Recommendations for the Management of Uveitis Associated With Juvenile Idiopathic Arthritis: The Czech and Slovak adaptation of SHARE Initiative.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is its most important extra-articular manifestation. Evidence-based recommendations are available only to a limited extent and therefore JIA associated uveitis management is mostly based on physicians experience. Consequently, treatment practices differ widely, both nationally and internationally. Therefore, an effort to optimize and publish recommendations for the care of children and young adults with rheumatic diseases was launched in 2012 as part of the international project SHARE (Single Hub and Access Point for Pediatric Rheumatology in Europe) to facilitate clinical practice for paediatricians and (paediatric) rheumatologists. The aim of this work was to translate published international SHARE recommendations for the diagnosis and treatment of JIA associated uveitis and to adapt them for use in the Czech and Slovak Republics. International recommendations were developed according to the standard methodology of the European League against Rheumatism (EULAR) by a group of nine experienced paediatric rheumatologists and three experts in ophthalmology. It was based on a systematic literature review and evaluated in the form of an online survey and subsequently discussed using a nominal group technique. Recommendations were accepted if > 80% agreement was reached (including all three ophthalmologists). A total of 22 SHARE recommendations were accepted: 3 on diagnosis, 5 on disease activity assessment, 12 on treatment and 2 on future recommendations. Translation of the original text was updated and modified with data specific to the czech and slovak health care systems and supplemented with a proposal for a protocol of ophthalmological dispensarization of paediatric JIA patients and a treatment algorithm for JIA associated uveitis. Conclusion: The aim of the SHARE initiative is to improve and standardize care for paediatric patients with rheumatic diseases across Europe. Therefore, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated based on the evidence and agreement of leading European experts in this field.

[Retinopathy of prematurity. Part I]. / Retinopatia prematúrnych detí I. cast

Retinopathy of prematurity (ROP) is a disease that affects immature vasculature in the eyes of premature babies that potentially leads to blindness. Authors describe incidence, risk factors, pathophysiology and international classification of retinopathy of prematurity (ICROP). Key words: retinopathy of prematurity, incidence, pathophysiology, international classification.

[Retinopathy of prematurity - therapy. Part 2]. / Retinopatia prematúrnych detí - terapia II. cast

Retinopathy of prematurity (ROP) is a disease that affects immature vasculature in the eyes of premature babies that potentially leads to blindness. Authors describe revised indications for the treatment of ROP, standard treatment - peripheral retinal ablation by laser photocoagulation and the cryotherapy using off label treatment-intravitreal anti-VEGF injection. Key words: retinopathy of prematurity, indications, laser photocoagulation, cryotherapy, intravitreal anti-VEGF therapy.

[Screening retinopathy of prematurity (ROP)]. / Skríning retinopatie prematúrnych detí (ROP).

Retinopathy of prematurity (ROP) is abnormal blood vessel development in the retina of the eye in a premature infant that potentially leads to blindness. The guidelines present the timing of initial examination and subsequent reexamination intervals for screening and treating ROP. Key words: retinopathy of prematurity, screening, timing of the examination.

[Orbital ontogen dermoid cyst]. / Odontogénna dermoidná cysta orbity.

In the paper is described the very rare orbital dermoid cyst in lacrimal sac region containing ectopic dental elements. There was an uneventful clinical picture after the first operation, but a recurrence of the cyst with the presence of teeth in lacrimal region of the down eyelid has occurred four years after the first operation. After exstirpation of entire cyst contents has been achieved the favourable cosmetic and functional result.

[Benefit of paint diode laser coagulation in the treatment of ROP]. / Prínos konfluujúcej (paint)-- diôdlaserkoagulácie v liecbe retinopatie nezrelýh detí.

PURPOSE: Authors compare results of ROP treatment with a single spot diodlasercoagulation (DLC) versus paint--DLC. METHODS: A retrospective chart review of patients with threshold retinopathy of prematurity treated between 2001-2010 was conducted. A single spot DLC was used from January 2001 to May 2008. In this group (SI) there were 338 patients (671 eyes) with ROP. In the second group (S II) since June 2008 to June 2010 we have used the paint DLC in 158 patients (316 eyes). Authors compare the need for reoperations to achieve regression of ROP in both groups. Rate of progression, frequency of retreatment, complications and structural outcomes were evaluated. RESULTS: In SI was retreatment only with DLC necessary in 43 eyes (6.4%). Additional cryotherapy was used in 22 eyes (3.3%). A scleral buckling was used in 107 eyes (15.9%). In S II was retreatment with DLC used in 4 eyes (1.3%), the additional cryotherapy in 6 eyes (1.9%) and the scleral buckling in 11 eyes (3.5%). CONCLUSION: According to our outcomes we have found out the paint DLC mode is more effective than the single spot DLC in the ROP treatment.

[Diagnosis of toxoplasmosis and toxocariasis using fluid from the anterior ocular chamber]. / Diagnostika toxoplazmózy a toxokarózy z moku prednej ocnej komory.

The authors discuss methods of improvement of the etiologic diagnosis of the toxoplasma and toxocara associated posterior uveititis, by examining specific antibodies in the aqueous humor. Paired samples of aqueous humor and serum were analyzed in 23 patients. Chorioretinitis of infectious etiology was suspected in 15 patients, 3 patients were treated for panuveitis, 4 patients for intermediate uveitis, and in 1 patient the sample was obtained to rule out malignant melanoma. The local ocular antibody production was calculated according to Desmonts. Toxoplasma etiology was confirmed by local antibody production analysis in 1 patient, toxocara etiology in 5 patients. In 20 patients in the control group local specific antibody production was not demonstrated.

[Diclof 0.1% eyedrops in pediatric ophthalmology]. / Diclof 0,1% guttae ophthal. v detskej oftalmológii.

The authors analyze their two years experience with 208 patients hospitalized at the Clinic of Pediatric Ophthalmology treated by the locally administered antiprostaglandin diclophenac, 0.1% eye drops. The spectrum of the disease was wide and comprised different conditions after intraocular surgery, in particular of cataract, glaucoma and perforation injuries, Yag laser capsulotomy, and conservatively treated conditions, in particular inflammatory processes, uveitis and keratoconjunctivitis. Diclophenac was not combined with other non-steroid antiphlogistics but frequently it was adjuvant treatment of corticosteroids, antibiotics and mydriatics. The authors did not observe any side-effects of the preparation, even after long-term administration or after short-term administration to neonates. As to the intensity of effect, diclophenac was comparable with other prostaglandin inhibitors and in pediatric ophthalmology it is an effective and safe antiphlogistic agent.