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Copyright of Acta Ophthalmologica Polonica / Klinika Oczna is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Ophthalmologica Polonica / Klinika Oczna is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Experimental & Clinical Diabetology / Diabetologia Doswiadczalna i Kliniczna is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Systemic lupus erythematosus belongs to the group of autoimmune diseases, in which the accumulation of antigen-antibody complexes may lead to multiple organ failure. Ocular manifestation of the disease is also possible. Ocular changes are attributable to either the disease itself or to the complications associated with administered therapies. The aim of this research was to present the utility of ophthalmic and diagnostic devices in interpreting ocular changes in patients with systemic lupus erythematosus. Ultrasound biomicroscopy and spectral domain optical coherence tomography provide the insight into the anterior segment morphology with special emphasis on the cornea and iridocorneal angle in patients with Systemic Lupus Erythematosus. Confocal microscopy presents particular corneal layers in vivo what enables detecting the location of inflammatory and chloroquine deposits. Ocular Response Analyzer estimates changes in corneal hysteresis and resistance parameters in patients with systemic lupus erythematosus. The optical coherence tomography of the macula and multifocal electroretinography enable detecting subclinical forms of maculopathy. Evaluation of arterial flow parameters and characteristics in ocular circulation measured during fluorescein angiography and colour Doppler imaging quantifies functional and morphological changes in ocular circulation. The appropriate use of diagnostic devices along with accurate interpretation of findings may be crucial for early detection of ocular changes in many diseases with ocular involvement, including systemic lupus erythematosus.

Retinal vascular tumours are congenital and acquired lesions of variable clinical manifestation. They are classified as benign, but their presence leads to vision impairment due to the development of complications. Each retinal vascular tumour possesses characteristic clinical features and is often associated with certain systemic disorders. Thus, a correct diagnosis is crucial for providing individualised treatment and expanded diagnostic management as well as prognostic assessment. The aim of the study was to present retinal vascular tumour cases of patients treated at the Department of Ophtalmology and Ocular Oncology of Jagiellonian University Collegium Medicum in Cracow.

Central serous chorioretinopathy is a common retinopathy, which is manifested by the idiopathic detachment of the neurosensory retina in the posterior pole, secondary to fluid leakage from choroidal vessels at the level of retinal pigment epithelium. The disease is typically unilateral and affects young men. We present a case of a 48-year old man, admitted to the Department of Vitreo-Retinal Surgery, Medical University in Lublin, reporting vision impairment in his right eye. The bilateral ocular exam followed by optical coherence tomography, ultra-widefield fluorescein angiography and microperimetry revealed bilateral central serous chorioretinopathy. This case presents a bilateral manifestation of central serous chorioretinopathy and emphasizes the role of advanced diagnostic imaging techniques in analyzing retinal function and disease management.

Pigmented paravenous retinochoroidal atrophy is a rare dystrophy, which is usually asymptomatic and limited to the paravenous area. Due to the slow progression of eye fundus changes, typically without the macular involvement, pigmented paravenous retinochoroidal atrophy is not thought to be a vision-threatening ocular disease. We report a case of a 64-year-old man with sudden unilateral reduction of vision and binocular diplopia, diagnosed with bilateral pigmented paravenous retinochoroidal atrophy. The diagnosis was based on a characteristic fundus appearance, additionally accompanied by the bilateral mild macular changes, minor optic disc pallor and moderate retinal artery narrowing. The presented case posed a diagnostic challenge due to the sudden onset and atypical manifestation.

Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

Purpose: To determine clinical effect of intravitreal bevacizumab (Avastin) in patients with cystoid macular edema after cataract surgery., Material and Methods: Four eyes of four patients treated with 1 intravitreal injection of 1.25 mg Avastin. In three cases duration of cystoid macular edema was less then 4 months, in one eye cystoid macular edema was chronic (more than 4 months). Visual acuity and clinical effect in spectral optical coherence tomography (central retinal thickness and fovea anatomy) was examined before and after intravitreal injection., Results: Visual acuity improved in 3 of 4 patients. In acute cystoid macular edema final visual acuity was 0.8-0.9, in chronic cystoid macular edema patient visual acuity improved from 0.05 to 0.2. In 3 of 4 patients central retinal thickness decreased and fovea anatomy was normalized. In patient with no clinical and anatomical improvement spectral optical coherence tomography examination revealed epiretinal membrane., Conclusions: Intravitreal Avastin may be successful treatment in most Irvine-Gass syndrome cases. The condition that exclude patients from bevacizumab treatment is horizontal (epiretinal membrane), and vertical traction revealed in spectral optical coherence tomography.

Purpose: To report a patient with polypoidal choroidal vasculopathy (PCV) with spontaneous regression of subfoveal changes during follow-up., Material and Methods: The seventy six years old men was referred to the treatment of exudative type of age related macular degeneration (AMD) in the RE. The routine ophthalmological examination, the optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA) were performed., Results: Decreasing of visual acuity of the RE and abnormal result of the Amsler test, hemorrhagic and exudative changes near inferior-temporalis vascular arcade were observed. Intraretinal fluid in the OCT was noted. FA revealed parapapillaris changes suggesting CNV. ICGA showed the presence of branching vascular network extending from choroidal vasculature (BVN) and polypoidal and aneurysmal vascular terminal lesion (PL) localized under retinal pigment epithelium (RPE)., Conclusions: Based on the results PCV was diagnosed and the patient was referred to laserotherapy. Due to the regression of the eye fundus changes during the period of observation, confirmed by control OCT and FA the treatment was not implemented.

Purpose: The aim of the study was the evaluation of the changes characteristic for type 2a idiopathic juxtafoveal retinal telangiectasia in spectral domain optical coherence tomography images., Material and Methods: The study covered 23 eyes with diagnosed idiopathic juxtafoveal retinal telangiectasia of type 2a - 5 men and 7 women. Stage 2 was noticed in 9 eyes, stage 3 in 5 eyes, stage 4 in 8 eyes. Stage 5 was noticed in one eye. All the patients included in the study underwent the macula analysis by SdOCT technique., Results: Stage 2 was characterized mainly by the occurrence of small hyporeflective microcysts (in 100% of cases), tiny hyperreflective deposits (in 90% of patients), focal retinal photoreceptor layer damage (in 80%) as well as large hyporeflective cysts (70%). Stage 3 in SdOCT scans showed dominating hyperreflective deposits, including both small ones (100%) and less frequent large shaded deposits (71%), and still numerous microcysts (86%) and larger hyporeflective compartments. Stage 4 was characterized by the occurrence of large spreaded areas of fading retinal photoreceptor layer (in 100% of examined eyes), accompanied by retina architecture disorders. We also noticed numerous tiny hyperreflective deposits (100% of examined eyes), as well as large hyperreflective deposits (80%). Microcysts occurred significantly less frequently than in other stages (60%). The average retina thickness in fovea in all eyes irrespective of the stage of disease amounted to 192.13 +/- 59.1 microm, on the other hand in the nasal and temporal parts of fovea 202.43 +/- 37.75 microm and 262.7 +/- 41.31 microm respectively (p< 0.05)., Conclusions: Thanks to its high resolution, SdOCT examination depicts changes in retina in the course of idiopathic juxtafoveal telangiectasia in great detail. Our study shows certain permanent changes occurring in this disease, characteristic to subsequent stages which allow to make a highly probable diagnosis before fluorescein angiography is carried out.

This paper presents the comparison of different schemes of two kinds of general steroidotherapy in one case of idiopathic, bilateral panuveitis and effectiveness of intravitreal dexamethason to one eye. The effectiveness of the treatment was mainly concerned on best corrected visual acuity, the illustration of macular retinal area in OCT (optic coherence tomography), where the reduction of cystic macular oedema was detected and the pictures of fluorescein angiography. The observation and the treatment has lasted for 3 years. At the beginning, the patient received general steroidotherapy (medrol), which lasted seventy four days. Improvement of clinical symptoms lasted only four months. The similar therapy the patient obtained once more. The symptoms of illness returned, after the same period of time. Then the intravitreal dexamethason (Posurdex) was injected. The better visual acuity and improvement of clinical symptoms was observed for three months. The patient couldn't obtain posurdex once more. The physician decided to apply the different scheme of general steroidotherapy. The observation after finished treatment, lasted over one year. Clinical symptoms of the illness retracted. The fluorescein angiography of the eyes were correct and the structure of the macular retinal area presented in optical coherence tomography were regular. The observation of the patient is continued.

Purpose: The aim of this study is to present and discuss three cases of acute posterior multifocal placoid pigment epitheliopathy (APMPPE)., Material and Methods: Three young patients (one woman and two men), developed rapid loss of vision in one or both eyes. Basic ophthalmic examination and additional diagnostic methods including: fluorescein angiography (FA), indocyanine green angiography (ICG), optical coherence tomography (OCT) and human leucocyte antigen (HLA) class I test were performed., Results: Based on the results of performed investigations the diagnosis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) was established. Fundus examination revealed characteristic multifocal, placoid, creamy or grey/white subretinal lesions. Fluorescein angiography in acute stage of the disease demonstrated early hypofluorescence followed by later hyperfluorescence of the lesions. Indocyanine green angiography demonstrated hypofluorescence in all stages of the angiogram. In one case, class I HLA-B7 antigen was found. In all presented cases visual acuity markedly improved with general glicocorticosteroids., Conclusions: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is characterized by rapid, but transient loss of visual acuity. Diagnosis is established in fluorescein angiography and prognosis for recovery is good, however in cases with poor visual acuity glicocorticosteroids might be beneficial.

Purpose: The aim of this review is to present cases of clinically differentiated picture of persistent fetal vasculature syndrome--PFVS (also called persistent hyperplastic primary vitreous body--PHPVB) observed in group of infants and children., Material and Methods: Case records of four children with characteristic changes of posterior form of persistent fetal vasculature syndrome, which were observed on fundus of the eyes, were analyzed retrospectively. Routine ophthalmological examination, genetic, cytogenetic and laboratory tests towards coexisting bacterial, viral and parasitic diseases and congenital anomaly of the eye or chorioretinal neoplastic changes of neonatal period were performed. Ophthalmological changes were archived using Ret-Cam II apparatus (Clarity Medical Systems). Measurement of the axial diameter of the eyes and exclusion coexisting ocular disease by ultrasonography (A-scan US i B-scan US and color Doppler ultrasonography--CDU), were performed., Results: Different clinical image of posterior form of persistent hyperplastic primary vitreous body was observe in ophthalmological examination. Changes such as fibrovascular tissue connecting optic disc (n. II) with ora serrata of the retina coexisting with retinoschisis, retrolental mass or persistent hyaloid artery were observed. Additionally concomitant features in pathological eyes were: iris hypoplasia, corectopia, microphthalmia, congenital cataract, secondary glaucoma, degeneration or retinoschisis and intrvitreous haemorrhage. Strabismus, nystagmus and heart disease in the form of persistent fetal circulation were associated with ophthalmological changes. Inflammatory and genetically determined diseases were excluded in differential diagnosis., Conclusions: The diagnosis of persistent hyperplastic primary vitreous body (PHPVB) was confirmed by characteristic clinical symptoms and results of the additional research. Suggestion of recognition of this syndrome (PHPVB) as well as persistent fetal vasculature syndrome (PFVS) should be implemented diagnostics towards other optic and systemic development defects.

Purpose: The aim of this paper is to present the early phase of treating exudative age-releted macular degeneration (AMD)--coexisting witch vitreoretinal pathology--with combined pharmacological-surgical therapy., Material and Methods: Our observation is based on one clinical case of combined therapy: pars planavitrectomy (PPV) and one intravitrealranibizumab injection. Observation is being carried on larger patient group according to the treatment scheme presented In this paper., Results: In this case described combined pharmacological-surgical therapy allowed a significant improvement in visual acuity and closure of choroidal neovascularization (CNV), leakage confirmed by fluorescein angiography (FA) and optical coherence tomography (AMD). The treatment is being continued--another ranibizumab injection according to PRONTO study reinjection criteria., Conclusions: The pathomechanism of exudative AMD and coexistance of vitreoretinal pathology implications confirm reasonability of combined therapy.Due to actual clinical studies: the pharmacological -surgical treatment reduces the number of required intravitreal anti-VEGF agents injections. To confirm this observation we need to perform large randomised clinical studies.

Purpose: Aim of the study is to determinate retinal thickness in macula region in primary open-angle glaucoma patients and in patients suspected of primary open-angle glaucoma--by using retinal thickness analyzer RTA, as well as evaluation of the applicability of the method in the early diagnosis of primary open-angle glaucoma., Material and Methods: Fifty primary open-angle glaucoma patient (95 eyes, average age 43.7 +/- 9.0 years), and 67 patients suspected of primary open-angle glaucoma (128 eyes, average age 43.2 +/- 11.0 years), underwent full ophthalmologic examination and also retinal thickness analysis with RTA analyzer. In particular, foveola average thickness VAV, foveal average thickness FAV, peri-foveal average thickness PFAV and posterior pole average thickness PPAV, were determined. The data were statistically evaluated and compared with those obtained for healthy subjects from the control group., Results: The retinal thickness values in the populations of primary open-angle glaucoma and primary open-angle glaucoma-suspected patients were: VAV 139.0 +/- 20.5 microm i 147.6 +/- 21.2 microm, FAV 149.9 +/- 17.4 microm i 157.1 +/- 18.6 microm, PFAV 173.0 +/- 11.4 microm i 187.3 +/- 15.6 microm oraz PPAV 168.1 +/- 11.3 microm i 182.5 +/- 14.8 microm, respectively. Statistically significant differences between both populations and the population of healthy subjects were observed., Conclusions: The retinal thickness in macula region in primary open-angle glaucoma and in patients suspected of primary open-angle glaucoma was significantly lower than in the population of the healthy subjects. The method can be successfully applied in the early diagnosis of primary open angle glaucoma and be a valuable supplementary examination of the optic nerve disc and peripapillary area.

Purpose: To present two cases of neuroretinitis in cat scratch disease We present two girls treated in Department of Ophthalmology of Poznai University of Medical Sciences because of unilateral, painless decrease of vision. Both patients presented following cat exposure fever and lymph nodes swelling. Ophthalmoscopic findings was neuroretinitis (optic disc edema with the macular star). Bartonella henselae antibody titers (IgG) were elevated. CSD is usually self-limited infection in immunocompetent patients and there is no clear treatment recommendations. One of our patients received treatment which included oral antibiotic (macrolides) and steroid. The second patient was left without treatment. In our case--the duration of visual loss was longer in patient who was not treated.

Purpose: To evaluate the relationship between isolated focal retinal pigment epithelium (RPE) proliferation and development of occult choroidal neovascularisation., Material and Methods: The natural clinical course of 43 eyes of 39 patients was analyzed. Patients with RPE proliferation as an isolated manifestation of retinal degeneration were included in this study. The mean age of patients was 75.0 (69-94). The mean observation period was 41.4 months (6-63)., Results: In 30 eyes (70%), occult choroidal neovascularisation occurred, in 13 eyes (30%), that complication was not observed. The development of neovascularisation was correlated with the presence of neovascular membrane in the fellow eye., Conclusions: Based on presented data we can estimate that isolated focal proliferation of retinal pigment epithelium is an important risk factor for the development of occult choroidal neovascularisation.

We presented a case of sudden and painless vision impairment connected with the recreational usage of cocaine. According to many authors illicit use of cocaine has been associated with the most common adverse effect among all psychoactive drugs. In the last years there were a few articles about vision problems after the usage of cocaine. In most cases the main mechanism was central retinal artery occlusion (CRAO). The vision impairment developed from 3 to 10 hrs after the cocaine use and the outcome, despite the intensive treatment, was usually poor. All doctors should keep in mind the possibility of cocaine usage, in young and healthy people, who developed a sudden and painless vision loss.

Anti-vascular endothelial growth factor (anti-VEGF) therapies that inhibit choroidal angiogenesis and reduce vascular permeability have revolutionized clinical practices for neovascular eye diseases. Ranibizumab (Lucentis) is a Fab-antibody with high affinity for VEGF, and has a potential to bind to all VEGF isoforms. Diseases of retinal and choroidal vasculature are the most prevalent causes of vision loss in developed countries. Among them diabetic macular edema (DME) is the most common sight threatening complication of diabetes. VEGF plays a critical role in the pathogenesis of DME. Due to modest outcomes with macular photocoagulation, other treatment modalities for DME have been evaluated. The results of the pilot studies and preliminary results of multicenter randomized, controlled studies showed that intraocular injections of ranibizumab decrease the mean retinal thickness and improve the BCVA (best corrected visual acuity) in patients with DME.

Serpiginous choroidopathy (SC) is classified as idiopathic chorioretinal disease. Atrophy of external retina comprising foveolar area and/or submacular neovascularisation is a leading cause of visual acuity deterioration. A case report shows progression of fundus lesion in the course of SC during 3 years of follow up.

Purpose: To present a rare idiopathic inflammation of the posterior segment of the eye - acute posterior multifocal placoid pigment epitheliopathy (APMPPE)., Material and Methods: A 17 years old male patient was referred to the Department of Ophthalmology of Medical College, Jagiellonian University in Krakow with the diagnosis of bilateral choroiditis of unknown etiology. The patient underwent the basic ophthalmological examination followed by fluorescein (FA) and indocyanine green (ICGA) angiography. Laboratory testing for Lyme disease, sarcoidosis and syphilis, as well as genetic testing, to determine the presence of HLA antigen complex, were performed, Results: Based on the outcomes of performed investigations the definitive diagnosis of APMPPE was established. Systemic steroidotherapy was initiated due to rapid progression of the inflammatory changes, progression of the central visual field changes and profound visual acuity deterioration., Conclusions: APMPPE is a rare, inflammatory and idiopathic eye disease with no clear indications for pharmacological therapy. However decision about necessity and sort of pharmacological therapy should be taken under consideration individually for each patient. ostra tylna wieloogniskowa plackowata epiteliopatia barwnikowa, steroidoterapia. acute posterior multifocal placoid pigment epitheliopathy, steroidotherapy.

We present a case of 21 years old male with significant unilateral decrease of vision. Ophthalmoscopic examination revealed distinct macular edema and peripheral retinal edema. Fluorescein angiography showed peripheral retinal telangiectasia, arteriolal and venous shunts and large areas of hypoperfusion. Base on that picture, diagnosis of miliary Leber aneurysms was made. It followed by laser photocoagulation of retina: macular GRID and peripheral scatter. After 4 months return of normal visual acuity was noted, as well as lack of retinal edema in fluorescein angiography.

Purpose: Aim of the study is an evaluation of the anatomic state of retina in the macular region in diabetic patients with various stages of retinopathy by using RTA analyzer, and an assessment of applicability of this method in early diagnosis of diabetic macular edema., Material and Methods: Forty diabetic patients (68 eyes) underwent full ophthalmologic examination and also retinal thickness analysis with RTA analyzer. In particular, foveal average thickness FAV and posterior pole average thickness PPAV were determined. The data were statistically evaluated., Results: Both FAV and PPAV are strongly correlated with the eyeground state and increased with increasing the severity of retinopathy and macular edema. The patients with minimal and mild nonproliferative retinopathy without any visible macular edema showed an increased retinal thickness when compared both with diabetic patients without any retinopathy and with control patients. The thickness was however lower than that in patients with diabetic macular edema., Conclusions: The eyes with minimal and mild nonproliferative diabetic retinopathy without any visible macular edema should be examined by some independent methods, like RTA. The method can be recommended for screening the macular edema in diabetic patients.

Purpose: Of our study is to check usefulness of OCT exam in qualification for PDT, and as independent diagnostic tool. OCT exam gives quantification of parameters for monitoring PDT Correlation between the results of OCT exams and visual acuity was estimated as well as the prognosis of PDT efficacy on the basis of results from OCT exams., Material and Methods: 59 eyes of 56 patients with CNV caused by AMD were examined and treated PDT. OCT and BCVA examination were done before PDT, 1 week, 4 weeks and 12 weeks after PDT OCT measurement: minimal retinal thickness in fovea, average retinal thickness in fovea, retinal volume in fovea and total retinal volume in macula. STRATUS OCT 3000 with soft. v.4.0.2 (0056) was used. All 59 eyes form group D. The eyes were divided into two antagonist subgroup: D1--38 eyes with visual acuity stabilization or worsening and D2--21 eyes with visual acuity improvement 12 weeks after PDT., Results: There was correlation between results in exams of retinal thickness and volume in macula. Group D has significant decrease of minimal retinal thickness, average retinal thickness in fovea and retinal volume in fovea 4 weeks after PDT. In subgroup D1 there was statistically significant decrease of minimal retinal thickness and total retinal volume in macula, 12 weeks after PDT. There was in subgroup D1 positive correlation between relative changes of total retinal volume in macula and relative changes of BCVA four weeks after PDT., Conclusions: OCT exam is very useful in qualification for PDT, but it could not be an independent diagnostic tool. Useful quantification of parameters in OCT exam are retinal thickness and retinal volume. OCT does not allow to prognosis efficacy of PDT

Purpose: The study presents a case report and demonstrates the diagnostic difficulties with differentiating Multiple Evanescent White-Dot Syndrome (MEWDS), with other disorders., Material and Methods: A 29 years old male presented with a week history of photopsia and scotoma in his left eye. Diagnostic tests included: visual acuity, fundoscopy, automated perimetry, fluorescein angiography, multifocal electroretinogram, OCT, MR and blood tests. The attention was drawn by the numerous white dots in fundoscopy and punctate hyperfluorescence in the AF. The additional important information was given by the blood tests., Conclusions: In the differential diagnosis we should take into consideration neuroretinitis and neurochorioretinitis of viral aetiology.

We present the case of punctate inner choroidopathy in a 45 years old woman B.S. In the case of PIC we should perform special tests, that may confirm diagnosis, help in the appropriate treatment and avoid complications.

Aim: The aim of our study was to evaluate the visual acuity, visual field, retinal bioelectrical function and fluorescein angiography (FA) results of patients with exudative AMD treated with an intravitreal injection of triamcinolone acetonide (IVTA)., Material and Methods: Visual acuity (Snellen chart), Humphrey automatic static perimetry (HASP) 30-2 W-W, mfERG were performed before, one month and three months after a single intravitreal injection of about 20 mg triamcinolone acetonide in 17 eyes of 17 patients (that did not meet the criteria for PDT). Fluorescein angiography was evaluated before and 3 months after treatment., Results: There was no significant improvement in visual acuity after a month and three months after treatment when comparing to the initial examination. Although a slight improvement of 1-2 lines on Snellen chart was noted in individual cases. No significant changes were observed in static perimetry results after 3 months follow-up. In mfERG, there was a significant decrease in both, response density and P1 wave amplitude in fifth peripheral ring. In the rest of the rings, in comparison to the initial examination significant changes were not observed. In 76% of the analyzed eyes stabilization of CNV activity was noted in FA. In majority of eyes, the active CNV diameter did not change or was reduced and transformed into a scar., Conclusions: Three months after an intravitreal injection oftriamcinolone acetonide, no significant improvement of visual functions was noted in the observed group of patients with exudative AMD. A decrease of leakage in FA and a lack of a significant decrease in visual function may lead to a conclusion that IVTA treatment may slow down the natural course of the disease.

The radiotherapy is worth to remember in the most progression causes of AMD, when there is no possibility for application the modern methods of the treatment. We present cause of patient with bilateral advanced changes and low visual acuity in course AMD, who had applied rtg therapy and laser fotocoagulation. The right eye was radiated with foton beam energy 10 MeV using linear accelerator. Dosage of 9 Gy was delivered in 3 fractions through 5 days. In right eye we observed increase of visual acuity from 2/50 before treatment to 3/50 after 12 months, and 0.1 after the 48 months of radiation. The visual acuity in the left eye decreased from 0.2 to 2/50 after the 48 months. The improvement of acuity vision after rtg therapy allowed the patient self-dependence life.

The aim of this paper is to present the most common diagnostic problem associated with a small choroidal melanoma. In some cases other lesions such as a choroidal naevus, an exudative type of age related macular degeneration (AMD) with the presence of subretinal haemmorrhage, retinal pigment hypertrophy, choroidal haemangioma and choroidal metastatic tumours may mimic small choroidal melanomas. Based on the literature and on our own experience we present the basic clinical features of these lesions, their characteristic fluorescein angiography, indocyanine green angiography and ultrasonography pictures that can be helpful in differential diagnosis.

Purpose: To evauate the association between use of lipid-lowering medications and occurrence of age-related macular degeneration (AMD)., Material and Methods: 91 patients with dry and 55 with exudative type AMD diagnosed with fundus fluorescein angiography were included to the study. Control group for the study Consisted of 68 participants without AMD. Data regarding use of cholesterol-lowering medications were collected with details., Results: In control group we noted significantly higher percentage of statin users compared to patients with AMD., Conclusions: Use of statins may be a protective factor against age-related macular degeneration.

Authors present review of modern diagnostic and therapeutic methods in dealing with retinal macroaneurysms, illustrated by own case reports. The key diagnostic test for retinal macroaneurysms is fluorescein angiography. Prognosis for preserving vision depends on the character of retinal macroaneurysm complications such as hard exudates and haemorrhages after macroaneurysm rupture and its localization in regard to the macular area. Treatment options are related to severity of subjective symptoms and can be conservative or surgical.

Unlabelled: It is commonly agreed nowadays that one of the key elements of neovascular age-related macular degeneration (AMO) pathogenesis is deregulation of the angiogenesis factors. Treatment of subfoveal choroidal neovascularizations (CNV) in course of AMD was limited to photodynamic therapy with verteporfin (PDT). The new approach to CNV treatment is to discover and eliminate factors, which directly induce CNV development. Extended studies have allowed to employ inhibitors of vascular endothelial growth factor (VEGF) for a treatment of neovascular AMD. Numerous of anti-VEGF compounds are still under developing in pre-clinical or phase-1/2 clinical studies whereas 2 of them have completed phase 3 of clinical trials. The newest compound that was launched on drug market is ranibizumab (Lucentis). Ranibizumab is a recombinant humanized IgG1 isotype, monoclonal antibody fragment designed for intravitreal use. Ranibizumab binds to and inhibits the biologic activity of human vascular endothelial growth factor A (VEGF-A). It has been proved on the base of MARINA and ANCHOR clinical trials that treatment ranibizumab is effective and save for patients treated for CNV secondary to AMD., Purpose: Interventional case series., Material and Methods: 67 eyes of 67 patients with all angiographic subtypes of wet AMD were treated with 0.5 mg of intravitreal ranibizumab, injected monthly for first 3 doses. Next doses were injected according to specified re-treatment criteria as assessed in monthly follow-up., Results: Mean change in visual acuity (VA) was +12.4 ETDRS letters. Percent of patient losing less than 15 ETDRS letters was 93.2%. Percent of patient gaining VA more than 3 ETDRS letters was 43.4%., Conclusions: Intravitreal ranibizumab is effective in treatment of CNV due to AMD. A significant number of patients have improved theirs VA. Implementation of anti-VEGF therapy for treatment of ocular diseases gave a new hope for patient that previously couldn't be treated with any of method.

Purpose: The authors present a case of the 66-year-old female patient suffering from the diffuse atrophy of the choroid., Material and Methods: The 66-year-old woman was referred to the Ophthalmological Clinic in Krakow with the diagnosis of choroideremia. The patient developed central vision problems (mainly in the left eye) and night blindness. We performed following investigations: distance and near visual acuity with Snellen charts, Amsler grid test, the investigation of the anterior and posterior segments of both eyes, and the fluorescein angiography as well as the infrared photo of the fundus. The assessment of ornithine serum level was performed., Results: The ophthalmological examination revealed: the distance visual acuity in the RE=0.5, and in the LE=0.25. The near visual acuity in the RE=0.5, in the LE=0.75. The Amsler grid test in the RE showed no pathology but in the LE revealed in the nasal aspect of the central visual field a relative scotoma. Fundoscopy, fluorescein angiography and infrared imaging revealed the broad patch form atrophy of the RPE and choriocapillaris within the whole fundus and also within the macula. The serum level of ornithine was within the normal limits., Conclusions: Based on the results of performed investigations the definitive diagnosis of a very rare dystrophy--a diffuse atrophy of the choroid was established.

Purpose: The aim of the study is to present a case of posterior staphyloma in the eyeball of the normal length., Methods and Results: A 17-year-old boy underwent full ophthalmologic examination due to impaired vision in the right eye (R.E.) lasting for one month. The visual acuity of R.E. and L.E. was found to be 0.8 and 1.0, respectively; near visual acuity for both eyes--0.5, intraocular pressure in both eyes--16 mmHg. The anterior part of both eyes was normal. The R.E. ophthalmoscopy revealed the presence of posterior staphyloma near the temporal-upper optic disc margin accompanied by serous retinal detachment above the macula. The L.E. ophthalmoscopy--normal. The eyeball length 23 mm and posterior staphyloma depth 2.4 mm. Refraction test--normal without any vision defect. Additionally fluorescein angiography, US B and OCT confirmed the presence of posterior staphyloma of the right eye. During the 3-month follow up the retinal detachment markedly decreased., Conclusions: The case report shown that posterior staphyloma may develop in the eyeball of normal length although its incidence is rare. New diagnostic methods, especially OCT, are very helpful in the clinical picture evaluation.

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.

Purpose: To appoint the most adequate follow-up parameter and to find the most reliable scheme of intravitreal TA injections in CME treatment in the course of CRVO and BRVO., Material and Methods: 18 eyes treated with intravitreal injection of 4 mg (in 0.1 ml) of crystalline TA., Results: There was improvement of BCVA for distance noticed in 38.9% of eyes and for near in 44.4% of cases. There was statistically significant difference in retinal thickness outcomes measured at baseline and at the end of the follow-up by both OCT and RTA. No correlation of BCVA changes and retinal thickness changes measured in OCT and RTA was found., Conclusions: The intravitreal TA injections should be considered as an effective method. Foveal morphology and thickness analysis performed by OCT is the most adequate method in follow-up monitoring of intravitreal TA injections in CME treatment in non-ischemic CRVO or BRVO. Central retinal thickness measured by RTA and FA changes analysis are alternative monitoring methods. Dosage of 4mg TA in 0.1 ml seems to be sufficient. In cases of CME recurrence of subsequent intravitreal injection in the first 6 month after initial injection seems to be unnecessary.

Purpose: The pathogenesis of Purtscher's retinopathy (PR) or Purtscher-like retinopathy (PIR) is illustrated on two case reports., Material and Methods: Five patients with PR or PIR were examined ophthalmologically. Fluorescein angiography, fundus photography, visual field testing, and electroretinography were also performed., Results: In three cases, the PIR was observed after acute pancreatitis, in one case it arosed from cryoglobulinemy, because of hepatitis C, and in one case it was due to a classic PR after the thorax trauma. In the case of a slow resolution of retinal edema, atrophy of the retinal pigment epithelium and optic nerve, occurred. The therapy has been based on the internal medicine treatment of the causal disease and the administration of corticosteroids, to reduce retinal edema., Conclusions: PR and PIR are interdisciplinary diseases caused by microembolization of retinal vessels. If changes are intensive and long lasting, visual prognosis is poor.

Unlabelled: Advanced forms of exudative AMD often form diagnostic difficulties and need to be differentiated with other proliferative diseases of the posterior pole. The necessary diagnostic examinations in theses cases are fluorescein and indocyanine green angiography, and nuclear magnetic resonance (MR) of the eye balls. Angiogenesis in the degenerative changes of the retina results in similar degree of enhancement in MR as in melanomas and metastases. The aim of this presentation is to discuss and compare the images of advanced forms of exudative AMD in images from fluorescein angiography, ultrasound, and especially MR based on clinical cases., Conclusions: Despite being a very sensitive method due to its high tissues differentiation MR does not allow to define degenerative and proliferative changes in small foci.

We demonstrated diagnostic cases of the early macular changes due to AMD, which caused central visual field disturbances. The aim of the study was to systemize the management in patients with macular lesions due to the age related macular degeneration, frequency determination and statement of the performed additional tests range. Patients reported central visual field distortions. We performed visual acuity testing, stereoscopic eye fundus examination, and PHP (macular visual field testing), which objectified distortions symptoms. Based on that tests and fellow eye condition, decision about OCT and FA and ICG performance were made. Further management was determined according to the results of that examinations: follow-up with vitamins and microelements supplementation or PDT. Our analysis confirm, that to monitor early macular changes due to AMD, follow-up examinations in 2-3 months interval are indicated: visual acuity testing, stereoscopic eye fundus examination and macular lesions modeling in PHP In difficult cases or in more advanced lesions FA, OCT and ICG were performed.

Purpose: The aim of the study was to evaluate choroidal circulation in the posterior pole of the eye in diabetic patients with nonproliferative retinopathy., Material and Methods: Angiographic evaluation of choroids in the posterior pole were performed in diabetic patients with clinically detectable diabetic retinal changes in the Department of Ophthalmology, Medical Center of Postgraduate Education in Warsaw from December 2002 to December 2004, using HRA-system (Heidelberg Engineering, Germany). HRA-system allows to perform simultaneous fluoresceine (FA) and indocyanine green (ICGA) angiography., Results: Simultaneous ICGA and fluorescein angiography pictures were evaluated. Choroidal abnormalities were defined as ICGA findings not detectable by FA. In ICGA we observed hypo- and hyperfluorescent areas or spots in different phases of the examination which proved break-down of outer blood-retinal barrier, retinal pigment epithelial oedema, increased permeability of choriocapillaries and chorioidal microaneurysms., Conclusions: 1. FA discloses only a part of vascular pathology in posterior pole of the eye in the course of diabetes. 2. ICGA may be useful as adjunctive to FA in the evaluation of the choroidal vascular changes in diabetic eyes. 3. Choroidal vessels changes may play role in the development of diabetic retinopathy.

Introduction: The aim of our study was to evaluate the visual acuity, visual field, retinal bioelectrical function and fluorescein angiography results in patients with subfoveal choroidal neovascularisation treated with photodynamic therapy (PDT)., Material and Methods: Visual acuity (Snellen chart), static perimetry (PS 30-2 W-W), mf-ERG (according to ISCEV standards) and fluorescein angiography were performed before, 3 and 6 months after initial photodynamic therapy in 20 eyes of 18 patients., Results: There was no significant change in the average visual acuity after 3 and 6 months after PDT comparing to the initial examination, although the visual acuity improved in individual cases from 1 to 5 lines. In the static perimetry a significant increase in PSD was observed after 3 and 6 months accompanied by a slight but non-significant improvement of foveal sensitivity at the same time. There was no significant changes in mfERG after 3 and 6 months except of decrease in P1 wave latency in ring 2 (p < 0.04 after 2 months and p < 0.02 after 6 months). Decrease in CNV activity area was detected in 45% of cases in FA examination., Conclusions: There was no significant influence ofPDT on visual outcome and macular bioelectrical function in 3 and 6 months follow-up, despite stabilization or improvement in FA findings in majority of cases.

Purpose: To evaluate the influence of local and systemic factors on diabetic maculopathy course, according to the vitreous adherence to the retina or its' lack. Ocular diabetic complications are among the most frequent causes of vision deterioration and blindness in adults in well developed countries. Diabetic maculopathy is the major condition decreasing vision in patients with type 2 of diabetes mellitus., Material and Methods: The study group consisted of 137 eyes in patients with type 2 of diabetes mellitus., Conclusions: All parameters analysis showed, that: better functional and anatomical results of the laser photocoagulation were achieved in PVD cases; vitreous adherence caused oedematic maculopathy persistence, in spite of properly performed laser photocoagulation; vitreo-retinal tractions presence was associated with more frequent oedematic maculopathy occurrence.

Introduction: Neuroretinitis in children is a rarely occurring entity that is characterized by optic disk edema, macular hard exudates, peripapillary subretinal exudates and the presence of posterior vitreous cells. Neuroretinitis' etiology can be infectious or non-infectious. The non-infectious causes include: systemic diseases, vascular diseases, diabetes, cancer. Most cases of neuroretinitis are idiopathic. Other forms can have an infectious cause: from animal, bacterial, viral, fungal. It occurs usually as a benign complication of pediatric infectious diseases, cat scratch disease (bartonellosis), tuberculosis. Relaminar vasculitis is responsible for the clinical picture of neuroretinitis as opposed to the primary demyelination seen in optic neuritis. Exudate from the optic nerve head resulted from leakage of the disc capillaries that had extended into the macular area along the plane of the outer plexiform layer., Material and Methods: The examination of 5 girls aged 8-12, hospitalized in the Ophthalmology Clinic of The Children's Memorial Health Institute in Warsaw in 2006-2007 revealed the intrabulbar neuroretinitis-type changes. Each patient was interviewed in detail and underwent full ophthalmologic examination., Results: All patients suffered from the loss of vision, 2 of them had ocular pain when looking at the sides. There was a marked afferent pupillary defect and the changes in the visual field were also reported. Fluorescein angiogram showed leakage of disk vessels; there was no leakage of other retinal vessels. In case of each girl, a vast differential diagnostics of infectious and systemic diseases was applied., Conclusion: Despite significant diagnostic difficulties in this age group, 2 girls were recognized with non-pulmonary tuberculosis as the cause of neuroretinitis. The application of tuberculosis treatment significantly improved recovery.

Purpose: To assess usefulness of optical coherence tomography (OCT) in adult-onset vitelliform macular dystrophy (AVMD) diagnosis. To assess retinal pathological changes during all stages of the disease., Material and Methods: Retrospective case-series report. 16 patients (9 men, 7 women, mean age 60.25), with vitelliform macular dystrophy, who underwent ophthalmic examination including optical coherence tomography (OCT Stratus III, Zeiss Meditec, CA, USA) in 2005 and 2006. Retinal Thickness Map and Fast Retinal Thickness Map Acquisition Protocols were used during OCT scanning. Patients were evaluated with ETDRS charts, biomicroscopy, fluorescein angiography and electrophysiological exams., Results: 7 patients (44%) were referred to our outpatient clinic with diagnosis of macular hole, 7 patients (44%) with diagnosis of AMD. In 2 patients Best disease was suspected. Diagnosis of AVMD was possible to establish in all patients including medical history, fundus photography and OCT., Conclusions: OCT enables retinal morphology assessment and can be treated as the basis of adult-onset vitelliform macular dystrophy early evaluation, diagnosis differentiation and monitoring progression.

We present the case of choroidal osteoma with subretinal haemorrhage not associated with choroidal neovascularisation. 22-year-old man presented with sudden onset of metamorphopsia in the right eye. Ophthalmoscopic examination showed massive subretinal haemorrhage in the superionasal quadrant of the retina. Patient underwent full diagnosis due to suspicion of melanoma malignum choroideae: fluorescein and indocyanine angiography, ultrasonographic examination, computed tomography. On these basis diagnosis of choroidal osteoma without CNV was made. Subjective symptoms regressed after resolution of haemorrhage. There is a possibility of subretinal haemorrhage without CNV in the course of choroidal osteoma.

Purpose: To appoint the most adequate follow-up parameter of intravitreal TA injections in CME treatment due to diabetic maculopathy and to find the most reliable treatment scheme., Material and Method: 4 mg (in 0.1 ml) of crystalline TA were injected into the vitreous of 17 eyes., Results: There was a statistically significant improvement of BCVA for distance and near vision. There was statistically significant difference in retinal thickness outcomes measured at baseline and at the end of thefollow-up by both OCT and RTA No correlation of BCVA changes and retinal thickness changes measured in OCT and RTA was found., Conclusions: Intravitreal TA administration seems to be an effective method of treatment in diabetic CME. OCT is the most adequate method of follow-up of intravitreal TA injections in treatment of CME due to diabetic maculopathy. RTA and FA changes analysis are alternative monitoring methods. Dosage of 4mg TA in 0.1 ml seems to be sufficient. In cases of CME recurrence subsequent intravitreal injection in the first 6 month after initial injection seems to unnecessary.

Purpose: To evaluate effects of intravitreal bevacizumab on visual acuity and angiographic lesions characteristics in patients with neovascular AMD and to report safety of such treatement., Material and Methods: 32 patients with confirmed choroidal neovascularisation (CNV) and AMD were treated. Patients received 2 intravitreal bevacizumabu (1.25 mg) iniections on 1-3 months basis. Control ophthalmic evaluations included visual acuity measurements with EDTRS charts, intraocular pressure measurements, complete ophthalmic examination in slit lamp, fluorescein angiography and blond pressure measurements., Results: In 18 patients (56%) visual acuity improvement at a mean 3 lines on EDTRS charts was observed, in 9 patients (28%) visual acuity did not change and in 5 (16%) cases decreased visual acuity (about 1,5 lines in EDTRS charts) was noted. Mean follow-up period was 3 months after second injection. In most study eyes fluorescein angiography revealed a marked reduction in leakage from CNV. Apart from one case with endophthalmitis symptoms after second bevacizumab injection, we did not observed systemic or ocular adverse effects of the applied treatment., Conclusions: Short-term results suggest that intravitreal bevacizumab is relatively safe form of AMD treatement and is associated with improvement in visual acuity and reduction in angiographic leakage in most patients with neovascular AMD. Further evaluation of the long-term effectiveness of this treatment is warranted.

The aim of this paper is to present the effects of photodynamic therapy for treatment of bilateral macular choroidal neovascularization in angioid streaks during 16 months period. 50 years old man has one PDT in the right eye and three in the left eye. In the left eye conversion from choroidal neovascular membrane (CNV) to a fibrous disciform lesion following photodynamic therapy, was observed. In the right eye vision decreased from 1.0 to 0.2, but the leakage was minimal and stabilization of CNV size after the progression was noted.

Purpose: Pregnancy is considered an important risk factor of the development and progression of diabetic retinopathy (DR). The aim of the study was to assess whether retinal changes tend to progress during pregnancy in women with type 1 diabetes., Material and Methods: 136 women with type 1 diabetes were enrolled to this 3 years prospective study. The patients were divided according to White's scale into the following classes: B (n=76), C (n=34), D (n=24), R (n=2). Before conception and during pregnancy the patients were treated with intensive insulin therapy to achieve optimal metabolic control. Ophthalmic examination was performed before planned conception, in each trimester of the pregnancy and after delivery., Results: No pathologies were discovered with fundoscopy in all the women belonging to class B, in 22 women from class C and in 4 women from class D. No progression of diabetic retinopathy was observed during the entire period of observation in 12 women from class C and in 20 from class D with nonproliferative DR in the first examination. In 3 women from class C progression of DR were observed in the second trimester with partial improvement after delivery. Visual acuity in these patients also deteriorated. Proliferative DR diagnosed in 2 patients from class R at the beginning of the observation, progressed during the pregnancy to diminish after delivery., Conclusions: Pregnancy does not influence significantly the progression of pre-existing diabetic retinopathy, provided that proper metabolic control is achieved and patients are subject to systematic ophthalmological control.