Objectives The aim of this study is to evaluate longitudinal RNFL thickness changes in patients with open-angle glaucoma (OAG) who underwent pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and ILM removal using OCT RTVue XR 100 Avanti. Methods Retrospective analysis of OCT scans of 40 patients who underwent PPV or combined phacovitrectomy with ILM peeling for the idiopathic ERM has been carried out. The patients were divided into two groups for the study: patients with the ERM and OAG and those with ERM without glaucoma. A trend analysis of the RNFL thickness changes in 1 month and 3, 6, and 12 months was created. Results At 1 month after surgery, the RNFL thickness increased significantly in the temporalis quadrant from 89.9 μm to 105.7 μm in patients with OAG. Comparison between group with OAG and group without glaucoma showed that the RNFLT in the temporalis quadrant decreased significantly 6 months after the surgery. Conclusion Postoperative changes in RNFL thickness appeared to be transient, and there was temporal retardation of the retinal nerve fibers without affecting visual acuity in both groups.
Age-related macular degeneration (AMD) is a progressive, chronic disease of the central area of the retina, which, if untreated, leads to blindness. This study aimed to compare the effectiveness of therapy using anti-VEGF drugs, namely brolucizumab and aflibercept, in patients with neovascular AMD (nAMD) during a monitoring period lasting around 20 weeks. The analysis consisted of 40 patients diagnosed with neovascular age-related macular degeneration, with 20 patients receiving aflibercept (Eylea, Bayer) at a dose of 2 mg/50 µL into the vitreous chamber at the following intervals—3 doses, 4 weeks apart, followed by a fourth dose after 8 weeks. The remaining 20 patients received brolucizumab (Beovu, Novartis) at a dose of 6 mg/50 µL, administered in the following schedule—3 initial doses, 4 weeks apart, with the administration of a fourth dose decided for each patient individually by the doctor, depending on disease activity, assessed through imaging tests. To evaluate treatment effectiveness, the following measurements were used: ‘read distance and near visual acuity’ for each eye separately using the Snellen chart; and non-invasive retinal imaging techniques—optical coherence tomography (OCT) and OCT angiography (OCTA). In patients treated using brolucizumab, during the observation period, statistically significant differences were found in the following parameters: flow area (p = 0.0277); select area (p = 0.0277); FOVEA (p = 0.0073); visus (p = 0.0064). In brolucizumab-treated patients, changes in OCT and OCTA, indicating an improvement, were already visible after the first injection of the drug, whereas in the aflibercept-treated group, changes were only visible after the fourth injection. We found a higher effectiveness of brolucizumab therapy compared to aflibercept in patients with nAMD during an observations period lasting 20 weeks. Our observations are significant, although they require further research.
Purpose Comparative analysis of central and peripheral corneal thickness in PEX patients using three different imaging systems: Pentacam-Scheimpflug device, time-domain optical coherence tomography (OCT) Visante, and swept-source OCT Casia. Materials and Methods 128 eyes of 80 patients with diagnosed PEX were examined and compared with 112 normal, non-PEX eyes of 72 cataract patients. The study parameters included 5 measured zones: central and 4 peripheral (superior, inferior, nasal, and temporal). Results The mean CCT in eyes with PEX syndrome measured with all three instruments was thicker than that in normal eyes. Corneal thickness measurements in the PEX group were statistically significantly different between Pentacam and OCT Casia: central corneal thickness (p = 0.04), inferior corneal zone (p = 0.01), and nasal and temporal corneal zones (p < 0.01). Between Pentacam and OCT Visante inferior, nasal and temporal corneal zones were statistically significantly different (p < 0.01). Between OCT Casia and OCT Visante, there were no statistically significant differences in measured parameters values. Conclusion The central corneal thickness in eyes with PEX syndrome measured with three different independent methods is higher than that in the non-PEX group, and despite variable peripheral corneal thickness, this one parameter is still crucial in intraocular pressure measurements.
PurposeThe most frequent qualifications for pars plana vitrectomy (PPV) in diabetic patients include recurrent hemorrhage into the vitreous body chamber and vitreoretinal proliferation, also with traction retinal detachment. The aim of this study was to evaluate the effectiveness of EX-PRESS implant for the treatment of secondary glaucoma in elderly diabetic patients following PPV 23G with silicon oil or SF6 gas endotamponade.Materials and methodsThis retrospective analysis comprised 18 patients (19 eyes). We applied EX-PRESS implants in 9 patients with neovascular glaucoma (NVG) and in 10 patients with non-NVG. All patients had earlier history of diabetes and vitrectomy 23G for diabetic complications. Intraocular pressure (IOP) was measured and compared before; 7 days; 1, 3, 6, and 12 months; and a year after the surgery.ResultsApplication of the implant exhibited a lowering effect on IOP. After 1 month, 53% of patients had IOP values beyond 22 mmHg, while 86% after 1 year.ConclusionThe implant can be used to treat both NVG and non-NVG in diabetic patients following PPV.
Background Surgical resection with adjuvant concurrent radiochemotherapy is the standard of care for stage III–IV oral cavity cancer. In some cases, the dynamic course of the disease is out of the prepared schedule of treatment. In that event, a stereotactic radiosurgery boost might be the only chance for disease control. Case presentation Here, we present a case study of a patient with oral cancer who underwent surgery. During adjuvant radiotherapy, a metastatic cervical lymph node was diagnosed based on fine-needle aspiration biopsy. To increase the total dose to the metastatic tumor, a stereotactic radiosurgery boost of 1 × 18 Gy was performed two days after the last fraction of conventional radiotherapy. The early and late tolerance of this treatment were positive. During the 18-month follow-up, locoregional recurrence was not detected. The patient died due to secondary malignancy. Conclusions This paper shows that a stereotactic radiosurgery boost added to adjuvant conventional radiotherapy is an effective approach permitting the maintenance of good local control in well-selected patients.
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