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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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Wnękowicz-Augustyn E, Teper S, Wylęgała E. Preventing the Progression of Myopia in Children-A Review of the Past Decade. Medicina (Kaunas) 2023; 59:1859. [PMID: 37893579 PMCID: PMC10608552 DOI: 10.3390/medicina59101859] [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] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The growing incidence of myopia worldwide justifies the search for efficient methods of myopia prevention. Numerous pharmacological, optical, and lifestyle measures have already been utilized, but there remains a need to explore more practical and predictable methods for myopia control. This paper presents a review of the most recent studies on the prevention of myopia progression using defocus-incorporated multiple-segment spectacle lenses (DIMSsl), repeated low-level red-light (RLRL) therapy, and a combination of low-dose atropine (0.01%) with orthokeratology lenses.
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Affiliation(s)
- Emilia Wnękowicz-Augustyn
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
- Municipal Hospital Group, Truchana 7, 41-500 Chorzów, Poland
- Eye and Optics Center Augmed, Łabędzka 20d, 44-100 Gliwice, Poland
| | - Sławomir Teper
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
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Micińska A, Nowińska A, Teper S, Kokot-Lesik J, Wylęgała E. Advanced Anterior Eye Segment Imaging for Ichthyosis. J Clin Med 2023; 12:6006. [PMID: 37762949 PMCID: PMC10532152 DOI: 10.3390/jcm12186006] [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: 06/29/2023] [Revised: 08/25/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
The purpose of this study was to describe ocular surface and anterior eye segment findings in various types of ichthyoses. METHODS This was a single-center prospective observational study. The study group consisted of five patients (P1-P5) aged 13-66 years. Multimodal imaging was performed, including slit-lamp examinations, swept-source optical coherence tomography (SS-OCT), and in vivo confocal microscopy (IVCM). RESULTS All patients were diagnosed with moderate-to-severe dry eye disease (DED). The corneas showed a significant pattern of irregularity, with a significant difference between the corneal thickness at the apex (CAT) and the corneal thinnest thickness (CTT), exceeding 375 µm. Three patients were diagnosed with ectasia patterns based on SS-OCT. All patients showed abnormalities in at least one Fourier index parameter for at least one eye at 3 or 6 mm in the keratometric, anterior, or posterior analyses. IVCM examinations revealed changes in all corneal layers. CONCLUSIONS By combining the results of multimodal imaging, we were able to detect preclinical abnormalities, distinguish characteristic changes common to ichthyosis, and reveal the depth and characteristics of corneal abnormalities. Therefore, patients with ichthyosis should be examined for DED and ectatic disorders early in clinical practice.
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Affiliation(s)
- Anna Micińska
- Ophthalmology Department, District Railway Hospital, 40-760 Katowice, Poland
| | - Anna Nowińska
- Ophthalmology Department, District Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Sławomir Teper
- Ophthalmology Department, District Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Joanna Kokot-Lesik
- Ophthalmology Department, District Railway Hospital, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Ophthalmology Department, District Railway Hospital, 40-760 Katowice, Poland
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Wąsowska A, Sendecki A, Boguszewska-Chachulska A, Teper S. Polygenic Risk Score and Rare Variant Burden Identified by Targeted Sequencing in a Group of Patients with Pigment Epithelial Detachment in Age-Related Macular Degeneration. Genes (Basel) 2023; 14:1707. [PMID: 37761846 PMCID: PMC10531282 DOI: 10.3390/genes14091707] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
A subset of ophthalmic imaging examination results from 334 patients were subjected to reanalysis to identify a specific group of patients with pigment epithelial detachment (PED) in at least one eye. Overall, we found a subgroup of 47 patients manifesting PED and studied their genotypes in comparison to those of patients with age-related macular degeneration without PED and healthy controls. We established a polygenic risk score that allowed the explanation of 16.3% of the variation within the disease. The highest predictive value was achieved for a model consisting of six non-coding variants: rs760306 (BEST1), rs148662546 (BEST1), rs11569560 (C3), rs74600252 (GUCA1B), rs2240688 (PROM1), and rs185507582 (TCF4). The risk of PED occurrence was found to be the highest in the first tercile, showing a 7.89-fold higher risk compared to the third tercile for AMD without PED (95% CI: 2.87; 21.71, p < 0.001) and a 7.22-fold higher risk compared to the healthy controls (95% CI: 2.60; 20.06, p < 0.001). In addition, we focused on rare variants in targeted genes. The rare variants' burden was compared among the groups, but no statistical significance was observed in the number of rare variants, predicted functional effects, or pathogenicity classification.
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Affiliation(s)
- Anna Wąsowska
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Genomed S.A., 02-972 Warszawa, Poland
| | - Adam Sendecki
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | | | - Sławomir Teper
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Ulfik-Dembska K, Teper S, Dembski M, Nowińska A, Wylęgała E. Idiopathic Epiretinal Membrane: Microvasculature Analysis with Optical Coherence Tomography and Optical Coherence Tomography Angiography. Tomography 2022; 8:189-199. [PMID: 35076629 PMCID: PMC8788506 DOI: 10.3390/tomography8010016] [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] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The present study examined the relationships among macular microvasculature, retinal structure, and epiretinal membrane (ERM) and explored the utility of optical coherence tomography (OCT) angiography (OCTA) in idiopathic ERM assessment. Methods: The study sample comprised 276 eyes of 276 patients. A total of 154 eyes with ERM and 122 normal (control) eyes were analyzed. Only one eye of each participant was randomly selected for posterior segment imaging. Each patient underwent OCT and OCTA. Images were analyzed with AngioTool 0.6. Results: Foveal avascular zone was significantly smaller in the ERM group (p = 0.044). Average retinal thickness and foveal thickness were significantly higher in the ERM group (both p = 0.001). Moreover, 64 (41.5%) patients exhibited no metamorphopsia, while 46 (29.8%) and 44 (28.7%) patients exhibited moderate and extensive metamorphopsias, respectively. Meanwhile, FAZ was negatively correlated with central retinal thickness in the ERM group. The vessel area (p = 0.0017) and vessel percentage area (p = 0.044) were significantly greater in the ERM group. Conclusions: Changes observed in the superficial plexus in OCTA are related to the severity of metamorphopsia and can be further evaluated to support decision making regarding the surgical management of idiopathic ERM.
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Affiliation(s)
- Klaudia Ulfik-Dembska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-566 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
- Correspondence: ; Tel.: +48-32-605-35-92
| | - Sławomir Teper
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-566 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Michał Dembski
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-566 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Anna Nowińska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-566 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-566 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
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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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Ulfik-Dembska K, Teper S, Dembski M, Nowińska A, Wylęgała E. Peripheral Retinal Degenerations and Idiopathic Epiretinal Membrane: Analysis with Ultra-Wide-Field Scanning Laser Ophthalmoscopy. J Clin Med 2021; 10:jcm10173876. [PMID: 34501323 PMCID: PMC8432095 DOI: 10.3390/jcm10173876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/15/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The present study examined the relationships among retinal structure, peripheral retinal abnormalities, and epiretinal membrane (ERM) and explored the utility of ultra-wide-field laser scanning ophthalmoscopy in idiopathic ERM assessment. METHODS The study sample comprised 276 eyes of 276 patients. Ultra-wide field fundus imaging was performed without mydriasis using Optos California. Each patient underwent a Goldmann three-mirror contact lens fundus examination. RESULTS Ultra-wide field laser scanning ophthalmoscopy revealed peripheral retinal degeneration in 84 (54.54%) eyes in the ERM and in 28 (22.95%) eyes in the control group. Goldmann three-mirror contact lens examination revealed peripheral retinal degeneration in 96 (62.33%) eyes in the ERM group and 42 (34.42%) eyes in the control group. Ultra-wide field ophthalmoscopy enabled the detection of nearly 87% of all peripheral retinal lesions in patients with ERM, but it cannot replace fundus examination with a Goldmann triple mirror or ophthalmoscopy with scleral indentation. CONCLUSIONS In most patients, idiopathic ERM coexisted with changes in the peripheral retina. Some of these changes promote retinal detachment. Thus, surgeons should consider the risk of retinal tear during vitrectomy, which increases the scope of surgery and may adversely affect prognosis. Although ultra-wide field imaging is a valuable diagnostic method, it is not a substitute for Goldmann three-mirror contact lens fundus examination or ophthalmoscopy with scleral indentation.
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Affiliation(s)
- Klaudia Ulfik-Dembska
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
- Correspondence: ; Tel.: +48-32-605-35-92
| | - Sławomir Teper
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Michał Dembski
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Anna Nowińska
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland
| | - Edward Wylęgała
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-760 Katowice, Poland; (S.T.); (M.D.); (A.N.); (E.W.)
- Clinical Department of Ophthalmology, District Railway Hospital, Panewnicka 65, 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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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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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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11
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Figurska M, Matysik-Wożniak A, Adamiec-Mroczek J, Dolar-Szczasny J, Misiuk-Hojło M, Teper S, Święch-Zubilewicz A, Ulińska M, Rejdak R, Rękas M. One-year outcomes of the Polish treatment program for the wet form of age-related macular degeneration using intravitreal therapy. Eur J Ophthalmol 2020; 30:586-594. [PMID: 32347762 DOI: 10.1177/1120672119874598] [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: 12/27/2022]
Abstract
PURPOSE To report 12-month outcomes of a Polish National Treatment Program using aflibercept and ranibizumab in eyes with wet, age-related macular degeneration in routine clinical practice. MATERIAL AND METHODS This was a non-randomized, retrospective, observational multicenter study. Anonymous data contained in the electronic Therapeutic Program Monitoring System were utilized in this study. RESULTS The study population consisted of 2828 eyes from 2718 patients. The median age was 76.0 [70.0, 81.0] years; 61.7% were female. Best corrected visual acuity increased from 58.86 [50.05, 69.95] letters to 65.1 [50.1, 73.9] letters (p < 0.001). The median change in best corrected visual acuity was 0.0 [-4.0, 12.2] letters: 2.9 [-2.9, 15.1] letters for treatment-naïve eyes and 0.0 [-4.0, 8.8] letters for those continuing treatment (p < 0.001). The median central retinal thickness was significantly reduced from 341.0 [281.0, 422.0] to 275.0 [221.0, 344.0] μm (p < 0.001). The median number of visits was 9.0 [8.0, 9.0]. The median number of injections was 7.0 [6.0, 8.0]: 8.0 [7.0, 8.0] for treatment-naïve eyes and 6.0 [5.0, 7.0] for those continuing treatment (p < 0.001). CONCLUSION Eyes treated as part of the Polish therapeutic program gained functional stability and morphological improvement. Treatment-naïve eyes showed the greatest functional benefit.
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Affiliation(s)
- Małgorzata Figurska
- Department of Ophthalmology, Military Institute of Medicine, The Central Clinical Hospital of the Ministry of National Defense, Warsaw, Poland
| | - Anna Matysik-Wożniak
- Department of General Ophthalmology, Medical University of Lublin, Independent Public Teaching Hospital No. 1, Lublin, Poland
| | | | - Joanna Dolar-Szczasny
- Department of Vitreoretinal Surgery, Medical University of Lublin, Independent Public Teaching Hospital No. 1, Lublin, Poland
| | - Marta Misiuk-Hojło
- Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Sławomir Teper
- Department of Ophthalmology, District Railway Hospital in Katowice, Katowice, Poland
| | - Anna Święch-Zubilewicz
- Department of Vitreoretinal Surgery, Medical University of Lublin, Independent Public Teaching Hospital No. 1, Lublin, Poland
| | - Magdalena Ulińska
- Department of Ophthalmology, Medical University of Warsaw, SPKSO Ophthalmic Hospital, Warsaw, Poland
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Independent Public Teaching Hospital No. 1, Lublin, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, The Central Clinical Hospital of the Ministry of National Defense, Warsaw, 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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13
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Teper S, Kubicka-Trząska A, Matysik-Woźniak A, Wylęgała E, Mackiewicz J, Michalska-Małecka K, Rękas M, Rejdak R. Rola doszklistkowych steroidów we współczesnym leczeniu cukrzycowego obrzęku plamki. Ophthalmology J 2018. [DOI: 10.5603/oj.2018.0036] [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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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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Koprowski R, Wilczyński S, Nowinska A, Lyssek-Boron A, Teper S, Wylegala E, Wróbel Z. Quantitative assessment of responses of the eyeball based on data from the Corvis tonometer. Comput Biol Med 2015; 58:91-100. [PMID: 25622180 DOI: 10.1016/j.compbiomed.2015.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 08/26/2014] [Revised: 12/31/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND The "air-puff" tonometers, include the Corvis, are a type of device for measuring intraocular pressure and biomechanics parameters. The paper attempts to analyse this response and its relationship with other parameters measured in the Corvis tonometer. METHODS A number of 13,400 2D images were acquired from the Corvis device and analysed (32 healthy and 16 ill people). A new method has been proposed for the analysis of responses of the eyeball based on morphological transformations and contextual operations. RESULTS The proposed algorithm enables to determine responses of the eyeball to an air puff coming from the Corvis tonometer. Additionally, responses of the eyeball have been linked to some selected features of corneal deformation. The results include, among others: (1) distinguishability between the left and right eye with an error of 7%; (2) the correlation between the area under the curve in corneal deformation and the response of the eyeball -0.26; (3) the correlation between the highest concavity time and the maximum deformation amplitude of 0.4. All these features are obtained fully automatically and repetitively at a time of 3.8s per patient (Core i7 10GB RAM). DISCUSSION It is possible to measure additional parameters of the eye deformation which are not available in the original software of the Corvis tonometer. The use of the proposed methods of image analysis and processing provides results directly from the eye response measurement when measuring intraocular pressure.
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Affiliation(s)
- Robert Koprowski
- Department of Biomedical Computer Systems, University of Silesia, Faculty of Computer Science and Materials Science, Institute of Computer Science, ul. Będzińska 39, Sosnowiec 41-200, Poland.
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, School of Pharmacy, Medical University of Silesia in Katowice, ul, Kasztanowa 3, Sosnowiec 41-200, Poland
| | - Anna Nowinska
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Anita Lyssek-Boron
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Sławomir Teper
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Edward Wylegala
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Zygmunt Wróbel
- Department of Biomedical Computer Systems, University of Silesia, Faculty of Computer Science and Materials Science, Institute of Computer Science, ul. Będzińska 39, Sosnowiec 41-200, Poland
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Nowinska AK, Wylegala E, Teper S, Wróblewska-Czajka E, Aragona P, Roszkowska AM, Micali A, Pisani A, Puzzolo D. Phenotype and genotype analysis in patients with macular corneal dystrophy. Br J Ophthalmol 2014; 98:1514-21. [PMID: 24926691 DOI: 10.1136/bjophthalmol-2014-305098] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM The aim of this study was to analyse corneal morphological organisation and identify mutations in the carbohydrate sulfotransferase 6 gene (CHST6) in patients with macular corneal dystrophy originating in a Polish population. METHODS Macular corneal dystrophy was diagnosed in 24 patients based on the slit-lamp exam, confocal microscopy, 1310 nm time domain and 840 nm spectral domain optical coherence tomography. 10 corneal buttons obtained from penetrating keratoplasty were processed for light microscopy. Genetic analysis of the CHST6 gene was performed, followed by a study of the sequencing results. RESULTS Highly reflective, diffuse corneal deposits and a general increase in reflectivity were revealed with optical coherence tomography and confocal microscopy. The deposits extended from the Bowman layer to the Descemet membrane and correlated with the Alcian blue-positive granular-filamentous material into and around the stromal keratocytes confirmed by structural analysis of the corneal buttons. The genetic analysis of the blood samples identified the following mutations and single nucleotide polymorphisms: novel P64L (heterozygous), Y110C (homozygous), R162G and L200R, and M1L (heterozygous and homozygous). CONCLUSIONS Genetic mutation heterogeneity was revealed. No phenotype heterogeneity was revealed among patients with in vivo corneal morphology assessment or histological analysis.
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Affiliation(s)
- Anna K Nowinska
- II Ophthalmology Clinic, Silesian Medical University, Katowice, Poland
| | - Edward Wylegala
- II Ophthalmology Clinic, Silesian Medical University, Katowice, Poland
| | - Sławomir Teper
- II Ophthalmology Clinic, Silesian Medical University, Katowice, Poland
| | | | - Pasquale Aragona
- Department of Experimental Medical-Surgical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Italy
| | - Anna M Roszkowska
- Department of Experimental Medical-Surgical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Italy
| | - Antonio Micali
- Department of Biomedical Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Antonina Pisani
- Department of Biomedical Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Domenico Puzzolo
- Department of Biomedical Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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17
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Teper S, Nowińska A, Lyssek-Boroń A, Wylegała E. [Neovascular form of age-related macular degeneration --current management in Poland and in Europe]. Pol Merkur Lekarski 2014; 37:56-60. [PMID: 25154202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Currently in Poland neovascular form of age-related macular degeneration (AMD) is treated with vascular endothelial growth factor (VEGF) inhibitors--ranibizumab, aflibercept and bevacizumab. Photodynamic therapy is still refunded, although it is very rarely used. It can be estimated that only small minority (about 5-10%) of cases are properly treated due to mainly refunding restrictions in Poland. In countries with wider access to treatment 50% reduction in AMD-related blindness incidence was noted. Low-cost off-label anti-VEGF agent bevacizumab is almost inaccessible in Polish public health system because of law regulations. In order to increase availability of anti-VEGF injections vials of all mentioned drugs are divided which raises safety concerns. Despite new potent drug in the market aflibercept, cost of treatment remains very high. The optimal treatment regimen includes three monthly injections, after which is usually used pro re nata therapy based primarily on the outcome of macular optical coherence tomography. Routinely recommended antibiotic prophylaxis of injection-related endophthalmitis probably has no meaning apart from the generation of resistance.
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MESH Headings
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/economics
- Bevacizumab
- Drug Administration Schedule
- Humans
- Macular Degeneration/drug therapy
- Neovascularization, Pathologic/drug therapy
- Neovascularization, Pathologic/etiology
- Photochemotherapy/economics
- Poland
- Ranibizumab
- Receptors, Vascular Endothelial Growth Factor/administration & dosage
- Receptors, Vascular Endothelial Growth Factor/economics
- Receptors, Vascular Endothelial Growth Factor/supply & distribution
- Recombinant Fusion Proteins/administration & dosage
- Recombinant Fusion Proteins/economics
- Recombinant Fusion Proteins/supply & distribution
- Reimbursement, Incentive
- Vascular Endothelial Growth Factor A/antagonists & inhibitors
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18
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Dierselhuis MP, Spierings E, Drabbels J, Hendriks M, Alaez C, Alberú J, Alvarez MB, Burlingham W, Campos E, Christiaans M, Claas F, Fasano ME, Gerbase-DeLima M, Gervais T, Gorodezky C, Larriba J, Lardy NM, Latinne D, Morales-Buenrostro LE, Moreno MJ, Oguz F, Opelz G, Sergeant R, Tambutti M, Teper S, Tilanus M, Turkmen A, Warrens AN, Weimar W, Goulmy E. Minor H antigen matches and mismatches are equally distributed among recipients with or without complications after HLA identical sibling renal transplantation. ACTA ACUST UNITED AC 2013; 82:312-6. [DOI: 10.1111/tan.12209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/31/2013] [Accepted: 09/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M. P. Dierselhuis
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - E. Spierings
- Department of Immunology; University Medical Center Utrecht; Utrecht; The Netherlands
| | - J. Drabbels
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - M. Hendriks
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - C. Alaez
- Department of Immunology & Immunogenetics; Instituto de Diagnostico y Referencia Epidemiologicos; Mexico City; Mexico
| | - J. Alberú
- Department of Transplantation; Instituto Nacional de Ciencias, Médicas y de la Nutrición; Mexico City; Mexico
| | - M. B. Alvarez
- Centro de Inmunología y Genética molecular; Buenos Aires; Argentina
| | - W. Burlingham
- Department of Surgery; University of Wisconsin; Madison; WI; USA
| | - E. Campos
- Universidade Federal de São Paulo and Associação Fundo de Incentivo à Pesquisa; São Paulo; Brazil
| | - M. Christiaans
- Department of Nephrology; Maastricht University Medical Center; Maastricht; The Netherlands
| | - F. Claas
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - M. E. Fasano
- Immunologia Trapianti c/o Genetica; Turin; Italy
| | - M. Gerbase-DeLima
- Universidade Federal de São Paulo and Associação Fundo de Incentivo à Pesquisa; São Paulo; Brazil
| | - T. Gervais
- Immunohaematology, Cliniques St. Luc; Université Catholique de Louvain; Brussels; Belgium
| | - C. Gorodezky
- Department of Immunology & Immunogenetics; Instituto de Diagnostico y Referencia Epidemiologicos; Mexico City; Mexico
| | - J. Larriba
- Histocompatibility and Immunogenetics-ICBME; Hospital Italiano de Buenos Aires; Buenos Aires; Argentina
| | - N. M. Lardy
- Sanquin-Diagnostic Services; Amsterdam; The Netherlands
| | - D. Latinne
- Immunohaematology, Cliniques St. Luc; Université Catholique de Louvain; Brussels; Belgium
| | - L.-E. Morales-Buenrostro
- Department of Nephrology and Mineral Metabolism; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran; México City; Mexico
| | - M. J. Moreno
- Histocompatibility Laboratory; CEMIC-Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno; Buenos Aires; Argentina
| | - F. Oguz
- Department of Medical Biology, Medical Faculty of Istanbul; Istanbul University; Istanbul; Turkey
| | - G. Opelz
- Institute of Immunology; University of Heidelberg; Heidelberg; Germany
| | - R. Sergeant
- Immunology; Imperial College Healthcare NHS Trust; London; UK
| | - M. Tambutti
- Histocompatibility and Immunogenetics-ICBME; Hospital Italiano de Buenos Aires; Buenos Aires; Argentina
| | - S. Teper
- Histocompatibility Laboratory; CEMIC-Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno; Buenos Aires; Argentina
| | - M. Tilanus
- Transplantation Immunology, Tissue Typing Laboratory; Maastricht University Medical Center; Maastricht; The Netherlands
| | - A. Turkmen
- Department of Medical Biology, Medical Faculty of Istanbul; Istanbul University; Istanbul; Turkey
| | - A. N. Warrens
- Immunology; Imperial College Healthcare NHS Trust; London; UK
| | - W. Weimar
- Internal medicine; Erasmus Medical Center; Rotterdam; The Netherlands
| | - E. Goulmy
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
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Wylegała E, Mańkowski W, Pilat J, Teper S, Skupień-Mańkowska H. [Diabetic macular edema--modern diagnostics and treatment]. Pol Merkur Lekarski 2010; 29:61-65. [PMID: 20712253] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Diabetic macular edema is very important medical and social problem and major cause of severe and permanent visual acuity depression in the working-age population. Rapid diagnostics with optical coherence tomography, color fundus photography, fluorescein angiography and appropriate treatment in patients with diabetes stops or retards progress of diabetic macular edema.
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Affiliation(s)
- Edward Wylegała
- Okregowy Szpital Kolejowy, Samodzielny Publiczny Zakład Opieki Zdrowotnej w Katowicach, Oddział Okulistyki.
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20
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Woyna-Orlewicz A, Wylegała E, Słoka A, Teper S, Piłat J, Orska M. [Perforating eye injury with retained inorganic intraorbital foreign body--case report]. Klin Oczna 2007; 109:226-9. [PMID: 17725294] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Authors would like to present a case of perforating eye injury with inorganic foreign body, which consequently stick behind the globe in muscular cone space. We discuss visual prognosis after injury which depends on injury mechanism, wound extension and localization as well as tolerance of intraorbital foreign body through eye's tissue and prevention of eye injuries. We would like to stress the necessity of meticulous primary microsurgical repair and possible secondary surgical reparation to reduce posttraumatic visual loss. There is also a possibility of late complication due to vitreoretinal proliferation as a consequence of healing process.
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Affiliation(s)
- Anna Woyna-Orlewicz
- Zakładu Pielegniarstwa i Społecznych Problemów Medycznych Slaskiej Akademii Medycznej w Katowicach
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Wylegała E, Moćko L, Woyna-Orlewicz A, Teper S, Orzechowska-Wylegała B. [Diabetic complications within ocular surface]. Pol Merkur Lekarski 2006; 21:495-7. [PMID: 17345849] [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] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Authors present one of the ocular diabetic complications--diabetic keratoepitheliopathy. The aim of this article is to summarize the knowledge about diabetic keratoepitheliopathy, its causes, manifestations and treatment options. Diabetes mellitus is associated with structural and functional disturbances in eyelids, conjunctiva and cornea. There are also changes in tear film present. Diabetic neuropathy resulting from the biochemical poor control of diabetes is the probable basic cause of the pathology. Mechanisms responsible for these changes are still not well understood. The corneal and conjunctival complications may occur spontaneously. But more often they arise from undue stress of intraocular surgery procedures. The incidence of diabetic keratoepitheliopathy in diabetic patients is high. However, it is rarely diagnosed. Effectiveness of symptomatic treatment with use of common medications is not satisfactory and it needs further investigation.
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Affiliation(s)
- Edward Wylegała
- Department of Nursing and Social Medical Issues, Silesian Medical University in Katowice, Poland
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Wylegała E, Woyna-Orlewicz A, Piłat J, Teper S, Ludyga A. [Traction maculopathies--pathogenesis and diagnostics]. Klin Oczna 2006; 108:457-63. [PMID: 17455727] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Traction maculopathies are a group of age-related degenerative diseases characterized by pathology of vitreomacular interface including idiopathic epimacular membranes, vitreomacular traction syndrome and idiopathic macular hole. The disorders develop due to mechanical forces caused by focal condensation or incomplete detachement of vitreous and shrinkage of pathological membranes. The forces can be tangential to retinal surface in epiretinal membranes, anterior-posterior in vitreomacular traction syndrome and oblique (trampoline) in idiopathic macular hole. Authors discuss pathogenesis and diagnostics of traction maculopathies with use of optical coherence tomography and microperimetry, based on current literature. This work presents also idiopathic macular hole classification with use of optical coherence tomography images compared with biomicroscopic classification by Gass.
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Affiliation(s)
- Edward Wylegała
- Zaktadu Pielegniarstwa i Społecznych Problemów Medycznych Slaskiej Akademii Medycznej w Katowicach
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Teper S. The pattern of pregnancy amongst adolescents and teenagers in Scotland, and its relationship to recent trends in national fertility. Scott J Sociol 2002; 2:229-40. [PMID: 12337073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Teper S. Sterilization 1. The changing attitude. Bull Eugen Soc 2002; 9:116-22. [PMID: 12178247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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George RC, Heptonstall J, Morse D, Reeves WG, Teper S. Quarterly communicable disease review. July to September 1992. From the PHLS Communicable Disease Surveillance Centre. J Public Health Med 1993; 15:103-11. [PMID: 8385968 DOI: 10.1093/oxfordjournals.pubmed.a042796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Rawlings RR, Graubard BI, Teper S, Ryback RS, Eckardt MJ. Conditional Quadratic Discrimination in the Identification of Biological Markers for Disease Screening. Biom J 1986. [DOI: 10.1002/bimj.4710280811] [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: 11/10/2022]
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Teper S. Adolescent health services. Fertil Steril 1984. [DOI: 10.1007/978-94-015-1308-1_76] [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: 11/28/2022]
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Abstract
A review of age-specific mortality-rates from cervical cancer in England and Wales and in Scotland in 1968--76 shows a decline, striking at some ages. In England and Wales, however, there has been an increase at ages 25--34 and, possibly, at 15--24. Signs of such an increase are also seen in Scotland for the age-groups 25--34 when figures for two regions with well-established screening programmes are removed. Indeed trends in these regions compared with those for the rest of Scotland support the benefit of cervical screening.
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Abstract
9000 women aged 20 years and under who had cervical smears taken in the 10-year period 1967-76 were studied. The number of young women with abnormal smears rose, but this increase was in proportion to the number screened. Abnormal smears were found in 145 (1.6%) cases. Follow-up for periods of up to 10 years showed that in over half the cases subsequent smears had reverted to normal without treatment. 19 of the 145 patients progressed to have smears which were suggestive of malignancy: 16 of these were diagnosed histologically as carcinoma-in-situ, and the other 3 were histological dysplasias. At follow-up no cases of carcinoma-in-situ were found in women under 21. No cases of invasive cancer were found on the initial biopsy. One microinvasive cancer was found in a woman aged 26 on a second biopsy 6 1/2 years after the first atypical smear. The preclinical cases were detected from smears taken during pregnancy, or, in the case of the one possibly nulliparous girl, during a gynaecological consultation. These women did not attend family-planning clinics until after a pregnancy.
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McKeown T, Carrier NH, Anstey V, Gellner E, Scharf BR, Muhsam HV, Teper S, Hobcraft J. Book reviews. Population Studies 1968. [DOI: 10.1080/00324728.1968.10405542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Teper S, Agarwala SN. Corrected Age Data of the 1931 Indian Census. Population Studies 1968. [DOI: 10.2307/2173032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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