items from the original questionnaire for a 9-item and a 6-item version of FAST®. For the 6-item questionnaire, the sensitivity and specificity were 71.9% and 74.3% respectively and the area under the curve was 0.815. CONCLUSIONS: The FAST® questionnaire is a valid and reliable tool for use in routine clinical practice and in clinical trials. The short versions of the questionnaire allow quick detection of the majority of patients with OHT or glaucoma at risk of dry eye.

17.
Cell Rep Med ; 5(3): 101437, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38428428

RESUMO

Leber hereditary optic neuropathy (LHON) is a mitochondrial disease leading to rapid and severe bilateral vision loss. Idebenone has been shown to be effective in stabilizing and restoring vision in patients treated within 1 year of onset of vision loss. The open-label, international, multicenter, natural history-controlled LEROS study (ClinicalTrials.gov NCT02774005) assesses the efficacy and safety of idebenone treatment (900 mg/day) in patients with LHON up to 5 years after symptom onset (N = 199) and over a treatment period of 24 months, compared to an external natural history control cohort (N = 372), matched by time since symptom onset. LEROS meets its primary endpoint and confirms the long-term efficacy of idebenone in the subacute/dynamic and chronic phases; the treatment effect varies depending on disease phase and the causative mtDNA mutation. The findings of the LEROS study will help guide the clinical management of patients with LHON.


Assuntos
Atrofia Óptica Hereditária de Leber , Ubiquinona/análogos & derivados , Humanos , Atrofia Óptica Hereditária de Leber/tratamento farmacológico , Atrofia Óptica Hereditária de Leber/genética , Atrofia Óptica Hereditária de Leber/diagnóstico , Antioxidantes/uso terapêutico , Ubiquinona/uso terapêutico , Ubiquinona/genética , Mutação
18.
Klin Oczna ; 115(3): 238-41, 2013.
Artigo em Polonês | MEDLINE | ID: mdl-24741932

RESUMO

AIM: The aim of the article is to present 2 cases of LHON revealed in cousins (patients' mothers were sisters). MATERIAL AND METHODS: They were both diagnosed in the Molecular Medicine Faculty and Department of Ophthalmology, Medical University of Wroclaw. RESULTS: Three of the most popular mutations characteristic for Leber's hereditary optic neuropathy were negative in both patients. CONCLUSION: The patients might have some rare, wild or unidentified mutations. Leber's hereditary optic neuropathy, mtDNA, LHON.


Assuntos
Atrofia Óptica Hereditária de Leber/diagnóstico , Atrofia Óptica Hereditária de Leber/genética , Adulto , Genes Mitocondriais , Humanos , Masculino , Polimorfismo Genético
19.
Klin Oczna ; 115(2): 130-4, 2013.
Artigo em Polonês | MEDLINE | ID: mdl-24059029

RESUMO

PURPOSE: The pupillary light reflex is a useful diagnostic tool used to assess the function of the eye and the visual system. The increased interest in testing the pupillary light reflex is the discovery that the intrinsically photosensitive retinal ganglion cells are involved in the reflex physiology. The aim of this study was to evaluate the usefulness of POLWROCHROM pupillometer, developed at the Wroclaw University of Technology, to study the pupillary light reflex to chromatic stimuli taking into account the photosensitive retinal ganglion cells activity. MATERIAL AND METHODS: The pupillary light reflex to 10 sec. light pulse were recorded. In the experiment, a long wavelength (640 nm bandwidth) red light and a short wavelength (470 nm bandwidth) blue light were used at 2 different light luminance levels (10 cd/m2 and 100 cd/m2). RESULTS: The greatest pupil response is obtained for short wavelength (blue) light at a high luminance level, whereas the markedly lower pupil response was obtained for long (red) wavelength light at a low luminance level. CONCLUSIONS: The observed sensitivity of the pupillary light reflex response to color and intensity of the light stimulus was similar to known from literature the results of in vitro photosensitive retinal ganglion cells electrophysiological activity study. The described system and measurement technique can provide a new tool in testing the pupillary light reflex to chromatic stimuli enabling the assessment of photosensitive retinal ganglion cells activity and identification of pupillary light reflex components derived from photoreceptors and ganglion cells, and therefore may become a clinical pupil test which allows differentiation between disorders affecting photoreceptors and those affecting retinal ganglion cells.


Assuntos
Imagem Óptica/instrumentação , Pupila/fisiologia , Reflexo Pupilar/fisiologia , Células Ganglionares da Retina/fisiologia , Visão Ocular/fisiologia , Humanos , Luz , Imagem Óptica/métodos , Estimulação Luminosa/métodos , Distúrbios Pupilares/diagnóstico
20.
Biology (Basel) ; 12(5)2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37237549

RESUMO

The use of stem cells (SCs) has emerged as a promising avenue in ophthalmology, offering potential therapeutic solutions for various vision impairments and degenerative eye diseases. SCs possess the unique ability to self-renew and differentiate into specialised cell types, making them valuable tools for repairing damaged tissues and restoring visual function. Stem cell-based therapies hold significant potential for addressing conditions such as age-related macular degeneration (AMD), retinitis pigmentosa (RP), corneal disorders, and optic nerve damage. Therefore, researchers have explored different sources of stem cells, including embryonic stem cells (ESC), induced pluripotent stem cells (iPSCs), and adult stem cells, for ocular tissue regeneration. Preclinical studies and early-phase clinical trials have demonstrated promising outcomes, with some patients experiencing improved vision following stem cell-based interventions. However, several challenges remain, including optimising the differentiation protocols, ensuring transplanted cells' safety and long-term viability, and developing effective delivery methods. The field of stem cell research in ophthalmology witnesses a constant influx of new reports and discoveries. To effectively navigate these tons of information, it becomes crucial to summarise and systematise these findings periodically. In light of recent discoveries, this paper demonstrates the potential applications of stem cells in ophthalmology, focusing on their use in various eye tissues, including the cornea, retina, conjunctiva, iris, trabecular meshwork, lens, ciliary body, sclera, and orbital fat.

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