95TH ANNIVERSARY OF THE CZECHOSLOVAK OPHTHALMOLOGICAL SOCIETY.

After the end of the First World War, the most important event in the history of our country was the establishment of the Czechoslovak Republic on October 28, 1918. Professor Deyl repeatedly spoke about the need to establish a Czechoslovak Ophthalmological Society. Only his successor, professor. O. Lešer implemented Deyl's idea and, in agreement with the heads of the Bratislava and Brno departments of ophthalmology, convened the opening general meeting of the Czechoslovak Ophthalmological Society on April 3, 1926, in the auditorium of the Czech department of ophthalmology with the participation of 37 ophthalmologists. Not all Czechoslovak ophthalmologists were present at this first meeting of the Czechoslovak Ophthalmological Society; their number can be estimated at about 55 in 1926. Immediately after the founding of the Czechoslovak Ophthalmological Society in 1926, a yearbook of congress works began to be published in the same year, every year until 1932, a total of 7 volumes. By the decision of the General Meeting of the Czechoslovak Ophthalmological Society, held on 15 May 1933, the publication of congress works was built on a new basis. The current form of the collection was abandoned, and the periodical journal Czechoslovak Ophthalmology was founded. In 1954, the Slovak branch of the ophthalmological section of the Czechoslovak Ophthalmological Society was founded, which quickly developed its activities and twice a year organized very successful and scientifically valuable congresses with rich participation and discussion. The name of the organization "Slovak branch of the Ophthalmological Section of the Czechoslovak Medical Society of J. E. Purkyně" was chosen. In 1969, under the Federalization Act, medical societies were reorganized; the Czech and Slovak Ophthalmological Society is established. The Federal Committee has since consisted of the chairs and secretaries of the two National Committees, who took turns in the leadership of the Federal Committee during their term of office. After the division of Czechoslovakia in 1993, the name of the magazine changed. Until 1994 it was published under the name Czechoslovak Ophthalmology and since 1995 the name has been changed to Czech and Slovak Ophthalmology. The first issue was published in February 1995, the continuity of the journal and the numbering has been preserved.

[Automatic Retinal Oxymetry in Patients with Diabetic Retinopathy]. / Automatická retinální oxymetrie u pacientu s diabetickou retinopatií.

AIM: To determine if oxygen saturation in retinal vessels depends on the degree of diabetic retinopathy. MATERIAL AND METHODS: A prospective study comparing values of oxygen saturation in retinal arteries, veins, and arterio - venous (A-V) difference in healthy persons and in patients with diagnosed diabetes. The study included 114 eyes of 76 patients with diagnosed diabetes, and 57 eyes of 57 patients without diabetes as a control group. RESULTS: The average retinal arterial saturation in patients without diabetes was 96.5 ± 2.6 %, and increased in patients with severe non-proliferative or proliferative diabetic retinopathy to 100.5 ± 5.6 %. The average venous saturation in patients without diabetes was 62.3 ± 7.4 % and increased to 74,0 ± 7.2 % in patients with severe non-proliferative diabetic retinopathy. CONCLUSION: In patients with diabetic retinopathy, we confirmed the increase of hemoglobin oxygen saturation as in the arterial as in the venous blood in retinal vessels; and significant decrease of arterio-venous difference according to the severity of diabetic involvement was confirmed as well.Key words: automatic retinal oxymetry, diabetic retinopathy, oxygen saturation, Oxymap.

[Treatment of Macular Oedema due to retinal vein occlusion with OZURDEX]. / Lécba makulárního edému pri okluzi centrální sítnicové zíly OZURDEXEM.

Macular edema due to retinal vein occlusion is the second most common cause of vascular vision impairment. The authors refer two case reports that describe different response to treatment with OZURDEX, biodegradable injectable implant slowly releasing 700 µg dexamethasone. Treatment with corticosteroids is effective also in the case of cystic retinal edema, but its effect can be temporary. The most common adverse events are elevation of intraocular pressure and cataract development.

[The benefit of pars plana vitrectomy for the resolution of complications of proliferative diabetic retinopathy]. / Prínos pars plana vitrektomie pro resení komplikací proliferativní diabetické retinopatie.

Between 1997 and 2007, we have conducted eye surgery on 72 patients (i.e. 72 eyes) as a consequence of proliferative diabetic retinopathy complications. The patients' average age was 61; the follow-up observations were carried out over a period of one year after the surgery. When we compare the initial vision with the visual acuity measured during the last follow-up examination in the late post-operative period, i.e. one year after the surgery, we can conclude that the vision of46 eyes (63%) had improved, 17 eyes (24%) did not show any change in vision, and the vision of nine eyes (13%) had deteriorated. Visual acuity of 1/60 (metric system) or better was found in 55 eyes (76%) during the late post-operative period; 6/60 vision or better was found in 29 eyes (40%), and four eyes (6%) showed 6/12 vision or better. If we compare the vision in the early post-operative period with the visual acuity during the last follow-up examination in the late post-operative period, we can conclude that in most cases, i.e. in 45 eyes (62.5%), the vision did not change any further during the months after the surgery, and one eye (1.5%) even showed improvement in visual acuity. It was confirmed that a positive result of pars plana vitrectomy observed in the early post-operative period may indeed persist even during the following months and years of the patient's life.

[Anatomical results of cryosurgical procedures in rhegmatogenous retinal detachment - our experience]. / Anatomické výsledky kryochirurgických operací pri rhegmatogenním odchlípení sítnice - nase zkusenosti.

AIM: To evaluate retrospectively anatomical results of cryosurgical treatment of non-complicated idiopathic rhegmatogenous retinal detachment. To assess the successfulness of primary cryosurgical surgeries, permanent retinal re-attachment; to review the efficacy of cryosurgical procedures according to chosen surgical technique and patients age as well. MATERIAL AND METHODS: In the evaluated group were included 120 eyes of 120 patients operated on in the years 2003- 2012 at the Department of Ophthalmology, Faculty Hospital and School of Medicine, Palacký University, Olomouc, Czech Republic, E.U. All of the patients were phakic. The patients were evaluated at one and three months after the surgery. The posterior pole examinations were done by means of biomicroscopic examination and indirect ophthalmoscopy. The retina was evaluated as attached in whole extent in case of re-established contact between the neurosensory retina and the retinal pigment epithelium in the whole periphery. RESULTS: In 106 (88 %) patients, the re-attachment of the retina was achieved by solely cryosurgical procedure; in 117 (97.5 %) patients, the definite re-attachment of the retina was achieved. In three patients (2.5 %), the retina remained detached. Statistically better results were obtained in patients with peroperative exodrainage of the subretinal fluid and in patients younger than 50 years of age. CONCLUSION: We established the usefulness of cryosurgical operative procedure in treatment of uncomplicated idiopathic rhegmatogenous retinal detachment in phakic patients. Especially in young phakic patients, the cryosurgical procedure may be protective to preserve the clear lens and eye accommodation.

[Functional results of cryosurgical procedures in rhegmatogenous retinal detachment including macula region - our experience]. / Funkcní výsledky kryochirurgických operací pri rhegmatogenním odchlípení sítnice vcetne makuly nase zkusenosti.

AIM: Aim of this study is to evaluate retrospectively functional results of cryosurgical treatment of uncomplicated, idiopathic rhegmatogenous retinal detachment including macula region in phakic patients operated on at the Department of Ophthalmology, Faculty Hospital, Palacký University, Olomouc, Czech Republic, E.U., during the period 2002 -2013, and to evaluate the significance of the macula detachment duration for the final visual acuity. METHODS: In the study group were included 56 eyes of 56 patients operated in the years 2003 - 2012 at the Department of Ophthalmology, Faculty Hospital, Palacký University, Olomouc. All patients were phakic and in all of them, the retinal detachment including the macula region was diagnosed. The mean follow-up period of the patients was 8,75 months. The initial and final visual acuity testing were performed. Comparing the initial and final visual acuity we rated the level of the visual acuity change. The result was stated as improved, if the visual acuity improved by 1 or more lines on the ETDRS chart. The result was rated as stabilized, if the visual acuity remained the same or it changed by 1 line of the ETDRS chart only. The result was evaluated as worsened, if the visual acuity decreased by 1 or more lines of the ETDRS chart. In the followed-up group, the authors compared visual acuity levels in patients with the macula detachment duration 10 days and 11 days. For the statistical evaluation of achieved results, the Mann - Whitney U test was used. RESULTS: The visual acuity improved in 49 (87 %), did not changed in 5 (9 %) and worsened in 2 (4 %) patients. The patients with macula detachment duration 10 days achieved statistically significant better visual acuity than patients with macula detachment duration 11 days. CONCLUSION: Patients with macula detachment duration 10 days have better prognosis for functional result than patients with macula detachment duration 11 days.

[The effect comparison of ranibizumab and sodium pegaptanib on the retinal pigment epithelium ablation size in the treatment of age-related macular degeneration]. / Porovnání úcinku ranibizumabu a pegaptanibu sodného na velikost ablace RPE pri lécbe vlhké formy vekem podmínené makulární degenerace.

AIM: To evaluate the effect difference of ranibizumab and sodium pegaptanib in the ablation treatment of the retinal pigment epithelium (RPE) in age-related macular degeneration MATERIAL AND METHODS: Retrospective analysis of data of patients with age-related macular degeneration treated by means of anti-VEGF therapy at the Department of Ophthalmology, School of Medicine, Palacky University, Olomouc, Czech Republic, E.U. during the period May 2009 - October 2010. For the analysis were used data from patients with follow-up period longer than 6 months and present serous RPE ablation caused by occult choroidal neovascularization (CNV), verified by optic coherence tomography (OCT) and fluoresceine angiography (FAG). STUDY GROUP: Ranibizumab was used as treatment during the period in 37 eyes of 37 patients (average age 73.2 years; right eye (RE) in 20 cases, left eye (LE) in 17 cases. Sodium pegaptanib was applied in 17 eyes of 17 patients (average age 72.4 years; RE in 10 cases and LE in 7 cases), The follow-up period in the ranibizumab group was 8.51 (SD 3.32) months, and in the pegaptanib group 9.94 (SD 5.50) months. RESULTS: In the ranibizumab group decreased the average RPE ablation base from 2865 microm (SD 810 microm) to 2270 microm (SD 1265 microm) and the prominence of the ablation from 334 microm (SD 160) to 238 microm (SD 178 microm). In patients treated by pegaptanib, decreased the average basis from 3245 microm (SD 930 microm) to 2159 microm (SD 1185 microm), and the prominence of the ablation from 354 microm (SD 173 microm) to 208 microm (SD 107 microm). The statistical significance test did not prove significant differences (level of significance p = 0.05) in the change either of the base or the prominence of the RPE ablation in any group of patients (prominence p = 0.09, base p = 0.21; Mann-Whitney test). In three patients (8.1%) treated by ranibizumab, the RPE rupture occurred. No RPE rupture was recorded in patients treated by sodium pegaptanib. CONCLUSION: Although no statistically significant difference in the efficacy of both drugs in the treatment of the RPE ablation was found, in patients treated by sodium pegaptanib, there is evident tendency of higher efficacy in decrease of the RPE ablation prominence, and lower incidence of RPE rupture. The study is limited by small number of patients and short follow-up period.

[Contemporary possibilities of artificial vision in blind patients using artificial neuro-prosthesis--review]. / Soucasné moznosti náhrady vid6ení nevidomých pacientü pomocí arteficiálních neuroprotéz.

The authors present the knowledge summarization of vision substitute using artificial retinal neuroprostheses. The overview was compiled from available literature found in the Medline and Embase databases. The text focuses on global summarizing of the whole issue since the beginning of the development to the state up to date. In individual types of neuroprostheses, the advantages, disadvantages, and possible obstacles to their use in clinical practice are discussed. Furthermore, the brain plasticity and functional changes of the brain in blinds are considered. The aim of the review is not to present all information in detail, but complex overview with relevant literature sources.

[Czech Ophthalmologic Society's data collecting system for the monitoring and evaluating of the exsudative age-related macular degeneration treatment--the nation-wide project "AMADEUS"]. / Informacní zázemí Ceské oftalmologické spolecnosti CLS JEP pro monitoring a hodnocení lécby vlhké formy vekem podmínené makulárni degenerace-národní projekt AMADEUS.

The Czech Ophthalmologic Society (member of the Czech Medical Society of Jan Evangelista Purkyne) in collaboration with the Institute of Biostatistics and Analysis of the Masaryk University in Brno established a nation-wide information system for the follow-up of the epidemiology and treatment of the exsudative age-related macular degeneration (ARMD). The project named AMADEUS is a multi-centric, non-invasive, observation prospective study with the aim to improve the patients' treatment and to unify the criteria for the follow-up of the ARMD in the real clinical practice in the Czech Republic. The basic instrument of the whole project is a clinical register collecting parametric data from 9 specialized centers. Especially the project monitors the photodynamic therapy with Verteporfyrine (Visudyne) and treatment by anti-VEGF agents, or Pegaptanib (Macugen) and Ranibizumab (Lucentis). The project's protocol is trying to collect representative data about ARMD diagnosis and treatment; during regularly controls, the efficacy and safety of the treatment are followed-up.The data collecting does not influence the treatment strategy or the availability of chosen treatment for the patient. Since October 2008 until the end of the year 2009, the registry collected complex information about more than 1402 newly treated ARMD patients; out of them, in 582 cases the one-year follow-up period was regularly terminated. The available data shows well-considered indication of drugs indications by the doctors; the treated patients fulfill the indications criteria set by the scientific society. According to the data from the registry, in some treating centers the application schedule is not followed-up in some drugs (especially Pegaptanib); there is the possibility to improve the treatment. All the clinical centers participating in the AMADEUS registry will continue in the data collecting, which after a longer period of time will facilitate further treatment optimization and eliminating of the established imperfections. Further information about the project may be found at the web site: www.amadeus.registry.cz.

[Exsudative age-related macular degeneration treatment results in patients registered in the nation-wide AMADEUS register]. / Výsledky lécby vlhké formy vekem podmínené makulární degenerace u pacientu evidovaných v celonárodním registru AMADEUS.

The nation-wide register of patients with the exsudative age-related macular degeneration surveys the appearance and the success rate of the treatment of this disease in the Czech Republic. During the 12 months follow-up period of 38 patients treated with Macugen in monotherapy, receiving at least 7 injections of Macugen during one year period, we found the loss of less than 15 letters of the ETDRS chart in 62.2 % of treated eyes. During the 12 months follow-up period of 205 patients treated with Lucentis in monotherapy, receiving at least 3 injections of Lucentis, we found the loss of less than 15 letters of the EDTRS chart in 82.0 % of treated eyes. During the 12 months follow-up period of patients treated with Visudyne in monotherapy we found the loss of 15 letters of the EDRTS chart in 77.1% of treated eyes.

[Sodium pegaptanib and ranibizumab in the treatment of the retinal pigment layer ablation in a patient with age-related macular degeneration--a case report]. / Pegaptanib sodný a ranibizumab v lécbe ablace pigmentového listu sítnice u pacienta s vekem podmínenou makulární degenerací-kazuistika.

The case report presents the difference of the effect of two drugs blocking vascular endothelial growing factor (anti-VEGF)--sodium pegaptanib and ranibizumab--in a female patient with the retinal pigment epithelium (RPE) layer ablation as a part of the exsudative age-related macular degeneration. Fifty-five years old female patient with RPE ablation as a sign of exsudative ARMD and central visual acuity 79 letters of the EDTRS chart in the left eye was treated by 5 intravitreal injections of sodium pegaptanib. The treatment was not sufficiently effective according to the fluorescein angiography (FAG) and optic coherence tomography (OCT) findings and was accompanied by further decrease of the visual acuity to 55 letters of the EDTRS chart. After the medication was switched to ranibizumab with 3 intravitreal applications, the RPE ablation flattened according to the OCT findings and the fluorescein leakage during the FAG markedly decreased. The central visual acuity improved to 63 letters of the EDTRS chart. The decreased activity of the choroidal neovascularization (CNV) is observed during the following 4 months after the last intravitreal application of ranibizumab. Ranibizumab seems to be more effective drug comparing to the sodium pegaptanib in patients with the RPE ablation, but it is necessary to consider the increased probability of the RPE rupture risk.

[Disturbances of the plasma coagulation defects in retinal venous occlusions]. / Poruchy hemokoagulacní kaskády u retinálních venózních okluzí.

Occlusions of retinal veins (central and branch) represent multifactorialy-conditioned disease involving presumably older patients, in whom the changes of retinal vessels caused by hypertension and atherosclerosis present the most important pathophysiological factors for development of this disease. In last years, the intensive scientific research is focused to the explanation of the role of the defects of the coagulations cascade. Especially in younger patients, the most often mentioned defect of the coagulations cascade is called as APC-resistance. Up to 95% of all patients with APC-resistance are carriers of so called Leiden mutation. The aim of our study was to establish the prevalence of the ACP-resistance in 92 patients with central or branch occlusion of the retinal vein verified by means of angiography treated at the Department of Ophthalmology, Faculty Hospital, Olomouc, Czech Republic, EU, during the period 1999-2005. The control group consisted of 40 patients without any vascular, eye-related disease. In the group of patients with occlusion of the retinal vein, the prevalence of the APC-resistance was 10.9% and in the control group 5%. In the group of patients 55 years old and younger the prevalence of the ACP-resistance was 14.3%, in patients older than 55 years it was 5.6%. According to the relatively small groups of patients, the established difference did not reach the level of statistical evidence. Results of our study confirmed the conclusions of previously published papers that the prevalence of the APC-resistance is not significantly higher in patients with retinal vein occlusion according to the prevalence in controls.

[Functional examination of retinal vessels in patients with central retinal vein occlusion]. / Funkcní vysetrení retinálních cév u pacientu s okluzí centrální sítnicové zíly.

Retina vessel analyzer (RVA) provides the functional examination of retinal vessels based on the analysis of the extent (size) of their dilation and constriction. The RVA measures continuously on-line the diameter of retinal arteries and veins after different kind of stimulation. Beyond dynamic vessel analysis, another possibility of the RVA's utilization is a static vessel assessment, measuring the arterial and venous diameter ratio (A/V ratio), which provides the information about the rate of arterial vasoconstriction. The aim of the presented study was to investigate static and dynamic retinal vessel changes in patients with central retinal vein occlusion (Group 1). The second investigated group consists of patients with arterial hypertension; as a control group, healthy persons without any vascular disease were examined. Altogether 40 eyes were examined. Statistically significant differences of A/V ratio were observed in the static vessel analysis in all three investigated groups. The dynamic analysis showed statistically significant differences in arterial dilatation and constriction between all investigated groups as well. The presented results confirm that the degree of retinal vessels endothelial dysfunction is one of the determinating ethiopathological factors of central retinal vein occlusion.

[Orbital apex syndrome of the aspergillus etiology--a case report]. / Syndrom orbitálního hrotu aspergilové etiologie--kazuistika.

The authors present a case report of a patient, in whom after a head injury the monolateral blindness occurred. Because of autoimmune thrombocytopeny the patient was treated with long-term corticosteroids. The clinical findings corresponded with the orbital apex syndrome. According to the results of the CT and MRI examinations, the sphenoidotomy was indicated, and the histological findings verified fragments of paranasal sinuses' aspergiloma. During the next course of the disease, despite antimycotic therapy, the progression of the aspergiloma in to the anterior cranial fossa occurred. Invasive sino-orbital aspergilosis, after the penetration of the infectious agent across the wall of the sinus, may cause the orbital apex syndrome with paralysis of all three cranial nerves innervating the extraocular muscles, sensoric defect in the area of the ophthalmic nerve and the involvement of the optic nerve.

[Ocular sparganosis in the Czech Republic--a case report]. / Ocní sparganóza v Ceské republice: Kazuistika.

The authors report a case of 14-year-old boy presented to the Ophthalmologic Department of University Hospital in Olomouc with the diagnosis af acute anterior uveitis. A living parasite has been detected in the anterior chamber in a slit lamp examination. The vitreous and retina remained uninvolved. The acute iridocyclitis associated with parasitic infection is a very rare cause of anterior uveitis in Central Europe. The patient underwent surgical removal of the parasite via paracentesis. The inflammation resolved under the treatment with atropine and dexamethasone drops within a few days. Histopathological examination revealed the parasite as a young larval stage of tapeworm from family Pseudophyllidea (sparganum). Based on the analysis of development cycles of different types of tapeworms and according the literature data on tapeworms found in the Czech Republic genus Spirometra seemed to be the most plausible cause of the patient's disease. As the most probable source of viable parasites authors suspect swallowed water containing tiny infected crustaceans in the dam near the town Olomouc in Moravia.

[The ultrasound findings in posttraumatic endophthalmitis]. / Ultrazvukové nálezy u poúrazových endoftalmitid.

The aim of this study was to evaluate the ultrasound findings in eyes with endophthalmitis following penetrating injury and to establish unfavorable predictive signs of this serious disease. In a retrospective study we evaluated findings in 7 eyes of 7 patients followed up because of posttraumatic endophthalmitis at the Department of Ophthalmology, School of Medicine, in Olomouc, Czech Republic, EU, during the period September 1999-December 2004. The mean age of the patients was 37.3 years (range 22-49 years). The mean duration of the period between the injury and the formation of the endophthalmitis was 8.4 days (range 1-21 days). The visual acuity at the time of admittance was very low; it ranged between light perception and 1/60 (0,016 or 20/1200). All patients underwent diagnostic-therapeutic pars plana vitrectomy with vitreous samples taken for microbiological examination and intravitreal antibiotic application. The final visual acuity (VA) ranged from 1/60 (0,016 or 20/1200) to 6/12 (0.5 or 20/40), so it was very variable and that gave us the possibility to follow the connection between the final VA and seriousness of the penetrating injury, and also with the interval between the emergence of the endophthalmitis and beginning of its treatment. During the ultrasound examination, the presence of membranes in the vitreous body, posterior vitreous detachment, thickening of the choroid, detachment of the choroid and detachment of the retina were of concern to us. Membranes were present in the vitreous in 5 eyes. Without membranes detected by the ultrasound, there were 2 eyes; in both of them the final VA was better than 6/36 (0,1667 or 20/120). The posterior vitreous detachment was detected in 3 eyes, and not detected in four eyes. We didn't find any connection between the final VA and posterior vitreous detachment. The thickening of the choroid was present at the ultrasound examination in all seven eyes. The detachment of the choroid was not found in any eye. The retina was detached in two eyes. In three eyes only, the final central VA was better than 6/36 (0.1667 or 20/120). In two of them, the intraocular foreign body was found and in both the bacteria Staphylococcus epidermidis was detected. In the third eye, the soil bacteria Enterococcus and Klebsiela were cultivated. The ultrasound findings in these three eyes are identical only in the term of thickening of the choroid, similar to other eyes. In two of them no membranes were detected by ultrasound and no posterior vitreous detachment was found. The ultrasound examination in eyes with endophthalmitis after penetrating injury is specific in particular because of the mechanism of the injury. In contrast to the cases of the postoperative endophthalmitis, no prognostic unfavorable sings in the ultrasound examination can be strictly identified.