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Background: The purpose of our study was to: (1) investigate the macular pigment optical density (MPOD) and ocular pulse amplitude (OPA) in subjects with different axial lengths (AL) and refractive errors (RE); (2) determine if there is a correlation between MPOD and OPA; and (3) evaluate whether MPOD and OPA depend on intraocular pressure (IOP)., Material and Methods: This study included 140 eyes of 70 subjects - 17 men and 53 women, aged 18 to 29 years (mean: 22.5 years; SD=2.8). Every examined person underwent a thorough eye examination including: visual acuity, anterior segment and fundus examination, keratometry, auto-refractometry, and MPOD, OPA, AL, and IOP measurements. The obtained results were analyzed statistically using Statistica 10 software. P values of <0.05 were considered statistically significant., Results: The following refractive errors were selected: emmetropia (34 eyes), hyperopia (18 eyes), low myopia (60 eyes), medium myopia (19 eyes), and high myopia (9 eyes). It has been established that the OPA increases with the rise in the spherical equivalents (SE) (Rs=+0.38, P<0.001), while the increase in AL correlates with the decrease of OPA (Rs=-0.40, P<0.001). The increase in IOP correlates with the rise in the OPA (Rs=+0.20, P<0.05). There were no significant correlations between IOP and SE or AL., Conclusions: (1) MPOD is not correlated with the OPA in subjects with different AL and RE; (2) OPA decreases with the rise of AL; (3) OPA decreases with the fall of the SE; and (4) OPA increases with the rise in IOP.

Purpose: To asses morphology of the optic nerve disc in correlation to the refractive error in eyes with myopia., Material and Methods: The examined group consisted of 47 patient (84 eyes), age 20 to 36 years (mean age 28 +/- 4,5), with refractive error -4.00 Dsph to -14.25 Dsph +/- 0.75 Dcyl. This group was divided into two subgroups according to value of refractive error. The control group contained matched persons according to the gender and age. The basic ophthalmological examination and scanning laser ophthalmoscopy with HRT retinal tomography were performed., Results and Conclusions: In patients with moderate and high myopia there was an increase of the optic nerve disc area and volume, and area and volume of the neuroretinal rim in comparison to the emmetropic eyes. In patients with high myopic eyes there was an increase of the area and depth of the optic nerve cup. The area of the optic nerve disc and the neuroretinal rim was found to be bigger as the refractive error increased in group of moderate myopia. There were no statistically significant differences of thescanning laser ophthalmoscopy with HRT parameters (C/D AR and L C/D R) of the cup to the area and the diameter of the disc between myopic and emmetropic eyes.

Purpose: To evaluate foveal function, retinal circulation and foveal thickness before and after intravitreal ranibizumab injections in eyes with wet type of age-related macular degeneration (AMD)., Material and Methods: The study group consisted of 21 eyes (20 patients) with choroidal neovascularisation (CNV) due to AMD. Inclusion criteria were based on fluorescein angiography (FA) and distance best corrected visual acuity (DBCVA)--log MAR scale. In each eye, 3 consecutive injections of ranibizumab every 4 weeks were administered and then individual course for re-injections according to DBCVA and optical coherence tomography (OCT) up to 12 months was applied. At baseline, 3, 6 and 12 months follow-up, the following tests were performed: DBCVA, multifocal electroretinogram (mfERG) and OCT. Additionally, FA was carried out before the treatment, 3 and 12 months from the baseline., Results: At baseline, FA revealed mainly minimally occult choroidal neovascularisation--57% (12/21) of eyes. At 3 months choroidal neovascularisation diameter was stable; no leakage from active choroidal neovascularisation was seen in 76% (16/21) of eyes. After 12 months follow-up, increase in choroidal neovascularisation diameter was seen in 43% (9/21) of eyes and no leakage in 57% (12/21) of cases. The mean DBCVA significantly improved only after 3 months (p < 0.02). Significant decrease of mean foveal thickness was observed in each follow-ups (p < 0.01). The mfERG data from the macular region remained stable or improved slightly in some cases., Conclusions: In our series of patients with the wet type of AMD after intravitreal injections of ranibizumab in 12 months follow-up, the reduction of foveal thickness was noted while DBCVA and the bioelectrical function from the macular region measured by the mfERG remained stable.

Purpose: Description of a rare case of bilateral fungal endophthalmitis in a patient and the associated diagnostic and therapeutic difficulties., Material and Methods: Patient 28 years old was diagnosed because of bilateral deterioration in endophthalmitis. Therefore, the diagnostic possibilities were run down and material taken from the vitreous chamber were handed to determine the Candida spp. antigen using Elisa test, standardized for serum and cerebrospinal fluid. Combination therapy including drugs and surgery were performed., Results: Ophthalmoscopy OP/OL showed the presence of "clusters of cotton" in vitreous body characteristic for ocular candidosis. Targeted treatment for Candida spp. with voriconazole were based on a very high concentration of mannan antigen in the resulting of the test. The final diagnosis was established after microbiological examination of material taken during vitrectomy., Conclusions: High level of mannan antigen Candida spp 4259.83 in vitreous body may indicate a fungal endophthalmitis. fungal endophthalmitis, ocular candidosis, endogenic infection of the eye.

Purpose: The aim of the study is to explore the interaction between stimulators and inhibitors of angiogenesis by measuring pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) plasma levels in patients with the wet and dry forms of age-related macular degeneration (AMD)., Material and Methods: Forty-six subjects with the wet form, 31 with the dry form of AMD as well as 47 non-AMD healthy controls were enrolled in the study. Plasma concentrations of VEGF and PEDF were measured using ELISA test., Results: A significant decrease in the PEDF plasma level in patients with the dry form of AMD was found. Multivariate analyses of patients and controls adjusted for age, sex, smoking, and concomitant vascular diseases as independent variables revealed that the dry form of AMD was the only independent factor associated with lower plasma PEDF levels (beta = -0.34; p = 0.026). On the contrary, in the wet AMD group, a strong positive correlation between VEGF and PEDF concentrations was observed (Rs = +0.63; p = 0.002), and significantly higher PEDF and VEGF plasma levels in patients with bilateral manifestations of the disease were also found., Conclusions: These findings suggest that different manifestations of AMD, i.e. the dry and wet forms, may be associated with various altered concentrations of counterbalancing stimulators and inhibitors of the angiogenesis process.

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: To evaluate 3 and 6 months binocular visual outcomes after microincision cataract surgery (MICS) with implantation of multifocal, hybrid Acri.LISA 366D 10OLs., Material and Methods: Three and six months after bilateral MICS with Acri.Lisa 366D implantation, 40 eyes of 20 patients were evaluated for surgical induced astigmatism (SIA--vector analysis), binocular UDVA, UNVA and UIVA (logMAR), spectacle independence, contrast sensitivities (CS-CSV-1000), subjective symptoms, patient satisfaction (Type Questionnaire) and complications., Results: Three and six months after surgery, SIA was equal 0.55 D and 0.58 D subsequently. Three months postoperatively mean binocular UDVA did not differ significantly from the six-month follow-up (-0.10 +/- 0.17 versus -0.14 +/- 0.11; p = NS). All patients had very good spectacle-free visual function at all distances and were totally spectacle independent. Mesopic distance and photopic distance and near CS were within normal age-matched limits at both follow-ups and did not change during observation time. A low degree of glare/halo was detected in 75% of subjects. Overall patient satisfaction was very high (9.05/10). There were no postoperative complications., Conclusions: Multifocal Acri.LISA 366D IOL implantation in selected cataract patients provides a very good visual outcome, a high level of patient satisfaction and spectacle-free visual function. microincision cataract surgery, Acri.Lisa 3660 101 implantation, visual outcome.

Background: The neovascular form of age-related macular degeneration (AMD) manifested with choroidal neovascularization (CNV) is one of the leading causes of rapid and irreversible visual loss. Recent reports suggest that bone marrow-derived stem/progenitor cells (SPCs) play a crucial role in the development and progression of the disease. The purpose of this study was to investigate whether or not undifferentiated non-haematopoietic stem cells, including those capable of differentiating into neural phenotypes, play a role in the pathological state of CNV formation., Methods: Peripheral blood samples were collected from 46 patients diagnosed with CNV and from 46 controls. The CXCR4(+)Lin(-)CD45(-) stem cells were counted and analysed by flow cytometry. Using qRT-PCR and immunocytofluorescence, the expression of early neural and glial cell markers (β-III-tubulin, nestin, and glial fibrillary acidic protein) in the sorted cells was analysed, and correlated with plasma concentrations of stromal cell-derived factor 1 (SDF-1) (enzyme-linked immunosorbent assay), which is a pivotal chemokine that regulates the trafficking of SPCs., Results: We found that the number of circulating CXCR4(+)Lin(-)CD45(-) cells did not differ in patients with active CNV as compared to the controls. However, we noticed significant intracellular overexpression of β-III-tubulin in the cells derived from AMD patients. Moreover, we observed significantly lower SDF-1 plasma levels in neovascular AMD patients compared to healthy individuals., Conclusions: Our findings suggest that neural progenitor cells, together with low SDF-1 concentrations, may play a considerable role in the process of AMD progression. Further investigations aimed at the precise elucidation of these issues may help with the future development of effective prevention against, and the treatment of, this disease.

Purpose: Stem cell regeneration of damaged tissue has recently been reported in many different organs. Here, we investigated the mobilization of different stem/progenitor cell (SPC) populations into the peripheral blood (PB), their subsequent homing to the injured retina (IR) and contribution to its regeneration in a retinal pigment epithelium (RPE) damage model induced by sodium iodate (NaIO(3))., Methods: Mobilization of SPCs was evaluated by flow cytometry. SPCs distribution in IR was assessed using bone marrow (BM)-derived GFP(+)Lin(-) cells transplanted intravenously into NaIO(3)-treated C57Bl/6 mice. The quantity of the chemokine SDF-1 in PB and IR was measured by ELISA and qRT-PCR, respectively. Apoptosis (TUNEL assay), cell proliferation (PCNA analysis) as well as functional retinal activity (electroretinogram) were examined at several time points after NaIO(3) administration., Results: Mobilization of SPCs along with the highest cell proliferation and massive apoptosis within IR were observed on the third day after NaIO(3) administration. Similarly, donor GFP(+)Lin(-) cells were detected in the retina as soon as day 4 after NaIO(3) injection. Plasma levels of SDF-1 did not differ significantly in mice exposed to NaIO(3) compared to healthy controls, however mRNA for SDF-1 was overexpressed locally in IR. Functional retinal recovery was not achieved., Conclusion: Our study provides evidence that BM SPCs egress into PB and home to the injured retina, but are not capable of restoring its function. These results indicate that if the range of retinal destruction is profound, endogenous regeneration is ineffective and may ultimately require adjuvant therapeutic transplantation of specific SPCs subpopulations.

Purpose: Circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) may serve as novel markers of endothelial dysfunction. The presence and clinical implications of CECs and the expression of endothelin (ET)-1, one of the most potent vasoconstrictors, have not been evaluated in patients with the neovascular form of age-related macular degeneration (AMD). This study was conducted to determine the different populations of endothelial cells (ECs) in the peripheral blood of AMD patients and to correlate these findings with the expression of ET-1 and the cytokines and growth factors responsible for EC migration and function., Methods: Peripheral blood samples were collected from 29 patients with diagnosed neovascular AMD and from 38 healthy control subjects. CD133(-)CD144(+) CECs and CD34(+)CD133(+)CD144(+) EPCs were counted and analyzed by flow cytometry. The intracellular expression of ET-1 in peripheral blood nuclear cells (PBNCs) was studied by using qRT-PCR, Western blot, and immunocytofluorescence assays, and ET-1, IGF-1, VEGF, SDF-1, and HGF plasma concentrations were measured in enzyme-linked immunosorbent assays., Results: Increased CECs and EPCs were found in the AMD patients compared with the counts in healthy individuals. The expression of intracellular ET-1 was significantly elevated in PBNCs from the AMD patients compared with the control subjects. In addition a significantly higher plasma concentration of IGF-1 was observed, but a lower SDF-1 level in the group of AMD patients., Conclusions: These findings suggest that circulating endothelial cells, together with high ET-1 content, may contribute to the development of AMD. Further prospective investigations on the mechanism involved may be relevant to the potential treatment of this disease.

Purpose: To evaluate the efficacy of combined PDT and 4 mg intravitreal triamcinolone acetonide injection, performed 48-72 hours after PDT, in patients with wet form of AMD., Material and Methods: Nonrandomised, interventional case series, 13 eyes of 13 patients with subfoveal CNV due to AMD that did not respond to PDT monotherapy - 7 females, 6 males - at the age of 65-85 (average age 76.6 +/- 6.7 years); standard PDT was performed in all patients followed by a 4 mg intravitreal injection of triamcinolone acetonide given 48-72 hours after PDT. Follow up visits were scheduled 1 and 7 days after the injection and then every 3 months afterwards and included: BVCA (Snellen chart), IOP measurements, FA, OCT, slit lamp and eye fundus examination. Lesions with active CNV leakage in FA were retreated every 3 months., Results: Average observation time was 10.8 +/- 3.5 months. Baseline visual acuity before PDT monotherapy was applied (Vo) was 0.17 +/- 0.12 (0.06-0.5), and after the therapy decreased to (V1) 0.14 +/- 0.13 (0.05-0.2). After combined PDT and Tc treatment BVCA increased to (V2) 0.21 +/- 0.13 (0.06-0.5), p<0,03. 76,9% of patients gained or maintained visual acuity after combined therapy in the observation time. In 70% of eyes no signs of active CNV was observed in AF and OCT after 1 session of combined PDT and Tc treatment. Only 4 patients required 1 repeated treatment session., Conclusions: 1. Combination of PDT and IVTA may be effective in patients with wet AMD with no response to PDT alone and significantly reduces the repeated treatment rate. 2. Intravitreal Tc injection performed 48-72 hours after PDT may improve the final functional effects in treated eyes as compared with PDT monotherapy. Our results need further investigation.

Purpose: The purpose of this study was to appraise the functional response of damaged retina to the stem cell-based therapy in mice. The majority of disorders leading to the irreversible vision loss in the developed world is caused by retinal degeneration. Since, recent reports emphasized regenerative potential of bone marrow stem marrow stem/progenitor cells (SPCs), we investigated here the beneficial effect of intravenously administrated SPCs on regeneration of acutely injured retina., Material and Methods: Selective chemical injury of murine retinas was induced by intravenous administration of sodium iodate (NalO3) in its toxic dose. Flash electroretinogram (ERG), was performed in different time points after infusion of bone marrow-derived and negative for linage antigens population of SPCs., Results: Stem cell-based therapy resulted in gradual increase of b-wave amplitude in ERG recordings starting from the 3rd day after NalO3 administration, what confirmed the improvement of retinal function in long-term observation., Conclusions: Our preliminary findings revealed that the selected stem cell-based therapy employed in the adjuvant mode has been shown to be effective in supporting the retinal function recovery after acute retinal damage.

Purpose: In recent years, emerging data support the concept of endothelial dysfunction in the course of age-related macular degeneration (AMD). Circulating endothelial cells (CECs) are desquamated mature cells that have detached from the intimal monolayer in response to endothelial injury. In this study we sought to explore the potential role of endothelial dysfunction in pathogenesis of AMD by measuring the concentration of CECs in peripheral blood of AMD patients., Material and Methods: Peripheral blood samples from 31 patients with diagnosed dry AMD and 46 patients with neovascular AMD were collected. Forty six, age- and sex-matched volunteers without AMD were enrolled as a control group. CECs were counted and analyzed by flow cytometry., Results: Multivariate analyses of patients and controls adjusted for age, gender, presence of ischemic heart disease, hypertension and smoking (current or past) revealed that both wet (beta = +0.45, p = 0.0003) and dry (beta = +0.28, p = 0.027) forms of AMD are independent factors associated with higher number of CECs., Conclusions: Our results suggest that there is an endothelial alteration accompanying AMD. Increased numbers of CECs AMD patients reflect a severe vascular disturbance and may contribute to the disease process. These findings can help expand our knowledge of the pathogenic mechanisms of AMD and may be relevant to the potential treatment of this disease.

Purpose: To evaluate 3 and 6 months binocular visual outcomes after cataract surgery using a multifocal IOL "mix and match" approach, with a refractive (ReZoom) IOL in the dominant eye and a diffractive (Tecnis) IOL in the fellow eye., Material and Methods: Three and 6 months after bilateral cataract surgery, 40 eyes of 20 patients were evaluated for binocular UDVA, UNVA and UIVA (logMAR), spectacle independence, contrast sensitivities (CS), stereoscopic vision, subjective symptoms, patient satisfaction and complications., Results: Three months after surgery mean binocular UDVA did not differ from the six-month follow-up (-0.13 +/- 0.08 vs. -0.18 +/- 0.08; p = NS ). All patients achieved binocular UNVA of 0.0 at both follow-ups. Mean binocular UIVA improved significantly from 0.06 to 0.01 (p<0.027), 6 months after surgery. All patients had very function at good visual all distances and were totally spectacle independent. CS under various conditions was within normal age-matched limits at both follow-ups. For some spatial frequencies six months postoperative results were significantly better than for the 3 months follow-up (p<0.05). Stereoscopic vision was normal. A low degree of glare/halo was detected in 75% of subjects. Overall patient satisfaction was very high (9.6/10). There were no postoperative complications., Conclusions: Mixing and matching multifocal IOLs in selected cataract patients provides an excellent visual outcome, a high level of patient satisfaction and spectacle-free visual function. A period of neuroadaptation lasting at least six months is necessary to obtain better visual function results.

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 review is to present cases of chorioretinitis in infants caused by viral and parasitic infections., Material and Methods: Four infants with viral chorioretinitis were identified in a routine ophthalmological examination. Laboratory tests towards bacterial, viral and parasitic diseases were performed., Results: Toxoplasmosis, rubella, and CMV infections were diagnosed in clinical and laboratory tests. After a wide spectrum of therapy a total remission of inflammatory process in all the discussed children was observed., Conclusions: Posterior uveitis is an ocular complication which can be connected with viral or parasitic infections in postnatal period. Prematurity, normal delivery, intrauterine transmission, breast feeding, comorbid diseases might be associated with chorioretinitis in infants.

Purpose: The aim of this work was to present a clinical picture of congenital defects in the anterior and posterior segment of the eye and coexisting systemic developmental anomalies in a group of children during the infantile period., Material and Methods: We performed a retrospective analysis in a group of 1507 infants seen at our outpatient ophthalmology clinic in 2006-2010. Attention was focused on case histories of nine children (0.6%) with congenital defects of the eye. A routine ophthalmologic examination was done and photographs of the anterior and posterior segment of the eye were archived with the Ret - Cam II apparatus. Maternal risk factors during pregnancy and the perinatal period were analyzed, as well as genetic, familial, infectious, traumatic, metabolic, and toxic factors, and drugs which could have contributed to the pathology of the organ of vision. Additionally, congenital polydysplasia was confirmed using ultrasonography, radiography, and imaging techniques (USG, X-ray, MRI)., Results: Congenital anomalies of the anterior and posterior segment of the eye were identified in the study group. Abnomalities of the anterior segment of the eye in four infants were in the form of congenital corneal anomalies (keratopathy, microcornea, sclerocornea, congenital mesenchymal dysgenesis), coloboma of the iris, and aniridia. Additionally, ectopic pupil, congenital cataract, aplasia of the lacrimal point, and palpebral coloboma were observed. Developmental anomalies of the posterior segment of the eye in the form of persistent hyperplastic primary vitreous body or primary fetal vasculature syndrome (PHVB or PFVS), choroid coloboma, coloboma of the optic nerve, and optic disc fovea were recognized in eight children. Anomalies of the anterior and posterior segment of the eye were observed in three children and were associated with microphthalmia, nystagmus, and strabismus. Moreover, systemic anomalies coexisting with ophthalmologic defects were confirmed in 6 children. They were seen in the heart (patent ductus arteriosus (PDA), patent foramen ovale (Pfo), atrial septal defect (ASD), nervous system (aplasia of the corpus callosum, hydrocephalus), osteoarticular system (talipes equinovarus, bifurcate rib, butterfly vertebra, dysmorphic splanchnocranium, contracture of the fingers), genitourinary system (cryptorchism, Wilms' tumor, vesicoureteral reflux grade IV), auditory organ (microtia, aplasia of the external auditory meatus, tympanic cavity, and internal ear), and skin (telangiectasia, syndactyly, appendages, and vegetations). Genetic tests revealed one case of an abnormal karyotype (49, XXXXX). Infections, metabolic disorders, and intoxications were excluded as the background for the anomalies., Conclusions: The finding of a congenital eye anomaly should be followed by a search for other systemic anomalies. Developmental anomalies of the eye and other organs will require a multidisciplinary approach to treatment and care.

Sequential morphological and functional features of retinal damage in mice exposed to different doses (40 vs. 20 mg/kg) of sodium iodate (NaIO(3)) were analyzed. Retinal morphology, apoptosis (TUNEL assay), and function (electroretinography; ERG) were examined at several time points after NaIO(3) administration. The higher dose of NaIO(3) caused progressive degeneration of the whole retinal area and total suppression of scotopic and photopic ERG. In contrast, the lower dose induced much less severe degeneration in peripheral part of retina along with a moderate decline of b- and a-wave amplitudes in ERG, corroborating the presence of regions within retina that retain their function. The peak of photoreceptor apoptosis was found on the 3rd day, but the lower dose induced more intense reaction within the central retina than in its peripheral region. In conclusion, these results indicate that peripheral area of the retina reveals better resistance to NaIO(3) injury than its central part.

Objective: To investigate the association among different circulating stem cell (SC) populations, the levels of selected growth factors and chemokines regulating SC migration in the peripheral blood, and the incidence of retinopathy of prematurity (ROP)., Methods: We evaluated 88 participants in this study: 29 preterm infants with ROP, 29 preterm infants without ROP, and 30 healthy full-term infants. Peripheral blood samples collected 10 weeks after delivery were analyzed using flow cytometry, immunofluorescence, real-time reverse transcriptase-polymerase chain reaction, and enzyme-linked immunosorbent assay. The following cell populations were analyzed: (1) lin⁻CXCR4(+)CD45⁻ (enriched in very small embryonic-like SCs), (2) lin⁻CXCR4(+)CD45(+) (enriched in hematopoietic SCs), and (3) CD34(+)CD133(+)CD144(+) (early endothelial progenitor cells) [lin indicates lineage]. The concentrations of vascular endothelial growth factor, basic fibroblast growth factor, hepatocyte growth factor, and stromal cell-derived factor 1 were measured in the plasma., Results: The very small embryonic-like SCs and early endothelial progenitor cells expressing neural and endothelial markers were significantly increased in the preterm infants. The number of early endothelial progenitor cells in the peripheral blood was significantly greater in the preterm infants with ROP than in the preterm infants without ROP. An accompanying increase in the concentrations of vascular endothelial growth factor and hepatocyte growth factor was found in the peripheral blood of the preterm infants with ROP. No significant associations were found between hematopoietic SCs and ROP or prematurity., Conclusions: The increased number of early endothelial progenitor cells along with elevated levels of vascular endothelial growth factor and hepatocyte growth factor in preterm infants with ROP suggest that circulating vasculogenic factors may play a role in the development and progression of ROP. The increased number of very small embryonic-like SCs in preterm infants suggests that the development of immature tissues and organs, including the retina, may require a contribution of circulating SCs.

Purpose: To obtain ultrasonographic measurements of ocular axial length (AL) in preterm infants without retinopathy of prematurity (ROP) but with different refractive power in regard to birth weight (BW) and gestational age (GA)., Methods: Refraction was measured after cycloplegia (at 6 months of life) in 350 eyes of 180 preterm (non-astigmatic) infants without ROP. Subjects were grouped according to the refractive error: A [above -6.0 dioptres (D)]; B (-3.1 to -6.0 D); C (0 to -3.0 D); D (0.1 to +3.0 D); E (+3.1 to +6.0 D); F (above +6.0 D). The AL measurement was performed by ocular A-scan ultrasound biometry (10 MHz probe)., Results: The longest AL was found in group B (20.62 mm) compared to group D and E (19.35, 19.28 mm; P< or =0.01) and group F and A (19.63, 19.39 mm; P< or =0.05). Only regressive correction for BW was statistically significant. Correlations between AL and BW (Rs=0.23) or GA (Rs=0.17) were found only in group E., Conclusions: AL of myopic eyes was significantly longer. In general, hyperopia was positively correlated with BW, whereas correlation between myopia and BW or GA was not found.

Purpose: Based on available literature, the authors describe the most frequent ocular diseases and symptoms, as well as bioelectrical dysfunction of the visual pathway in patients with Parkinson's disease (PD)., Material and Methods: Data published in literature available in PubMed library. The most often ocular diseases, symptoms and the bioelectrical dysfunction were diagnosed using routine ophthalmological examination including tear film tests, perimetry, optical coherence tomography (OCT), color and contrast sensitivity tests, and electrophysiological recordings like EOGs, flash, pattern and multifocal ERGs, VEPs., Results: The most frequent ocular diseases in PD are dry eye syndrome and glaucoma. At least 25% of PD patients manifest visual hallucinations. The most prominent bioelectrical dysfunction of the visual pathway was observed in outer layers of the retina (retinal pigmented epithelium, phoptreceptors) and it was registered mainly in EOG, PERG and mfERG tests., Conclusions: During examination of PD patents, general ophthalmologists should especially pay attention to diagnosis and treatment of glaucoma and dry eye syndrome. In PD visual deficits may occur without any noticeable changes in the routine ophthalmological examination. Electrophysiological recordings can explain, at least partially, visual dysfunction in course of PD.

Background: Mean vascular resistance in the retrobulbar arteries of SLE patients and the statistical relationship between its parameters and the presence of certain antibodies were determined., Material/methods: Forty-three eyes of 43 SLE female patients aged 46.28+/-8.45 years with disease duration of 10.03+/-7.96 years were examined. Physical and ophthalmic examinations with assessments of the immunological markers ANA/IgG-IgM, aCL, anti-beta2GPI, LA, and anti-dsDNA antibodies were performed. color Doppler imaging (CDI) was used in the OA, CRA, LPCA, and MPCA vessels. The vascular resistance indices (RIs) were compared with those of 43 eyes of 43 female controls. Covariance and multiple regression analysis with chi squared, Pearson, Shapiro-Wilk, and Levene tests were used in the statistical analysis (significance levels at p

Stem cells (SCs) maintain the balance among somatic cell populations in various tissues and are responsible for organ regeneration. The remarkable progress of regenerative medicine in the last few years indicates promise for the use of SCs in ophthalmic disorder treatment. This review describes the current view on hierarchy in the SC compartment and presents the latest attempts to use adult SCs in the regeneration of the retina. Research performed primarily in animal models gives hope for using similar strategies in humans. However, the search for the optimal source of SCs for cell therapy continues. We briefly discuss various potential sources of adult SCs that could be employed in regenerative medicine, particularly focusing on recently identified, very small embryonic-like SCs (VSEL-SCs). These cells are even present in the bone marrow and adult tissues of older patients and could be harvested from cord blood. We believe that VSEL-SCs, after the establishment of ex vivo expansion and differentiation protocols, could be harnessed for retina regeneration.

Purpose: Insulin-like growth factor-1 plays an important role in fetal growth and development, and its level increases with gestational age. The latest reports show that IGF-1 can directly influence the production of VEGF and regulate the development of blood vessels. Thus, the aim of the study was to evaluate the plasma concentrations of IGF-1 and VEGF as well as analyze their mutual correlation in preterm infants with retinopathy of prematurity (ROP), compared with preterm infants without ROP and full-term babies., Material and Methods: To address this issue, peripheral blood samples (PB) were analyzed and collected 10 weeks after delivery from: 25 preterm infants with proliferative stage of retinopathy of prematurity (ROP) and neovascularization (stage 3 or more advanced), 25 preterm infants without ROP, and 25 healthy full-term control infants. Plasma concentrations of VEGF and IGF-1 were measured using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits., Results: Increased concentrations of VEGF (p < 0.05), were found in the PB of the preterm infants with ROP compared with the preterm babies without retinopathy as well as with the full-term control infants, in whom the lowest levels of the growth factor were observed. The plasma concentrations of IGF-1 in the preterm infants were significantly lower than those of the full-term babies (p < 0.001). After adjustment for gestational age as a independent variable, a tendency to higher concentrations of IGF-1 was observed in the preterm infants with ROP., Conclusions: Disturbances in the interactions of VEGF and IGF-1 at early stages of ROP, leading to uncontrolled increases in their levels in the proliferative phase of disease, can play an important role in the pathogenesis of retinopathy of prematurity.

Aim: Recent findings suggest that chronic inflammatory processes play a role in the progression of age-related macular degeneration (AMD). Here we asked whether the development of different forms of AMD is connected with the elevation of plasma C3a-desArg concentration., Methods: We recruited 30 subjects with a clinical diagnosis of exudative AMD with newly diagnosed choroidal neovascularization (CNV), 30 subjects with dry AMD and 30 age- and sex-matched volunteers without AMD. The concentration of C3a-desArg complement compound was measured in the subjects' peripheral blood. We evaluated the association between the level of C3a-desArg and age, sex, smoking, atherosclerosis, and hypertension., Results: We found that the levels of C3a-desArg were significantly elevated in patients with exudative AMD compared to the control group. The concentrations of C3a-desArg in patients with dry AMD were similar to those of controls. Additionally, patients and controls with documented atherosclerosis (AS) displayed significantly higher levels of C3a-desArg compared to subjects without AS., Conclusions: Our results suggest an association between systemic complement activation and the development of CNV. Moreover, we found an association of complement activation with atherosclerosis and confirmed the hypothesis that AMD can be a local manifestation of systemic disease.

Purpose: To evaluate the visual outcome, spectacles independence, contrast sensitivity (CS), subjective symptoms, patient satisfaction and complications three and 12 months after cataract surgery with bilateral ReZoom multifocal refractive intraocular lens (IOL) implantation., Patients and Methods: This study comprised 40 eyes of selected 20 patients who had uneventful cataract surgery with bilateral implantation of ReZoom (AMO) multifocal IOL. Three and 12 months after bilateral surgery binocular uncorrected, the best corrected distance, near and uncorrected intermediate visual acuities (VA), spectacle independence, the best corrected binocular distance (with and without glare), near photopic CS, subjective symptoms, patient satisfaction and complications were evaluated., Results: Three and 12 months after surgery all patients had binocular uncorrected distance visual acuity (VA) of 0.5 or better; the best corrected distance VA was 1.0 in all cases. Three months after surgery, the mean binocular uncorrected intermediate VA was J4.10. The mean binocular uncorrected and the best corrected near VA were J3.10 and J1.70 respectively. Total spectacle independence and independence for distance, intermediate and near vision were achieved in 65%, 100%, 95% and 70% of patients respectively. The best corrected binocular distance and near CS were within normal limits. The most frequent subjective symptoms were mild glare and halo (65%--13/20 of patients).Total vision satisfaction was very high (9.6/ 10). There were no postoperative complications. One year after surgery, statistically significant improvement occurred in the best distance corrected near VA (p < 0.04), photopic distance best corrected CS without glare for 12 cycl/deg (p < 0.03) and in the level perception of glare/halo (p < 0.02) in comparison to the results from 3 months follow-up. The rest of analyzed parameters was unchanged. No complications were noticed except posterior capsule opacification in four patients one year after surgery who needed YAG laser treatment., Conclusion: Bilateral ReZoom multifocal IOL implantation was effective in selected cataract patients, providing very good uncorrected distance, intermediate, and near visual acuities as well as very high level of patient satisfaction. Longer than three months of the neuroadaptation time after bilateral surgery is necessary to obtain significantly better visual function results.

Age related macular degeneration (AMD), is the leading cause of blindness in individuals over age 50 years old. The pathogenesis of AMD is still not well understood with both genetic and environmental factors known to influence susceptibility to this condition. Data accumulated in the last decade implicate the chronic inflammatory processes as playing an important role in the progression of AMD. According to the recent findings, complement system is suggested to be a triggering point of the initiation of pathologic inflammatory response in the development and clinical course of AMD.

Background: The aim was to examine blood flow velocity and vascular resistance in retrobulbar arteries in young type-1 diabetes (DM-1) patients. Statistical relationships between blood flow parameters and serum lipid levels (TCH, HDL, LDL, TG, ApoB) were also determined., Material/methods: Fifty-two eyes with diabetic angiopathy were examined (average age: 18.54 years). Color Doppler imaging (CDI) was performed in the ophthalmic (OA), central retinal (CRA), and temporal posterior ciliary (TPCA) arteries. The parameters PSV, EDV, MV, PI, and RI were compared with those of a control group (46 eyes). The Student's t, Shapiro-Wilk, and Mann-Whitney U statistical tests were used (p< or =0.01 and p< or =0.05 were considered significant)., Results: Significant decreases in PSV, MV, PI, and RI in the OA, CRA, and TPCA and negative correlations between TCH, LDL, and ApoB and decreased PI and RI in the OA as well as positive correlations between these parameters and EDV in the OA were found. Increased ApoB correlated with decreased PI and RI in the TPCA. There were no significant relationships between TG and HDL and the blood flow parameters. Elevated levels of HbA1c and dyslipidemia were confirmed., Conclusions: CDI is an effective method for detecting retinochoroidal circulation disorders in the early stage of diabetic angiopathy. The alterations in retrobulbar blood flow were characterized by significant decreases in PSV, MV, and RI in the CRA and PSV, MV, PI, and RI in the TPCA. Dysregulation of TCH, LDL, and ApoB was associated with vascular resistance fluctuation, mainly in the OA.

Purpose: Occult macular dystrophy (OMD) is an unusual, inherited macular dystrophy characterized by a slowly progressive decline of visual acuity with normal fundus and fluorescein angiography (FA). The authors present a 43-year-old man who was diagnosed as having OMD because of the results of electrophysiological, psychophysical, optical coherence tomography (OCT) tests., Methods: Routine ophthalmological evaluation, FA, visual field tests, electroretinographic examinations (EOG, ERG, PERG and mfERG recordings according to ISCEV standards) and foveal thickness measurements (OCT) were performed., Results: Funduscopic examinations, FA, full field ERG as well as PERG results were all normal. In both eyes, the abnormalities were observed in static perimetry (relative central scotomas), mfERG (significant reduction of P1 amplitude in the central retinas) and OCT (significantly thinner foveal thickness)., Conclusions: A new case with OMD is added to preceding reports. The mfERG and OCT tests are important in detection of OMD patients. It can help in differential diagnosis of amblyopia, optic nerve diseases and non-organic visual disorders.

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.

Introduction: To estimate the in vitro level of L-ascorbic acid radical in lenses of patients with senile or diabetic cataract using EPR (Electron Paramagnetic Resonance) spectroscopy., Material and Methods: 24 human cataractous nuclei obtained during extracapsular removal were used. 5 of them (21%) were from diabetic patients. The analysis was carried out at the Department of Medical Physics of the Pomeranian Medical University using EPR spectroscopy. The in vitro level of L-ascorbic acid radical was calculated as the number of unpaired spins in the lens calculated in units x 10(16)/gram (spin/g), which is proportional to the in vivo level of vitamin C in lenses., Results: The average L-ascorbic acid radical level in lenses of diabetic patients amounted 0.53 x 10(16) spin/g +/- 0.22 x 10(16) spin/g, and was lower than in group of non-diabetic patients in which it ranged 0.87 x 10(16) spin/g +/- 0.31 x 10(16) spin/g (p = 0.036). There was no significant correlation between L-ascorbic acid radical level and sex, age or visual acuity in these two groups of patients., Conclusions: (1) EPR spectroscopy can be used to determine the in vitro level of L-ascorbic acid radical in human lenses. (2) The in vitro L-ascorbic acid radical level in cataract lenses of patients with diabetes was lower than in patients without diabetes. (3). Lower in vitro level of L-ascorbic acid radical in lenses of patients with diabetes means lower in vivo level of vitamin C, what suggests an increased intensity of free radical reactions in the group of patients with diabetes than in the group without diabetes.

Purpose: To evaluate the mfVEP test in detection of the optic nerve neuropathy in pituitary tumors., Material and Methods: We examined 30 eyes of 15 patients with confirmed by MRI pituitary tumors (7 patients with macroadenomas and 8 patients with microadenomas). In all patients the routine ophthalmologic examination, multifocal visual evoked potentials (mfVEP) and standard static perimetry (central 24-2 threshold), were performed. The control group consisted of 30 eyes of 15 healthy persons., Results: In 53% (16/30) of eyes manifested changes in static perimetry and/or in mfVEP test. In 13% (4/30) of eyes abnormal static perimetry and mfVEP were simultaneously observed. The only mfVEP abnormalities were the most frequent feature and were observed in 30% (9/30) of eyes. Only abnormal static perimetry results were observed in 10% (3/10) of eyes. In those eyes in related areas of mfVEP recordings the mean peak-to-peak amplitude was significantly reduced compare to the control group. In mfVEP test statistically significant peak-to-peak amplitude reduction was observed in superotemporal quadrants in comparison to the control group (p < 0.009)., Conclusions: MfVEP can be useful test in the optic nerve dysfunction/ neuropathy diagnosis in patients with pituitary tumors.

Purpose: To evaluate the relationship between different ocular factors and age-related macular degeneration (AMD)., Material and Methods: 281 eyes with AMD diagnosed with fundus fluorescein angiography were included to the study and divided into two groups: with dry and exudative type of AMD. 149 eyes without AMD consisted of control group. We performed ophthalmic examination and questionnaire. We collected data concerning exposition to the sun, using of sunglasses and other factors., Results: Arterial sclerosis in the retina was associated with twice 2-fold increased risk (OR = 1.96) of exudative AMD. There was not association of iris color, using of sunglasses, work conditions and age-related macular degeneration., Conclusions: The coexistance of arterial sclerosis in the retina suggests that vascular disorders take part in pathogenesis of exudative type of AMD. Factors like iris color, using of sunglasses and work are not associated with the risk of AMD.

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.

Purpose: In this study the authors present the ocular diseases and bioelectrical dysfunction of the retina and optic nerve in patients with Alzheimer's disease, based on available literature., Materials and Methods: The paper focuses on the most often occurring ocular diseases and optic nerve dysfunction associated with Alzheimer's disease measured by ERG, PERG and VEP tests., Results: The most common ocular diseases in Alzheimer's disease are glaucoma, cataract and AMD. Electrophysiological tests can be abnormal in patients with Alzheimer's disease even with normal eye fundus in routine ophthalmic examination., Conclusions: Early diagnosis of ocular changes associated with Alzheimer's disease can prevent from significant loss of vision and can prolong self-reliant existence of patients with this disease. Electrophysiological tests are expected to be helpful in differentiation between patients with early stages of Alzheimer's disease and healthy people or people suffering from other types of dementia or mental diseases. Future research to estimate the diagnostic value of this tests are needed.

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.

The aim of this research is to describe one of the most frequent ophthalmology disease-glaucoma and to look at their neurodegenerative nature and methods to stop disease. We use neuroprotection in glaucoma from a short time but despite of ethiological reasons neuroprotection seems to be one of the main mechanism to slow their progression. This research is talking about new opinions about neuroprotection in glaucoma and their epidemiology and etiology.

Introduction: The purpose of this study was to show to what extent developmental dyslexia influences a scope of stereoscopic., Material and Methods: 176 pupils and students with developmental dyslexia were examined, including 52 girls and 124 boys aged between 8 and 19. Subjects were divided into three groups in respect of their age: I group 8-10 years, II group 10-14 years, III group 15-19 years of age, and in respect of a type of dyslexia into: visual and spatial type (W), language and auditory (S) and mixed (M). Long distance visual acuity in both eyes was 1.0 and near sight visual was 0.5 according to Snellen charts after correction of refraction error. Error of refraction ranged from +/- 0.5 Dsph to -2.25 Dsph and +3.0 Dsph, while astigmatism ranged from +/- 0.5 Dcyl to -2.0 Dcyl, +2.25 Dcyl. All the subjects had binocular vision in free space and on synoptophore (simultaneous perception, fusion, stereopsis). Reference group consisted of children and school children without ophthalmological pathological state. While analysing the obtained results it was found that the pupils and students with developmental dyslexia of group I and II and of dyslectic pathogenic groups (W, S, M) reached statistically considerably higher values of stereoscopic vision angle compared with analogous the control group. No significant differences were found between the age groups of pupils and students with dyslexia and dyslectic pathogenic groups and the control group within the scope of stereoscopic vision acuity and perception of Titmus test stereopsis threshold value of 40 arc sec., Results: In dyslectic pathogenic groups (W, S, M) compared with the control group, the perception of Titmus test threshold value of 40 arc sec was observed significantly and statistically, less frequent., Conclusions: In all pupils and students with developmental dyslexia value of stereopsis angle was statistically considerably higher, while the frequency of stereopsis threshold value perception for Titmus test was observed statistically considerably less often compared with values obtained in control group.