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Purpose Assessment of retinal oxygen saturation, thickness of a retinal nerve fibre layer (RNFL) and functional changes in the optic nerve during optic neuritis (ON) in patients with multiple sclerosis (MS). Methods Thirty-two patients with ON due to MS within 3 months of onset of symptoms were enrolled [22 females, 10 males, age 34 ± 9 years, median 32.5 years, 22 patients with the clinically isolated syndrome (CIS), 10 patients with relapsing-remitting from of MS (RRMS)]. All patients were examined using optical coherence tomography (OCT model 4000, Carl Zeiss Meditec, Dublin, CA, USA), automatic optical oximetry (Oxymap ehf, Reykjavik, Iceland) and using visual evoked potentials (VEP) (Metronic Keypoint®, Minneapolis, MN, USA). Results Arterio-venous difference (AVD) was increased in patients ON affected eye compared to patients' unaffected eye (PUE) [34.2 ± 4.7 versus 31.3 ± 4.6, p = 0.044 (mean ± standard deviation)]. No statistically significant difference was found in vessel oxygen saturation as well as in RNFL thickness in ON affected eyes when compared to unaffected MS eyes and healthy individuals. Significantly lower optic nerve conduction velocity was found in the affected eye when compared to unaffected MS eye and healthy (p

Purpose: Evaluation of the cost and effectiveness of therapy for patients with the wet form of age-related macular degeneration (AMD) in routine clinical practice. Methods: A retrospective multicentre evaluation of changes in the best-corrected visual acuity in applied kinds of therapy and a comparison with the cost of individual therapeutic procedures. Results: An overall total of 788 eyes of 763 patients with an average age of 73.2 ± 8.6 years was evaluated for a 1-year minimum period. In the ranibizumab and pegaptanib therapy groups, a reduction of 1.3 letters (p = 0.303) and 1.4 letters (p = 0.197) was found, respectively. In the group of photodynamic therapy (PDT) with verteporfin, a reduction of 5.2 letters was achieved (p < 0.001). Under the conditions of routine practice in the Czech Republic, the annual cost is highest (EUR 5,467.63/patient) in patients with pegaptanib therapy. The annual cost in patients with ranibizumab therapy is lower by EUR 1,220.16. The cost is nearly half (EUR 2,783.65) in the group treated with PDT with verteporfin. Conclusion: An initiation of AMD therapy by ranibizumab is cost-effective as compared to pegaptanib. Both ranibizumab and pegaptanib are significantly more efficient as compared to PDT with verteporfin. Therapy with ranibizumab and pegaptanib, as compared to PDT with verteporfin, prevents the loss of 1 line of vision on the ETDRS chart for EUR 1,225.98 and 2,286.18, respectively.

SummaryAim To assess whether oxygen saturation of the retinal vessels is related to degree of diabetic retinopathy. Methods A prospective study included 114 eyes of 76 patients with diagnosed diabetes and 57 eyes of 29 non diabetic patiens. The diabetic patients were divided into groups according to severity of the retinopathy. Results In healthy controls mean arterial saturation was 96.5 ± 2.6%, mean vein saturation was 62.3 ± 7.4% and A-V difference was 34.3 ± 7.2%. In diabetic patients with no retinopathy mean arterial saturation was 96.5 ± 3.2%, mean vein saturation was 66.3 ± 6.3% and A-V difference was 30.2 ± 4.9%. In patients with mild diabetic retinopathy mean arterial saturation was 96.7 ± 4.6%, mean vein saturation was 67.9 ± 7.2% and and A-V difference was 28.8 ± 8.2%. In patients with moderate nonproliferative retinopathy mean arterial saturation was 97.8 ± 4.6%. mean vein saturation was 69.9 ± 6.7% and A-V difference 27.9% ± 5.8%. In patients with severe non-proliferative and proliferative retinopathy mean arterial saturation was 100.5 ± 5.6%, mean vein saturation was 74 ± 7.2% and A-V difference was 26.5 ± 7.8%. Conclusion We confirmed an increase in oxygen saturation in both retinal artery and vein in relation to degree of diabetic retinopathy.

Purpose To determine the effect of pars plana vitrectomy (PPV) on oxygen saturation in retinal vessels in patients with diabetes and non-diabetes after a 1-year follow-up. Methods This was a prospective consecutive interventional case series in 82 eyes in 82 patients. The sample consisted of 25 patients with non-proliferative diabetic retinopathy with macular oedema based on vitreoretinal traction or epiretinal membrane (ERM) and 57 non-diabetic patients with macular hole and ERM. Automatic retinal oximetry (Oxymap Inc.) was used on all patients 24 hr prior to PPV, and it was also used 7 and 52 weeks after PPV (classic 20G or sutureless 23G). We analysed the data according to subgroup diagnosis and lens status. Results Arterial saturation increased significantly from 96.4 ± 2.9% at baseline to 96.6 ± 3.4% at week 7 and 97.3 ± 3.4% at week 52 (p

Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment naive patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P less than 0.001) and lower incidence of CNV greater than 5DA (P less than 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment. Cíl. Zjistit vliv věku, pohlaví, zrakové ostrosti a tloušťky makuly na počátku léčby, typu a velikosti choroidální neovaskularizace na časnou morfologickou odpověď u pacientů s vlhkou věkem podmíněnou makulární degenerací. Metodika. Od 09/2008 do 06/2013 jsme zhodnotili výsledky léčby ranibizumabem u 1153 nově diagnostikovaných, předtím neléčených pacientů. Na základě morfologické odpovědi v makule po 3 injekcích ranibizumabu byli pacienti rozděleni do dvou skupin na základě aktivity nebo inaktivity choroidální neovaskularizace. Výsledky. Po 3 úvodních injekcích ranibizumabu jsme vyšetřili skupinu 841 očí s aktivní CNV a 312 očí s inaktivní CNV. V inaktivní skupině jsme našli statisticky vyšší počet okultních CNV (P less than 0.001) a nižší incidenci okultních CNV menších než 5DA (P less than 0.001) v porovnání s aktivní skupinou. Nenašli jsme statisticky signifikantní rozdíl u věku, pohlaví, zrakové ostrosti a tloušťky makuly na počátku léčby mezi inaktivní a aktivní skupinou. Závěr. Okultní CNV a CNV menší než 5DA je jsou faktory prognosticky prognosticky příznivější morfologické a terapeutické odpovědi na počátku léčby ranibizumabem. Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment naive patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P less than 0.001) and lower incidence of CNV greater than 5DA (P less than 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment.

Purpose: To determine the effect of pars plana vitrectomy (PPV) on oxygen saturation in retinal vessels. Methods: We performed a prospective consecutive interventional case series of 20 eyes of 20 patients with macular hole or epiretinal membrane. We performed automatic retinal oximetry (Oxymap Inc., Reykjavik, Iceland) in each patient 24 hr prior to and 45 days (range 42–49) after PPV (classic 20G or sutureless 23G). We analysed oxygen saturations in retinal arteries and veins. Vessel segments of first or second degree were selected. The same segment was analysed before and after PPV. Oximetry data were compared by paired two-tailed t-test. Results: Pars plana vitrectomy did not alter arterial haemoglobin saturation with oxygen (98 ± 2% prior to the surgery and 98 ± 3% after the procedure, p = 0.549). The mean venous haemoglobin saturation with oxygen increased after vitrectomy from 63 ± 10% to 66 ± 8% (p = 0.012). Conclusions: Oxygen saturation is higher in retinal veins after pars plana vitrectomy. Further studies are needed to unveil the mechanism of how vitrectomy affects oxygen metabolism in the retina.