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1.
Cesk Slov Oftalmol ; 80(1): 42-51, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38365581

RESUMO

PURPOSE: Intracranial aneurysms and their hemorrhagic and thromboembolic complications represent a serious nosological unit that significantly endangers those afflicted. They are mostly asymptomatic until rupture occurs. In two case reports, we present our observations of young patients with impaired vision and headaches, in whom we found the presence of intracranial aneurysms. OBSERVATIONS: Presentation of two case reports of patients who came to our department with impaired vision and headaches. The patients underwent a complete eye examination at our center, including a visual field examination. Based on the results of the examination, they were referred for  an imaging examination of the brain, which revealed the presence of intracranial aneurysms. The patients were subsequently sent to the interventional neuroradiology center, where they underwent a noninvasive endovascular neuroembolization procedure with flow diverter implantation. We continued to monitor the patients after the procedure and document the examination results up to 1 year after the procedure. CONCLUSIONS AND SIGNIFICANCE: Thanks to the fast detection, diagnosis, and management of both patients, we prevented the occurrence of aneurysm rupture, thus a life-threatening complication. After endovascular procedures with flow diverter implantation, we observed a significant improvement in visual acuity as well as perimetric findings in both patients. When intracranial aneurysms are found within a week of the onset of eye symptoms and treated within three months, defects in the visual fields improved in our two patients within 6-12 months, and in one of the two patients the defects almost completely disappeared.


Assuntos
Aneurisma Intracraniano , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/terapia , Campos Visuais , Stents/efeitos adversos , Resultado do Tratamento , Estudos Retrospectivos , Transtornos da Visão/etiologia , Cefaleia/complicações
2.
Eur J Ophthalmol ; : 11206721241229310, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38295331

RESUMO

BACKGROUND: Age-related macular degeneration (AMD) is one of the major causes of vision loss in individuals aged ≥ 65 years in developed countries. This study aimed to determine the associations between modifiable risk factors and AMD. This is the first study describing the relationship between lifestyle factors and AMD in the Czech Republic. METHODS: In this cross-sectional case-control study, 93 AMD cases and 58 controls without AMD and cataract were included. All participants were examined by Optical coherence tomography at the Clinic of Eye Treatment at the University Hospital Brno. Data were collected using a pre-tested self-report questionnaire in a face-to-face interview. RESULTS: We found significant associations between those who were living in the city (OR 95% CI: 2.19 (1.0-4.6); p = 0,039), with a positive family history of AMD (OR 95% CI: 12.75 (1.6-98.6); p = 0,015), exposure to cigarette smoke (OR 95% CI: 2.72 (1.4-5.4); p = 0,004), and daily exposure to passive smoking (OR 95% CI: 2.29 (1.0-5.1); p = 0,045) and AMD. In men, we found significant associations between daily sunlight exposure (OR 95% CI: 2.98 (1.0-8.5); p = 0,041), short or long sleep duration (OR 95% CI: 3.98 (1.2-13.2); p = 0,024) and AMD. Men daily exposed to sunlight were at a 2.98 times higher risk of AMD than men with less than daily sunlight exposure. Men with short or long sleep duration (< 6 and > 8 h) were at a 3.98 times higher risk of AMD than men with recommended sleep duration of 6-8 h. CONCLUSIONS: An increased risk of AMD was observed for living in the city, family history of AMD, exposure to cigarette smoke, and daily exposure to passive smoking. Increased risk of AMD was observed for daily sunlight exposure and short or long sleep duration; however, only in men.

4.
Brain Sci ; 13(11)2023 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-38002564

RESUMO

This study explores how gait imagery (GI) influences lower-limb muscle activity with respect to posture and previous walking experience. We utilized surface electromyography (sEMG) in 36 healthy young individuals aged 24 (±1.1) years to identify muscle activity during a non-gait imagery task (non-GI), as well as GI tasks before (GI-1) and after the execution of walking (GI-2), with assessments performed in both sitting and standing postures. The sEMG was recorded on both lower limbs on the tibialis anterior (TA) and on the gastrocnemius medialis (GM) for all tested tasks. As a result, a significant muscle activity decrease was found in the right TA for GI-1 compared to GI-2 in both sitting (p = 0.008) and standing (p = 0.01) positions. In the left TA, the activity decreased in the sitting posture during non-GI (p = 0.004) and GI-1 (p = 0.009) in comparison to GI-2. No differences were found for GM. The subjective level of imagination difficulty improved for GI-2 in comparison to GI-1 in both postures (p < 0.001). Previous sensorimotor experience with real gait execution and sitting posture potentiate TA activity decrease during GI. These findings contribute to the understanding of neural mechanisms beyond GI.

5.
Bratisl Lek Listy ; 124(12): 907-914, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37983286

RESUMO

BACKGROUND: Recently, trabeculectomy with mitomycin C (MMC) where MMC is applied by injection into the Tenon layer has attracted close attention. However, the data on efficacy and safety of this technique is still limited and more clinical studies are needed. Therefore, the work is aimed at comprehensive evaluation of the effectiveness of trabeculectomy using MMC applied by intra-Tenon injection. METHODS: A set of 50 eyes in 50 patients underwent trabeculectomy using MMC at concentration of 0.4 mg/ml in a total volume of 0.05 ml. The primary end point was to control intraocular pressure (IOP) on postoperative days 1, 8, 30 and 90 and subsequently at 6 and 12 months after surgery. The secondary end point was to evaluate the changes in various corneal parameters prior to and 90 days after surgical procedure. RESULTS: The mean preoperative IOP was 32.34 ± 9.45 mmHg. After surgery, the mean IOP significantly decreased to 17.52 ± 4.58 mmHg at the 90-day follow-up, and to 18.14 ± 3.74 and 19.30 ± 3.82 mmHg at 6 and 12 months after the procedure, respectively. The mean BCVA values remained unchanged compared to baseline (0.77 ± 0.23) to the 90-day follow-up (0.80 ± 0.23).  The mean number of anti-glaucoma medications significantly reduced from 3.50 ± 0.74 to 0.58 ± 1.03 postoperatively. Similarly, the mean corneal hysteresis and ACD of the eye as well as CECD were significantly changed postoperatively. CONCLUSIONS: Trabeculectomy using MMC applied by injection is a safe and effective surgical method for the treatment of primary and secondary forms of open-angle glaucoma. It has a significant hypotonising effect and allows a complete discontinuation of antiglaucoma drugs (Tab. 3, Fig. 3, Ref. 58).


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Trabeculectomia , Humanos , Trabeculectomia/métodos , Mitomicina/uso terapêutico , Glaucoma/cirurgia , Glaucoma de Ângulo Aberto/cirurgia , Glaucoma de Ângulo Aberto/tratamento farmacológico , Resultado do Tratamento , Pressão Intraocular , Seguimentos
6.
Front Big Data ; 6: 1174478, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37600499

RESUMO

We have developed a Recurrent Neural Network (RNN)-based phase picker for data obtained from a local seismic monitoring array specifically designated for induced seismicity analysis. The proposed algorithm was rigorously tested using real-world data from a network encompassing nine three-component stations. The algorithm is designed for multiple monitoring of repeated injection within the permanent array. For such an array, the RNN is initially trained on a foundational dataset, enabling the trained algorithm to accurately identify other induced events even if they occur in different regions of the array. Our RNN-based phase picker achieved an accuracy exceeding 80% for arrival time picking when compared to precise manual picking techniques. However, the event locations (based on the arrival picking) had to be further constrained to avoid false arrival picks. By utilizing these refined arrival times, we were able to locate seismic events and assess their magnitudes. The magnitudes of events processed automatically exhibited a discrepancy of up to 0.3 when juxtaposed with those derived from manual processing. Importantly, the efficacy of our results remains consistent irrespective of the specific training dataset employed, provided that the dataset originates from within the network.

7.
Cent Eur J Public Health ; 31(2): 140-143, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37451248

RESUMO

OBJECTIVES: Age-related macular degeneration (AMD) is the leading cause of irreversible blindness among older adults in developed countries. Although many risk factors are known, the pathogenesis of AMD is still unclear. However, oxidative stress probably plays a vital role in the process of AMD. The increasing prevalence of AMD, risk of vision loss, limited treatment of dry form, expensive treatment of wet form, and decreased quality of life are factors that lead to considering modifiable risk factors of AMD, such as nutrition. This is the first study describing the relationship between dietary habits, dietary nutrient intake and AMD in the Czech Republic. METHODS: In this research, a total of 93 cases with AMD and 58 controls without AMD and cataracts participated. All participants were ophthalmologically examined at the Clinic of Eye Treatments at the University Hospital Brno. Data were collected using a pre-tested self-report questionnaire in a face-to-face interview. Food consumption frequency was assessed by an 18-item semiquantitative food-frequency questionnaire (FFQ). Dietary nutrient intakes were calculated from a 24-hour recall. RESULTS: Patients with AMD compared with controls had significantly higher consumption of legumes and lower consumption of meat products, salt and salty products. In men, we found statistically significant differences in alcohol consumption. The case group consumed alcoholic beverages more frequently (median: 2 times a week) than the control group (median: 1-3 times a month). No differences in alcohol consumption were found in women. In comparison to the case group, the control group had a significantly higher dietary intake of energy (5,783.8 vs. 4,849.3 kJ/day; p = 0.002), proteins (65.3 vs. 52.3 g/day; p = 0.002), fats (57.6 vs. 49.4 g/day; p = 0.046), saturated fatty acids (21.7 vs. 18.9 g/day; p = 0.026), carbohydrates (150.4 vs. 127.1 g/day; p = 0.017), dietary fibre (13.2 vs. 11.3 g/day; p = 0.044), vitamin B2 (1.0 vs. 0.9 mg/day; p = 0.029), vitamin B3 (13.9 vs. 10.0 mg/day; p = 0.011), pantothenic acid (3.5 vs. 2.8 mg/day; p = 0.001), vitamin B6 (1.3 vs. 1.0 mg/day; p = 0.001), potassium (1,656.5 vs. 1,418.0 mg/day; p = 0.022), phosphorus (845.4 vs. 718.7 mg/day; p = 0.020), magnesium (176.5 vs. 143.0 mg/day; p = 0.012), copper (1.0 vs. 0.8 mg/day; p = 0.011), and zinc (7.1 vs. 6.1 mg/day; p = 0.012) counted from a 24-hour recall. CONCLUSIONS: According to FFQ, dietary habits in the patients with AMD and controls were similar. In men from the case group, we found statistically significant higher alcohol consumption. According to a 24-hour recall, the controls achieved recommended dietary intakes rather than cases. In comparison to the case group, the control group had a significantly higher dietary intake of energy, proteins, fats, saturated fatty acids, carbohydrates, dietary fibre, vitamin B2, vitamin B3, pantothenic acid, vitamin B6, potassium, phosphorus, magnesium, copper, and zinc.


Assuntos
Degeneração Macular , Magnésio , Masculino , Humanos , Feminino , Idoso , Cobre , Estudos de Casos e Controles , Ácido Pantotênico , Qualidade de Vida , Dieta , Ingestão de Alimentos , Ingestão de Energia , Comportamento Alimentar , Zinco , Fibras na Dieta , Ácidos Graxos , Niacinamida , Degeneração Macular/epidemiologia , Degeneração Macular/induzido quimicamente , Riboflavina , Vitamina B 6 , Fósforo , Potássio , Gorduras na Dieta
8.
Med Acupunct ; 35(3): 107-110, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37351450

RESUMO

Introduction: Conservative treatment of peripheral nerve injuries is based on physical therapy approaches, including electrostimulation of denervated muscle. Electrostimulation retards denervation atrophy and prolongs the time window for axon reinnervation. Aim: This article focuses on the potential of electroacupuncture, which combines electrostimulation with acupuncture, in the context of the latest knowledge on the mechanisms of axonal regeneration. Results and conclusions: The possibilities of influencing the growth rate of the axon itself through neurotrophic factors have primarily been previously proven in rodent models. Electroacupuncture as mini-invasive electrostimulation using acupuncture needles appears to be a promising option for the treatment of peripheral nerve paresis. However, this therapy needs to be evaluated in the context of human medicine.

9.
Brain Sci ; 12(12)2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36552120

RESUMO

The GAITFAST study (gait recovery in patients after acute ischemic stroke) aims to compare the effects of treadmill-based robot-assisted gait training (RTGT) and therapist-assisted treadmill gait training (TTGT) added to conventional physical therapy in first-ever ischemic stroke patients. GAITFAST (Clinicaltrials.gov identifier: NCT04824482) was designed as a single-blind single-center prospective randomized clinical trial with two parallel groups and a primary endpoint of gait speed recovery up to 6 months after ischemic stroke. A total of 120 eligible and enrolled participants will be randomly allocated (1:1) in TTGT or RTGT. All enrolled patients will undergo a 2-week intensive inpatient rehabilitation including TTGT or RTGT followed by four clinical assessments (at the beginning of inpatient rehabilitation 8-15 days after stroke onset, after 2 weeks, and 3 and 6 months after the first assessment). Every clinical assessment will include the assessment of gait speed and walking dependency, fMRI activation measures, neurological and sensorimotor impairments, and gait biomechanics. In a random selection (1:2) of the 120 enrolled patients, multimodal magnetic resonance imaging (MRI) data will be acquired and analyzed. This study will provide insight into the mechanisms behind poststroke gait behavioral changes resulting from intensive rehabilitation including assisted gait training (RTGT or TTGT) in early subacute IS patients.

10.
Sensors (Basel) ; 21(21)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34770589

RESUMO

Mechanisms behind compromised balance control in people with transtibial amputation need to be further explored, as currently little is known specifically about postural control strategies in people with traumatic transtibial amputation (tTTA). The aim of this study is to assess automatic and voluntary postural control strategies in individuals with unilateral tTTA compared to those in control subjects and to define the effect of balance-related factors on these strategies. Automatic posture reactions and volitional motion toward given direction using standardized posturographic protocols (NeuroCom) of the Motor Control Test (MCT) and Limits of Stability (LOS) were assessed in eighteen participants with tTTA and eighteen age-matched controls. Compared to the controls, the participants with tTTA bore less weight on the prosthetic leg (p < 0.001) during the MCT and had reduced inclination toward the prosthetic leg (p < 0.001) within the LOS. In the tTTA group, the weight-bearing symmetry and the inclination toward the prosthetic leg (p < 0.05) was positively correlated with prosthesis use duration (p < 0.05). The current study indicates that decreased utilization of the prosthetic leg in tTTAs represents adaptive postural control strategy, but as prosthesis use duration increased, the engagement of the prosthetic leg improved.


Assuntos
Membros Artificiais , Equilíbrio Postural , Amputação Cirúrgica , Humanos , Postura , Suporte de Carga
11.
Medicina (Kaunas) ; 57(5)2021 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-33923158

RESUMO

Herpes simplex virus type 1 (HSV-1) is a leading cause of infectious blindness worldwide. Most of the initial infection cases manifest as acute epithelial keratitis. Reactivation of herpesviruses is common in critically ill patients, including patients with severe Coronavirus disease (COVID-19). However, the data on COVID-19-related ocular infections is sparse, despite recent observations that more than 30% of COVID-19-infected patients had ocular manifestations. We report five cases of HSV-1 keratitis in COVID-19 patients. In total, five COVID-19 patients underwent ophthalmic examination, showing similar symptoms, including photophobia, tearing, decreased vision, eye redness, and pain. After initial assessment, tests of visual acuity and corneal sensitivity, a fluorescein staining test, and complete anterior and posterior segment examinations were performed. A diagnosis of HSV-1 keratitis was confirmed in all cases. Therapy was initiated using a local and systemic antiviral approach together with local antibiotic and mydriatic therapy. The complete reduction of keratitis symptoms and a clear cornea was achieved in all patients within 2 weeks. SARS-CoV-2 infection may be a risk factor for developing HSV-1 keratitis, or it may act as a potential activator of this ocular disease.


Assuntos
COVID-19 , Herpesvirus Humano 1 , Ceratite Herpética , Antivirais/uso terapêutico , Humanos , Ceratite Herpética/diagnóstico , Ceratite Herpética/tratamento farmacológico , SARS-CoV-2
12.
Front Neurosci ; 14: 814, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32922256

RESUMO

BACKGROUND: Gait disturbance accompanies many neurodegenerative diseases; it is characteristic for Parkinson's disease (PD). Treatment of advanced PD often includes deep brain stimulation (DBS) of the subthalamic nucleus. Regarding gait, previous studies have reported non-significant or conflicting results, possibly related to methodological limitations. OBJECTIVE: The objective of this prospective study was to assess the effects of DBS on biomechanical parameters of gait in patients with PD. METHODS: Twenty-one patients with advanced PD participated in this prospective study. Gait was examined in all patients using the Zebris FDM-T pressure-sensitive treadmill (Isny, Germany) before DBS implantation and after surgery immediately, further immediately after the start of neurostimulation, and 3 months after neurostimulator activation. We assessed spontaneous gait on a moving treadmill at different speeds. Step length, stance phase of both lower limbs, double-stance phase, and cadence were evaluated. RESULTS: In this study, step length increased, allowing the cadence to decrease. Double-stance phase duration, that is, the most sensitive parameter of gait quality and unsteadiness, was reduced, in gait at a speed of 4.5 km/h and in the narrow-based gaits at 1 km/h (tandem gait), which demonstrates improvement. CONCLUSION: This study suggests positive effects of DBS treatment on gait in PD patients. Improvement was observed in several biomechanical parameters of gait.

13.
BMC Ophthalmol ; 20(1): 18, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31918685

RESUMO

BACKGROUND: To evaluate the efficacy and safety of two individualized ranibizumab retreatment schemes in neovascular age-related macular degeneration. METHODS: Patients (N = 671) were randomized (1:1) to receive three initial monthly ranibizumab 0.5 mg injections, then retreatment guided by either best-corrected visual acuity (BCVA) loss (Group I) or BCVA loss and/or signs of disease activity on optical coherence tomography (OCT; Group II). The study was terminated prematurely and the decision to discontinue the study was made by the sponsor. Efficacy analyses were performed on patients who completed 12 months of the originally planned 24-month study. Safety analyses are presented for all safety analyzable patients. RESULTS: Of 671 randomized patients, 305 completed 12 months of the study. For the 12-month completers, baseline mean (standard deviation) BCVA and reading-center evaluated central subfield thickness (CSFT) were comparable [Group I: 60.9 (13.10) letters and 517.7(201.79) µm; Group II: 60.2 (12.21) letters and 515.3 (198.37) µm]. The change from baseline at Month 12 in BCVA was 6.7 (13.48) letters in Group I and 8.3 (13.53) letters in Group II and the change in CSFT was - 161.3 (163.48) µm and - 175.3 (170.45) µm, respectively. The mean number of ranibizumab injections was 8.2 in Group I and 8.4 in Group II. CONCLUSION: Ranibizumab treatment resulted in visual and anatomic gains at 12 months for both retreatment strategies, with a trend in favor of OCT-guided vs BCVA loss guided retreatment. No new safety signals were seen. TRIAL REGISTRATION: www.ClinicalTrials.gov (NCT01780935). Registered 31 January 2013.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Ranibizumab/uso terapêutico , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/efeitos adversos , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Ranibizumab/efeitos adversos , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/fisiopatologia
14.
Ophthalmologica ; 243(1): 58-65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31121590

RESUMO

PURPOSE: To evaluate the effect of intravitreal aflibercept injections in treatment-naive type 3 neovascularization using a fixed treatment regime during the first year of therapy. METHODS: Fourteen eyes of 14 patients diagnosed with type 3 neovascularization were studied. All patients were treated with intravitreal aflibercept injections using a fixed treatment regime of 3 consecutive monthly dosages followed by 2-month interval injections. Results were assessed after a 12-month follow-up period. Changes of best corrected visual acuity (BCVA), central retinal thickness (CRT), central macular volume (CMV), and retinal pigment epithelium (RPE) atrophy at fundus autofluorescence and infrared reflectance images were recorded and analyzed. RESULTS: BCVA improved from 60.3 ± 11.7 ETDRS letters at the baseline to 70.9 ± 10.3 ETDRS letters at 12-months follow-up (p = 0.036). Also, CRT and CMV statistically improved after the treatment (from 425 ± 117 to 308 ± 117 µm [p = 0.031] and from 9.52 ± 1.90 to 8.29 ± 0.95 mm3 [p = 0.073], respectively). In 4 patients, development and progression of RPE atrophy were observed, and it was associated with the presence of serous pigment epithelium detachment at the baseline. Furthermore, the development of a fibrotic lesion eccentric to the fovea was observed in 5 patients, without significant impairment of BCVA (p = 0.290). CONCLUSION: Intravitreal aflibercept administered in a fixed treatment regime during the first year of therapy may be effective for the improvement and stabilization of BCVA in eyes with type 3 neovascularization. However, RPE atrophy and subretinal/intraretinal fibrosis can develop during the treatment.


Assuntos
Macula Lutea/patologia , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Epitélio Pigmentado da Retina/patologia , Acuidade Visual , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Estudos Retrospectivos , Tomografia de Coerência Óptica , Degeneração Macular Exsudativa/diagnóstico
15.
Sensors (Basel) ; 19(19)2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31561481

RESUMO

An increasing number of individuals and institutions own or operate meteorological stations, but the resulting data are not yet commonly used in the Czech Republic. One of the main difficulties is the heterogeneity of measuring systems that puts in question the quality of outcoming data. Only after a thorough quality control of recorded data is it possible to proceed with for example a specific survey of variability of a chosen meteorological parameter in an urban or suburban region. The most commonly researched element in the given environment is air temperature. In the first phase, this paper focuses on the quality of data provided by amateur and institutional stations. The following analyses consequently work with already amended time series. Due to the nature of analyzed data and their potential use in the future it is opportune to assess the appropriateness of chronological and possibly spatial interpolation of missing values. The evaluation of seasonal variability of air temperature in the scale of Brno city and surrounding area in 2015-2017 demonstrates, that the enrichment of network of standard (professional) stations with new stations may significantly refine or even revise the current state of knowledge, for example in the case of urban heat island phenomena. A cluster analysis was applied in order to assess the impact of localization circumstances (station environment, exposition, etc.) as well as typological classification of the set of meteorological stations.

16.
Ophthalmic Genet ; 39(1): 4-10, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28557591

RESUMO

BACKGROUND: The wet form of age-related macular degeneration (AMD) is characterized by pathological vascularization of the outer retinal layers. The condition responds to treatment with antibodies against vascular endothelial growth factor (VEGF), but the patients receiving such anti-VEGF therapy sometimes show undesirable acute short-term increases in the intraocular pressure (IOP). The cause of this adverse effect is unknown, and here, we are testing a hypothesis that it is related to CD36 gene polymorphisms. MATERIALS AND METHODS: A group of 134 patients with AMD were given three therapeutic doses of anti-VEGF antibody (ranibizumab) at monthly intervals. Their IOP was measured immediately before and 30 min after each injection. Patients' DNA was analyzed, and the changes in IOP were matched against seven polymorphisms of the CD36 gene. RESULTS: Three polymorphisms were found to be associated with increases in IOP: rs1049673 (p = 0.006), rs3211931 (p = 0.01), and rs1761667 (p = 0.043) at the time of the third injection only. Pronounced elevations (IOP > 25 mmHg) were associated with rs1049673 polymorphism: GC genotype (p < 0.01) and CC genotype (p < 0.05); both increasing the risk 2.6-fold, the presence of C-allele conferring a 1.5-fold greater risk and with rs3211931 polymorphism: AG genotype (p < 0.01) and GG genotype (p < 0.05); increasing the risk 2.6-fold (AG) and 2.7-fold (GG). CONCLUSIONS: CD36 receptor may be involved in mediating the effects of VEGF on IOP. The findings will help to identify the patients at risk of acutely elevated IOP following the anti-VEGF therapy.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Antígenos CD36/genética , Pressão Intraocular/genética , Hipertensão Ocular/genética , Polimorfismo de Nucleotídeo Único , Ranibizumab/uso terapêutico , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Feminino , Humanos , Injeções Intravítreas , Masculino , Reação em Cadeia da Polimerase , Tonometria Ocular , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/genética
17.
Small ; 11(38): 5047-53, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26237446

RESUMO

Highly macroporous semisynthetic cryogel microcarriers can be synthesized for culturing stem cells and neuronal type cells. Growth factors loaded to heparin-containing microcarriers show near zero-order release kinetics and cell-loaded microcarriers can be injected through a fine gauge cannula without negative effect on the cells. These carriers can be applied for cell transplantation applications.


Assuntos
Anoikis/efeitos dos fármacos , Transplante de Células , Criogéis/farmacologia , Microesferas , Neurônios/citologia , Células-Tronco/citologia , Animais , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Injeções , Neurônios/efeitos dos fármacos , Células PC12 , Ratos , Ratos Transgênicos , Células-Tronco/efeitos dos fármacos
18.
Artigo em Inglês | MEDLINE | ID: mdl-25916281

RESUMO

AIMS: The aim of this communication was to evaluate ranibizumab in the treatment of wet age-related macular degeneration. METHODS: Anonymised data on treatment efficacy and safety were consecutively entered into the Czech national database. From 01/09/2008 to 25/10/2011, 671 patients/685 eyes treated with ranibizumab monotherapy were entered in the registry. 454 ranibizumab treated eyes and 444 patients were monitored for 12-months. The dependent variable used to monitor disease progression and treatment results was change in visual acuity in the ETDRS (Early Treatment Diabetic Retinopathy Study) chart over time. RESULTS: After 12 months of treatment, a loss of < 15 letters in the ETDRS chart was found in 81.5% of eyes treated with ranibizumab. A gain of ≥ 15 letters was found in 9.7% of eyes on ranibizumab. The results for our patients treated in clinical practice with ranibizumab were poorer than those in the SUSTAIN (Ranibizumab in Patients With Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration) study. A rationale for this was sought in a sub-analysis. CONCLUSIONS: Sub-analysis demonstrated that treatment naive CNV (choroidal neovascularization), occult CNV and lower height of the macular oedema at the outset of the disease may be positive prognostic factors for final visual acuity in anti-VEGF (vascular endothelial growth factor) treated patients.


Assuntos
Degeneração Macular/tratamento farmacológico , Ranibizumab/uso terapêutico , Sistema de Registros , Idoso , Inibidores da Angiogênese/uso terapêutico , República Tcheca/epidemiologia , Feminino , Humanos , Incidência , Degeneração Macular/diagnóstico , Degeneração Macular/epidemiologia , Masculino , Estudos Retrospectivos , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual
19.
J Ophthalmol ; 2015: 867479, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25821593

RESUMO

Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age-related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment-naïve patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P < 0.001) and lower incidence of CNV greater than 5DA (P < 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment.

20.
J Ophthalmol ; 2014: 724780, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25009743

RESUMO

Retinal vein occlusion (RVO) is a major cause of vision loss. Of the two main types of RVO, branch retinal vein occlusion (BRVO) is 4 to 6 times more prevalent than central retinal vein occlusion (CRVO). A basic risk factor for RVO is advancing age. Further risk factors include systemic conditions like hypertension, arteriosclerosis, diabetes mellitus, hyperlipidemia, vascular cerebral stroke, blood hyperviscosity, and thrombophilia. A strong risk factor for RVO is the metabolic syndrome (hypertension, diabetes mellitus, and hyperlipidemia). Individuals with end-organ damage caused by diabetes mellitus and hypertension have greatly increased risk for RVO. Socioeconomic status seems to be a risk factor too. American blacks are more often diagnosed with RVO than non-Hispanic whites. Females are, according to some studies, at lower risk than men. The role of thrombophilic risk factors in RVO is still controversial. Congenital thrombophilic diseases like factor V Leiden mutation, hyperhomocysteinemia and anticardiolipin antibodies increase the risk of RVO. Cigarette smoking also increases the risk of RVO as do systemic inflammatory conditions like vasculitis and Behcet disease. Ophthalmic risk factors for RVO are ocular hypertension and glaucoma, higher ocular perfusion pressure, and changes in the retinal arteries.

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