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Adamczyk-Zostawa J, Wylęgała A, Lis M, Zostawa J, Fiolka R, Wylęgała E, Adamczyk-Sowa M, Czuba Z. The level of cytokines in tears as a novel indicator of demyelinating diseases. Neurol Res 2024:1-8. [PMID: 38602307 DOI: 10.1080/01616412.2024.2337502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION A novel research objective is to identify new molecules in more readily accessible biological fluids that could be used in the diagnosis of multiple sclerosis (MS) and other demyelinating disorders. AIM To compare the level of selected cytokines in tears between patients with MS or other demyelinating disorder and healthy controls. MATERIAL AND METHODS 84 patients with diagnosed MS during remission or with other demyelinating disease of the CNS and 70 healthy controls were enrolled in the study. Tears were collected without any stimulation and stored till the day of assessment. The concentration of selected cytokines was measured by the Bio-Plex Pro Human cytokine screening panel 27 cytokines assay according to the manufacturer's instructions. Statistical analysis was performed with Statistica 13. RESULTS IL-1b level was significantly lower in the study group compared to the control group [3,6 vs 8.71, p < 0.001]. The same pattern was observed for IL-6 [3,1 vs 5.26, p = 0.027] and IL-10 [1,7 vs 10.92, p < 0.001] (Table 1). In the study group, IL-1RA (p = 0.015), IL-5 (p = 0.04), IL-9 (p = 0.014), and IL-15 (p = 0.037) showed significant correlations with age. In the total sample, IL-1Ra (p = 0.016) and IFN-g (p = 0.041) were significantly correlated with age, while in the control group, IL-8 (p = 0.09), MIP-1a (p = 0.009), and RANTES (p = 0.031) showed significant correlations. CONCLUSIONS Our results show that MS and other demyelination diseases lead to decrease in the overall level of cytokines in tears. Further research is needed to determine the role of tear fluid in the assessment of demyelinating disorders like MS.
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Affiliation(s)
- Jowita Adamczyk-Zostawa
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Wylęgała
- Department of Pathophysiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Martyna Lis
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jacek Zostawa
- Department of Urology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Rafał Fiolka
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Sendecki A, Ledwoń D, Tuszy A, Nycz J, Wąsowska A, Boguszewska-Chachulska A, Wylęgała A, Mitas AW, Wylęgała E, Teper S. Association of Genetic Risk for Age-Related Macular Degeneration with Morphological Features of the Retinal Microvascular Network. Diagnostics (Basel) 2024; 14:770. [PMID: 38611684 PMCID: PMC11011905 DOI: 10.3390/diagnostics14070770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is a multifactorial disease encompassing a complex interaction between aging, environmental risk factors, and genetic susceptibility. The study aimed to determine whether there is a relationship between the polygenic risk score (PRS) in patients with AMD and the characteristics of the retinal vascular network visualized by optical coherence tomography angiography (OCTA). METHODS 235 patients with AMD and 97 healthy controls were included. We used data from a previous AMD PRS study with the same group. The vascular features from different retina layers were compared between the control group and the patients with AMD. The association between features and PRS was then analyzed using univariate and multivariate approaches. RESULTS Significant differences between the control group and AMD patients were found in the vessel diameter distribution (variance: p = 0.0193, skewness: p = 0.0457) and fractal dimension distribution (mean: p = 0.0024, variance: p = 0.0123). Both univariate and multivariate analyses showed no direct and significant association between the characteristics of the vascular network and AMD PRS. CONCLUSIONS The vascular features of the retina do not constitute a biomarker of the risk of AMD. We have not identified a genotype-phenotype relationship, and the expression of AMD-related genes is perhaps not associated with the characteristics of the retinal vascular network.
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Affiliation(s)
- Adam Sendecki
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland; (A.S.); (A.W.); (A.W.); (E.W.); (S.T.)
| | - Daniel Ledwoń
- Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland; (A.T.); (A.W.M.)
| | - Aleksandra Tuszy
- Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland; (A.T.); (A.W.M.)
| | - Julia Nycz
- Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, 98693 Ilmenau, Germany;
| | - Anna Wąsowska
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland; (A.S.); (A.W.); (A.W.); (E.W.); (S.T.)
- Genomed S.A., 02-971 Warszawa, Poland;
| | | | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland; (A.S.); (A.W.); (A.W.); (E.W.); (S.T.)
| | - Andrzej W. Mitas
- Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland; (A.T.); (A.W.M.)
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland; (A.S.); (A.W.); (A.W.); (E.W.); (S.T.)
| | - Sławomir Teper
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland; (A.S.); (A.W.); (A.W.); (E.W.); (S.T.)
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Kryszan K, Wylęgała A, Kijonka M, Potrawa P, Walasz M, Wylęgała E, Orzechowska-Wylęgała B. Artificial-Intelligence-Enhanced Analysis of In Vivo Confocal Microscopy in Corneal Diseases: A Review. Diagnostics (Basel) 2024; 14:694. [PMID: 38611606 PMCID: PMC11011861 DOI: 10.3390/diagnostics14070694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Artificial intelligence (AI) has seen significant progress in medical diagnostics, particularly in image and video analysis. This review focuses on the application of AI in analyzing in vivo confocal microscopy (IVCM) images for corneal diseases. The cornea, as an exposed and delicate part of the body, necessitates the precise diagnoses of various conditions. Convolutional neural networks (CNNs), a key component of deep learning, are a powerful tool for image data analysis. This review highlights AI applications in diagnosing keratitis, dry eye disease, and diabetic corneal neuropathy. It discusses the potential of AI in detecting infectious agents, analyzing corneal nerve morphology, and identifying the subtle changes in nerve fiber characteristics in diabetic corneal neuropathy. However, challenges still remain, including limited datasets, overfitting, low-quality images, and unrepresentative training datasets. This review explores augmentation techniques and the importance of feature engineering to address these challenges. Despite the progress made, challenges are still present, such as the "black-box" nature of AI models and the need for explainable AI (XAI). Expanding datasets, fostering collaborative efforts, and developing user-friendly AI tools are crucial for enhancing the acceptance and integration of AI into clinical practice.
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Affiliation(s)
- Katarzyna Kryszan
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland; (A.W.); (M.K.); (E.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland; (P.P.); (M.W.)
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland; (A.W.); (M.K.); (E.W.)
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Magdalena Kijonka
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland; (A.W.); (M.K.); (E.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland; (P.P.); (M.W.)
| | - Patrycja Potrawa
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland; (P.P.); (M.W.)
| | - Mateusz Walasz
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland; (P.P.); (M.W.)
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland; (A.W.); (M.K.); (E.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland; (P.P.); (M.W.)
| | - Bogusława Orzechowska-Wylęgała
- Department of Pediatric Otolaryngology, Head and Neck Surgery, Chair of Pediatric Surgery, Medical University of Silesia, 40-760 Katowice, Poland;
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Orzechowska-Wylęgała B, Wylęgała A, Zalejska Fiolka J, Czuba Z, Toborek M. Saliva-Based Protein Analysis in Pediatric Dentofacial Inflammation. Pediatric Health Med Ther 2024; 15:95-102. [PMID: 38435797 PMCID: PMC10908279 DOI: 10.2147/phmt.s440223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/09/2024] [Indexed: 03/05/2024] Open
Abstract
Aim Saliva contains various proteins that are important in developing inflammatory processes and their prevention. One key aspect of saliva research is the relationship between oral infections and inflammation, and the role of some salivary proteins. The Work Aims To demonstrate which salivary cytokines can be biomarkers of acute odontogenic oral and facial infections in children. Material and Methods The study included two groups of patients: a study group of 28 children: 7 girls and 21 boys aged 3 -17 years with acute dentofacial inflammation (DI) and a control group of 52 children: 16 girls and 36 boys aged 4-17 years with uncomplicated dental caries (CE). The levels of Interleukin-5 (IL-5), Interleukin -10 (IL-10), Interleukin-17A (IL-17A), Interleukin-12p70 (IL-12p70), Eotaxin, Rantes, Vascular Endothelial Growth Factor (VEGF), and Interferon gamma-induced protein 10 (IP10) in the saliva of children in DI and CE groups were compared. Statistical analysis was performed with Statistica 13. The Student's t-test and the Wilcoxon signed-rank test were used. Results The results show that IL-10, IL-17A, and Eotaxin showed a statistically significant increase in the DI group compared to the CE group. The significance level for IL-10 was p=0.02, for IL-17A was equal to Eotaxin and p=0.04. The other measured parameters did not differ statistically significant between the two groups. Conclusion IL-10, IL-17A, and Eotaxin can be used as potential biomarkers for tooth-related inflammatory states of the oral cavity and face in children. These biomarkers can be useful in identifying and monitoring the presence of inflammation in the oral cavity and face.
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Affiliation(s)
- Bogusława Orzechowska-Wylęgała
- Department of Pediatric Otolaryngology, Head and Neck Surgery, Chair of Pediatric Surgery, Medical University of Silesia (SUM), Katowice, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management, Department of Pathophysiology in Katowice, SUM, Katowice, Poland
| | | | - Zenon Czuba
- Department and Division of Microbiology and Immunology in Zabrze, SUM, Katowice, Poland
| | - Michal Toborek
- Department of Biochemistry and Molecular Biology, University of Miami, School of Medicine, Miami, FL, USA
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Wróblewska-Czajka E, Dobrowolski D, Wylęgała A, Jurkunas UV, Wylęgała E. Outcomes of Boston Keratoprosthesis Type I Implantation in Poland: A Retrospective Study on 118 Patients. J Clin Med 2024; 13:975. [PMID: 38398288 PMCID: PMC10889181 DOI: 10.3390/jcm13040975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Boston Keratoprosthesis Type I (BI-KPro I) is a synthetic cornea that can be used to restore vision in patients with corneal blindness. This retrospective study evaluated the outcomes of BI-KPro implantation in 118 patients. Material: The mean age of the patients was 56.76 ± 14.24 years. Indications for keratoprosthesis implantation were as follows: graft failure, 47 (39.83%); ocular burn, 38 (32.20%); neurotrophic keratopathy, 11 (9.32%), mucous membrane pemphigoid 9 (7.67%); autoimmune, 6 (5.08%); Stevens-Johnson syndrome, 4 (3.39%); and aniridia (2.54%). Methods: The surgeries were performed between March 2019 and June 2022 at a single clinical center in two locations. The postoperative visual acuity, complications, and need for additional surgical procedures were analyzed. Results: The Best Corrected Visual Acuity before surgery was 0.01 ± 0.006. After one year (V1), it was 0.30 ± 0.27; at two years (V2), it was 0.27 ± 0.26; and at three years (V3), it was 0.21 ± 0.23. The percentage of patients with visual acuity better than 0.1 on the Snellen chart was 37.29% after 1 year, 49.35% after 2 years, and 46.81% after 3 years of follow up. The most common complications were glaucoma (78 patients; 66.1%), corneal melting (22 patients; 18.6%), and retroprosthetic membranes (20 patients; 17.0%). Conclusions: The BI-KPro can significantly improve visual acuity. The worst long-term results were obtained in the group of patients with autoimmune diseases; therefore, careful consideration should be given to implanting BI-KPro in this group. The high incidence of de novo glaucoma or the progression of pre-existing glaucoma suggests the need for careful monitoring.
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Affiliation(s)
- Ewa Wróblewska-Czajka
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (D.D.); (E.W.)
- Ophthalmology Department, Railway Hospital in Katowice, 40-760 Katowice, Poland
| | - Dariusz Dobrowolski
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (D.D.); (E.W.)
- Ophthalmology Department, Railway Hospital in Katowice, 40-760 Katowice, Poland
- Department of Ophthalmology, Santa Barbara Hospital, 41-200 Sosnowiec, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences, Medical University of Silesia, 40-760 Katowice, Poland;
| | - Ula V. Jurkunas
- Cornea Center of Excellence, Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Edward Wylęgała
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (D.D.); (E.W.)
- Ophthalmology Department, Railway Hospital in Katowice, 40-760 Katowice, Poland
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Fiolka R, Wylęgała E, Toborek M, Szkodny D, Czuba Z, Wylęgała A. Fuch's Endothelial Corneal Dystrophy in Cataract Patients Is Associated with Elevated Levels of Inflammatory Chemokines, but Not Growth Factors, in the Aqueous Humor. Int J Mol Sci 2024; 25:1894. [PMID: 38339172 PMCID: PMC10856247 DOI: 10.3390/ijms25031894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/17/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
The study investigated a profile of chemokines and growth factors in the aqueous humor (AH) of eyes with Fuch's endothelial corneal dystrophy (FECD) and cataracts in comparison with cataract patients as a control group. A total of 52 AH samples (26 FECD + cataract and 26 cataract/control) were collected before cataract surgery. None of the patients had any clinically apparent inflammation at the time of AH collection. The AH levels of MCP-1 (CCL2), MIP-1α (CCL3), MIP-1β(CCL4), RANTES (CCL5), eotaxin (CCL11), IP-10 (CXCL10), FGF basic, G-CSF, GM-CSF, PDGF-bb, and VEGF were compared between the groups. The analyses were performed using the Bio-Plex 200 System from Bio-Rad. Among the studied parameters, the AH levels of RANTES, eotaxin, and IP-10 significantly increased in the FECD + cataract eyes, compared with the cataract controls (p < 0.05). Elevated levels of the RANTES, Eotaxin, and IP-10 indicate more intense inflammation in the eyes of patients in the FECD + cataract group. Moreover, these factors exhibit potential as predictive biomarkers for early detection of FECD in cataract patients. The discovery of elevated concentrations of biochemical markers in a patient, who has not yet received a clinical diagnosis, may suggest the need for heightened observation of the other eye to monitor the potential development of FECD.
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Affiliation(s)
- Rafał Fiolka
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (E.W.); (D.S.)
- Doctoral School of the Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (E.W.); (D.S.)
| | - Michał Toborek
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, FL 33136, USA;
| | - Dominika Szkodny
- Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland; (E.W.); (D.S.)
| | - Zenon Czuba
- Department of Microbiology and Immunology, Faculty of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Adam Wylęgała
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland;
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Bolek B, Wylęgała A, Rebkowska-Juraszek M, Wylęgała E. Endocyclophotocoagulation Combined with Phacoemulsification in Glaucoma Treatment: Five-Year Results. Biomedicines 2024; 12:186. [PMID: 38255291 PMCID: PMC10813537 DOI: 10.3390/biomedicines12010186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND this study aimed to assess the effectiveness and safety of phaco-endocyclophotocoagulation (phaco-ECP) in patients with glaucoma over five consecutive years. METHODS Thirty-eight patients (38 eyes) with primary and secondary glaucoma were enrolled to undergo phaco-ECP (Endo Optiks URAM E2, Beaver-Visitec International, Waltham, MA, USA). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after phaco-ECP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as a cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and in the first week and 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively. RESULTS The mean ± SD values of IOP preoperatively, at 12, 24, 36, 48, and 60 months postoperatively were 22.6 ± 6.7 mmHg, 15.9 ± 3.9 mmHg (p < 0.001), 15.9 ± 2.9 mmHg (p < 0.001), 15.6 ± 2.7 mmHg (p < 0.001), 15.5 ± 3.8 mmHg (p < 0.001), and 15.2 ± 2.6 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.7%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 40.6%. All patients at the 60-month follow-up visit required the use of antiglaucoma medications-none of the patients achieved complete success. During the follow-up period, nine patients (28.3%) that required retreatment due to nonachievement of the target IOP were considered failures. Six patients (15.8%) were lost from the follow-up. A total of 23 patients were evaluated 60 months after their phaco-ECP. Complications directly associated with the procedure, such as corneal edema (25.6%), IOP spikes (20.5%), IOL dislocation (2.6%), and uveitis (12.8%), were observed in our patients. Hypotony was not observed in any of our patients. CONCLUSIONS The phaco-ECP procedure was effective, well-tolerated, and safe for reducing IOP in glaucoma patients with cataracts over a long-term follow-up. Randomized, larger-scale studies are required to validate the results obtained.
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Affiliation(s)
- Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, 40-760 Katowice, Poland
- Clinical Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | | | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, 40-760 Katowice, Poland
- Clinical Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
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Markuszewski B, Wylęgała A, Szentmáry N, Langenbucher A, Markuszewska A, Wylęgała E. Comparative Analysis of the Visual, Refractive and Aberrometric Outcome with the Use of 2 Intraocular Refractive Segment Multifocal Lenses. J Clin Med 2023; 13:239. [PMID: 38202246 PMCID: PMC10779799 DOI: 10.3390/jcm13010239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
To demonstrate the results of ray tracing higher- and lower-order aberrations in pseudophakic eyes with rotationally asymmetrical segment multifocal lenses, total high- and low-order aberrations, measured by root mean square value (RMS), refraction, uncorrected distance and uncorrected near visual acuity (UCDVA and UCNVA), and tear break-up time, were measured at scotopic size in 42 eyes of patients implanted with bifocal refractive Mplus15/Mplus30 IOL with +1.5 dpt near addition (42 eyes of patients implanted with Mplus15)/+3.0 dpt near addition (91 eyes of patients implanted with Mplus30), and 107 eyes of control group. No significant differences were noticed between the examined groups concerning UCDVA, UCNVA, and tear break-up time (p < 0.001). Coma and total high-order aberrations were significantly higher for the Mplus30 lens in comparison to the Mplus15 lens and the control group (Coma, Trefoil p < 0.001, Secondary Astigmatism p = 0.002). The spherical aberrations were significantly higher in the lower-addition lens (p = 0.016) in comparison to the control group and to the higher-addition lens group (p < 0.001). Both intraocular lens models were successful at reaching refractive aim, good distance, and near function with the lower higher-order aberrations for the low-addition lens.
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Affiliation(s)
- Bartłomiej Markuszewski
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland; (A.W.)
- Wrocławskie Centrum Okulistyczne, 50-231 Wrocław, Poland
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland; (A.W.)
| | - Nóra Szentmáry
- Dr. Rofl M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, 66424 Homburg, Germany;
| | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, 66424 Homburg, Germany
| | | | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland; (A.W.)
- Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
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9
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Nandzik M, Wylęgała E, Wylęgała A, Szkodny D, Roszkowska AM, Wróblewska-Czajka E. Visual Acuity Examination Methodology in Keratoconus. J Clin Med 2023; 12:7620. [PMID: 38137688 PMCID: PMC10743794 DOI: 10.3390/jcm12247620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/18/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of visual acuity testing in studies on keratoconus was thoroughly analyzed. The analysis showed that the most commonly indicated chart for testing visual acuity papers on keratoconus is the Snellen chart. It was shown that in 150 out of 295 articles, the authors do not describe the methodology for testing visual acuity. What is more, it was also shown that in 68 of the 295 articles which were analyzed, a procedure for converting visual acuity tested with a Snellen chart into a logMAR scale was used. In this review, we discuss the validity and reliability of such conversions. In particular, we show that insufficient description of visual acuity testing methodology and lack of information on the conversion of visual acuity results into the logMAR scale may contribute to the misinterpretation of visual acuity test results.
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Affiliation(s)
- Magdalena Nandzik
- Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
| | - Adam Wylęgała
- Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
| | - Dominika Szkodny
- Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
| | - Anna Maria Roszkowska
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy
| | - Ewa Wróblewska-Czajka
- Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
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Wylęgała A, Wozniak P, Sędziak-Marcinek B, Bolek B, Szkodny D, Wylęgała E. Retro-Mode in NIDEK Mirante: A Comparative Analysis with Other Imaging Modalities for AMD and CSR. Diagnostics (Basel) 2023; 13:2846. [PMID: 37685384 PMCID: PMC10486949 DOI: 10.3390/diagnostics13172846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Retro-mode is a novel technique capable of creating pseudo-3D images of the retina. However, its clinical utility remains unknown. This study aimed to evaluate the Nidek Mirante multimodal imaging platform for ocular assessment in patients with various retinal conditions. METHODS A total of 115 participants with central serous chorioretinopathy (CSR) and age-related macular degeneration (AMD) were included. Two experienced graders independently evaluated the images, and statistical analysis was performed to assess interclass correlation coefficients (ICC) between graders and modalities; Results: For CSR detection, retro-mode demonstrated exceptionally high ICC rates (ICC = 1; 100%), while color and autofluorescence (FAF) showed moderate coefficients (0.69 and 0.78, respectively). The detection of pigment epithelial detachment was high across all methods, with only retro-mode deviated right (DR) allowing detection in 69% of cases, while retro-mode DR and deviated left (DL) achieved 100% detection. FAF-green achieved a 95% detection rate. In detecting retinal atrophy, most modalities demonstrated high detection rates, with the lowest detection rates offered by retro-mode DL (ICC = 0.85) and DR (ICC = 0.89), while retro-mode ring aperture offered 0.97. Infra-red and fluorescein angiography imaging offered the highest detection rates among the tested modalities, with 97% and 100%, respectively. CONCLUSION Retro-mode showed promise for comprehensive ocular evaluation and diagnosis, with certain imaging modalities demonstrating higher accuracy in detecting specific retinal features.
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Affiliation(s)
- Adam Wylęgała
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Przemysław Wozniak
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Bogumiła Sędziak-Marcinek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Dominika Szkodny
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
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Bolek B, Wylęgała A, Wylęgała E. Microcyclophotocoagulation in Glaucoma Treatment: A Medium-Term Follow-Up Study. J Clin Med 2023; 12:4342. [PMID: 37445376 DOI: 10.3390/jcm12134342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND This study aimed to assess the effectiveness and safety of transscleral microcyclophotocoagulation (µCPC) in patients with glaucoma for eighteen consecutive months. METHODS Sixty-one patients (64 eyes) with primary and secondary glaucoma were enrolled to undergo µCPC (diode laser FOX 810, A.R.C. Laser, Nuremberg, Germany). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after µCPC. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, and 18 months postoperatively. RESULTS The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1, 3, 6, 12, and 18 months postoperatively were 25.1 ± 8.4 mmHg, 17.3 ± 4.5 mmHg (p < 0.001), 16.5 ± 6.1 mmHg (p < 0.001), 20.5 ± 8.3 mmHg (p < 0.001), 17.1 ± 6.2 mmHg (p < 0.001), 18.0 ± 7.1 mmHg (p < 0.001), 15.8 ± 3.2 mmHg (p < 0.001), and 17.0 ± 5.9 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.5%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 38.5%. Two patients at 18-month follow-up did not require the use of antiglaucoma medications-complete success rate-3.1%. During the follow-up period, twenty-five eyes (39.1%) that required retreatment due to nonachievement of the target IOP were considered as failures. Eleven patients (12 eyes-18.8%) were lost to follow-up. A total of 26 patients (27 eyes) were evaluated 18 months after µCPC. Hypotony was observed in one patient (1.6%) and uveitis in two patients (3.1%) after the procedure. There were no other significant intraoperative or postoperative complications observed. CONCLUSIONS The µCPC is well tolerated and safe for reducing IOP in glaucoma patients in medium-term follow-up; however, success is moderate. Randomized, larger studies are needed to confirm the obtained results.
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Affiliation(s)
- Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management, Pathophysiology Department, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, 40-760 Katowice, Poland
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Wylęgała A, Roszkowska AM, Kokot J, Dobrowolski D, Wylęgała E. Clinical Evaluation of the Efficacy of Femtosecond Laser-Assisted Anterior Lamellar Keratoplasty. J Clin Med 2023; 12:jcm12031158. [PMID: 36769806 PMCID: PMC9917846 DOI: 10.3390/jcm12031158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To evaluate the clinical outcome, efficacy, and safety of femtosecond laser-assisted anterior lamellar keratoplasty. MATERIAL AND METHODS In this prospective study, 21 males and 10 females aged from 15 to 62 years (mean 38.5) with different pathologies of the anterior corneal layers were enrolled for anterior lamellar keratoplasty using femtosecond laser VisuMax (Carl Zeiss, Germany). All patients were examined for uncorrected (UCVA) and best-corrected (BCVA) distance and near visual acuity, astigmatism, endothelial cell density, corneal thickness, and intraocular pressure. These examinations were performed before transplantation, at hospital discharge, and after 3 and 12 months. The mean follow-up time was 65.36 ± 28.54 months. RESULTS A statistically significant improvement of both UCVA and BCVA for distance and near vision was registered. BCVA improved from 0.11 preoperatively to 0.168 (p = 0.03), 0.267 (p < 0.01), and 0.472 (p < 0.01) on the hospital discharge day, three months, and 12 months respectively. There were no statistically significant differences in astigmatism, intraocular pressure, endothelial cell density, and corneal pachymetry as compared to preoperative and postoperative values. Six patients (19%) had a graft failure with a rate of 33% at 26 months. CONCLUSIONS Femtosecond laser-assisted anterior lamellar keratoplasty is a safe and effective surgical method, providing satisfactory graft survival rates.
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Affiliation(s)
- Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, Poland
- Ophthalmology Department, Railway Hospital, 40-760 Katowice, Poland
- Correspondence:
| | - Anna M. Roszkowska
- Ophthalmology Clinic, Department of Biomorphological Sciences, University of Messina, 98124 Messina, Italy
- Ophthalmology Section, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland
| | - Joanna Kokot
- Ophthalmology Department, Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, II School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
| | - Dariusz Dobrowolski
- Ophthalmology Department, Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, II School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
- Ophthalmology Clinic of St. Barbara Hospital, 42-200 Sosnowiec, Poland
| | - Edward Wylęgała
- Ophthalmology Department, Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, II School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
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Mazur R, Wylęgała A, Wylęgała E, Dobrowolski D. Comparative Analysis of Corneal Parameters Performed with GalileiG6 and OCT Casia 2. Diagnostics (Basel) 2023; 13:diagnostics13020267. [PMID: 36673077 PMCID: PMC9857403 DOI: 10.3390/diagnostics13020267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUNDS To compare keratometry (Ks and Kf), astigmatism (Ast.), and the astigmatism axes (Ax.) of the posterior surface of the cornea; the total, central cornea thickness (CCT); and the thinnest corneal thickness (TCT) measured using two different measurement methods. METHODS Patients qualified for cataract surgery at the Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland, were included in the study and monitored with the following two devices: OCT-CASIA2 and Dual Scheimpflug Analyzer GalileiG6. Our work was a randomized, prospective study in which compliance with the agreement of measurements between the devices was evaluated using the Bland-Altman method. RESULTS A total of 110 patients (62 females and 48 males) were examined. Overall, 100 eyes of patients that qualified for cataract surgery were enrolled in the study. No statistically significant difference was observed for Total-Ks and Total-Kf. A significant difference was observable for the following parameters: total Ks-ax, total Kf-ax, the total power of astigmatism, and in all parameters of the part of the cornea and corneal thickness (CCT and TCT). CONCLUSIONS The measurements obtained using Casia2 and the Dual Scheimpflug Analyzer GalileiG6 were significantly different and not interchangeable except for total Ks and Kf.
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Affiliation(s)
- Robert Mazur
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Adam Wylęgała
- Pathophysiology Department, School of Medicine, Medical University of Silesia, 40-055 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dariusz Dobrowolski
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Bolek B, Wylęgała A, Wylęgała E. Ultrasound ciliary plasty in glaucoma treatment: A long‐term follow‐up study. Acta Ophthalmol 2022; 101:293-300. [PMID: 36448501 DOI: 10.1111/aos.15290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/19/2022] [Accepted: 10/29/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The present study aimed to evaluate the efficacy and safety of ultrasound ciliary plasty (UCP) in patients with open-angle glaucoma for three consecutive years. METHODS Sixty-one patients (62 eyes) with primary and secondary glaucoma were enrolled to undergo UCP. The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use and visual acuity after UCP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, 18, 24, 30 and 36 months postoperatively. RESULTS A total of 41 patients (41 eyes) were evaluated 36-month after UCP. The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1; 3; 6; 12; 18; 24; 30 and 36 months postoperatively were 22.7 ± 5.0 mmHg, 17.1 ± 4.2 mmHg (p < 0.001), 15.7 ± 4.8 mmHg (p < 0.001), 18.8 ± 4.8 mmHg (p < 0.001), 17.3 ± 3.7 mmHg (p < 0.001), 16.9 ± 3.2 mmHg (p < 0.001), 16.6 ± 2.7 mmHg (p < 0.001), 16.3 ± 3.0 mmHg (p < 0.001), 15.8 ± 3.4 mmHg (p < 0.001), 15.3 ± 2.1 mmHg (p < 0.001) and 16.3 ± 3.0 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 28.5%. The qualified success rate was 64.0%. All patients at 36-month follow-up visit required the use of antiglaucoma medications - none of the patients achieved complete success. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. Choroid detachment was observed in three patients (4.8%), while macular oedema was observed in three patients (4.8%) after the procedure. No other major intraoperative or postoperative complications occurred. CONCLUSION Ultrasound ciliary plasty seems to be an effective and well-tolerated method to reduce IOP in patients with refractory glaucoma. Further studies with a larger group are needed to confirm the efficacy of this procedure.
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Affiliation(s)
- Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze Medical University of Silesia in Katowice, District Railway Hospital Katowice Poland
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze Medical University of Silesia in Katowice, District Railway Hospital Katowice Poland
- Health Promotion and Obesity Management, Pathophysiology Department Medical University of Silesia Katowice Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze Medical University of Silesia in Katowice, District Railway Hospital Katowice Poland
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15
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Szkodny D, Wylęgała A, Chlasta-Twardzik E, Wylęgała E. The Ocular Surface Symptoms and Tear Film Parameters during and after COVID-19 Infection. J Clin Med 2022; 11:jcm11226697. [PMID: 36431174 PMCID: PMC9695362 DOI: 10.3390/jcm11226697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study aimed to evaluate the ocular surface parameters of post-COVID-19 patients when compared to healthy controls. METHODS Patients after symptomatic SARS-CoV-2 infection, as confirmed by a PCR test of their nasopharyngeal swab sample, were enrolled. Complete ophthalmic examination, including visual acuity test, intraocular pressure measurement (IOP), slit-lamp examination, tear osmolarity test, central corneal thickness, endothelial cell number measurements, non-invasive keratograph break-up time (NIKBUT), meniscus height, and the Schirmer's test were performed and compared with the controls. RESULTS It must be noted that there were 36 COVID-19 patients and 25 control subjects included in the study. Eye itching and burning (19%) were the most common symptoms of COVID-19 infection, followed by a subjective decrease in vision (17%), conjunctivitis and eye pain were present in 11%, and 6% of the patients had episcleritis. The mean time from initial infection was 6.5 ± 3.9 (range 1-24 weeks). Meniscus height was not significantly changed between the COVID-19 (0.34 ± 0.13 mm) group and the control (0.33 ± 0.12 mm, p = 0.88) group. In addition, the NIKBUT-1 (p = 0.88; 7.22 ± 4.60 s and 6.91 ± 4.45 s) and NIKBUT average (p = 0.91, 12.30 ± 5.86 s and 11.77 ± 4.97 s) test results showed no significant change either. Neither was a significant result found in the IOP (p = 0.17, 14.56 ± 2.10 mmHg and 14.11 ± 1.96 mmHg); the Schirmer test (p = 0.18, 20.22 ± 7.92 mm and 20.02 ± 7.17 mm); Tosm (p = 0.16, 294.42 ± 54.51 mOsm/dL and 299.33 ± 5.65 mOsm/dL); CCT (p = 0.06, 549.15 ± 28.98 vs. 539.21 vs. 29.08 µm); nor the endothelial cell density (p = 0.07, 2516.64 ± 287.61 vs. 2454.21 ± 498.60 cells/mm2). CONCLUSIONS Through this study it was not revealed that there were any significant differences between the post-COVID group and control group in the objective measurements of ocular surface conditions, when performed after the acute phase of COVID-19. The exact incidence and mechanism of ocular findings, especially dry eye disease, in correlation with SARS-CoV-2 requires further research.
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Affiliation(s)
- Dominika Szkodny
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland
- Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
- Correspondence:
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland
| | | | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland
- Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
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Zalejska-Fiolka J, Birková A, Hubková B, Wielkoszyński T, Čižmárová B, Szlachta B, Fiolka R, Błaszczyk U, Wylęgała A, Kasperczyk S, Grzanka A, Mareková M, Toborek M. SUCCESSFUL CORRECTION OF HYPERGLYCEMIA IS CRITICAL FOR WEIGHT LOSS AND A DECREASE IN CARDIOVASCULAR RISK IN OBESE PATIENTS. J Nutr Biochem 2022; 106:109021. [DOI: 10.1016/j.jnutbio.2022.109021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/14/2022] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
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Inferrera L, Aragona E, Wylęgała A, Valastro A, Latino G, Postorino EI, Gargano R, Orzechowska-Wylęgała B, Wylęgała E, Roszkowska AM. The Role of Hi-Tech Devices in Assessment of Corneal Healing in Patients with Neurotrophic Keratopathy. J Clin Med 2022; 11:jcm11061602. [PMID: 35329927 PMCID: PMC8955972 DOI: 10.3390/jcm11061602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 12/21/2022] Open
Abstract
To prove the role of high-tech investigation in monitoring corneal morphological changes in patients with neurotrophic keratopathy (NK) using Keratograph 5M (K5M) and anterior segment OCT (AS-OCT), corneal healing was monitored with Keratograph 5M (Oculus, Wetzlar, Germany) and AS-OCT (DRI, Triton, Topcon, Tokyo, Japan) in 13 patients (8F and 5M), aged from 24 to 93 years (67.8 ± 19) with severe NK, who were treated with Cenegermin 0.002% (20 μg/mL) (Oxervate®, Dompè, Farmaceutici Spa, Milan, Italy). The surface defects were evaluated on Keratograph 5M with ImageJ software and the corneal thickness variations were measured using DRI-Triton OCT software. Instrumental procedures were performed at baseline, and after 4 and 8 weeks of the treatment, respectively. The main outcome measures were reduction of the ulcers’ area and corneal thickness recovery. The mean area of the corneal ulcers was reduced between baseline and 4 weeks examination in all patients, and at 8 weeks all ulcers were completely healed. An increase of the corneal thickness was evidenced between the baseline visit and after the 4- and 8-week follow-up, respectively. Additionally, only in collaborating subjects the In Vivo Confocal Microscopy (IVCM) was performed with HRT Rostock Cornea Module (Heidelberg Eng GmbH) to study the corneal nerves fibres. High-tech diagnostics with K5M, AS-OCT and IVCM proved useful in the assessment of corneal morphology and the healing process in patients with NK and could be extended to assess other corneal pathologies.
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Affiliation(s)
- Leandro Inferrera
- Eye Clinic, Department of Medical, Surgical Sciences and Health, University of Trieste, 34100 Trieste, Italy;
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy; (A.V.); (G.L.); (E.I.P.); (A.M.R.)
| | - Emanuela Aragona
- Ophthalmology Clinic, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Pathophysiology Department, School of Medicine, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Antonio Valastro
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy; (A.V.); (G.L.); (E.I.P.); (A.M.R.)
| | - Gianluigi Latino
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy; (A.V.); (G.L.); (E.I.P.); (A.M.R.)
| | - Elisa I. Postorino
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy; (A.V.); (G.L.); (E.I.P.); (A.M.R.)
| | - Romana Gargano
- Department of Economics, University of Messina, 98100 Messina, Italy;
| | - Bogusława Orzechowska-Wylęgała
- Clinic of Otolaryngology, Head and Neck Surgery, Department of Pediatric Surgery, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Anna M. Roszkowska
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, 98100 Messina, Italy; (A.V.); (G.L.); (E.I.P.); (A.M.R.)
- Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland
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Wylęgała A, Szkodny D, Wylęgała E. Comment on: Optical Coherence Tomography Angiography Features in Post-COVID-19 Pneumonia Patients: A Pilot Study. Am J Ophthalmol 2022; 234:332. [PMID: 34619110 PMCID: PMC8490127 DOI: 10.1016/j.ajo.2021.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022]
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Wylęgała A, Wróblewska-Czajka E, Wylęgała E. Subconjunctival dirofilariasis. Am J Ophthalmol 2022; 233:e1. [PMID: 34695396 DOI: 10.1016/j.ajo.2021.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/01/2022]
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Hunt M, Teper S, Wylęgała A, Wylęgała E. Response to 1-Year Fixed-Regimen Bevacizumab Therapy in Treatment-Naïve DME Patients: Assessment by OCT Angiography. J Diabetes Res 2022; 2022:3547461. [PMID: 35237693 PMCID: PMC8885291 DOI: 10.1155/2022/3547461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/13/2022] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of intravitreal bevacizumab treatment in patients with diabetic macular edema (DME) by assessing retinal changes using optical coherence tomography angiography (OCT-A). METHODS This prospective study was performed in patients with treatment-naïve DME. The eyes of patients were imaged using a swept-source OCT system with a scan area of 6 × 6 mm. The DME patients with a central macular thickness (CMT) of ≥300 μm received nine bevacizumab injections within 12 months. The demographic, systemic, and ocular parameters, including the best-corrected visual acuity (BCVA), CMT, microaneurysm (MA) count, and foveal avascular zone (FAZ) area in both superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as vessel density in SCP, were assessed in the patients. In addition, the response (good or poor) of the DME eyes to bevacizumab treatment and the final visual acuity (BCVA of 75 letters) were analyzed. RESULTS Seventy-seven eyes of DME patients were subjected to the final analysis. Bevacizumab treatment reduced CMT from 425.06 μm (±77.15) to 350.25 μm (±82.04) and improved BCVA by about 8.61 letters (from 64.73 to 73.34) in the patients. The mean number of MAs in SCP decreased from 3.51 ± 2.07 to 2.31 ± 1.15 (p < 0.001) and in DCP from 17.12 ± 11.56 to 12.21 ± 6.99 (p < 0.001), whereas the area of FAZ increased in SCP from 328.22 ± 131.38 to 399.70 ± 156.98 (p < 0.001) and in DCP from 571.13 ± 396.01 to 665.89 ± 412.77 (p = 0.001). The final BCVA letter score and CMT were statistically significant in both poor and good responders, as well as in BCVA < 75 and BCVA ≥ 75 groups. CONCLUSION The fixed-regimen intravitreal bevacizumab therapy was effective in treating DME. Apart from noninvasive visualization of microvascular damage, OCT-A showed limited usefulness in predicting treatment response. Although the study showed that the number of MAs was significantly reduced during treatment, which is an OCT-A predictor of a good response to bevacizumab treatment at a 12-month visit, commonly observed artifacts may reduce the usefulness of OCT-A.
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Affiliation(s)
- Magdalena Hunt
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland
| | - Sławomir Teper
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
| | - Edward Wylęgała
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland
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Sędziak-Marcinek B, Wylęgała A, Chełmecka E, Wylęgała E, Teper S. How to Achieve Near-Normal Visual Acuity with Bevacizumab in Diabetic Macular Edema Patients. J Clin Med 2021; 10:3572. [PMID: 34441868 PMCID: PMC8397100 DOI: 10.3390/jcm10163572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022] Open
Abstract
Patients suffering from diabetic retinopathy (DR) and diabetic macular edema (DME) are inherently interested in achieving normal or near-normal visual acuity. The study aimed to investigate factors influencing the visual acuity achieved by DME patients after bevacizumab (IVB) treatment. 98 patients (98 eyes) diagnosed with DR and DME underwent IVB treatment (9 injections/12 months). Patients were diagnosed and monitored using swept-source optical coherence tomography (SS-OCT), ultra-wide-field fluorescein angiography (UWFFA) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart testing. We assessed macular central subfield thickness (CST), non-proliferative diabetic retinopathy (NPDR) indicators and best-corrected visual acuity (BCVA). After the treatment, patients were divided into BCVA≤75 and BCVA>75 groups. The IVB therapy increased the number of ETDRS letters read by about 9 and 8 in the BCVA≤75 and the BCVA>75 group, respectively. Before and after treatment, the BCVA>75 group had lower CST than the BCVA≤75 group. The treatment reduced macular CST by 177 μm in the BCVA≤75 group and only by 93 μm in the BCVA>75 group. Total non-perfusion area (NPA) decreased in both BCVA score groups after IVB therapy. Normal or near-normal vision can be achieved with IVB treatment, provided it starts when visual acuity is not significantly reduced yet. The ophthalmic screening of DR patients should also target those with relatively high visual acuity.
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Affiliation(s)
- Bogumiła Sędziak-Marcinek
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Panewnicka 65 Street, 40-760 Katowice, Poland; (E.W.); (S.T.)
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 65, 40-728 Katowice, Poland;
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences, Medical University of Silesia, Ostrogórska 30 Street, 41-200 Sosnowiec, Poland;
| | - Edward Wylęgała
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Panewnicka 65 Street, 40-760 Katowice, Poland; (E.W.); (S.T.)
| | - Sławomir Teper
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Panewnicka 65 Street, 40-760 Katowice, Poland; (E.W.); (S.T.)
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22
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Szkodny D, Wylęgała E, Sujka-Franczak P, Chlasta-Twardzik E, Fiolka R, Tomczyk T, Wylęgała A. Retinal OCT Findings in Patients after COVID Infection. J Clin Med 2021; 10:jcm10153233. [PMID: 34362017 PMCID: PMC8347407 DOI: 10.3390/jcm10153233] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The aim of this study was to assess and compare the optic nerve, retina, and retinal vessel parameters in recovered COVID-19 patients and healthy patients by using optical coherence tomography angiography (OCT-a). METHODS In all, 156 eyes of post-COVID-19 patients and 98 eyes of subjects from a control group were enrolled in our study. BCVA, intra ocular pressure (IOP) measurement, fundus examination, and OCT images, including macular cube, OCT-RNFL, and angio-OCT 6 × 6 mm examinations, were performed for both groups. The measurements were acquired using Swept Source OCT DRI OCT Triton. In the post-COVID-19 group, 762 OCT protocols were obtained. For statistical analysis, parameters from only one eye from each subject were taken. RESULTS In the measured parameters, no significant differences were observed, i.e., central macular thickness (p = 0.249); RNFL (p = 0.104); FAZ (p = 0.63); and vessel density of superficial retinal vascular plexus in central (p = 0.799), superior (p = 0.767), inferior (p = 0.526), nasal (p = 0.402), and temporal (p = 0.582) quadrants. Furthermore, a slit-lamp examination did not reveal any COVID-19-related abnormalities. CONCLUSION OCT examination did not detect any significant changes in morphology or morphometry of the optic nerve, retina, or the retina vessels due to COVID-19.
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Affiliation(s)
- Dominika Szkodny
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, 40-760 Katowice, Poland; (E.W.); (E.C.-T.); (R.F.); adam. (A.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
- Correspondence:
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, 40-760 Katowice, Poland; (E.W.); (E.C.-T.); (R.F.); adam. (A.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
| | - Paulina Sujka-Franczak
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
| | - Edyta Chlasta-Twardzik
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, 40-760 Katowice, Poland; (E.W.); (E.C.-T.); (R.F.); adam. (A.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
| | - Rafał Fiolka
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, 40-760 Katowice, Poland; (E.W.); (E.C.-T.); (R.F.); adam. (A.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
| | - Tomasz Tomczyk
- Temporary Hospital of Health Care Facility of the Ministry of the Interior and Administration in Katowice, 40-163 Katowice, Poland;
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia in Katowice, 40-760 Katowice, Poland; (E.W.); (E.C.-T.); (R.F.); adam. (A.W.)
- Department of Ophthalmology, District Railway Hospital in Katowice, 40-760 Katowice, Poland;
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Affiliation(s)
- Adam Wylęgała
- Pathophysiology Department, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Adam Sendecki
- Ophthalmology Department, Railway Hospital, Katowice, Poland.,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Department, Railway Hospital, Katowice, Poland.,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
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Roszkowska AM, Wylęgała A, Gargano R, Spinella R, Inferrera L, Orzechowska-Wylęgała B, Aragona P. Impact of corneal parameters, refractive error and age on density and morphology of the subbasal nerve plexus fibers in healthy adults. Sci Rep 2021; 11:6076. [PMID: 33727601 PMCID: PMC7966734 DOI: 10.1038/s41598-021-85597-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/02/2021] [Indexed: 01/20/2023] Open
Abstract
The purpose of this study was to analyze corneal sub-basal nerve plexus (SBNP) density and morphology and their relationships with corneal parameters and refractive status. In this single center study, in vivo confocal microscopy (IVCM) was performed in 76 eyes of 38 healthy subjects aged 19–87 (mean age 34.987 ± 1.148). Nerve fiber analysis was performed using Confoscan 4 microscope with semi-automated software (Nidek Technologies, Italy) The nerve fiber length (NFL) µm/mm2, nerve fiber density (NFD) no./mm2, tortuosity coefficient (TC), and nerve beadings density (NBD) no./mm were considered. Relationship between SBNP parameters and corneal curvature, thickness, diameter, and refraction were analyzed. Additionally, the association with gender, laterality and age were determined. NFL was inversely correlated with age (r = − 0.528, p < 0.001), myopic refractive error (spherical value) (r = − 0.423, p < 0.001), and cylindrical power (r = − 0.340, p = 0.003). NFD was inversely correlated with age (r = − 0.420, p < 0.001) and myopic refractive error (r = − 0.341, p = 0.003). NBD showed a low inverse correlation with cylindrical power (r = − 0.287, p = 0.012) and a slight positive correlation with K (r = 0.230, p = 0.047). TC showed a significant negative correlation between age (r = − 0.500, p < 0.001) and myopic refractive error (r = − 0.351, p = 0.002). Additionally, there were strong positive correlations between NFL and NFD (r = 0.523, p < 0.001), NFL and TI (r = 0.603, p < 0.001), and NFD and TC (r = 0.758, p < 0.001). Multiple regression analysis revealed age to be the most significant factor affecting SBNP density (B = − 0.467, p = 0.013) and length (B = − 61.446, p < 0.001); myopic refractive error reduced both SBNP density (B = − 2.119, p = 0.011) and length (B = − 158.433, p = 0.016), while gender and laterality had no significant effects (p > 0.005). SBNP fiber length decreases with age, myopic refractive error and cylindrical power. SBNP fiber density reduces with age and myopic refractive error. Corneal nerve parameters are not influenced by gender or laterality.
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Affiliation(s)
- Anna M Roszkowska
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, Via Consolare Valeria, 98100, Messina, Italy.
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Pathophysiology Department, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Romana Gargano
- Department of Economics, University of Messina, Messina, Italy
| | - Rosaria Spinella
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, Via Consolare Valeria, 98100, Messina, Italy
| | - Leandro Inferrera
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, Via Consolare Valeria, 98100, Messina, Italy
| | - Bogusława Orzechowska-Wylęgała
- Clinic of Otolaryngology, Head, Neck Surgery, Department of Pediatric Surgery, Medical University of Silesia, Katowice, Poland
| | - Pasquale Aragona
- Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, Via Consolare Valeria, 98100, Messina, Italy
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Sędziak-Marcinek B, Teper S, Chełmecka E, Wylęgała A, Marcinek M, Bas M, Wylęgała E. Diabetic Macular Edema Treatment with Bevacizumab Does Not Depend on the Retinal Nonperfusion Presence. J Diabetes Res 2021; 2021:6620122. [PMID: 33728349 PMCID: PMC7936894 DOI: 10.1155/2021/6620122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/07/2021] [Accepted: 02/14/2021] [Indexed: 01/27/2023] Open
Abstract
This study evaluated the relationship between the retinal nonperfusion area (NPA) presence and the effectiveness of bevacizumab treatment (IVB) in patients with diabetic macular edema (DME). It also tested the prognostic usefulness of ultra-wide-field fluorescein angiography (UWFFA) and OptosAdvance software for diabetic retinopathy monitoring. Eighty-nine patients with DME with a macular central subfield thickness (CST) ≥ 250 μm, with (N = 49 eyes) and without (N = 49 eyes) retinal NPA, underwent nine bevacizumab injections over 12 months. NPA distribution, leakage area distribution, microaneurysm (MA) count, macular CST, diabetic retinopathy severity, and best-corrected visual acuity (BCVA) were assessed. The results show that bevacizumab reduced the macular CST from 420 to 280 μm (p < 0.001) and improved BCVA (p < 0.001) by about 10 ETDRS letters in both groups of patients. Additionally, the therapy reduced total retinal NPA from 29 (14-36) mm2 to 12 (4-18) mm2 (Me (Q1-Q3); p < 0.001) in patients with diagnosed nonperfusion. The effect of the therapy measured with vascular leakage, MA count, BCVArelative, and CSTrelative strongly depended on the zone of the retina and the NPA distribution. We conclude that the bevacizumab treatment had a positive effect on DME and BCVA in both study groups and on the size of retinal NPA in patients with retinal nonperfusion.
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Affiliation(s)
- Bogumiła Sędziak-Marcinek
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
| | - Sławomir Teper
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences in Sosnowiec, 41-200 Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-728 Katowice, Poland
| | - Mateusz Marcinek
- Department of Urology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-760 Katowice, Poland
| | - Mateusz Bas
- Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland
| | - Edward Wylęgała
- Chair and Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland
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Böhm M, Leon P, Wylęgała A, Ong Tone S, Condron T, Jurkunas U. Cost-effectiveness analysis of preloaded versus non-preloaded Descemet membrane endothelial keratoplasty for the treatment of Fuchs endothelial corneal dystrophy in an academic centre. Br J Ophthalmol 2021; 106:914-922. [PMID: 33637619 DOI: 10.1136/bjophthalmol-2020-317536] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 11/04/2022]
Abstract
AIMS To determine the cost-effectiveness of preloaded Descemet membrane endothelial keratoplasty (pDMEK) versus non-preloaded DMEK (n-pDMEK) for the treatment of Fuchs endothelial corneal dystrophy (FECD). METHODS From a societal and healthcare perspective, this retrospective cost-effectiveness analysis analysed a cohort of 58 patients with FECD receiving pDMEK (n=38) or n-pDMEK (n=30) from 2016 to 2018 in the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA. Exclusion criteria were previous ocular surgeries (other than uncomplicated cataract surgery), including other keratoplasty procedures, ocular pathological conditions as glaucoma, amblyopia, laser treatments, or any retinal or corneal disease. The main outcome parameters were the incremental cost-utility ratio (ICUR) and net monetary benefit (NMB). RESULTS pDMEK was less costly compared with n-pDMEK (healthcare: $13 886 vs $15 329; societal: $20 805 vs $22 262), with a slighter greater utility (QALY 0.6682 vs QALY 0.6640) over a time horizon of 15 years. pDMEK offered a slightly higher clinical effectiveness (+0.0042 QALY/patient) at a lower cost (healthcare: -$1444 per patient; societal: -$1457 per patient) in improving visual acuity in this cohort of patients with FECD. pDMEK achieved a favourable ICUR and NMB compared with n-pDMEK. Based on sensitivity analyses performed, the economic model was robust. CONCLUSIONS From the societal and healthcare perspective, pDMEK was less costly and generated comparable utility values relative to n-pDMEK. Therefore, pDMEK appears to be cost-effective and cost saving with respect to n-pDMEK. Further long-term follow-up data are needed to confirm these findings.
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Affiliation(s)
- Myriam Böhm
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.,Department of Ophthalmology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Pia Leon
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Adam Wylęgała
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephan Ong Tone
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Tracy Condron
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Ula Jurkunas
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
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Pilśniak A, Wylęgała A, Otto-Buczkowska E. Ophthalmologic disorders in adolescents with type 1 diabetes. Clinical Diabetology 2020. [DOI: 10.5603/dk.2020.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wylęgała A, Bolek B, Wylęgała E. Trends in optical coherence tomography angiography use in university clinic and private practice setting between 2014-2018. Expert Rev Med Devices 2020; 17:1109-1113. [PMID: 32996341 DOI: 10.1080/17434440.2020.1831384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim was to assess the trends in optical coherence tomography angiography (OCTA) use compared with fluorescein angiography (FA). METHODS A bilateral patient's exam on a single day was considered one examination. A total of 3680 and 700 OCTA examinations and 3387 and 439 FA examinations were performed between 2014 and 2018 in a university clinic and private practice, respectively. A regression analysis was completed. RESULTS The use of OCTA procedures grew 17-fold from 2015 till 2018. In a university clinic, ultrawide-field FA accounted for 2% of all FA examinations performed in 2015, and its use increased to 68% in 2018 while the number of narrow-field FA examinations dropped from 617 in 2014 to 220 in 2018. This decrease inversely correlated with the rise of diabetic retinopathy cases diagnosed with FA (R= -0.86, p= 0.02). In private practice, the increase in the use of OCTA was a primary driver of the decline of the FA use from 127 in 2015 to 27 in 2018, while the number of OCTA examinations was 344 in 2018 (R= -0.99, p= 0.06). CONCLUSION The results of the study indicate that OCTA is a valuable tool capable of replacing FA in some selected cases.
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Affiliation(s)
- Adam Wylęgała
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia , Katowice, Poland.,Department of Ophthalmology, Wylegala Medical Center , Katowice, Poland
| | - Bartłomiej Bolek
- Ophthalmology Department, Railway Hospital, II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia , Katowice, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, Wylegala Medical Center , Katowice, Poland.,Ophthalmology Department, Railway Hospital, II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia , Katowice, Poland
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Bolek B, Wylęgała A, Wylęgała E. Assessment of Scleral and Conjunctival Thickness of the Eye after Ultrasound Ciliary Plasty. J Ophthalmol 2020; 2020:9659014. [PMID: 33029390 PMCID: PMC7532393 DOI: 10.1155/2020/9659014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study aims to assess scleral and conjunctival thickness using optical coherence tomography after ultrasound ciliary plasty (UCP) procedure with reference to scleral marks appearing in the area where the ultrasound energy was applied. MATERIALS AND METHODS Seventy-eight patients with primary and secondary refractory glaucoma participated in this study. Complete ophthalmic examinations including measurements of scleral and conjunctival thickness were performed preoperatively and at 1 week, and 1, 3, 6, 12, 18, and 24 months postoperatively. The parameters were determined using the Swept Source OCT with anterior attachment. Thirty-eight patients (58 scleral marks-23 superior and 35 inferior) fulfilled the inclusion criteria and completed the follow-up period of 24 months. RESULTS The mean ± SD scleral and conjunctival thickness in superior scleral mark before the procedure and at 1 week, and 1, 3, 6, 12, 18, and 24 months after the procedure was 684.57 ± 83.58 μm, 771.78 ± 112.03 μm (p < 0.001), 771.74 ± 100.12 μm (p < 0.001), 731.38 ± 83.92 μm (p=0.012), 719.52 ± 73.20 μm (p=0.037), 702.91 ± 66.50 μm (p=0.247), 694.13 ± 72.22 μm (p=0.482), and 699.35 ± 70.68 μm (p=0.200), respectively. The mean ± SD scleral and conjunctival thickness in inferior scleral mark before the procedure and at 1 week, and 1, 3, 6, 12, 18, and 24 months after the procedure was 816.86 ± 79.30 μm, 936.37 ± 107.33 μm (p < 0.001), 946.00 ± 130.40 μm (p < 0.001), 896.63 ± 123.40 μm (p < 0.001), 877.69 ± 114.38 μm (p=0.003), 843.03 ± 71.55 μm (p=0.021), 811.86 ± 68.91 μm (p=0.731), and 805.03 ± 69.52 μm (p=0.248), respectively. The transient thickening of the sclera was observed after the procedure; however, after 12 months postoperatively, the parameters returned to the initial value and no significant difference was noted. CONCLUSION The sclera thickness increases after UCP. However, with time the thickness reduces to its initial value with no significant difference. Clinical implication of the scleral changes lasts shorter than the measured significant difference in scleral thickness.
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Affiliation(s)
- Bartłomiej Bolek
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, Katowice, Poland
| | - Adam Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, Katowice, Poland
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Nowik KE, Wylęgała A, Nowik K, Wylęgała E. A single-centre retrospective observational study of fungal keratitis in Poland with a review of findings in Europe. Ann Agric Environ Med 2020; 27:343-347. [PMID: 32955212 DOI: 10.26444/aaem/109414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Fungal keratitis is a severe condition which may lead to blindness. Fungal keratitis, also known mycotic keratitis or keratomycosis, has worldwide distribution, but is more common in tropical climates compared to moderate zones. In recent years, there have been several studies suggesting an increase in the number of mycotic keratitis cases in countries with a moderate climate. There is little data available with no literature review concerning fungal keratitis in European countries. OBJECTIVE To analyse the causes, presentation, and clinico-pathological associations of fungal keratitis in a retrospective series of patients referred to the Department of Ophthalmology of the Railway Hospital in Katowice, south-west Poland, and comparing the findings to previously published studies in peer reviewed articles from other European countries published between 2000-2019. MATERIAL AND METHODS Data were collected using the medical records of patients with fungal keratitis. Risk factors, clinical manifestation and treatment results were analysed from 45 patients (45 eyes) with fungal keratitis treated in the Department of Ophthalmology of Railway Hospital in Katowice between January 2013 - December 2017. The factors affecting the development of infection, visual acuity at baseline and at the end of treatment, as well as treatment method selection, were analysed. Literature review was performed using the Medline, Pubmed, Embase databases and Google scholar. The inclusion criteria were peer reviewed papers published between 2000-2019 which reported data from patients with fungal keratitis in at least one European country. 11 peer reviewed articles which matched the inclusion criteria were analysed. RESULTS The mean BCVA of patients treated in the Department of Ophthalmology of the Railway Hospital in Katowice upon diagnosis was 2.3 (logMAR), compared to 1.95 (logMAR) at the end of treatment. Pearson's chi-squared test was used to establish the final mean BCVA in eyes with keratitis caused by Candida spp. compared with keratitis caused by Filamentous spp. The reviewed articles showed poor results of treatment and diagnostic difficulties in fungal keratitis. CONCLUSIONS Fungal keratitis is a significant diagnostic and therapeutic challenge and may occur in rural and urban areas. Early and accurate diagnosis followed by proper antifungal treatment can prevent blindness and improve BCVA results.
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Affiliation(s)
- Katarzyna Ewa Nowik
- Department of Ophthalmology, School of Medicine with the Division of Dentistry, Zabrze, Poland Medical University of Silesia, Katowice, Poland
| | - Adam Wylęgała
- Department of Ophthalmology, School of Medicine with the Division of Dentistry, Zabrze, Poland Medical University of Silesia, Katowice, Poland
| | - Kamil Nowik
- Department of Management and Financial Science, School of Economics, Warsaw, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, School of Medicine with the Division of Dentistry, Zabrze, Poland Medical University of Silesia, Katowice, Poland
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Wylęgała A, Bolek B, Mazur R, Wylęgała E. Repeatability, reproducibility, and comparison of ocular biometry using a new optical coherence tomography-based system and another device. Sci Rep 2020; 10:14440. [PMID: 32879353 PMCID: PMC7467923 DOI: 10.1038/s41598-020-71192-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022] Open
Abstract
Precise measurement of axial length before cataract surgery is necessary for the proper lens implantation. We included 100 eyes of 56 patients in the study. The mean age was 41 (15–84 years). Measurements of axial length, anterior chamber depth (ACD) carried out with the new Revo NX were compared with those obtained with the IOLMaster 500. Interoperator testing was performed on 56 eyes of 56 participants. To test repeatability, axial length, ACD, central corneal thickness, and lens thickness were used. Inter-operator reproducibility was also assessed. The results were evaluated using Bland–Altman analyses. The mean ACD measured with the IOLMaster and Revo NX was 3.41 and 3.40 mm p = 0.467, respectively. The interclass correlation was excellent at the level of 0.975. ICC for axial length values was 0.999, and the mean was equal to 23.47 for the new device and 23.48 for IOLMaster. ICC for Inter-operator repeatability was higher than 0.99 in all parameters. Revo NX showed a very high level of repeatability with ICC ranging from 0.9929 for central corneal thickness to 0.9997 for axial length. Both devices showed excellent agreement and differences that are insignificant, which suggests that they can be used interchangeably.
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Affiliation(s)
- Adam Wylęgała
- Ophthalmology Department, Railway Hospital, Panewnicka 65, 40-765, Katowice, Poland. .,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland.
| | - Bartłomiej Bolek
- Ophthalmology Department, Railway Hospital, Panewnicka 65, 40-765, Katowice, Poland.,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Robert Mazur
- Ophthalmology Department, Railway Hospital, Panewnicka 65, 40-765, Katowice, Poland.,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Department, Railway Hospital, Panewnicka 65, 40-765, Katowice, Poland.,II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
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Wylęgała A, Wang L, Zhang S, Liu Z, Teper S, Wylęgała E. Comparison of foveal avascular zone and retinal vascular density in healthy Chinese and Caucasian adults. Acta Ophthalmol 2020; 98:e464-e469. [PMID: 31773884 DOI: 10.1111/aos.14316] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/02/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE The aim of this study was to measure and compare the retinal vascular parameters and foveal avascular zone (FAZ) in Chinese and Caucasian populations by using optical coherence tomography angiography (OCT-A). METHODS Fifty-one eyes of Han Chinese and 43 eyes of Caucasians were retrospectively included in our study. The measurements were acquired using Zeiss Cirrus 5000, with the same software version 10 in Poland and China. RESULTS The size of the FAZ was 0.33 ± 0.012 and 0.28 ± 0.014 mm2 (p = 0.0289) and the diameter was 2.43 ± 0.06 and 2.18 ± 0.07 mm (p = 0.0057) for Chinese and Caucasian populations, respectively. However, no differences were observed in circularities between the populations. The full Early Treatment of Diabetic Retinopathy Study (ETDRS) vessel length density was significantly different for Chinese (17.05 ± 0.24 mm/mm2 ) and Caucasian (16.08 ± 0.43 mm/mm2 ) populations. In addition, the outer ETDRS vessel length density was significantly different for Chinese (16.43 ± 0.42 mm/mm2 ) and Caucasian (17.47 ± 0.24 mm/mm2 ) populations, but the central 7.33 ± 1.68 versus 9.32 ± 1.54 mm/mm2 for the Caucasian and Chinese and inner 16.14 ± 0.52 for Caucasian and 16.93 ± 0.27 mm/mm2 for Chinese subjects density was not. A significant yet weak positive correlation between FAZ and vessel density was observed (r = 0.216). Furthermore, no significant intersexual differences were observed in study parameters. CONCLUSION The Chinese population had larger FAZ with higher vessel length density in the superficial layers of the retina than the Caucasian population.
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Affiliation(s)
- Adam Wylęgała
- Ophthalmology Department Railway Hospital Katowice Poland
- School of Medicine Division of Dentistry Zabrze Medical University of Silesia Katowice Poland
| | - Lifei Wang
- Department of Ophthalmology Hebei Provincial Eye Hospital Xingtai City China
| | - Shengjuan Zhang
- Department of Ophthalmology Hebei Provincial Eye Hospital Xingtai City China
| | - Zhiqiang Liu
- Department of Ophthalmology Hebei Provincial Eye Hospital Xingtai City China
| | - Sławomir Teper
- Ophthalmology Department Railway Hospital Katowice Poland
- School of Medicine Division of Dentistry Zabrze Medical University of Silesia Katowice Poland
| | - Edward Wylęgała
- Ophthalmology Department Railway Hospital Katowice Poland
- School of Medicine Division of Dentistry Zabrze Medical University of Silesia Katowice Poland
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Wylęgała A, Mazur R, Bolek B, Wylęgała E. Reproducibility, and repeatability of corneal topography measured by Revo NX, Galilei G6 and Casia 2 in normal eyes. PLoS One 2020; 15:e0230589. [PMID: 32240192 PMCID: PMC7117679 DOI: 10.1371/journal.pone.0230589] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/03/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To test the repeatability and reproducibility of the topography module in posterior segment spectral domain optical coherence tomography with Revo NX (new device) and to compare keratometry values obtained by a Scheimpflug tomography (Galilei G6) and a swept source OCT (Casia 2). Methods In this prospective study, healthy subjects with nonoperated eyes had their central corneal thickness (CCT), anterior and posterior K1/K2 corneal power measured with the new device. Two operators made 6 measurements on the new device to check intraobserver repeatability and reproducibility, and measurement on Casia 2 and Galilei G6. Bland-Altman plots were used to assess the agreement between the devices for each analyzed variable. Results 94 eyes (94 patients) were studied. All devices produced significantly different mean CCT, the highest for Galilei 569.13±37.58 μm followed by Casia 545.00 ±36.15 μm and Revo 537.39±35.92 μm. The mean anterior K1 was 43.21 ± 1.37 for Casia 2 43.21 ± 1.55 for Revo NX and 43.19 ± 1.39 for Galilei G6, and the differences were insignificant p = 0.617. The posterior K1 for Revo NX was -5.77 ± 0.25 whereas for Casia 2 it was -5.98±0.22 and for Galilei G6–6.09±0.28 D p< 0.0001. The Revo NX showed intraclass correlation coefficient ranging from 0.975 for the posterior K2 surface, and 0.994 for anterior K1 and 0.998 for CCT. Conclusions Revo NX is independent of the user and offers a high level of repeatability for the anterior and posterior cornea. The wide range of differences between the devices suggests they should not be used interchangeably.
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Affiliation(s)
- Adam Wylęgała
- Ophthalmology Departament, Railway Hospital, Katowice, Poland
- School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
- * E-mail:
| | - Robert Mazur
- Ophthalmology Departament, Railway Hospital, Katowice, Poland
- School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Bartłomiej Bolek
- Ophthalmology Departament, Railway Hospital, Katowice, Poland
- School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Departament, Railway Hospital, Katowice, Poland
- School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
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Abstract
RATIONALE Conjunctival papilloma is a benign neoplastic lesion of epithelial origin, with a minimal tendency toward malignancy and an exophytic growth type. Etiological factors that contribute to the appearance of papilloma are UV exposure, HPV infection, smoking, and immunodeficiency. A case report of limbal conjunctival papilloma treatment with topical interferon alpha-2b eye drops applied to the conjunctival sac. PATIENT CONCERNS A 49-year-old female patient treated in the Clinical Department of Ophthalmology for conjunctival lesion located in the temporal quadrant near the limbus of the right eye. Ocular examination of the patient's eye did not show any abnormalities: visual acuity-20/20, intraocular pressure-16 mmHg. DIAGNOSES During physical examination, a broad-based pink lesion of size 4 mm × 6 mm was found in interpalpebral bulbar conjunctiva with prominent feeder vessels and soft consistency. Lesion in the biomicroscopic examination did not show any sign of malignancy. In Swept Source Optical Coherence Tomography (SS-OCT) there was no sign of infiltration into sclera or cornea. In vivo confocal microscopy (IVCM) examination, revealed loss of the normal conjunctival epithelium - hyper-reflective cells, variation of cell size. A clinical diagnosis of limbal conjunctival papilloma was made. INTERVENTIONS Interferon alpha-2b 1 million IU/ml eye drops were applied 4 times a day for 5 months. The treatment lasted 5 months without changing the dosing regimen. Three months after the start of the interferon treatment, a complete regression of the lesion was achieved. Treatment was continued for the following 2 months. Controlled IVCM after 6 months showed only few hyper-reflective cells and fibrotic tissue. OUTCOMES Treatment of conjunctival papilloma with topical interferon alpha-2b led to the complete regression of the lesion. Although after the therapy the conjunctiva appears normal both in slit lamp and in the OCT examination, there is a noticeable fibrosis of the tissue in confocal microscopy. During the 14-month follow-up period, there were no recurrent lesions. LESSONS In this study, topical interferon alpha-2b has been shown to be an effective and safe therapy for small-to-medium-size conjunctival papilloma without any sign of malignancy.
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Wylęgała A, Mazur R, Wylęgała E. Disseminated Intravascular Coagulation after Liposuction. Ophthalmology 2019; 126:1287. [PMID: 31443791 DOI: 10.1016/j.ophtha.2019.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Adam Wylęgała
- Ophthalmology Department, Railway Hospital, Katowice, Poland; School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Robert Mazur
- Ophthalmology Department, Railway Hospital, Katowice, Poland; School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Department, Railway Hospital, Katowice, Poland; School of Medicine, Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland
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Abstract
PURPOSE OF REVIEW The article reviews the recent findings on the use of optical coherence tomography angiography (OCTA) in neurology. RECENT FINDINGS OCTA is a new addition to the powerful and complementary technology of the OCT. Due to its noninvasiveness, and reproducibility, it is possible to obtain high-resolution 3D images of the vessels of the human eye. As the vessels of the retina with the presence of endothelial cell's tight junctions resemble the brain vessels, it was hypothesized that the imaging of the retinal vessels might bring insight into brain vessels. OCTA has been effectively used to predict retinal vessel abnormalities in dementia, demyelization, optic disc neuropathies, and inherited degenerative diseases. Most common findings were decrease of vascular density and flow and an increase of avascular zones. Although OCTA is a relative new technology, recent studies show that it can be successfully applied in neurology.
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Affiliation(s)
- Adam Wylęgała
- Ophthalmology Department, Railway Hospital, Katowice Panewnicka 65, 40765, Katowice, Poland.
- II School of Medicine with the Division of Dentistry, Zabrze Medical University of Silesia, Katowice, Poland.
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Kokot J, Wylęgała A, Wowra B, Wójcik Ł, Dobrowolski D, Wylęgała E. Corneal confocal sub-basal nerve plexus evaluation: a review. Acta Ophthalmol 2018; 96:232-242. [PMID: 28741902 DOI: 10.1111/aos.13518] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 06/01/2017] [Indexed: 12/12/2022]
Abstract
The aim of this study was to review the most recent data about corneal sub-basal nerve plexus (SNP) evaluated with the use of corneal confocal microscopy (CCM). For this purpose, an electronic search was conducted based on PubMed and Google Scholar and Web of Science databases from 2008 up to the end of 2016. Ninety-eight articles in English were cited, as well as abstracts in other languages, concerning the morphology and function of corneal SNP in various diseases. Changes in corneal SNP as a result of local treatment were also introduced. Figures with scans from confocal microscopy from our Department were included. The main conclusion of this review was that both corneal SNP diminishment and high tortuosity as well as low sensitivity are in principle related to the presence or level of pathology. In addition, increased nerve tortuosity may represent a morphological determinant of nerve regeneration. However, the presented literature shows that SNP changes are not characteristic for one unified corneal pathology; rather, they reflect the non-specific pathological process present in many diseases. Future studies should use automatized biometric software and also examine the effects of new treatments on SNP.
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Affiliation(s)
- Joanna Kokot
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Adam Wylęgała
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Bogumił Wowra
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Łukasz Wójcik
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Dariusz Dobrowolski
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Edward Wylęgała
- Ophthalmology Department; Railway Hospital Katowice; II School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
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Mańkowski W, Wylęgała A, Wylęgała E. Assessment of visual evoked potentials in patients eligible for penetrating keratoplasty. Medicine (Baltimore) 2018; 97:e9861. [PMID: 29489683 PMCID: PMC5851766 DOI: 10.1097/md.0000000000009861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Corneal opacities can obstruct ophthalmology examination in patients before penetrating keratoplasty (PK).To assess the usefulness of visual evoked potentials (VEPs) in estimating postoperative visual acuity (VA) in patients eligible for (PK) with opaque cornea in 1 eye and good VA in the fellow eye.In this observational study, the mean age of 52 males and 48 females was 57.17 ± 15.99 (21-87 years old). A total of 100 patients eligible for PK underwent an ophthalmological examination including VA and a VEP examination. The P2/P2 ratio was calculated. The correlation coefficient of the VA and the P2/P2 ratio was evaluated 1, 6, and 12 months after PK.A positive correlation of the P2/P2 ratio and VA 1, 6, and 12 months after PK were observed.VEPs including the P2/P2 ratio can be useful in estimating postoperative VA in patients eligible for PK.
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Affiliation(s)
| | - Adam Wylęgała
- II School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Edward Wylęgała
- Department of Ophthalmology, District Railway Hospital Katowice
- II School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
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Lyssek-Boroń A, Wylęgała A, Dobrowolski D, Kowalczyk E, Polanowska K, Wylęgała E. Evaluation of EX-PRESS glaucoma implant in elderly diabetic patients after 23G vitrectomy. Clin Interv Aging 2017; 12:653-658. [PMID: 28435237 PMCID: PMC5391864 DOI: 10.2147/cia.s128618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The most frequent qualifications for pars plana vitrectomy (PPV) in diabetic patients include recurrent hemorrhage into the vitreous body chamber and vitreoretinal proliferation, also with traction retinal detachment. The aim of this study was to evaluate the effectiveness of EX-PRESS implant for the treatment of secondary glaucoma in elderly diabetic patients following PPV 23G with silicon oil or SF6 gas endotamponade. MATERIALS AND METHODS This retrospective analysis comprised 18 patients (19 eyes). We applied EX-PRESS implants in 9 patients with neovascular glaucoma (NVG) and in 10 patients with non-NVG. All patients had earlier history of diabetes and vitrectomy 23G for diabetic complications. Intraocular pressure (IOP) was measured and compared before; 7 days; 1, 3, 6, and 12 months; and a year after the surgery. RESULTS Application of the implant exhibited a lowering effect on IOP. After 1 month, 53% of patients had IOP values beyond 22 mmHg, while 86% after 1 year. CONCLUSION The implant can be used to treat both NVG and non-NVG in diabetic patients following PPV.
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Affiliation(s)
- Anita Lyssek-Boroń
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec
| | - Adam Wylęgała
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec
| | - Dariusz Dobrowolski
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec.,Department of Ophthalmology, Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital, Katowice, Poland
| | - Ewelina Kowalczyk
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec
| | - Katarzyna Polanowska
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec
| | - Edward Wylęgała
- Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec.,Department of Ophthalmology, Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital, Katowice, Poland
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Orzechowska-Wylęgała B, Wylęgała A, Buliński M, Niedzielska I, Madej A. Pharmacoeconomic analysis of antibiotic therapy in maxillofacial surgery. BDJ Open 2017; 3:17002. [PMID: 29607075 PMCID: PMC5842825 DOI: 10.1038/bdjopen.2017.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/05/2016] [Accepted: 12/15/2016] [Indexed: 11/09/2022] Open
Abstract
Objectives/Aims: The aim of this study was to investigate the microbial cultures collected in the years 2013–2014 at the craniomaxillofacial department and outpatient clinic to analyse optimisation of the treatment cost of the bacterial infections and present the results. Design and setting: We analysed 485 cultures from 263 patients, of which 77.28% consisted of Gram-positive bacteria. On the basis of the antibiotic efficacy, antibiotic price and the cost of entire treatment during hospitalisation, the most useful antimicrobial agents for the most common pathogens were selected. Results: The most frequently collected material was pus. The most common pathogens were found to be the Staphylococcus epidermidis (18%), Streptococcus mitis and Str. oralis (14%) and S. aureus (6.5%). Discussion: The most frequently isolated bacteria in other studies were the Streptococcus strain. Other authors showed that ceftriaxone is the most cost efficient agent. The use of postoperative antibiotic prophylaxis remains controversial. Conclusion: The results of this study suggest that the most useful antibiotics for therapy, from the perspective of the cost minimisation, were gentamycin, trimethoprim with sulfamethoxazole and vancomycin.
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Affiliation(s)
| | - Adam Wylęgała
- Department of Ophthalmology Santa Barbara Hospital, Sosnowiec, Poland
| | - Michał Buliński
- Department of Cranio-Maxillofacial Surgery, Medical University of Silesia, Katowice, Poland
| | - Iwona Niedzielska
- Department of Cranio-Maxillofacial Surgery, Medical University of Silesia, Katowice, Poland
| | - Andrzej Madej
- Department of Internal Diseases and Subdepartament of Cardiac and Diabetology Unit, The Boni Fratres Catoviensis Hospital, Katowice, Poland
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Abstract
BACKGROUND Retinal vascular diseases are one of the most common causes of blindness in the developed world. Optical Coherence Tomography Angiography (OCT-A) is a new noninvasive method that uses several algorithms to detect blood movement. This enables the creation of high-resolution vascular images with contrast depicting motionless tissue. METHODS This review presents the results of articles relevant to age-related macular degeneration (AMD), diabetic retinopathy (DR), and OCT-A. The OCT-A technique can successfully be used in the diagnosis of neovascularization, retinal vein occlusion (RVO) and retinal artery occlusion (RAO), vessel abnormalities and even anterior segment neovascularization. OCT-A can also be applied to compute data such as vessel density, and flow index in both superficial and deep plexuses. RESULTS Many studies have compared fluorescein angiography with OCT-A. Other studies have reported differences in vascular density in AMD patients and have compared them with people having healthy eyes. Although OCT-A offers rapid picture acquisition, high repeatability and resolution, it also has many drawbacks. The most common are: motion artifacts, projections from overlying vessels and limited field of view.An interesting new application is the possibility to assess changes during antivascular endothelial growth factor (anti-VEGF) therapy. Another function of OCT-A is the possible application in the study of choriocapillaries in many fields of ocular pathology. CONCLUSION OCT-A is a new promising method that allows the visualization of the retinal vascular network and the counting of blood flow parameters. This technique provides reliable images useful in clinical routines.
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Affiliation(s)
- Adam Wylęgała
- Departament of Ophthalmology, Santa Barbara Hospital, Sosnowiec
| | - Sławomir Teper
- Ophthalmology Clinic, Railway Hospital Katowice, II School of Medicine with the Division of Dentistry in Zabrze, Silesian Medical University, Katowice, Poland
| | - Dariusz Dobrowolski
- Departament of Ophthalmology, Santa Barbara Hospital, Sosnowiec
- Ophthalmology Clinic, Railway Hospital Katowice, II School of Medicine with the Division of Dentistry in Zabrze, Silesian Medical University, Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Clinic, Railway Hospital Katowice, II School of Medicine with the Division of Dentistry in Zabrze, Silesian Medical University, Katowice, Poland
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