Photoreceptor Inner and Outer Segment Junction Reflectivity after Vitrectomy for Macula-Off Rhegmatogenous Retinal Detachment.

Purpose. To evaluate the spatial distribution of photoreceptor inner and outer segment junction (IS/OS) reflectivity changes after successful vitrectomy for macula-off retinal detachment (PPV-mOFF) using spectral domain optical coherence tomography (SdOCT). Methods. Twenty eyes after successful PPV-mOFF were included in the study. During a mean follow-up period of 15.3 months, SdOCT was performed four times. To evaluate the IS/OS reflectivity a four-grade scale was used. Results. At the first follow-up visit the IS/OS had very similar reflectivity in entire length of the central scan with total average value of 1,05. At the second visit the most significant increase of the reflectivity was observed in temporal and nasal parafovea with average values of 2,17 and 2,22, respectively. The third region of increased reflectivity of an average value of 2,33 appeared during the third follow-up visit and was located in the foveola. At the last follow-up visit in entire central cross section the IS/OS reflectivity exceeded grade 2 reaching the highest average values in nasal and temporal parafovea and foveola. Conclusions. A gradual increase of the IS/OS reflectivity was observed in eyes after PPV-mOFF. The process is not random and starts independently in the peripheral and central part of the macula which may be attributed to the variable regenerative potential of cones and rods.

Tear meniscus measurement by spectral optical coherence tomography.

PURPOSE: To evaluate the use of lower tear meniscus measurements obtained with anterior segment Spectral Optical Coherence Tomography (OCT) in quantitative tear evaluation and diagnosis of dry eye syndrome. To verify sensitivity and specificity of different tear meniscus parameters in diagnosis of dry eye syndrome. METHODS: A total of 111 eyes in consecutive patients, mean age 34.35 years (SD, 11.17), were enrolled. Each patient completed a standard Ocular Surface Disease Index questionnaire and general ophthalmic examination. Lower tear meniscus was evaluated using Spectral OCT (RTVue, Optovue) with cornea-anterior segment lens short. Three parameters were measured: tear meniscus cross-section area (TMA, mm), tear meniscus height (TMH, mm), and tear meniscus depth (TMD, mm). Break-up time and Schirmer tests after instillation of topical anesthetic drops were also evaluated. RESULTS: The highest correlation with Schirmer test results was found with TMA, followed by TMH and TMD. Respective Spearman correlation coefficient values were 0.54, 0.52, and 0.3, respectively. TMA, TMH, and TMD measurements were significantly lower in dry eyes than in controls. Sensitivity and specificity for dry eye diagnosis were 80.56% and 89.33% for TMH, 86.11% and 85.33% for TMA, and 77.78% and 52.7% for TMD, respectively. There was a significant negative correlation between both TMA and TMH and Ocular Surface Disease Index questionnaire scores. CONCLUSIONS: Lower tear meniscus parameters measured with Spectral OCT correlate well with the Schirmer test, break-up time, and subjective symptoms. TMA and TMH measurements have high sensitivity and specificity for the diagnosis of dry eye syndrome.

[Neurofibromatosis type 1--own experiences]. / Nerwiakowlókniakowatosc typu 1. W obserwacjach wlasnych.

PURPOSE: Neurofibromatosis type 1 is one of the most common inherited syndromes. The aim of this study was to evaluate eye symptoms on this disease. MATERIAL AND METHODS: 52 patients with neurofibromatosis type 1 were observed (28 males and 24 females), age between 3 and 49 years old (mean 21). The patients were divided into five groups depending on the age: 0-10 years old, 11-20 years old, 21-30 years old, 31-40 years old and older than 40 years. Frequency of the eye symptoms was estimated in each group. RESULTS: The eye sings were observed in 69.2%. Frequency of the eye symptoms were higher in the older groups. After 21th years of age ophthalmological signs were observed in all patients. The most common were café-au-lait spots on the lids, Lisch nodules on the iris, changes in CNS, especially gliomas of the optic pathway, nodular neurofibromas in the orbit region. CONCLUSIONS: Eye signs of the disease may be noticed in the most patients with NF 1. After 21th years of age ophthalmological symptoms are observed in all patients. The frequency of typical well known for NF 1 signs were different and characteristic for each age group.

[Pathogenesis and the most frequent symptoms of neurofibromatosis type 1]. / Patogeneza i najczestsze objawy nerwiakowlókniakowatosci typu 1.

PURPOSE: This study was to evaluate pathogenesis, symptoms, clinical course and possible treatment of neurofibromatosis type 1. Neurofibromatosis type 1, von Recklinghausen's disease, is one of the phacomatoses. It belongs to the most frequent inherited diseases in human population. This disease is autosomal dominant, but new spontaneous mutation are also common. The symptoms are caused by disorders in the melanocytes and gliocytes. In ophthalmological examination Lisch nodules, café-au lait spots, neurofibromas of the lids, optic pathway gliomas and deformation of the orbit bones, can be observed. The symptoms are different, depend upon the age and demonstrate charateristic evolution through the lifetime.

[Open globe injuries--selected epidemiologic features in own material]. / Urazy przenikajace galki ocznej-- wybrane cechy epidemiologiczne w materiale wlasnym.

PURPOSE: To evaluate chosen epidemiological factors in perforating eye injuries in own material MATERIAL AND METHOD: Retrospective case review over period from 2001 to 2003 hospitalised in the Department of Ophthalmology in Bydgoszcz. The group studied comprised 78 patients (79 eyes) aged from 4 to 77 years. Analyzed were following data: age, gender, the extend of the injury, visual acuity at presentation, the presence of - and intraocular foreign body nature, type of injury, professional activity, and other factors (alcohol use, glasses). RESULTS: The group studied involved 89.7% men. Mean age of all the patients was 35.6 years (SD=17.1), male: 35 years (D=17.0), female: 41 (SD=18.5). Severe wounds, including corneal and scleral laceration totaled 32.9%. In 41.8% cases initial visual acuity was less than 0.001, including 42.4% of light perception. There was no light perception in 18.2% in this group. Intraocular foreign bodies were found in 39.2% of studied eyes (75.8% involved ferromagnet metal). Domestic activities accounted for 50% of injuries, and 33.3% occurred at worksite. In the group studied there were 28.2% of unemployed, the pensioners were affected in 9%. CONCLUSIONS: Most of the penetrating eye injuries affected young males aged mean 35 and happened at home. Almost one half of the patients experienced severe injuries leading to severe visual loss. Ferromagnet metal predominated intraocular foreign bodies.

Changes of corneal thickness in patients wearing frequent-replacement contact lenses.

PURPOSE: To evaluate changes in corneal thickness after 2, 4, and 6 weeks of frequent-replacement contact lens wearing. MATERIAL AND METHODS: Twenty-eight patients were fitted with ACUVUE (Johnson & Johnson) contact lenses. Central and peripheral corneal thickness was measured before contact lens fitting and after 2, 4, and 6 weeks of wearing. RESULTS: Analysis of variance shows that the period of contact lens wearing has no influence on central corneal thickness. After a small increase in the second week, central corneal thickness returns to the initial values in the fourth and sixth weeks of contact lens wearing. Peripheral corneal thickness was statistically related to the time of contact lens wearing (P < 0.01). A statistically significant difference was observed between the baseline and peripheral corneal thickness measurements in the second, fourth, and sixth week of contact lens wearing (P < 0.01). CONCLUSIONS: Frequent-replacement contact lenses (ACUVUE) cause a small amount of corneal edema, which is higher in the periphery than in the center. Central corneal swelling disappears after 6 weeks of wearing, but in the periphery it remains stable throughout the period of observation.

[Frequent replacement contact lenses--patient's evaluation]. / Soczewki kontaktowe systematycznej wymiany w ocenie pacjentów.

PURPOSE: To measure the level of satisfaction connected with use of frequent replacement contact lenses. MATERIAL AND METHODS: Questionnaire forms were sent to 600 patients aged 7 to 54 years fitted with contact lenses between the years 1996 to 1999. Each questionnaire consisted of 31 questions about satisfaction, complications and every day care. RESULTS: 281 patients (46.8%) answered questionnaires, 94.7% of them were satisfied with the vision ensured by contact lenses. However 43% of contact lenses wearers used one pair of lenses at last 1 week longer then it was allowed. Only 38% of them followed control visit schedule. CONCLUSIONS: Our study demonstrated high level of satisfaction related to the use of frequent replacement contact lenses. However it was observed, that ophthalmologist indications were not completely fulfilled.