Acute Zonal Occult Outer Retinopathy in a Patient Suffering from Epilepsy: Five-Year Follow-Up

We report an unprecedented case of a young patient with epilepsy coexisting with acute zonal occult outer retinopathy (AZOOR), a rare white dot syndrome of unknown etiology, associated with damage to the large zones of the outer retina. Recently, it has been established that epileptic episodes contribute to an inflammatory response both in the brain and the retina. A 13-year-old male patient with epilepsy was referred by a neurologist for an ophthalmologic consultation due to a sudden deterioration of visual acuity in the left eye. The examination, with a key role of multimodal imaging including color fundus photography, fluorescein angiography, indocyanine green angiography (ICGA), fundus autofluorescence (FAF), swept-source optical coherence tomography (SS-OCT) with visual field assessment, and electroretinography indicated AZOOR as the underlying entity. Findings at the first admission included enlargement of the blind spot in visual field examination along a typical trizonal pattern, which was revealed by FAF, ICGA, and SS-OCT in the left eye. The right eye exhibited no abnormalities. Seminal follow-up revealed no changes in best corrected visual acuity, and multimodal imaging findings remain unaltered. Thus, no medical intervention is required. Our case and recent laboratory findings suggest a causative link between epilepsy and retinal disorders, although this issue requires further research.

Endothelin-1 Serum Concentration in Pediatric Chronic Idiopathic Uveitis

Purpose

The aim of our study was to determine endothelin-1 (ET-1) concentration in chronic idiopathic uveitis in children and adolescents depending on anatomical location and grade of inflammation.

Methods

The cross-sectional study was conducted among 17 patients with chronic idiopathic uveitis and 22 healthy controls. Concentration of ET-1 in serum was determined using a commercially available ELISA kit. The concentration of C reactive protein (CRP) in serum was determined by immunoturbidimetric method using CRP4 reagent kit (Roche Diagnostics GmbH, Mannheim, Germany).

Results

Statistically significant difference between ET-1 concentration in patients with chronic idiopathic uveitis and controls was found 1.33 (1.22; 1.48) vs 1.93 (1.1; 3.11), p = 0.008). No correlations were found between ET-1 concentration and age, either in chronic idiopathic uveitis patients or controls. Nine out of 17 patients presented with anterior uveitis, 5 with posterior and 3 with panuveitis. There were no differences in ET-1 concentration between anterior, posterior and panuveitis (p = 0.634), and in terms of grade of inflammation.

Conclusion

ET-1 expression is disturbed in pediatric chronic idiopathic uveitis irrespective of the anatomical location and grade of inflammation. Lower expression of ET-1 plays a crucial role in disturbed vascular tone control and can result in permanent visual impairment in chronic non-infectious uveitis.

Endothelin-1 Serum Concentration is Lower in Children and Adolescents with High Myopia, a Preliminary Study

The aim of this study is to evaluate the levels of enothelin-1 (ET-1) in children and adolescents with high myopia and its association with the axial length of the eye and the presence of myopic retinal degeneration. The cross-sectional study was carried out in 57 patients with high myopia and 29 control subjects. Serum concentrations of ET-1 were measured using enzyme-linked immunosorbent assay (ELISA) kit. A significantly lower concentration of ET-1 in highly myopic patients compared to controls was found (1.47 (0.91; 1.87) vs. 1.94 (1.1; 2.69) pg/mL, p = 0.005). In patients with high myopia, a weak negative correlation between ET-1 concentration and the longest axial length out of the two eyes was found (r = −0.255, p = 0.0558). Further analysis revealed statistically significant differences in ET-1 concentration between patients with the axial length of the eye > 26 and ≤ 26 mm (p < 0.041) and patients with the axial length of the eye > 26 mm and controls (p < 0.001). ET-1 expression is disturbed in highly myopic children and adolescents. Lower ET-1 concentration in patients with the axial length of the eye > 26 mm may co-occur with high myopia and should be considered a risk factor in the pathophysiology of high myopia progression.

Citrate usage in the leading causes of blindness: new possibilities for the old metabolite

INTRODUCTION

Citrate is an old metabolite which is best known for the role in the Krebs cycle. Citrate is widely used in many branches of medicine. In ophthalmology citrate is considered as a therapeutic agent and an useful diagnostic tool-biomarker.

OBJECTIVES

To summarize the published literature on citrate usage in the leading causes of blindness and highlight the new possibilities for this old metabolite.

METHODS

We conducted a systematic search of the scientific literature about citrate usage in ophthalmology up to January 2018. The reference lists of identified articles were searched for providing in-depth information.

RESULTS

This systematic review included 30 articles. The role of citrate in the leading causes of blindness is presented.

CONCLUSIONS

Citrate might help inhibit cataract progression, in case of questions confirm glaucoma diagnosis or improve cornea repair treatment as adjuvant agent (therapy of ulcerating cornea after alkali injury, crosslinking procedure). However, the knowledge about possible citrate usage in ophthalmology is not widely known. Promoting recent scientific knowledge about citrate usage in ophthalmology may not only benefit of medical improvement but may also limit economic costs caused by leading causes of blindness. Further studies on citrate usage in ophthalmology should continuously be the field of scientific interest.

Serum Concentration of Zinc, Copper, Selenium, Manganese, and Cu/Zn Ratio in Children and Adolescents with Myopia

The purpose of the present study was the assessment of the serum concentration of antioxidant microelements-zinc, copper, selenium, manganese, and Cu/Zn ratio in children and adolescents with myopia. Eighty-three children were examined (mean age 14.36 ± 2.49 years) with myopia. The control group was 38 persons (mean age 12.89 ± 3.84 years). Each patient had complete eye examination. The serum concentration of zinc, copper, manganese, and selenium was determined by atomic absorption spectrometry. Cu/Zn ratio, which is the indicator of the oxidative stress, was also calculated. The average serum concentration of zinc in myopic patients was significantly lower (0.865 ± 0.221 mg L^-1) in comparison to the control group (1.054 ± 0.174 mg L^-1). There was significantly higher Cu/Zn ratio in myopic patients (1.196 ± 0.452) in comparison to that in the control group (0.992 ± 0.203). The average serum concentration of selenium in the study group was significantly lower (40.23 ± 12.07 μg L^-1) compared with that in the control group (46.00 ± 12.25 μg L^-1). There were no essential differences between serum concentration of copper and manganese in the study group and the control group. Low serum concentration of zinc and selenium in myopic children may imply an association between insufficiency of these antioxidant microelements and the development of the myopia and could be the indication for zinc and selenium supplementation in the prevention of myopia. Significantly, higher Cu/Zn ratio in the study group can suggest the relationship between myopia and oxidative stress.

Plasma citrate concentration: a possible biomarker for glaucoma in children

OBJECTIVES

The main aim of the present study was to examine a possible role of plasma and urine citrate levels as glaucoma indicators in school-aged children with glaucoma diagnosis.

PATIENTS

34 school-aged children with a glaucoma diagnosis (mean age 15.69±1.86 years) were qualified for the study group and 34 patients with no ophthalmological ailments were qualified for the control group (mean age 16.1±1.98 years). Plasma and urine citrate levels in the study and the control group (Kruskal-Wallis test) were compared.

RESULTS

Plasma citrate levels in the study (16.33±4.51 mg/L) and the control group (19.11±3.66 mg/L) were different; the statistical significance (p=0.0036). Plasma citrate concentrations were significantly lower in the study group in comparison with the control group. There were no statistically important differences between the study group (291.12±259.13 mg/24 hours; 275.82±217.57 mg/g) and the control group (434.88±357.66 mg/24 hours; 329.81±383.27 mg/g) including urine citrate level (p=0.052) and urine citrate to creatine ratio (p=0.4667).

CONCLUSION

Plasma citrate concentration might be considered as glaucoma biomarker in paediatric population.

The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia

Background

A significant increase in myopia among children and teenagers can be observed all over the world. Yet at the same time, there is still an insignificant number of studies concerning this health problem.

The aim of this study was to assess the level of trait anxiety among myopic group of teenagers in comparison to teenagers with emmetropia, and to confirm whether the level of trait anxiety relates to age and gender.

Methods

Two hundred thirty-nine students aged 13–17 years were included in the study. The study group comprised 114 persons with myopia (81 girls and 33 boys), while the control group comprised 125 persons without refractive error (79 girls and 46 boys). Volunteers completed a set of questionnaires including: personal data, State-Trait Anxiety Inventory for Children (STAIC) (13–14 year-olds), or State-Trait Anxiety Inventory (STAI) (15–17 year-olds). The trait anxiety subscales were thus analyzed.

Results

Among younger adolescents (13–14 years of age) with myopia there was a significantly higher incidence of pathological intensification of anxiety as a constant trait. After taking into account the distribution of gender, there was a higher level of trait anxiety in the group of boys with myopia than in the control group aged 13–17 years and 13–14 years. There was also a higher level of trait anxiety detected in males than in females.

Conclusions

Myopia may affect the level of trait anxiety among 13–14-year-olds. In both age groups of girls, a higher percentage of patients with high level of anxiety was discovered (≥7 sten), as compared to their peers without vision defects. Our results can contribute to a more accurate analysis of young teenagers’ psychological problems, especially among boys diagnosed with myopia.

Assessment of therapeutic options for reducing alkali burn-induced corneal neovascularization and inflammation

This article aims to review and provide the current knowledge of the possibilities of topical treatment of corneal neovascularization due to alkali burns, evidenced by laboratory experiments, in vitro studies, and clinical trials published in the specialized literature. Authors present clinically relevant treatment of corneal neovascularization used in clinical practice, potential antiangiogenic topical therapeutics against corneal neovascularization, which are under investigation, and anti-angiogenic gene-therapy.

The assessment of multifocal ERG responses in school-age children with history of prematurity

PURPOSE

The authors examined macular function in preterm-born children, using multifocal ERG (mfERG). Possible alterations in P1 amplitudes, P1 amplitudes density and P1 implicit time between school-age children with history of prematurity and their peers were researched. The correlations between parameters of mfERG responses and birth weight, gestational age, macular volume and central macular thickness were verified.

METHODS

A group of 18 preterm-born school-age children were analyzed (mean age 10.18 ± 1.21 years). The study group was compared to the group of 15 peers born appropriate for gestational age (mean age 10.8 ± 1.52 years). The mfERG was evaluated in all children.

RESULTS

There were statistically significant differences for P1 amplitudes from ring 1 (p = 0.0001) and P1 amplitudes density from ring 1 (p = 0.0001). Calculating the correlation coefficients, we receive significant results for P1 amplitudes from ring 1 versus gestational age (r = 0.54; p = 0.026), birth weight (r = 0.54; p = 0.026) and central macular thickness (r = -0.62; p = 0.008), and for P1 amplitudes density from ring 1 versus central macular thickness (r = -0.51; p = 0.034).

CONCLUSIONS

The study suggests that P1 amplitudes and P1 amplitudes density vary in preterm-born children in comparison with their peers born appropriate for gestational age, which might suggest discreet macular dysfunction. The correlation between low birth weight, early gestational age, central macular thickness and mFERG components from ring 1 might evidence that decreased bipolar cells density caused by premature birth is the result of altered development of central retina reflecting in structural anomalies of the fovea.

[The opinion of the Expert Group of the Polish Society of Ophthalmology on using nepafenac in the prevention of postoperative macular edema after cataract surgery in diabetic patients]

Nepafenac is an innovative non-steroidal anti-inflammatory drug used in ophthalmology for the prevention of macular edema after cataract surgery. Along with its anti-inflammatory effect, nepafenac has some unique properties which distinguish it from other non-steroidal anti-inflammatory drugs. It is a prodrug activated to amfenac after it penetrates through the corneal layers to the aqueous humour and the ciliary body. Having electrically neutral molecules of lipophilic properties, nepafenac does not accumulate in the cornea and does not cause its degeneration. Additionally, it quickly achieves higher concentrations in the aqueous humour as compared to other non-steroidal anti-inflammatory drugs. Nepafenac shows high selectivity and activity against COX-2 isoform, the key enzyme implicated in inducing inflammation, which is the main cause of macular edema. Furthermore, nepafenac has the unique scleral and suprachoroidal distribution pathways. Finally, its effect on the intraocular pressure is none to negligible. Nepafenac treatment should be initiated prior to cataract surgery and continued long enough to reduce the risk of late-onset macular edema. The Expert Group of the Polish Society of Ophthalmology consider using nepafenac in the prevention of post­operative macular edema in diabetic patients undergoing cataract surgery as expedient and reasonable. The proposed optimum pre- and postoperative treatment regimen can be modified for individualised therapy.

Traumatic hyphema in children and adolescents – aetiology and treatment

PURPOSE

Retrospective analysis of patients with traumatic hyphema, including type of injury, treatment and visual outcome.

MATERIAL AND METHODS

We analysed a cohort of patients after blunt trauma, who were examined and treated between 2011– –2015. In each case, the baseline and ultimate visual acuity was determined, followed by slit lamp examination, intraocular pressure measurement, indirect binocular ophthalmoscopy of the fundus, ultrasound scan and OCT Visante. The type of treatment as well as duration of inpatient treatment and late complications were assessed for each case.

RESULTS

45 patients (45 eyes) with traumatic hyphema due to blunt ocular trauma were enrolled. 42 of them were boys (93.3%), and 3 were girls (6.7%). The age range was 2.5–17.5 years (mean age of 11.92 ± 3.75 years). Upon admission, 10 (22.2%) children had full visual acuity (1.0). The most common injuries concomitant with hyphema included iridodialysis, corneal oedema, mydriasis and corneal erosion. Secondary hemorrhage occurred three days following injury in only one (2.2%) patient. The mean duration of inpatient admission was 4.3 days (ranged from 2 to 8 days). At the last follow-up visit, 36 (80%) patients had a full visual acuity of 1.0.

CONCLUSIONS

Visual outcomes improve with earlier treatment commencement. Conservative management was sufficient to resolve traumatic hyphema in reported cases

[Evaluation of macular structure and thickness using spectral optical coherence tomography SOCT Spectralis in children after prior laser photocoagulation performed due to the retinopathy of prematurity]

OBJECTIVES

To evaluate morphobiometric properties of the macula (its structure and thickness) in children with a known history of retinopathy of prematurity using optical coherence tomography (SLO/OCT Spectralis).

MATERIAL AND METHODS

16 subjects (group B1) (mean age 9.2 years) with a history of stage 3 retinopathy of prematurity treated with retinal laser photocoagulation and 18 subjects (group B2) with a history of spontaneously regressing retinopathy of prematurity (mean age 10.2 years) were studied prospectively. The control group consisted of 21 healthy subjects (group K) (mean age 10.9 years). Each participant underwent a thorough ocular examination and had an optical coherence tomography performed. The U Mann-Whitney and Spearman’s rank correlation tests were used for statistical analyses.

RESULTS

The minimum central foveal thickness and total macular volume were significantly higher in both study groups (B1 and B2) as compared to the control group (K). The subfoveal choroidal thickness was reduced in both study groups (B1 and B2), as compared to the control group (K).

CONCLUSIONS

The altered macular structure in eyes with the history of retinopathy of prematurity is related to the presence of all retinal layers within the fovea. However, these changes do not significantly affect visual acuity.

Central nervous system tumour diagnosis in pediatric population – the role of an ophthalmologist and the utility of visual evoked potentials

Objective: To determine possible alterations of P100 and P1 amplitudes and latencies in school-aged children with a history of a central nervous system tumour. Material and methods: The pattern visual evoked potential and flash visual evoked potential testing was performed in 42 school- -aged children: 15 patients with a history of the central nervous system tumour (mean age of 13.44 ± 2.41 years and 13.75 ± 2.29 years, respectively) and 27 healthy subjects as a control group (mean age 11.84 ± 1.44 years, and 14.78 ± 4.26 years, respectively). Results: P100 amplitudes of pattern visual evoked potentials were statistically decreased in the study group as compared to the control group. The only statistically signifcant difference between the study group and the controls was latencies recorded from O1 in 15-minute stimuli. P2 amplitudes of flash visual evoked potentials were decreased and latencies were increased in the study group, however, the differences were not statistically significant. Conclusions: Visual evoked potential alterations can be a sign of functional disturbances of the visual system in patients with any central nervous system tumour. Therefore, a diagnostic process of a central nervous system tumour should include a thorough ocular exam, even in patients with normal visual acuity.

Fundus albipunctatus: review of the literature and report of a novel RDH5 gene mutation affecting the invariant tyrosine (p.Tyr175Phe)

Fundus albipunctatus (FA) is a rare, congenital form of night blindness with rod system impairment, characterised by the presence of numerous small, white-yellow retinal lesions. FA belongs to a heterogenous group of so-called flecked retina syndromes. This disorder shows autosomal recessive inheritance and is caused mostly by mutations in the RDH5 gene. This gene encodes the enzyme that is a part of the visual cycle, the 11-cis retinol dehydrogenase. This study is a brief review of the literature on FA and a report of the first molecular evidence for RDH5 gene mutation in a Polish patient with this rare disorder. We present a novel pathogenic RDH5 gene mutation in a 16-year-old female patient with symptoms of night blindness. The patient underwent ophthalmological examinations, including colour vision testing, fundus photography, automated visual field testing, full-field electroretinography (ERG) and spectral optical coherent tomography (SOCT). The patient showed typical FA ERG records, the visual field was constricted and fundus examination revealed numerous characteristic, small, white-yellowish retinal lesions. DNA sequencing of the RDH5 gene coding sequence (exons 2–5) enabled the detection of the homozygous missense substitution c.524A > T (p.Tyr175Phe) in exon 3. This is the first report of RDH5 gene mutation that affects the invariant tyrosine, one of the most conserved amino acid residues in short-chain alcohol dehydrogenases/reductases (SDRs), crucial for these enzymes’ activity. The location of this substitution, together with its predicted influence on the protein function, indicate that the p.Tyr175Phe mutation is the cause of FA in our patient.

The smallest de novo deletion of 20q11.21-q11.23 in a girl with feeding problems, retinal dysplasia, and skeletal abnormalities

We report on a de novo interstitial deletion of 20q11.21-q11.23 in a 2-year-old girl with a set of dysmorphic features, cleft palate, heart defect, severe feeding problems, failure to thrive, developmental delay, preaxial polydactyly (right thumb), and retinal dysplasia. Interstitial microdeletions of the long arm of chromosome 20 are rare. Exclusively rare are proximal microdeletions involving 20q11-q12 region. Our patient is the fourth described so far and has the smallest deleted region 20q11.21-q11.23 of 5.7 Mb. The defined clinical phenotype of our patient is very similar to previously published cases and confirms the existence of retinal dysplasia and skeletal abnormalities as a part of phenotypic spectrum for deletion 20q11-q12. Description of four similar patients, including two almost identical, suggests a new distinct, phenotypicaly recognizable microdeletion syndrome associated with the loss of 20q11-q12 region.

[Visual function assessment in children after surgical management of congenital eyelid ptosis using the silicone rod]

PURPOSE

To analyse the early and late postoperative visual function in children undergoing surgery for congenital eyelid ptosis with the use of silicone rod.

MATERIAL AND METHODS

Congenital eyelid ptosis was diagnosed in 14 children aged 3-18 years. Analyzing the patients we focused on visual function parameters in early and late postoperative period. The follow up period ranged from 6 months to 1 year after the surgery.

RESULTS

The visual outcome analysis in patients with congenital eyelid ptosis shows good functional and cosmetic results. The visual function improved gradually depending on patient age and severity of ptosis.

CONCLUSIONS

Functional and aesthetic outcomes of the procedure performed using the silicone rod were good. The technique contributed to the shortened duration of postoperative visual rehabilitation period.

[Surgical management of congenital eyelid ptosis with silicone rod--outcome analysis]

PURPOSE

To analyze the outcomes of surgical management of congenital eyelid ptosis with the use of silicone rod.

MATERIAL AND METHODS

Congenital eyelid ptosis was diagnosed in 12 children aged 2-18 years: 6 cases with unilateral, and 6 with bilateral ptosis. Analyzing the patients we focused on the function of levator muscle before and after the surgery in particular. Ptosis repair was performed with the use of silicone rod in all children.

RESULTS

Functional and cosmetic outcomes of the procedure with the silicone rod were good.

[Evaluation of anterior segment lesions in children and adolescents with ocular trauma using Visante OCT]

AIM

To evaluate the anterior eye segment in children and adolescents after unilateral ocular trauma, using optical coherence tomography Visante OCT.

MATERIAL AND METHODS

19 patients (17 boys and 2 girls), hospitalized in Department of Pediatric Ophthalmology due to ocular trauma, were examined. Mean age was 12.6 years (6-17 years). 12 patients had blunt ocular trauma, and 7 patients had a penetrating injury.

RESULTS

Hyphaema impeded the view in 5 eyes, so Visante OCT was helpful for the right treatment. The anterior chamber shallowing was diagnosed in 9 cases, and anterior chamber deepening in 5 cases. Lens pathology (subluxation, cataract) was recognized in 4 patients. OCT was useful in diagnosis of corneal wound (1 case) and in foreign body removal (1 case).

CONCLUSIONS

Visante OCT provides easy visualization and high-resolution documentation. Its ability to image the anterior segment structures despite corneal opacification seems particularly important. This technique can be very useful in children and adolescents with ocular trauma.

[Assessment of macular and optic disc morphology in children with unilateral hypermmetropic amblyopia]

PURPOSE

To investigate macular thickness and retinal nerve fiber layer thickness of the optic disc using high resolution spectral optical coherence tomography.

MATERIAL AND METHODS

A study group consisted of 54 eyes of children aged from 5 to 13 years with unilateral hypermmetropic amblyopia. 25 children aged from 6 to 14 years with emmetropia or mild hyperopia (SE less than +1.0 D) were recruited as a reference group. All patients underwent a comprehensive ocular examination, including Scanning Laser Ophthalmoscope/Optical Coherence Tomography scans of the macula and the optic disc. The total macular volume, minimal central foveal thickness, parafoveal and perifoveal retinal thickness, global retinal nerve fiber layer thickness and in 4 quadrants were assessed using Statistica 10.0.

RESULTS

The total macular volume was significantly higher in amblyopic as compared to non-amblyopic eyes--8.9 (8.09-9.27) in the study group, 8.3 (7.17-9.32) in the reference group respectively. However, the retinal nerve fiber layer was significantly thinner in amblyopic eyes.

CONCLUSIONS

Amblyopia does not affect retinal thickness symmetry between the right and left eye. The analysis of Scanning Laser Ophthalmoscope/Optical Coherence Tomography morphometric parameters in amblyopic eyes is useful only when compared with the age-matched reference group. hypermmetropic amblyopia, macular retinal thickness, retinal nerve fiber layer thickness, spectral optical coherence tomography.

[Macular morphology and peripapillary retinal nerve fiber layer thickness in children with regressed retinopathy of prematurity]

PURPOSE

morphobiometric evaluation of macula and peripapillary retinal nerve fiber layer thickness with the use of high-resolution optical coherence tomography in children with a history of regressed retinopathy or prematurity.

MATERIALS AND METHODS

18 patients at the age of 8 to 14 years with a history of spontaneously regressed retinopathy of prematurity were studied prospectively. For statistical purposes a control group of 21 matched subjects at the age of 8 to 15 years was used. Ophthalmic examination and optical coherence tomography were performed in each patient. Peripapillary nerve fibre layer thickness, foveal and parafoveal thickness ratio, total macular volume and subfoveal choroidal thickness were measured in both groups.

RESULTS

in the optical coherence tomography, the foveal thickness in children with retinopathy of prematurity was significantly higher [269.5 μm (232-321)] compared to the controls [224.5 μm (207-267)]. The macular volume in the study group was also higher (8.68 mm³). The subfoveal choroidal thickness was reduced in study group [321 μm (112-365)] compared to the control group [337 μm (294-358)]. There was no statistical significant difference in total peripapillary nerve fibre layer thickness between the two groups.

CONCLUSION

The morphobiometric macular changes in eyes with a history of regressed retinopathy of prematurity are possibly related to the developmental abnormalities, which retinopathy of prematurity is due to the presence of the abnormal foveal structure across all retinal layers.

[Assessment of retinal ganglion cells thickness in high myopia]

PURPOSE

Studies on glaucoma markers have shown that assessment of thickness macular ganglion cell complex plays an important role in diagnosis of early stage open-angle glaucoma. There are no available data on thickness in ganglion cell complex in high myopic patients. We investigate thickness of macular ganglion cell complex in children with high myopia.

MATERIAL AND METHODS

38 children (aged from 9 to 19 years), with high myopia (over -6.00 D) underwent full ophthalmological examination, including SD-OCT of the macula and optic disc. The reference group consisted of 38 emmetropic or slightly hyperopic children aged from 8 to 18 years old.

RESULTS

Superior and interior ganglion cell complex (GCC) thickness were significantly lower in high myopic group compared to reference group: p < 0.01, respectively for GCC Sup. median was 90 microm (range 67-108.5) and 95 microm (range 80-105.5); for GCC Inf. median was 91 microm (range: 67-109.5) and 98 microm (range 85-109). Positive correlation between GCC and Total RNFL was found.

CONCLUSIONS

In children with high myopia thinning of macular ganglion cell complex and retinal nerve fiber layer of the optic disc was found. These changes may be responsible for higher suspectibility of developing open-angle glaucoma in high myopic eyes. macular ganglion cell complex, high myopia, spectral optical coherence tomography.

[Optic nerve head drusen in children--visual function and OCT outcomes]

PURPOSE

To evaluate the effect of optic nerve head drusen on retinal nerve fiber layer (RNFL) thickness in children, with the use of optical coherence tomography (OCT).

MATERIAL AND METHODS

21 patients (mean age 13.9 years) with optic nerve head drusen were studied prospectively. For statistic comparison a group of 15 control subjects (mean age 14.1 years) participated. Ophthalmologic examination, automated visual field testing and optical coherence tomography were performed in each patient. For statistical analysis we used Shapiro-Wilk and U Mann-Whitney tests.

RESULTS

In the OCT measurements the nasal RNFL was significantly thinner as compared to the reference group. Neither statistically significant thinning of global RNFL between groups nor relation between subjects age and RNFL thickness was found.

CONCLUSIONS

Optic nerve head drusen can lead to visual function defects, therefore early and correct diagnosis is mandatory. Optical coherence tomography is a usefull diagnostic tool used to determine the cause of disc elevation, which is especially important in childhood, when drusen can cause disc to appear papilledema-like. Overall OCT appears to be a non-invasive, sensitive and early-indicating method of RNFL thinning.

[Evaluation of anterior chamber depth measurements in emmetropic, hypermetropic and myopic eyes in children and adolescents using OCT Visante]

PURPOSE

To evaluate the anterior chamber depth (ACD) measurements in emmetropic, hypermetropic and myopic eyes in children and adolescents using optical coherence tomography (OCT).

MATERIAL AND METHODS

86 patients at the age from 4 to 17 years were examined. 27 patients with mean age 14.0 +/- 2.94 years had myopia with spherical equivalent refraction (RE) from -0.50 to - 19.50 D (mean RE = -8.63 +/- 3.89 D). 29 patients with mean age 8.7 +/- 1.95 years had hypermetropia with RE from +0.50 to +9.00 D (mean RE = +4.49 +/- 2.11 D). 30 patients control group) with mean age 9.8 +/- 1.03 years had emmetropia. The anterior chamber depth was measured by OCT Visante. In myopic eyes measurements of axial length were obtained using ultrasound A scan.

RESULTS

172 eyes (86 subjects) were evaluated. The mean ACD measurement was 3.18 +/- 0.31 mm in myopic eyes, 2.73 +/- 0.2 mm in hypermetropic eyes, and 2.92 +/- 0.11 mm in emmetropic eyes. There were significant differences in ACD between these three groups of eyes (p<0.01). ACD was correlated with spherical equivalent refraction (Spearman correlation, r = -0.688, p<0.001), and axial length (r = 0.388, p = 0.003) in myopic eyes. There were no statistically significant differences in ACD between 30 eyes of 15 patients with anisometropia >3.00 D.

CONCLUSIONS

There were significant differences in ACD between emmetropic, hypermetropic and myopic eyes in children and adolescents. ACD was associated with refractive error and axial length in the eyes with myopia. Further observations are necessary on larger number of patients.

[Optical coherence tomography in diagnosis of intracranial hypertension in children]

Intracranial hypertension (IH) is important cause of optic disc edema. It is essential to distinguish the primary and secondary causes of IH. Persistent increasement of intracranial pressure over 200-250 mmH2O is caused by impairment of the balance between production and absorption of cerebrospinal fluid. Though the exact mechanism of IH is still unknown.

PURPOSE

Assessment of usefulness of spectral optical coherence tomography with dual beam eye tracking (SLO/OCT) in diagnosis of intracranial hypertension in children.

MATERIALS AND METHODS

4 children (at the age of 3-12 years) with IH underwent an comprehensive ophthalmological examination, including visual acuity testing (Snellen charts), color vision (Ishihara charts), evaluation of anterior and posterior segment of the eye in slit lamp. On SLO/OCT (Spectralis, Heidelberg) scans RNFL profile of the optic disc was assessed at admission day and after 8 weeks of treatment with oral diuretics. In all patients MRI of the central nervous system was performed.

RESULTS

In all children best corrected visual acuity and MRI scans were normal. 3 of 4 patients had secondary IH. Median global RNFL was 273 microm at admission day. In 3 of 4 children remission of optic disc edema was observed after 8 weeks of treatment with diuretics - median global RNFL was 138 microm.

CONCLUSIONS

Diagnosis of intracranial hypertension requires interdisciplinary cooperation. SLO/OCT is useful in monitoring remission of the optic disc edema.

[Concentration assessment of interleukin 8 in serum at children with uveitis]

PURPOSE

Uveitis in children is a visual threatening disease with a complication rate of more than 75%. At the children the uveitis differs in several aspect from adults like: clinical presentation or complication of disease. The etiology of uveitis is still unknown, but T lymphocytes are generally key mediators of the pathogenesis of uveitis. In our study we evaluate IL-8 concentration in serum in uveitis patients.

MATERIAL AND METHODS

Serum sample were collected from 28 uveitis patients and 20 people from control group. The level IL-8 was measured with specific enzyme- linked immunoassays ELISA methods (R & D Systems).

RESULTS

Level of IL-8 in uveitis group was a significant higher (p<0.04) compared with control group.

CONCLUSIONS

Increased levels of interleukin 8 in serum of children with uveitis may suggest innate immune mechanisms in the acute disease.

[Nasolacrimal duct disorders in children. Part II. Treatment]

Congenital nasolacrimal duct obstruction (CLDO) is considered as common and onerous disorder present at infancy. Over 5% of infants have CLDO affecting one or both eyes. The symptoms of CLDO appear shortly after birth or during the first weeks of life. The main symptoms are: epiphora, ropy, mucous discharge in the conjunctival sac. In conservative treatment a lacrimal sac massage is proposed, though it is not always successful. Topical antibiotics are reserved only if secondary conjunctivitis occurs. Fortunately, most cases resolve spontaneously. However, sometimes nasolacrimal duct probing performed under local or general anesthesia is necessary. Prognosis for probing decreases with the increasing number of probings and the age of the patient. In children, who have failed nasolacrimal duct probing, intubation or balloon catheter dilatation of the nasolacrimal system with or without silicone tubing should be considered. In the case of the upper sac obstructions one can use laser endoscopic dacryocystorhynostomy. If it is still not amenable to opening a endonasal endoscopic dacryocystorhinostomy (EESC-DCR), or traditional external dacryocysto-rhinostomy (EXT-DCR), should be performed.

[Treatment of nasolacrimal duct obstruction with probing in children younger than 4 years]

PURPOSE

To evaluate the efficacy of nasolacrimal duct probing as the treatment of nasolacrimal duct obstruction in children younger than 4 years.

MATERIAL AND METHODS

A total amount of 320 eyes in 275 children 4 to 48 months old, receiving nasolacrimal duct probing were enrolled in a retrospective study. The patients were divided into 4 groups depends on age: I group--4-12 months, II group--12-24 months, III group--24-36 months and IV group--36-48 months.

RESULTS

The percentage of efficient duct probing was: in I group--84%, in II group--79%, in III group--78% and in IV group--59%.

CONCLUSIONS

In children 4 to 36 months old, probing is a successful treatment of nasolacrimal duct obstruction with no decline in treatment success with increasing age.

Cataract surgery with primary intraocular lens implantation in children suffering from chronic uveitis

PURPOSE

To evaluate the visual outcome of cataract surgery with intraocular lens (IOL) implantation in children with chronic uveitis.

MATERIAL AND METHODS

The records of seven children (9 eyes), with chronic uveitis who had cataract extraction with IOL implantation between 2001 and 2007, were retrospectively examined. The mean follow-up was 47.9 months, respectively. The postoperative visual outcome and complications were analyzed.

RESULTS

The mean age of 2 girls and 5 boys was 17.4 years (range from 12 to 21 years). 5 patients had unilateral cataract. 6 patients underwent cataract extraction with IOL implantation, one patient underwent combined cataract surgery with IOL implantation and trabeculectomy. Median age at surgery was 17.7 years. At the final follow-up examination 8 eyes (88.9%), had improved visual acuity. The visual acuity was 20/20 in one eye, 20/40 or better in 5 eyes and 20/50 in 3 eyes. Posterior capsule opacification was observed in 5 eyes, high intraocular pressure in 2 eyes and cystoid macular edema in 1 eye.

CONCLUSIONS

The outcomes of cataract extraction with IOL implantation in children's eyes with chronic uveitis may be satisfactory. Correct time of surgery, adequate long-term preoperative and postoperative anti-inflammatory therapy may promote good results.

Aphakic glaucoma after congenital cataract surgery with and without intraocular lens implantation

PURPOSE

To evaluate the incidence and individual risk factors for the development of aphakic glaucoma after congenital cataract surgery.

MATERIAL AND METHODS

We retrospectively reviewed the records of 113 eyes of children who underwent surgery for cataract between 1998 and 2002. Outcome variables studied included intraocular pressure, number of medication changes required over the course of the follow-up, and surgical interventions required.

RESULTS

We enrolled 113 eyes who had cataract extraction with IOL (101 eyes), or lensectomy with anterior vitrectomy (12 eyes). Median age during cataract surgery was 11.5 months. The median time to development of postoperative glaucoma was 3.2 years (range, 6 months-10 years). Mean post cataract surgery follow-up was 6.2 years. Postoperative glaucoma developed in 9.7% of eyes of children with cataract. Postoperative open-angle glaucoma developed in 6 pseudophakic eyes and in 2 aphakic eyes; postoperative closed-angle glaucoma developed in 3 aphakic eyes. The mean follow-up period after the diagnosis of glaucoma was 3.8 years. During the course of follow-up, all of 11 eyes required 1-3 medication changes for controlling glaucoma and 3 of them (31.4%), required surgical intervention.

CONCLUSIONS

Despite modern surgical techniques the incidence of aphakic glaucoma must be considered in all patients after pediatric cataract extraction. Our results show the importance of careful follow up of intraocular pressure after cataract surgery in children. Young patients undergoing cataract surgery should be monitored routinely for glaucoma.

[Estimation of morphology and function of the eye in Usher's syndrome]

PURPOSE

Retinitis pigmentosa (RP) is a set of heterogenous retinal diseases that affect primarily photoreceptors and retinal pigmented epithelium. The Usher's syndrome (RP associated with hearing impairment or loss), is responsible for about 10-20% of all cases. We investigate macular morphology using spectral domain optical coherence tomography in correlation with visual function.

MATERIAL AND METHODS

Two patients with Usher syndrome: a 13 years old girl and her 9 years old sister underwent comprehensive ophthalmological examination including: BCVA testing (Snellen charts), biomicroscopy of the anterior and posterior segment of the eye, electroretinography and SD-OCT scans of the macular region.

RESULTS

BCVA was noticeable decreased in both eyes (Vod = 5/16, Vos = 5/16), of 13 years old patient, while it was slightly diminished in her younger sister (Vod = 5/6, Vos = 5/6). In patient with visual deterioration a blue cone deficiency was found. Central foveal thickness (CFT) and foveal outer segment/pigment epithelium thickness (FOSPET) was significantly reduced in 13 years old patient.

CONCLUSIONS

Spectral optical coherence tomography is a useful method to monitor morphological changes of the macula and their progress in patients with retinitis pigmentosa in Usher's syndrome.

[Intraocular pressure in children and adolescents with myopia]

PURPOSE

To determine, whether intraocular pressure (IOP) is associated with myopia and axial length in children and adolescents.

MATERIAL AND METHODS

129 patients in age from 9 to 18 years (mean 14.5 years), were examined. They underwent dynamic contour tonometry, cycloplegic autorefraction, and A-scan biometry. For analyses, refractive error was split into three groups: low myopia (spherical equivalent refraction - SE < -3.00 D), moderate myopia (SE from -3,00 D to -6,00 D), and high myopia (SE > -6.00 D).

RESULTS

There were no significant IOP differences between eyes with low (mean IOP = 15.15 mm Hg +/- 2.73), moderate (15.3 mmHg +/- 2.6) or high myopes (15.6 mmHg +/- 2.33). IOP was not correlated with spherical equivalent refraction (p = 0.49) or axial length (Spearman correlation, r = 0.04). There were also no statistically significant differences in IOP between the less myopic and more myopic eyes of 11 patients with anisometropia > 3,00 D. Neither spherical equivalent (p = 0.49) nor axial length (p = 0.51) were significantly associated with IOP in anisometropic patients.

CONCLUSIONS

IOP was not associated with refractive error and axial length in the eyes of myopic children and adolescents. Further observations are necessary, because myopia can be a risk factor in developing juvenile glaucoma.

[The evaluation of efficacy of Ahmed valve implantation in the surgical treatment of glaucoma in children and adolescents]

PURPOSE

To report the safety and efficacy of Ahmed glaucoma valve implantation in the management of secondary glaucoma in children and adolescents.

MATERIAL AND METHODS

6 patients with secondary glaucoma underwent Ahmed valve implantation. 1 patient had aphakic glaucoma, 3 patients had traumatic glaucoma, 1 patient had aniridia and 1 patient had ectropion uveae. IOP values range from 35 to 51 mmHg (mean 41.3 mmHg), with maximal medical treatment by this time. Mean follow-up was 2.17 years.

RESULTS

Mean pooperative IOP ranged from 2 to 8 mmHg (mean 6 mmHg), during the first week. 6 months later IOP increased to 15.2 (6-21) mmHg. The mean IOP at last follow-up was 15 mmHg and overall success rate was 83.3%. We observed one hypotony, one tube exposure and one Tenon's cyst formation.

CONCLUSIONS

The Ahmed valve is effective treatment for secondary glaucoma in children. It can be useful to avoid enucleation of the eye with traumatic glaucoma.

[Nasolacrimal duct disorders in children. Part I. Anatomy, physiology and clinical signs]

Congenital nasolacrimal duct obstruction (CLDO) is considered as common and onerous disorder present at infancy. Over 5% of infants have CLDO affecting one or both eyes. The symptoms of CLDO appear shortly after birth or during the first weeks of life. The main symptoms are: excessive and persistent watering, ropy mucous discharge in the conjunctival sac. In conservative treatment a lacrimal sac massage is proposed, though it is not always successful. Topical antibiotics are reserved only if secondary conjunctivitis occurs. Fortunately, most cases resolve spontaneously. However, sometimes nasolacrimal duct probing performed under local or general anesthesia is necessary.

[The psychological consequences of amblyopia]

This is the review of references about problem of amblyopia and its psychosocial effects on children being cured. The study emphasies the need for psychological approach to problems that trouble children wearing glasses, suffering from strabismus and being cured by occlusion.

[Ophthalmologic findings in child in the Cornelia de Lange syndrome]

PURPOSE

Cornelia de Lange syndrome is a rare disease showing characteristic facial appearance, development delay, low birth weight, skeletal anomaly, hirsutism and various ophthalmologic and hearing findings.

MATERIAL AND METHODS

We described ophthalmologic problems in 2-year-old girl.

RESULTS

We have find arched eyebrows, long lashes, epiphora, ptosis, nystagmus, myopia, and fundus eye changes.

CONCLUSIONS

We recommend early ophthalmologic examination in patients with Cornelia de Lange syndrome.

[Estimation of the quality of life 8-year-old child with bilateral anophthalmia]

PURPOSE

The main aim of our work was to estimate the physical and psychomotor development and the arrangement to the daily life for a 8-year-old girl with inborn bilateral anophthalmia.

MATERIAL AND METHODS

The basic ophthalmic, pediatric and neurological examinations were performed with additional genetic and radiological examinations.

RESULTS

The ophthalmic and MRI examination find out the absence of the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation.

CONCLUSIONS

Anophthalmia limits in a big grade an independent life of the child. However, currently the girl's development indicates for good intellectual abilities what is promising for future independent life and professional work.

[Impairment of optic nerves as the result of cerebral sinus venous thrombosis]

Cerebral venous sinus thrombosis is a disease with potentially serious consequences and usually affecting young to middle aged people. Headache was the most frequent symptom. Diagnosis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given, taking into consideration parameters of coagulation system and the type of thrombus. Because of moderate to high mortality rate, patients should be closely monitored.

PURPOSE

Presentation of the case of bilateral optic nerve atrophy after extensive thrombus of sigmoid and right transverse sinuses.

MATERIAL AND METHODS

We present the case of a boy, who suffered inflammation of venous sinuses of cranial basis, when he was 6 years old. It happened 1 month after right mastoid bone injury. In the course of this disease, intracranial hypertension with bilateral optic disc swelling appeared.

RESULTS

5 years after thrombosinusitis, the child has pale optic discs, changes in the peripheral visual field, abnormal VEP and incorrect contrast sensitivity.

CONCLUSIONS

Trauma in the region of the temporal bone may cause hard complications from thrombosinusitis, and lead to bilateral optic damage.

[The role of chemokines CCL3/ MIP-1 alfa and CCL4/ MIP-1 beta in pathogenesis of dry eye syndrome]

PURPOSE

To evaluate the concentration of chemokines CCL3/ MIP-1 alfa and CCL4/ MIP-1 beta in film tears in patients with dry eye syndrome.

MATERIAL AND METHODS

Tears samples were collected from 62 patients with dry eye syndrome and 18 patients from control group. The concentration of chemokines in film tears were determined by immunoenzymatic assay ELISA.

RESULTS

We found statistically increased levels of chemokines CCL3/ MIP-1 alfa and CCL4/ MIP-1 beta in film tears of patients with dry eye syndrom compared with control group.

CONCLUSION

Inflammation may play role in pathogenesis of dry eye syndrome.

Assessment of visual function in children with foldable intraocular lens implants

PURPOSE

The aim of the current study was to assess the results of cataract surgery involving implantation of foldable intraocular lenses in children.

MATERIAL AND METHODS

Cataract surgery with foldable lenses was performed in 60 children. Postoperative visual acuity, endothelial cell density, corneal pachymetry, postoperative astigmatism and complications were analyzed.

RESULTS

Quick visual recovery was observed in children after surgery. Only a few postoperative complications occurred.

CONCLUSIONS

The foldable intraocular lenses are easy to insert. The surgical procedure with foldable lens implantation is a useful and safe method of treatment.

[Clinical features, the effectiveness of treatment and function of vision organ in children and adolescents with ocular toxocariasis]

PURPOSE

Toxocariasis is caused by Toxocara canis, the intestinal nematode commonly found in dogs. Patients are mostly young children, with an average age of 7.5 years. Patients have unilateral progressive painless vision loss and occasional leukocoria. Ocular toxocariasis has a variable presentation, from localized peripheral or macular granulomas to chronic endophthalmitis.

MATERIAL AND METHODS

Clinical features, the effectiveness of treatment and function of vision organ in 19 children and adolescents with ocular toxocariasis were analyzed retrospectively.

RESULTS

The mean patient age was 10.3 years. Inflammation was unilateral in all patients. In 11 cases (57.9%) there was peripheral granuloma, in 3 cases (15.8%) posterior pole granuloma and endophthalmitis in 5 cases (26.3%). Zentel was applied in 14 patients, Hetrazan in 3 patients and Mintezol in 2 patients. Improvement of visual acuity was achieved in 11 eyes (57.9%), no improvement in 7 eyes (36.8%), deterioration in 1 eye (5.3%).

CONCLUSIONS

Ocular toxocariasis is the disease with differentiated clinical presentation. Toxocara uveitis can cause significant vision loss. In some cases quick diagnosis and effective treatment with corticosteroids and antihelminthics allowed to obtain clinical improvement.

[The role of chemokines in ocular diseases. Part II. Participation of chemokines in ocular diseases]

The chemokines are family of ca. 50 chemotactic cytokines produced by leucocytes and tissue cells, which regulate and stimulate leucocytes migration. Dysregulation of this process is apparent in chronic inflammation, allergic eye disease, corneal graft rejection, proliferative vitreoretinopathies and age-related macular degeneration. Antagonists of chemokine receptors have demonstrated anti-inflammatory and antiviral activity and may represent new generations of therapeutic agents.

[The role of chemokines in ocular diseases. Part I. Structure and role of chemokines in chosen diseases]

The chemokines are a large family of chemotactic cytokines produced by leucocytes, fibroblasts, keratynocytes and the others tissue cells. Chemokines stimulate and regulate leucocytes migration in inflammations. All the described human chemokines transmit intracellular signals by binding and activating specific G protein-coupled receptors on the cell surfaces of their target cells. Chemokines are involved in variety of inflammatory and autoimmune diseases.

Pattern visual evoked potentials in the early diagnosis of optic neuropathy in the course of Graves' ophthalmopathy

THE AIM OF THE STUDY

To investigate by means of pattern visual evoked potentials (PVEPs) early neuropathic changes in Graves' ophthalmopathy (GO) patients without any clinical symptoms of optic neuropathy in order to evaluate the prevalence of subclinical optic neuropathy in GO patients and to elucidate whether there is a relationship between PVEP (P100 and N75 latency), intraocular pressure (IOP) and exophthalmometry.

MATERIAL AND METHODS

Two groups of patients were examined: 15 patients with GO without clinical signs of dysthyroid optic neuropathy (DON) and 12 healthy controls. The correlations between the N75 and P100 latencies, IOP and Hertel exophthalmometry were investigated.

RESULTS

The mean PVEP N75 and P100 latencies were significantly delayed in the GO uncomplicated with DON in comparison with controls (LP100- 106.2 +/- 4.4 ms vs. 102.4 +/- 2.7 ms, p < 0.01 and LN75- 79.0 +/- 3.7 ms vs. 73.9 +/- 2.8 ms, p < 0.001). In GO patients we documented a positive correlation between the LN75 latency and exophthalmometric readings (R = 0.51; p < 0.01). The value of LP100 and LN75 was above the normal limit in 5/30 eyes (17%) and in 3/30 eyes (10%) respectively.

CONCLUSIONS

The assessment of PVEPs (especially the P100 latency) in GO patients without clinical signs of DON is a useful tool for the early diagnosis of optic nerve involvement.

Macular pigmentary changes as a sequelae of retinal hemorrhages in premature infants with retinopathy of prematurity

PURPOSE

We assess the incidence of macular changes in ROP patients with retinal hemorrhages.

PATIENTS AND METHODS

The premature group consisted of 360 children born 32 weeks gestation and/or with weight below 1,500 g. We used the RetCam-120 Digital Retinal Camera to document retinal changes.

RESULTS

Of the 360 premature infants 241 (67%) had no ROP, and 119 (33%) had ROP. Of the preterm infants with ROP retinal hemorrhages were found in 46 (38%) children. Of the newborns with ROP and with retinal hemorrhages, macular pigmentary changes were found in 3 (6%) patients. Of these 3 patients, the first had pre-threshold ROP, the second threshold ROP and had underwent diode laser photocoagulation, and the third patient had stage 2 ROP. In the patients with pre-threshold and threshold ROP retinal hemorrhages appeared 6 weeks after birth and macular pigmentary changes were found 6 months after birth. In the patient with stage 2 ROP hemorrhages appeared 7-8 weeks after birth and macular pigmentary changes were detected 12 months after birth.

CONCLUSIONS

Although macular hemorrhages almost always resorb without complications, our study allows the assumption that retinal hemorrhages may cause macular pigmentary changes in the macula, and thus may lead to deprivation amblyopia. Our results may suggest that the presence of the macular pigmentary changes may be related to the hemorrhage and not to the specific therapy or to the disease.

[Effect of human growth hormone treatment on the eyes of patients with somatotropic pituitary insufficiency and in girls with Turner's syndrome]

INTRODUCTION

The increased use of human growth hormone (hGH) in numbers of children rise questions concerning the safety of GH replacement therapy (GHRT). Adverse effects of hGH treatment (pseudotumor cerebri, papilloedema, retinal changes mimicking diabetic retinopathy, neovascularization) have been reported in some papers.

PURPOSE

The aim of this study was to evaluate the influence of hGH therapy on the organ of vision.

MATERIAL AND METHODS

10 girls with Turner's syndrome aged 12-16 years (mean 13.8+/-1.69) and 20 patients with somatotropic pituitary insufficiency aged 7-18 years (mean 12.98+/-2.81) were studied. The mean duration of GHRT in patients with Turner's syndrome was 3.05+/-1.42 years (from 1 year to 5 year), in patients with somatotropic pituitary insufficiency was 2.45+/-2.32 years (from 8 months to 10 years). All patients underwent ophthalmic examination, including contrast sensitivity, direct and indirect ophthalmoscopy and fluorescein angiography.

RESULTS

All parts of ophthalmological examination were normal. There were no abnormalities in fluorescein angiography. Contrast sensitivity was correct in all eyes.

CONCLUSIONS

There was no harmful effect of GHRT on the retina and optic nerve in young patients. The follow-up and ophthalmologic evaluation is advisable.

[Optical coherence tomography in diagnosis of retinal diseases in children and adolescents]

This report describes the new optical technique of optical coherence tomography (OCT) for imaging eye fundus. OCT is noninvasive, capable of high-resolution of 10 to 17 microns imaging of biological tissue. It has been used, to investigate several ocular diseases in children and adolescents. These include macular disease, glaucoma, optic nerve disorders, and myopia.

[Cataract progression in patients with atopic dermatitis]

Atopic dermatitis is a relatively common hereditary condition. Ocular sequellae are commonly seen in this disorder, and may include involvement of both the anterior and posterior segments of the eye. The case of female patient with atopic dermatitis and ocular manifestations is presented.

[Corneal endothelium in children and adolescents with myopia]

PURPOSE

To determine, whether the myopia could has an influence on corneal endothelium morphology.

MATERIAL AND METHODS

Patients' age was from 13-th to 18-th years. Lens wearers and patients with external eye diseases and ocular surgery in the history, were excluded. The endothelium was imaged by non-contact microscope Topcon SP-2000P. The following parameters were examined: corneal thickness, corneal endothelial density, mean cell area of endothelial cells, coefficient of variation of cell size.

RESULTS

There were no significant differences in the corneal thickness among various degrees of myopic refractive error. Endothelial cell density (ECD) decreased in eyes with high myopia, but it not correlated either with corneal thickness nor with axial length of eyes. There was correlation between average cell area (AVG) and the degree of myopia.

[Results of treatment in congenital esotropia]

THE AIM

We analyzed results of the operations in congenital esotropia.

MATERIAL AND METHODS

In paediatric ophthalmology department were treated 42 children in age 1.5 to 2.5 years with congenital esotropia. Strabismus angles were from +20 degrees to +45 degrees. After the operations children were controlled in paediatric ophthalmology clinic. The pleoptic-ortoptic therapy was applied when children finished 3.5 years old.

RESULTS

28 children had orthoposition after primary operations and 20 had binocular vision. 6 children had second operation due to excessive functional activity inferior oblique muscle or residual angle.

CONCLUSION

The operations of children with congenital esotropia between 1.5 to 2.5 years old provided good functional results.

[The effect of monocytes on early activation of lymphocytes T among children with idiopathic uveitis]

PURPOSE

We have investigated T Lymphocytes ability for CD69 molecule induction in presence and absence of monocytes in idiopathic uveitis.

MATERIAL AND METHODS

Twenty-five children with idiopathic uveitis were studied. The control group consisted of 12 healthy children. Peripheral blood mononuclear cells (PBMCs) were isolated from heparinised venous blood, by density gradient centrifugation. CD69 expression was cytometrically assessed on freshly isolated and cultured T lymphocytes.

RESULTS

CD69 expression on freshly isolated peripheral blood T lymphocytes was low in both studied groups. LPS-stimulated monocytes added to cultures of T lymphocytes induced increase in CD69 expression but significantly lower in children with idiopathic uveitis compare to healthy children.