[Angioid streaks in systemic disease]. / Szemfenéki angioid csíkok szisztémás betegségekben.

Angioid streaks are defined as the special morphological alteration of the fundus; the most common clinical manifestations are irregular, reddish brownish stripes around the optic nerve head or on the posterior pole. On the basis of histological examination, the cause of this phenomenon is the breaks and continuity deficiencies in the thin layer of Bruch membrane caused by the degeneration of elastic fibers. The aim of this study is to present the ocular complication of this rare entity through the description of three cases, and to draw attention to systemic diseases in the background. In our first and third cases, pseudoxanthoma elasticum (Grönblad-Strandberg syndrome) was in the background, while in our second case, hematological disease was confirmed. In our first and second cases, the ocular complication was the choroidal neovascularization, which we treated with intravitreal anti-VEGF injection. In our third case, the choroidal rupture was the ocular complication, caused by trauma. Angioid streaks on the fundus may be sub-phenomena of systemic diseases, the detection, differential diagnosis and treatment require interdisciplinary collaboration between associate physicians. Orv Hetil. 2019; 160(25): 994-1000.

Comparison of visual and refractive outcomes between hydrophilic and hydrophobic trifocal intraocular lenses sharing the same optical design.

PURPOSE: To compare clinical outcomes between two trifocal intraocular lenses (IOLs): the new FineVision POD F GF trifocal IOL made of hydrophobic acrylic glistening-free material, and the FineVision POD F IOL made of hydrophilic acrylic material with 26% water uptake in patients undergoing routine cataract surgery using standard phacoemulsification. SETTING: Semmelweis University, Department of Ophthalmology, Budapest, Hungary. DESIGN: Prospective controlled randomized single-center single-surgeon study. METHODS: Each patient had the hydrophilic POD F IOL implanted in one eye and the hydrophobic POD F GF IOL in the contralateral eye, according to a randomization table. Clinical outcomes included distance (4 m), intermediate (70 cm), and near (35 cm) visual acuities, contrast sensitivity measured under photopic and mesopic conditions, and defocus curves under photopic conditions. The follow-up was 6 months. RESULTS: The study comprised 25 patients. Under photopic conditions, there was no statistically significant difference between POD F GF and POD F IOLs for uncorrected distance (UDVA) (P = .607), uncorrected intermediate (UIVA) (P = .491), and uncorrected near (UNVA) (P = .414) visual acuities. Under mesopic conditions, there was no statistically significant differences between the 2 IOLs for UDVA (P = 1.00), UIVA (P = .149), and UNVA (P = .551). No statistically significant differences in contrast sensitivity were found between the groups under photopic (P = .4347) and mesopic (P = .425) conditions. No safety issues were reported. CONCLUSION: The study demonstrated equally good visual and refractive outcomes for the POD F GF IOL and the POD F IOL, giving the surgeon the option to choose the preferred material for the individual patient without compromising clinical outcomes.

[Ocular manifestations and management of Fusarium and Sarocladium infections]. / Fusarium és Sarocladium okozta fertozések szemészeti vonatkozásai és azok kezelése.

Since 2017, the nomenclature of Fusarium, Acremonium and Sarocladium species have changed, as these morphologically homogeneous, but phylogenetically heterogeneous species and species complexes may be differentiated using MALDI-TOF MS examination, analyzing nucleotic sequences. This resulted in taxonomical changes. We summarize the clinical course, diagnostic and therapeutic options of keratitis caused by Fusarium and Sarocladium. The challenge of Fusarium and Sarocladium keratitis management for an ophthalmologist lies in delayed diagnosis and therapy, fulminant progression and penetration of the Descemet's membrane, restricted availability, poor penetration of antifungal agents and therapy resistance. The diagnosis is based on the clinical history of corneal trauma or contact lens wear, PCR and MALDI-TOF MS, confocal microscopic examination, microbiological culture and light-microscopic analysis of corneal scrapings. As primary conservative treatment, 5% natamycin eye drops have to be used and with results of an antimycogram, topical 1% voriconazole or 0.15-0.25% amphotericin B, in some cases 0.02% polyhexamethylene-biguanide (PHMB) may be applied. Fusarium keratitis may benefit from additional 2 × 200 mg oral voriconazole treatment, daily. In therapy resistant cases, early, large diameter penetrating keratoplasty (PKP) has to be performed, with complete removal of the infected area. With late diagnosis, delayed specific treatment and surgery, mycotic hyphae may penetrate the Descemet's membrane, leading to the loss of vision and enucleation in about every fourth patient. In our paper, we also present the heterogeneous clinical history of five Fusarium and Sarocladium keratitis cases. Orv Hetil. 2019; 160(1): 2-11.