OphthaTherapy. Therapies in Ophthalmology

Uveal Melanoma – a review of treatment methods

2024-02-26T16:53:25+01:00

Uveal melanoma is the most common primary intraocular malignancy. In Europe, the incidence of uveal melanoma is approximately 8 cases per million people per year. In about 50% of cases, uveal melanoma metastasizes. Scientific papers on uveal melanoma published between 1 January 2018 – 1 March 2023, available in the PubMed database were analysed. Currently, methods such as enucleation, transpupillary thermotherapy, photodynamic therapy, eye plaque brachytherapy, proton beam therapy and stereotactic surgery are used to treat this cancer. In this paper we summarize the current knowledge about the classic treatment methods and the promising novel ones.

Endogenous endophthalmitis with iridolenticular involvement – a case report and systematic review

2024-02-26T16:39:04+01:00

Endogenous endophthalmitis (EE) is a sight- and life-threatening disease. EE associated with the involvement of iris and crystalline lens is an uncommon presentation. We reported a case of EE with iridolenticular involvement in a 19-year-old woman with a history of candidemia. Therapeutic vitrectomy with lensectomy was performed, and the patient was treated with intravitreal meropenem and amphotericin B. She was discharged with 6 weeks of oral fluconazole. At follow-up, her vision was 20/60 with aphakic correction. We also conducted a systematic review of the current literature to analyse the clinical features, risk factors, and outcomes of EE with iridolenticular involvement. The systematic review included 10 cases, and found that Candida albicans was the main causative organism. Intravenous drug use and a history of invasive procedures were important risk factors. 70% of the cases required vitrectomy and lensectomy. Post treatment, majority of the cases (80%) had a good visual prognosis of better than 20/60. Our results suggested that in cases of EE with iridolenticular involvement, early surgical removal of the infectious nidus via vitrectomy and lensectomy is recommended for a good visual outcome. A high level of suspicion is crucial in diagnosing the disease, and early aggressive therapy is fundamental.

Peripheral hypertrophic subepithelial degeneration – case report

2024-02-26T16:53:18+01:00

Purpose: The aim of the paper is to present the case of a 53-year-old female patient who, based on the clinical picture and optical coherent tomography of the anterior segment (AS-OCT), was diagnosed with peripheral hypertrophic subepithelial degeneration (PHSD) and underwent surgical treatment in the form of superficial keratectomy with mechanical removal of degenerative plaques.

Methods: Analysis of AS-OCT images and corneal tomography based on Scheimpflug images and surgical treatment – superficial keratectomy with mechanical removal of degenerative plaques.

Results: Before treatment, the best corrected visual acuity (BCVA) for distance, as assessed by the Snellen chart, was 3/50 c.cor +10.50/-6.50 ax 18° in the right eye (RE) and in the left eye (LE) 5/10 c.cor +10.75/-3.00 ax 48°. Preoperative keratometry performed with the Pentacam device was K1 32.7 D and K2 46.0 D in the OP and K1 42.5 D and K2 44.7 D in the LE. Postoperative BCVA in RE was 5/8 c.cor +3.50/-1.00 ax 120° at 5 months of follow-up and in LE 5/6 c.cor +4.75/-1.00 ax 64° at 3rd month of observation. Postoperative keratometry (Pentacam) in RE K1 was 44.6 D, K2 46.9 D in the 5th month of observation, and in LE K1 45.6 D, K2 46.5 D in the 3rd month of observation. As a result of the treatment, BCVA improved, astigmatism decreased and corneal translucency improved.

Conclusions: AS-OCT and Scheimpflug-based corneal tomography are helpful in the diagnosis of PHSD. Superficial keratectomy with mechanical removal of degenerative plaques seems to be an effective treatment for PHSD

Sulodexide – a new model for treating the early stages of diabetic retinopathy

2024-02-26T16:42:14+01:00

Glycocalyx is the surface layer of endothelial cells, it lines the blood vessels and provides a cellular barrier against damage. Sulodexide has a protective effect on the glycocalyx and allows it to be rebuilt, and has anti-inflammatory, antioxidant, anticoagulant, and lipid profile-enhancing properties. Diabetic retinopathy damages the glycocalyx and vascular endothelium in the retina. Sulodexide rebuilds the glycocalyx and increases the integrity of the blood-retinal barrier, thereby protecting the retinal vasculature retina from hyperglycemia-induced damage. Clinical studies have confirmed that in non-proliferative diabetic retinopathy, sulodexide improves visual acuity, reduces microaneurysms and hard exudates. Further in a study evaluating recurrent retinal vein thrombosis, sulodexide reduced the recurrence rate. Sulodexide is a safe and well-tolerated drug and may play an important role in the treatment of diabetic retinopathy, both in reducing symptoms and improving visual function.

Comparison of drugs belonging to the group of ophthalmic non-steroidal anti-inflammatory drugs

2024-02-26T16:53:15+01:00

Ophthalmic non-steroidal anti-inflammatory drugs are non-steroidal anti-inflammatory drugs used to treat or prevent eye inflammation. Their main action is to relieve symptoms such as pain, redness and swelling that can be caused by eye diseases, injuries or eye surgery. Non-steroidal anti-inflammatory drugs used in ophthalmology include substances such as diclofenac, ketorolac, bromfenac and nepafenac. So far, many studies have been published comparing the effectiveness of various systemic and local non-steroidal anti-inflammatory drugs. This work contains a comparative analysis of the above-mentioned substances in terms of their use and effectiveness in ophthalmology.

Resveratrol and curcumin against diabetic retinopathy. Better together than apart

2024-02-26T16:53:11+01:00

The health-promoting effects of curcumin and resveratrol have been known for a long time. The most important features of polyphenols include their effect on blood vessels and participation in the neutralization of free oxygen radicals. Both resveratrol and curcumin exhibit antioxidant effects, and the combined use of both substances significantly improves their effectiveness. In the fight against diabetic retinopathy, the antiangiogenic effect of polyphenols also turn out to be important. Many researchers also point to the possibility of using resveratrol and curcumin in cancer therapy.

Triple hit on ocular surface inflammation – case reports

2024-04-09T13:21:17+02:00

In everyday medical practice, finding the exact cause of conjunctivitis can be difficult without thorough laboratory testing. Therefore, the paper presents cases of treating ocular surface disorders of unknown etiology with the help of combination preparations in the form of a suspension, which allows a wide range of therapeutic effects including bacteria, chlamydia and allergic inflammation and provides a more stable and longer-lasting drug concentration level compared to drugs in the form of aqueous solutions.

Technical aspects and intraoperative factors influencing the efficiency of non-penetrating deep sclerectomy and implantation of PreserFlo MicroShunt

2024-02-26T16:53:07+01:00

Glaucoma is a neurodegenerative disorder marked by the death of retinal ganglion cells which causes characteristic vision field loss. At the moment the only well-known risk factor for progression of the glaucoma is intraocular pressure. In this regard the lowering of intraocular pressure became the main focus of treatment.

Different types of glaucoma surgeries have developed over the last decades. Most of them facilitate outflow of aqueous humor, few decrease the production. This article takes into account two of them: non-penetrating deep sclerectomy and implantation of PreserFlo MicroShunt.

Deep sclerectomy is a well established non-penetrating type of glaucoma surgery. With use of adjuvant methods such as use of space-maintaining implants, use of viscoelastic agent and use of antimetabolites during procedure it allowed to achieve success rate of standard penetrating surgery with lower rate of complications.

PreserFlo MicroShunt implantation is a promising new filtration procedure for glaucoma treatment. First published studies show promising efficacy and safety outcomes, although further research is needed.

Direct brow lift – indications, diagnostics, operating techniques

2024-02-26T16:53:03+01:00

Eyebrow lift is one of the most effective rejuvenating procedures in facial plastic surgery. Lifting the aging soft structures around the eye socket yields both cosmetic and, in some cases, therapeutic effects. Regardless of the indications, preoperative assessment of the patient should be based on a thorough interview, establishing the patient’s expectations, determining the achievable outcome of the procedure, and anticipating potential complications. During the physical examination, it is crucial to identify relevant anatomical structures, assess facial symmetry, scope, and the technique of the procedure. Often, patients opt for combining direct eyebrow lift with eyelid surgery, significantly enhancing the overall result. The primary complication of direct eyebrow lifting is a visible scar, which may be a contraindication for individuals prone to keloid formation and those with a brow deficit. The aim of this study is to define the indications, diagnostics, and describe the surgical techniques used in eyebrow lift procedures.

Ocular surface disturbances after laser refractive surgery

2024-02-26T16:53:01+01:00

Most patients undergoing laser refractive surgery demonstrate transient and mild symptoms of dry eye disease. The article presents the main mechanisms involved in dry eye disease after the most frequently performed laser vision correction methods. Differences in the occurrence of dry eye disease between flap, surface procedures and minimally invasive lenticule extraction were highlighted.