Diplopia and Optic Disc Edema as the Ocular Manifestations of COVID-19 in a Seven-Year-Old Child.

Serious ocular complications due to SARS-CoV-2 disease in children are rare. Herein, we present a case report of a seven-year-old patient, who was diagnosed with pediatric inflammatory multisystem syndrome (PIMS) due to COVID-19 and developed the ocular manifestations comprising diplopia and binocular optic disc edema. The patient condition improved within few weeks without any ocular sequels so far.

Unilateral extrafoveal choroidal . ......... eovascularization in a 13-year-old child with bilateral optic nerve drusen.

AIM: The aim of our research was to describe the effect of an off-label intravitreal ranibizumab injection for treatment of unilateral extrafoveal choroidal neovascularization a with bilateral optic nerve drusen. MATERIAL AND METHODS: 13-year-old girl presented with decreased visual acuity of her left eye and optic nerve drusen confirmed by B-scan ultrasound examination in both eyes. Fluorescein angiography and optical coherence tomography revealed the presence of choroidal neovascularization in the left eye. The patient was treated with a single injection of ranibizumab and monitored by clinical examination, optical coherence tomography and fluorescein angiography. RESULTS: Choroidal neovascularization was successfully treated and the best corrected visual acuity (Snellen) fully recovered from 20/50 to 20/20 over a period of 2 months. After this time at the 30 months follow-up, visual acuity and fundus were stable without the recurrence of choroidal neovascularization. CONCLUSIONS: Optic nerve drusen should be taken into account and carefully observed as a possible cause of peripapillary choroidal neovascularization in children. Ranibizumab can be a successful off-label treatment in children suffering from choroidal neovascularization associated with optic nerve drusen.

[Orbital lymphoblastic lymphoma in 7 years old child]. / Chloniak limfoblastyczny oczodolu u 7-letniego dziecka.

The aim of the study is to present a case of unilateral orbital tumor (lymphoma) in a 7 years old boy. The edema of the temporal area of the right orbit with considerable narrowing of the palpebral fissure increased quickly during about 3 weeks. The skin redness without increased skin warmness and hardening by palpation above the lesion were observed. The orbit ultrasound and nuclear magnetic resonance were performed and the biopsy for histopathologic evaluation and immunohistochemical staining was taken. The last examination reveled a very rare kind type of the lymphoma in this age and location--lymphoblastic lymphoma beginning from B cells. In case of lymphoma the biopsy for histopathologic and immunohistochemical evaluation is essential, allowing for diagnosis and appropriate chemotherapy, as far as there is different outline for the treatment of different lymphomas.

[The disturbances of the eye position and motility in patients after scleral buckling surgery due to retinal detachment]. / Ustawienie i ruchomosc galek ocznych u pacjentów po chirurgii konwencjonalnej z powodu odwarstwienia siatkówki.

PURPOSE: The aim of the study was the evaluation of the frequency and intensity of the disturbances of the eye position and motility in patients after scleral buckling surgery due to retinal detachment, treated in Ophthalmology Clinic in Poznar. Additionally the aim was to diagnose the reason for muscles damage by means of the Hess screen. MATERIAL AND METHODS: Seventy patients were treated with this method between 2007-2009 and the study group was built by 40 patients, treated in average 15 months before the examination, at the age 12-79 years (mean age 55 years and 8 months). The correlation between the location of retinal holes treated with cryotherapy, the type of surgery and the changes in eye position and motility or diplopia in clinical evaluation and on the Hess screen, were evaluated. RESULTS: The disturbances of eye motility in clinical evaluation was diagnosed in 10 eyes (25% cases), and on the Hess screen in 16 eyes (40% cases). We noted, that the damaged muscle (overacting or weakened), was localized always on the site of cryotherapy or in the area at three o'clock from the retinal hole. CONCLUSIONS: (1) Patients during visual rehabilitation after scleral buckling surgery should be controlled for eye motility disturbances and diplopia. (2) The percentage of eye motility disturbances in our study group was comparable to this presented in literature, but higher in evaluation by means of Hess screen. (3) Accidental cryotherapy of the muscle, causing its weakening or overaction, seems to be a particular risk factor of extraocular muscles function disturbances.

[The results of the treatment of the cataract in children and youth treated in Ophthalmology Clinic in Poznan]. / Wyniki leczenia zacmy u dzieci i mlodziezy bedacych pacjentami Kliniki Okulistycznej Uniwersytetu Medycznego w Poznaniu.

Cataract is a leading course of a treatable blindness and serious visual impairment in children. Treatment, especially in one-sided cataract is a challenge and it is connected with the risk of complications. The decision to perform a surgery in older children with already coexisting amblyopia is not easy to make. The aim of our study was to present the effects of the cataract treatment in children between 3 and 18 years old, in the Ophthalmology Clinic in Poznan. Between 2006 and 2008, the surgery was done in 36 children (42 eyes). The data of those patients, e.g. the type and location of the cataract, accompanying disorders and visual acuity reached, were analyzed. In this group of patient 60% of children reached visual acuity equal to 0.5, and 24% of them full visual acuity. The way to prepare the patient to the surgery, the way to calculate the power of the intraocular lens to be implanted and the surgery technique will be discussed.

[Central serous choroidoretinopathy--the characteristics of the clinical picture and the evaluation of the influence of general conditions at the prognosis and the course of the disease. Metaanalysis]. / Centralna surowicza choroidoretinopatia--charakterystyka obrazu klinicznego i ocena wplywu stanu ogólnego na rokowanie i przebieg schorzenia. Przeglad pismiennictwa.

Central serous choroidoretinopathy (CSCR)--recurrent disorder characterized by the detachment of neurosensory retina and/or detachment of the RPE in the posterior pole, caused by fluid leakage from choroidal vessels, coming through retinal pigment epithelium layer. The aim of the following paper was to create a historic revue of examinations of CSCR and modern description of signs and symptoms of this disease. CSCR may be present in various clinical forms with different prognosis, and therefore also all kind of retina and choroidea lesions were described. The role of hypertension, steroid treatment and stress in course of CSCR was shown in many studies during past years and for that reason the correlation between those factors and the incidence and the course of CSCR, was analysed. It is important to stress, that in contrast to current opinion, steroids can evoke CSCR and intensificate its symptoms and are contraindicated in the treatment of this disease. To addition CSCR is not always a benign disease, and may cause significant impairment of the visual acuity and colour vision, therefore, it should be carefully followed-up.

[Central serous choroidoretinopathy (CSCR)--the diagnostics, monitoring and treatment]. / Centralna surowicza choroidoretinopatia--diagnostyka, monitorowanie i leczenie.

There are many clinical forms of central serous choroidoretinopathy (CSCR) with different prognosis. Although fluoresceine angiography still plays the most important role in the diagnosis of CSCR, it should be pointed out, that examination with retinal thickness analyser and optical coherent tomography is a modern and non-invasive method of retinal examination, which can provide with some significant and reliable observations helping in objective monitoring of CSCR. The aim of this paper was the description of diagnostic methods and analysis of optimal methods used for monitoring of CSCR. Because the research of the literature suggests, that local: nonsteroid anti-inflammatory drugs, beta-blockers and systemic or local carbonic anhydrase inhibitors may be helpful in therapeutic choice, the treatment options of CSCR were also analysed.

Acute retinal pigment epithelitis in 18 years old patient.

We report case of acute retinal pigment epithelitis (ARPE), a very rare ophthalmic disorder, which has a very good final visual prognosis. The 18 years old woman was examined by ophthalmologist for sudden visual decrease of vision and dark spot in visual field of her left eye. The best corrected visual acuity (BCVA) of the left eye at the initial diagnosis was 0.1 and after 4 months improved to 0.9. The diagnosis or ARPE was made on the basis of fundoscopy, fluorescein angiography, electroretinography and optical coherence tomography (OCT) examination.

[Disadvantageous course of ophthalmological changes in young women with long-lasting diabetes mellitus followed by the symptoms of anorexia nervosa]. / Niekorzystny przebieg zmian w narzadzie wzroku u mlodych kobiet z dlugo trwajaca cukrzyca i objawami jadlowstretu psychicznego.

PURPOSE: To present the course and progression of very severe proliferative retinopathy in young women with long lasting diabetes mellitus and symptoms of anorexia nervosa. MATERIAL AND METHODS: The data of 5 young women, in age 25-32 years, suffering from diabetes mellitus 15 to 29 years with intended weight lose. The progression of ophthalmological changes was observed, followed by considerable fluctuations of glucose blood. RESULTS: In the time of weight lose in all patients, the worsening of the visual acuity was observed and it was the first reason for ophthalmological check-up. The initial best corrected visual acuity was 0.1-0.9. The rubeosis of the iris, cataracts and proliferative retinopathy with intravitreal hemorrhage and tractional retinal detachment were observed. Despite the immediate ophthalmological treatment (lasertherapy, pars plana vitrectomy, criopexy and retinopexy) the useful visual acuity (>0.1) was maintained only in one eye. CONCLUSIONS: 1. In case of significant exacerbation of progression of ophthalmological changes in patients with long lasting diabetes mellitus and anorexia nervosa the monitoring of their psychological and physical conditions is essential. 2. In the case of weight lose in patients with long lasting diabetes mellitus the rigorous ophtalmological monthly consultations are obligate.

[Influence of Eqb 761 on the function of the retina in children and adolescent with long lasting diabetes mellitus--preliminary report]. / (146)Wplyw preparatu Egb 761 na czynnosc siatkówki u dzieci i mlodziezy z dlugo trwajaca cukrzyca insulinozalezna--doniesienie wstepne.

PURPOSE: Early detection of patological function of the retina, before anatomical changes, plays very important role in monitoring of visual complications in patients with diabetes mellitus. The aim of the study was the evaluation of anatomical and functional changes in visual organ in children and adolescents with long lasting diabetes mellitus type 1 and taking Egb 761 (Tanakan Beaufour Ipsen) as an adjuvant. MATERIALS AND METHODS: Group consists of 15 patients, age between 11 and 19 years, with diabetes mellitus lasting 6-12 years. All patients had full ophthalmologic examination and color vision tests (Panel D 15 saturated and desaturated). The examination was done 3 times, every 3 months. Egb 761 was given: 1 tablet - 3 times a day, during 3 months. RESULTS: No diabetic retinopathy was found. The results of color vision test were better after therapy (25% of pathological results) and 3 months later (only 4 % of patients). CONCLUSIONS: 1. Egb 761 seems to be good adjuvant in patient with long lasting diabetes mellitus. 2. Color vision tests are sensitive tests of the retinal function and are easy to perform.

[The evaluation of macular thickness in patients with retinal detachment treated with conventional surgery--preliminary report]. / Ocena grubosci siatkówki w plamce u chorych operowanych metoda konwencjonalna z powodu odwarstwienia siatkówki--doniesienie wstepne.

The aim of the study was to evaluate retinal thickness in macular area (before and after surgery), and its correlation with visual acuity in patients with retinal detachment treated conventional surgery. Twenty eyes of 20 patients, treated in our clinic and eyes of 20 healthy subjects without any ocular pathology were evaluated. Retinal thickness in macular area (obtained with retinal thickness analyzer RTA - TALIA Technology) and visual acuity achieved after surgery compared with ocular pathology before and after surgery were analyzed. The correlation between visual acuity changes after successful surgery and macular thickness was evaluated. Retinal thickening in macula in patients with detached retina (even if macula was attached), and immediately after successful surgery in comparison to control group was observed. In selected cases, withdrawal of subclinical macular edema correlated with improvement of visual acuity. RTA allows for quantitative evaluation of retinal thickness in macula and its correlation with visual rehabilitation in patients with retinal detachment treated conventional surgery. Therefore RTA can be a useful tool in monitoring and determining visual acuity improvement.

[Cataract in persons over 90 years old]. / Zacma u osób powyzej 90. roku zycia.

PURPOSE: To evaluate effect of age over 90-ty on cataract surgery course, perioperative period and final corrected visual acuity. MATERIAL AND METHODS: A case series of 34 patients aged over 90 years (39 eyes) undergoing cataract extraction between 1993 - 2000 was studied. Detailed ophthalmological examination (best corrected visual acuity, tonometry, retinometry, anterior and posterior segment exmination, ultrasonography scan A and B), before and after operations was performed. Analyzed data was widen by internal physical examination. RESULTS: ECCE with posterior intraocular lens (IOL) in 38 eyes, and anterior IOL in 1 case (intraopertive posterior lens capsule rupture) implantation was performed. Postoperative course without complications in 35 eyes (89,7%), complications in 4 eyes (10,3%): keratopathy (2), exudative membrane (2). Improvement in visual acuity (defined as at least 2 lines in Snellen tables) was noted in 35 eyes (89,7%). Visual acuity over 0,3 was achieved in 23 eyes (58,9%), over 0,5 in 20 eyes (51,3%). Ocular comorbids: age related macular degeneration 7 eyes (17,9%), glaucomatous atrophy of optic nerve 5 eyes (12,8%), no diabetic retinopathy was diagnosed. CONCLUSIONS: 1. Advance in years is not a contradiction for cataract extraction. 2. Cataract surgery improved visual acuity: to far in 89,7%, to near in 71,8% - comparing with preopertive status. 3. Restoration of visual function, especially in persons with severe visual acuity reduction, has good impact on psychological status of patients. 4. Accurate perioperative care protects patients from serious systemic complications.

[Incidence and the progression of the acute-phase of the retinopathy of prematurity in infants hospitalized in Neonatology Department of University of Medical Sciences in Poznan]. / Wystepowanie i przebieg fazy aktywnej retinopatii wczesniaków u dzieci hospitalizowanych w Katedrze i Klinice Neonatologii w Poznaniu.

PURPOSE: The assessment of the epidemiological data of acute-phase of retinopathy of prematurity (ROP). MATERIAL AND METHODS: Infants with birth weights less than 1500g and birth dates between April 1, 2002, and May 30, 2003, admitted to special care baby unit in Department of Neonatology in Poznan, were examined. The incidence of retinopathy of prematurity, infants sex, multiple births, the onset of acute-phase ROP (considering the day of life and postmenstrual age) and also the day of life, at which the treatment was started, were analysed. RESULTS: Among 190 infants enrolled to the study 48.9% were female and 51.1% were male. There were 20.5% infants from multiple births. In the examined group in infants with a birth weight under 1250g the incidence of ROP was 32.6% and in infants with a birth weight above 1250g--7.4%. The ROP was diagnosed earliest in 4th week of life, the latest in 12th week of life (mean time of diagnosis the 8th week of life). The earliest time of performing the treatment with diode laser was 37th day of life, the latest--97th day of life (mean time of treatment the 67.5th day of life). CONCLUSIONS: Presented epidemiological data may be helpful in foreseeing the natural history of acute-phase of ROP in population of Polish premature infants with a birth weight under 1500g.