[Endophthalmitis following intravitreal triamcinolone acetonid injection--a case report]. / Zapalenie wnetrza galki ocznej po iniekcji doszklistkowej octanu triamcynolonu--opis przypadku.

PURPOSE: To report a case of acute endophthalmitis following intravitreal triamcinolone acetonide injection. MATERIAL AND METHODS: A 54-year-old woman with diabetic macular edema developed endophthalmitis after triamcinolone injection. First she was treated with intravitreal antibiotic injections and next with four surgeries--facovitrectomy, revitrectomy, silicone oil removal and revitrectomy. RESULTS: The initial visual acuity was 0.5. From the vitreous cultured Staphylococcus epidermidis. Depite the intensive medical intervention, the toxic retinal damage occurred and the final visual acuity was hand movement. CONCLUSIONS: intravitreal triamcinolone injections can induce bacterial endophthalmitis, which has a devastating effect on the ocular tissues and results in severe loss of vision. The procedure of injection in diabetic and immunocompromised patients should be performed with great care.

Early vitrectomy and diagnostic testing in severe infectious posterior uveitis and endophthalmitis.

BACKGROUND: To determine the therapeutic and diagnostic value of vitreoretinal surgery in various types of severe viral retinitis and endogenous endophthalmitis. MATERIAL/METHODS: Pars plana vitrectomy with silicon-oil tamponade was performed on 12 eyes (12 patients) with severe viral retinitis and endogenous endophthalmitis. The mean age of the patients was 35.2 years (range, 18-56 years). Investigations consisted of chest radiography, RT 23, serology (for toxoplasmosis, cytomegalovirus, herpes simplex virus, and human immunodeficiency virus), and routine blood tests and urinalysis. Examination of vitreous samples consisted of polymerase chain reaction for cytomegalovirus, herpes simplex virus, and Mycobacterium tuberculosis, and cultures for fungi and bacteria. The results were analyzed 7 days and 6 months after surgery. RESULTS: Analysis of vitreous samples showed cytomegalovirus in 3 patients, herpes simplex virus in 2, tuberculosis in 2, and Candida albicans in 5. All patients had improvement in visual acuity and severity of clinical signs seven days after surgery and in 10 cases after long-term follow-up. Final visual acuity was compromised by chronic macular edema, postinflammatory macular scarring, optic atrophy, subcapsular cataract formation, and capsular opacification after cataract surgery. CONCLUSIONS: Modern laboratory tests are useful for quick and accurate diagnosis of atypical cases of severe infectious posterior uveitis. Early pars plana vitrectomy with silicon oil tamponade is valuable in diagnosing and treating severe infectious posterior uveitis and endophthalmitis.

Proliferative diabetic retinopathy-The influence of diabetes control on the activation of the intraocular molecule system.

AIMS: Demonstrate the influence of type 2 diabetes control on the degree of retinal endothelial damage (vWF, E-selectin) and local increases in the concentrations of selected adhesion molecules (ICAM-1, VCAM-1, E-selectin) in proliferative diabetic retinopathy (PDR). METHODS: Vitreous and serum samples were collected during vitrectomy from 19 patients with PDR and 15 patients who underwent vitrectomy for other reasons. Tests were performed using the ELISA method. RESULTS: Serum and intraocular concentrations of ICAM-1, VCAM-1, E-selectin, vWF were considerably higher in the subjects with PDR than in the controls. In the vitreous, the increase in vWF depended on the elevated levels of vWF in the serum (r=0.905, p<0.001). E-selectin correlated with diastolic blood pressure (r=0.506, p=0.045). The concentrations of vWF and E-selectin in both samples were related to the significant increases in intraocular ICAM-1, ICAM-1, VCAM-1 in the serum of PDR patients. Increased VCAM-1 level in the vitreous correlated with the concentration of HbA(1)c (r=0.59, p=0.007). CONCLUSIONS: Upon local and systemic damage to the endothelium there were significant increases in ICAM-1, VCAM-1, E-selectin. A significant positive correlation of VCAM-1 increase in the vitreous with HbA(1)c is an important argument for the influence of diabetes on immuno-inflammatory activation in the retinal microcirculation.

[Safety and efficacy of using bevacizumab in the treatment of exudative age-related macular degeneration]. / Skutecznosc i bezpieczenstwo stosowania bevacizumabu w leczeniu wysiekowego zwyrodnienia plamki zwiazanego z wiekiem.

PURPOSE: To evaluate the efficacy and safety of intravitreal bevacizumab administered on "as required" basis in patients with exudative age-related macular degeneration (AMD). MATERIAL AND METHODS: A prospective uncontrolled cohort study of patients with exudative AMD treated with intravitreal bevacizumab administered "as required" based on PRONTO reinjection criteria. Main outcome measures include standardized best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured with optical coherence tomography (Stratus OCT). RESULTS: 153 eyes of 153 consecutive patients with AMD were treated with intravitreal bevacizumab injection, followed monthly and reinjected "as required". Mean follow-up time was 14.2 weeks (4-52 weeks). Distance BCVA improved from 0.79 log MAR at baseline to 0.69 at 4 weeks, 0.7 at 8 weeks, 0.64 at 12 weeks, 0.71 at 16 weeks and 0.63 at 20 weeks (p<.05). Near BCVA improved from 0.13 at baseline to 0.22 at 4 and 8 weeks, 0.25 at 12 weeks, 0.22 at 16 weeks and 0.28 at 20 weeks (p<.05). Mean CMT decreased from 395 microm at baseline to 265 at 4 weeks, 260 at 8 weeks, 268 at 12 weeks, 255 at 16 weeks and 257 at 20 weeks (p<.05). Mean time between first and second injection was 91.9 days, and between second and third injection 99.7 days. No adverse events were observed. CONCLUSIONS: Short-term results suggest that intravitreal bevaciuzmab administered "as required" is safe and effective in patients with exudative AMD. "As required" schedule may decrease the risk of adverse events and lower the cost of treatment.

Assessment of selected adhesion molecule and proinflammatory cytokine levels in the vitreous body of patients with type 2 diabetes--role of the inflammatory-immune process in the pathogenesis of proliferative diabetic retinopathy.

BACKGROUND: The aim of the study is to demonstrate the participation of the inflammatory-immune process in the pathogenesis of proliferative diabetic retinopathy (PDR). METHODS: Twenty four women and 22 men with type 2 diabetes (mean age 63.97 +/- 9.00 years, mean duration of diabetes 12.56 +/- 6.87 years) were enrolled in the study. Serum concentrations of soluble forms of ICAM-1, VCAM-1 as well as IL-6 and TNF-alpha were evaluated in all study subjects. In 19 patients, simultaneous assessment of selected parameter levels in both serum and vitreous samples was performed. Vitrectomy was performed due to intravitreal hemorrhage, accompanied in some patients by traction retinal detachment. The control group consisted of 15 patients having undergone vitrectomy for reasons other than PDR. Tests were performed using the ELISA method. RESULTS: Serum and intraocular concentrations of sICAM-1, sVCAM-1, IL-6, TNF-alpha were considerably higher in study subjects with PDR than in controls. Simultaneously, a positive correlation was found between intraocular sVCAM-1 (r = 0.590, p = 0.007), TNF-alpha (r = 0.822, p < 0.001) concentrations and HbA(1)c levels. The above-mentioned dependence was not shown for sICAM-1 and IL-6 vitreous concentration. Local vitreous VCAM-1 level increase was also dependent on vitreous TNF-alpha concentration growth (r = 0.470, p = 0.043). No significant correlation was found between serum and vitreous levels of the selected parameters in the group of 19 patients with PDR. CONCLUSIONS: Increase in sICAM-1 and sVCAM-1 levels, as well as their correlation with high vitreous IL-6 and TNF-alpha concentrations in patients with PDR, seem to confirm the inflammatory-immune nature of this process. In diabetes, inadequate metabolic control remains an important risk factor in the development of PDR.

[Contribution of selected cellular adhesion molecules and proinflammatory cytokines in the pathogenesis of proliferative diabetic retinopathy]. / Udzial wybranych molekul adhezyjnych oraz cytokin prozapalnych w patogenezie proliferacyjnej retinopatii cukrzycowej.

UNLABELLED: Proliferative diabetic retinopathy (PDR) is caused by structural and functional disorders of the retinal vessels. Complex pathobiological mechanisms of this process have not been clearly explained so far. PURPOSE: To prove the role of immunological-inflammatory process in the development of the proliferative diabetic retinopathy. MATERIAL AND METHODS: Forty six patients, aged 63.97+/-9 were enrolled in the study, treated for diabetes type 2 for 12.56+/-6,87 years. In 19 patients (12 women and 7 men aged 64.63+/-8.38, treated for diabetes for 12.47+/-6.75 years) a parallel analysis of given parameters was performed in both serum and vitreous body samples. Vitrectomy, in course of which the vitreous body samples were obtained, was performed in these patients because of vitreous haemorrhage, causing traction retinal detachment in some patients. The control group consisted of 15 patients (9 women and 6 men), aged 63.00+/-14.58, who underwent the vitrectomy procedure because of reasons other than diabetic retinopathy. The concentration values of the soluble forms of ICAM-1, VCAM-1, IL-6 and TNF-alpha were estimated both in the serum and vitreous body samples on the basis of the ELISA method. The biochemical tests were performed routinely in the clinical laboratory. RESULTS: Mean concentrations of the investigated parameters were significantly higher in the group of patients suffering from PDR, both in the serum and in the vitreous body samples, in comparison with the values observed in the control group. In the presence of HbAlc at the level of 9.21+/-2.17% a directly proportional correlation between the TNF-alpha either in serum or in the vitreous body samples and VCAM-1 in the vitroeus body samples was found. It is worth mentioning that the increase of the TNF-alpha concentration in the vitreous body was significantly related to the rise of the VCAM-1. CONCLUSIONS: The above mention of findings prove the remarkable role of the immunological and inflammatory response in the pathogenesis of this specific vascular complication of diabetes. The research was a source of evidence which highlighted the necessity of optimal metabolic control of the disease in the prevention of vascular complications of diabetes.

[Secondary epithelial cyst of the iris--case report]. / Wtórna nablonkowa torbiel teczówki--opis przypadku.

Authors present a case of 33 years old man who developed implantation secondary cyst of the iris, after penetrating trauma in a childhood. He was treated with cyst aspiration and endolaser photocoagulation of the cyst base. Postoperatively visual function significantly improved. No recurrence of cyst was observed. Within 6 months cataract developed with pupillary obstruction caused by irydocorneal adhesions, which required reoperation. Authors indicate that management of secondary cyst of the iris may require repeated laser or surgical treatment.

[Vitrectomy with peeling retinal limiting membrane (ILM) in eyes with diabetic macular edema]. / Witrektomia z usunieciem blony granicznej wewnetrznej siatkówki w leczeniu cukrzycowego obrzeku plamki.

PURPOSE: To evaluate the efficacy of pars plana vitrectomy with retinal internal limiting membrane (ILM) peeling in eyes with diabetic macular edema. MATERIAL AND METHODS: Twenty five eyes of 25 patients with diabetic macular edema. All eyes underwent a pars plana vitrectomy including separation of the posterior hyaloid, ILM peeling and air endotamponde. Preoperatively visual acuity (VA), funduscopic examination and the presence or absence of posterior vitreous detachment, were evaluated. Fluorescein angiography was performed in all patients prior to surgery. Eyes with cystoid macular edema or macular ischaemia were excluded. Postoperative VA, anatomic results, and complications were recorded. The follow-up was 7 to 27 months (mean 17). RESULTS: Intraoperatively, thick posterior hyaloid was found to be attached to the posterior pole in 20 cases. The mean postoperative VA (0.2) was significantly better than the preoperative VA (0.08) (p = 0.0001). VA improved postoperatively in 21 eyes (84%), at least two lines on the Snellen chart in 8 eyes (32%). It remained unchanged in 4 eyes (16%). Confluent hard exudates in fovea were present significantly more frequently in eyes without VA improvement (p = 0.004). The postoperative VA was better in eyes that had not undergone photocoagulation (improvement by 0.14 line) than in others (improvement by 0.11 line) but the difference was non-significant. Reduction of macular exudates was noted in every case in the follow-up over 6 months. Postoperative complication included retinal detachment were treated by re-vitrectomy with oil endotamponade. Cataract has been noted in six eyes. CONCLUSIONS: Vitrectomy including removal of ILM in diabetic macular edema, leads to improvement of visual acuity and long-term stabilization of visual function.

[Effect of different shape and material of intraocular lens on posterior capsule opacification]. / Wplyw ksztaltu i materialu soczewki wewnatrzgalkowej na powstawanie przymglenia torebki tylnej.

In this paper we compare 4 groups of intraocular lenses: PMMA, silicone, hydrogel, acrylic and their influence on posterior capsule opacification is discussed. The possible clinical consequences of different shape in optic part of intraocular lens is also described. This article contains also a short presentation of posterior capsule opacification mechanism and intraocular lens materials biocompatibility in in-vivo and in-vitro experiments.

[The role of cellular adhesion molecule in the development of proliferative diabetic retinopathy]. / Rola molekul adhezyjnych w rozwoju proliferacyjnej retinopatii cukrzycowej.

Development of proliferative diabetic retinopathy's pathogenesis is still unknown. Last years publications seems to show immuno-inflammatory base of structural and functional retinal vessels endothelial cells' changes. Chronic retinal ischemia leads to development of pathological vessels and formation of fibrovascular tissue at the vitreoretinal interface. One of the important cause of the damage is leukocytes activation and adhesion to vascular endothelium, that is mediated by the specific adhesion molecules. Increase of soluble cellular adhesion molecules (CAMs) in serum, vitreous, epiretinal membranes of patients with PVR seems to confirm its role in the pathogenesis of this process. This publication attempts to estimate the CAM's role in progression of PDR.

[The role of anti-pericyte antibodies in the development of diabetic retinopathy]. / Rola przeciwcial przeciw pericytom sciany naczyniowej w rozwoju retinopatii cukrzycowej.

Diabetic retinopathy is one of the most common devastating complications of diabetes. Pericyte loss, microaneurysms and acellular capillaries are characteristic for the diabetic retina. Researches have provided evidence that hyperglycaemia is one of the main factors driving the onset and progression of diabetic retinopathy. Although it has been shown that tight metabolic control has beneficial effects on the development and progression of this complication, the increase of blood glucose concentrations does not account for all the risk for development and progression to sight threatening retinopathy. A number of reports suggest that autoimmune mechanism play a role in diabetic microangiopathy (circulating antiendothelial cells autoantibodies, antiphospholipid antibodies, presence of immunoglobulins, lymphocytes and cytokines in diabetic retinal tissue). Diabetic subjects were also found to have autoantibodies to microvascular pericytes in their circulation. These results may contribute to understanding why retinopathy progresses in some patients, despite consistent reduction of blood sugar. This publication tries to estimate the anti-pericyte autoantibodies role in progression of diabetic retinopathy.

[Outcome results in macular hole surgery with internal limiting membrane removal]. / Wyniki usuniecia blony granicznej wewnetrznej siatkówki w chirurgii otworu w plamce.

PURPOSE: To determine the visual outcome and anatomic closure rate of macular hole surgery using pars plana vitrectomy with internal limiting membrane (ILM) peeling. MATERIAL AND METHODS: Fifty three eyes of 52 consecutive patients with a full-thickness idiopathic macular holes (stage 3 or 4). All eyes underwent a pars plana vitrectomy including separation of the posterior hyaloid, ILM peeling with trypan blue (TB) or indocyanine green (ICG) and gas endo-tamponade with instructions to the patient, to be face down for 4-5 days. Postoperative anatomic results, visual acuity (VA), and complications were recorded. The follow-up was 3 to 22 months. RESULTS: VA improved postoperatively in 45 eyes (84.9%), at least two lines on the Snellen chart in 24 eyes (45.3%). It remained unchanged in 6 eyes (11.3%) and deteriorated in 2 eyes (3.80%). The mean preoperative VA was 0.1 +/- 0.04 and does not differ significantly between stage 3 and 4. The improvement of postoperative VA was statistically significantly better in stage 3, in comparison to stage 4. The anatomical success rate (flat/closed) was 88.7% (47 eyes). There were no differences in VA improvement between TB- or ICG-stained eyes. CONCLUSIONS: 1. Vitrectomy with ILM removal in macular holes provides with meaning improvement in visual acuity. 2. Patients with macular hole in stage 3 have a better prognosis for visual rehabilitation. 3. A kind of dye and preoperative VA do not influence postoperative visual function improvement.

[Vitrectomy for idiopathic and secondary preretinal macular membrane]. / Skutecznosc witrektomii w leczeniu samoistnego i wtórnego rozrostu przedsiatkówkowej blony plamkowej.

PURPOSE: To evaluate the results of pars plana vitrectomy and membrane stripping for idiopathic and secondary preretinal macular membrane (PMM). MATERIAL AND METHODS: Twenty one consecutive subjects (21 eyes) ranging in age from 40 to 78 (mean 66.9) with PMM underwent vitrectomy and membrane peeling. 17 cases had membranes that were considered idiopathic, and 4 cases were associated with other disorders: 3 occurred after successful retinal reattachment surgery, 1--after laserotherapy in the course of diabetic retinopathy. Visual acuity (VA), Amsler grid, and postoperative complications were assessed. The follow-up was 1 to 22 months, mean 5.7. RESULTS: Visual acuity improved postoperatively in 15 eyes (71.4%), at least two lines on the Snellen chart in 8 eyes (38.1%), entirely in patients with idiopathic PMM. It remained unchanged in 3 eyes (14.3%) and deteriorated in 3 eyes (14.3%). Eyes with transparent membrane showed greater visual improvement than opaque ones. The preoperative Amsler test was positive in 15 patients (71.4%), postoperatively--in 4 cases (19%). 2 idiopathic cases with VA of 0.7 showed postoperatively VA of 1.0. Complications included retinal detachment in 2 eyes (1 in idiopathic and 1 in secondary PMM), and development of nuclear sclerotic cataract in 2 eyes. At 6 months of follow-up, a residual membrane formation in 1 cases appeared. Macular pseudohole was observed in 1 eye with no impact on visual results. CONCLUSIONS: 1. Vitrectomy with membrane peeling for preretinal macular membrane provides improvement in visual acuity and reduces metamorphopsia 2. Thin, cellophane-like appearance of the membrane gives a better prognosis of visual function improvement.

Immunohistopathologic evaluation of choroidal neovascular membranes following verteporfin-photodynamic therapy.

PURPOSE: To evaluate the vascularization and proliferative activity in choroidal neovascular membranes due to age-related macular degeneration after verteporfin photodynamic therapy and submacular removal. DESIGN: Interventional case series. METHODS: In a retrospective review of seven patients who underwent removal of subfoveal classic choroidal neovascular membranes after treatment with photodynamic therapy 3 to 146 days earlier, membranes were stained for CD 34, CD 105, and Ki-67 and correlated with clinical pictures and fluorescein angiography. RESULTS: Fluorescein angiography performed on the day of surgery disclosed nonperfusion of the treated area 3 days after photodynamic therapy, but perfusion and leakage were seen at greater post-photodynamic therapy intervals. Membranes excised 3 days after photodynamic therapy showed CD34 and CD105 positive, mostly occluded vessels. The endothelial cells appeared damaged. Ki-67 activity was low. In membranes excised 34 to 146 days after photodynamic therapy, all vessels appeared patent and were lined by healthy endothelial cells with strong expression of CD34 and CD105. Ki-67 expression was elevated after 34 days but decreased thereafter. CONCLUSION: Photodynamic therapy did not cause a general or complete occlusion of vessels within the choroidal neovascular membranes, as suggested by fluorescein angiography 3 days postintervention, but the endothelial cells appeared to be severely damaged. Proliferative activity within these specimens was reduced. At longer intervals after photodynamic therapy, the fibrovascular tissue seemed to recover; perfusion, hyperfluorescence, and leakage of the choroidal neovascular membranes could be detected by fluorescein angiography. The clinical appearance showed a correlation with the immunohistologic characteristics of an increased proliferative activity and patent vascularization.

Expression of endoglin in choroidal neovascularization.

Endoglin (CD105) is a membrane protein involved in the TGF-beta receptor signalling pathway with predominant expression by proliferating endothelial cells. The aim of this study is to analyze the expression of Endoglin in choroidal neovascularization membranes (CNVM) and to compare it to the overall proliferative status of CNVM. Thirty surgically excised CNVM, secondary to age-related macular degeneration, were investigated using light microscopic immunohistochemistry and confocal immunofluorescence microscopy using verified antibodies directed against the endothelial cell markers Endoglin, von Willebrand factor (vWF) and CD34 and the proliferation marker Ki-67. Donor eyes were used as controls. A selective expression of CD34 and vWF as well as Endoglin was found in endothelial cells. Endoglin expression was elevated in vascular endothelial cells contained within CNVM, but a moderate Endoglin expression could also be visualized in quiescent CD34 and vWF positive ocular vasculature. Ki-67 positive cells were detected in CNVM, but these were rarely endothelial cells. Endoglin expression in endothelial cells of CNVM is increased, but rarely associated with a concomitant expression of the proliferation marker Ki-67. The elevated expression of Endoglin in surgically excised CNVM suggests a persisting post-mitotic activation in an advanced stage of this neovascular tissue.

Histological findings in experimental macular surgery with indocyanine green.

PURPOSE: To analyze the effect of different concentrations and application intervals of indocyanine green (ICG) on the retina in an experimental setting of macular surgery. METHODS: Twenty-one porcine eyes were used within 5 hours after enucleation. The eyes were hemisected and the vitreous removed. Different doses of ICG (up to 1 mg) were applied over the trephined macula, and the remainder of the eyecup was filled with a balanced salt solution (BSS). Both the ICG solution and the BSS were drained after 30 or 60 seconds and the complete eyecup irrigated and filled with fresh BSS. The posterior pole was then illuminated with a standard surgical light pipe and light source at maximum power for 3 minutes. Both the ICG-treated retina and the nontreated surrounding retina were processed for histology. RESULTS: Exposure of the retina at different concentrations of ICG either for 30 or 60 seconds, followed by illumination, caused no histologically detectable damage compared with the controls. No microarchitectural disorganization or cellular disruption was detected. The vitreoretinal interface seemed unaffected. CONCLUSIONS: Previously described severe damage to the inner retina of human donor eyes could not be found with even higher doses of ICG in this porcine model. Although differences within the species may contribute to these contradictory results, it is conceivable that the postmortem time and the vitality of the tissue influence the outcome in this ex vivo system.

[Vitrectomy in treatment of ocular tuberculosis--case report]. / Witrektomia w leczeniu gruzlicy ocznej--opis przypadku.

The authors present a case of ocular tuberculosis in otherwise healthy young men, diagnosed with positive tuberculin test and positive PCR for Mycobacterium tuberculosis in conjunctiva and vitreous samples. An early vitrectomy and typical systemic treatment (tuberculostatic drugs) resulted in regression of the disease.

[Treatment of subretinal macular hemorrhages with intravitreous injections of tissue plasminogen activator and SF6 gas]. / Leczenie krwotoków podsiatkówkowych w plamce doszklistkowym podawaniem tkankowego aktywatora plazminogenu oraz gazu SF6.

PURPOSE: Of our retrospective study was the estimation of the efficacy of recombinant tissue plasminogen activator (tPA) and intravitreal injections of SF6 gas in cases of subretinal macular haemorrhages. MATERIAL AND METHODS: In 20 patients aged 23-83 years, the subretinal macular haemorrhages were diagnosed, due to senile macular degeneration (9), hypertension (3), myopic retinochoroidal degeneration (3), other retinal heredodegeneration (2), retinal macroaneurysm (2) and trauma (1). We injected the solution of recombinant tissue plasminogen activator--Actilise (Boehringer Ingelheim) into vitreous cavity of these eyes. After lowering IOP, the intravitreous injections of 0.5 ccm SF6 gas were done, and following 24 hours down head positioning were carried out. RESULTS: The initial visual acuity before treatment was: HM or CF, from less then 1 meter in most of our cases (12 patients). The after treatment visual acuity ranged CF from 2 meters to 0.7. The early treatment conditioned better acuity. Even in cases of delayed treatment, the diminishing of central visual scotoma could be awaited. CONCLUSIONS: The new method of treatment in cases with subretinal macular haemorrhages despite of its symptomatic characters seems to be helpful in restoring the central vision in some cases.

[Surgical treatment of giant retinal tear]. / Leczenie chirurgiczne otworów olbrzymich siatkówki.

PURPOSE: The purpose of the study was to evaluate anatomical and functional results of pars plana vitrectomy in giant retinal tears. MATERIALS AND METHODS: Ten eyes with giant retinal tears underwent pars plana vitrectomy. The time of observation after surgical intervention was 3 months to 2.5 years. RESULTS: Retinal reattachment was obtained in 9 eyes (90%). In one eye, despite second vitrectomy, there was no positive effect due to massive vitreo-retinal proliferation. CONCLUSIONS: Surgical treatment of giant retinal tear yields good anatomical and functional results. Rarely massive vitreo-retinal proliferation may cause the redetachment. Perfluorodecalin used during surgery facilitates unfolding and flattening of the retina.

[Vitrectomy in the treatment of endogenous fungal endophthalmitis in a patient after renal transplantation]. / Zastosowanie witrektomii w leczeniu endogennego grzybiczego zapalenia wnetrza galki ocznej u pacjentki po przeszczepie nerek.

The authors present a case of fungal endophthalmitis in the immunosuppressed patient after renal transplantation. The treatment comprised pars plana vitrectomy with silicone oil tamponade, peribulbar injections of Fungizone and intravenous Diflucan. Diagnostic and therapeutic difficulties in endogenous endophthalmitis are discussed.