Agnieszka Nowosielska

Publications of Agnieszka Nowosielska

• [Complications of intravitreal injections--own experience].

  Authors: Agnieszka Jamrozy-Witkowska, Katarzyna Kowalska, Irmina Jankowska-Lech, Barbara Terelak-Borys, Agnieszka Nowosielska, Iwona Grabska-Liberek

  Klinika oczna. 01/2011; 113(4-6):127-31.

  PURPOSE: Authors present complications associated with intravitreal injection perfomed in Ophthalmic Clinic CMKP MATERIAL AND METHODS: retrospective study, between January 2006 and July 2009 wePURPOSE: Authors present complications associated with intravitreal injection perfomed in Ophthalmic Clinic CMKP MATERIAL AND METHODS: retrospective study, between January 2006 and July 2009 we performed intravitreal injections with triamcinolone acetonide (Kenalog, 4 mg), ranibizumab (Lucentis, 0.5 mg), bevacizumab (Avastin, 1.25 mg) and pegaptanib (Macugen, 0.3 mg). We treated eyes with age-related macular degeneration, diabetic macular edema, after retinal venous occlusion, with uveitis, Irvine-Gass syndrome, idiopathic juxtafoveolar teleangiectasia and central serous retinopathy. RESULTS: 943 eyes received intravitreal injections. The most common ocular complication was subconjunctival hemorrhage which was seen in 36% cases. Temporary elevated intraocular pressure above 21 mmHg was noticed in 18 eyes (5%) after anti-VEGF agents injections and in 30 eyes (23.4%) after Kenalog injection. Anterior uveitis developed in sixteen cases (1.7%) from the Avastin (5 eyes) and Lucentis (3 eyes) group. Anterior-posterior inflammation occurred in 8 eyes (0.8%), including four eyes (0.4%) with sterile endophthalmitis (3 following bevacizumab and 1 following ranibizumab injection), one eye (0.1%) with pseudoendophthalmitis (after triamcinolone). There were three cases of suspected endophthalmitis (2 following bevacizumab and 1 following triamcinolone injection). The infectious endophthalmitis after triamcinolone injection was culture-proven and revealed Staphylococcus epidermidis. Cataract formation or progression was noted in 34 eyes totally. In Kenalog group progression of cataract was seen in 23.4% of eyes (30 cases) during 2-years of follow-up and in anti-VEGF agents group--in two cases (0.6%) and 2 cases of iatrogenic cataract. Three diabetic patients suffered systemic adverse events: one patient developed renal insufficiency, one patient developed cerebrovascular accidents and one suffered a myocardial infarction resulting in death. Conclusions: Intravitreal injections are associated with a low incidence of serious adverse events. The most common ocular complication was subconjunctival hemorrhage. There was one case of serious complication--the culture-proven infectious endophthalmitis after Kenalog injection. Cataract formation and increase of intraocular pressure were more often observed following intravitreal triamcinolone injection.

• [Vitrectomy--absolute indication in case of intraocular foreign body localized in vitreous cavity or within vitreo-retinal interface]

  Authors: Jacek Robaszkiewicz, Agnieszka Nowosielska, Ewa Wójcik

  Klinika oczna. 02/2005; 107(4-6):326-9.

  Ocular trauma is the leading cause of visual loss in young adults. Open globe injuries with intraocular foreign bodies are an important part of this group, and in general an early surgery isOcular trauma is the leading cause of visual loss in young adults. Open globe injuries with intraocular foreign bodies are an important part of this group, and in general an early surgery is required, in order to preserve the visual acuity and the eye globe. Primary surgical repair and foreign body removal may be performed using external magnet or vitrectomy. Based on published reports and our clinical experience we think that vitrectomy is safer procedure, giving better chance for good postoperative visual outcome.

• [Acute, idiopathic, bilateral uveitis with periphlebitis--case report]

  Authors: Agnieszka Nowosielska, Wojciech Czarnecki, Joanna Brydak-Godowska, Ewa Dróbecka-Brydak, Ewa Nowacka, Mieczysław Lao, Magdalena Durlik

  Klinika oczna. 02/2005; 107(4-6):372-5.

  The purpose of this paper is to present the case of a 35 years old healthy male suffering from acute, bilateral uveitis with periphlebitis which despite broad ophthalmic and internal diagnosisThe purpose of this paper is to present the case of a 35 years old healthy male suffering from acute, bilateral uveitis with periphlebitis which despite broad ophthalmic and internal diagnosis remained of unknown origin. Despite anti-inflammatory treatment with acyclovir, ciprofloxacin and Encorton remission of inflammation was not achieved. Due to the failure of steroid treatment the decision of immunosuppressive therapy with Rapamycine and Endoxan was made. New therapeutic regimen caused the remission of inflammation and preserved patient's useful visual acuity.

• [The influence of spontaneous posterior vitreous detachment in resolution of diabetic macular edema in NIDDM]

  Authors: Agnieszka Nowosielska, Jacek Robaszkiewicz, Ewa Graczyńska, Wojciech Czarnecki, Andrzej Stankiewicz

  Klinika oczna. 02/2003; 105(6):355-61.

  PURPOSE: To establish the influence of posterior vitreous detachment on development and resolution of diabetic macular edema in NIDDM. To asses the posterior vitreous detachment role in argon laserPURPOSE: To establish the influence of posterior vitreous detachment on development and resolution of diabetic macular edema in NIDDM. To asses the posterior vitreous detachment role in argon laser treatment of diabetic macular edema. MATERIAL AND METHODS: Retrospective study. RESULTS: 68 eyes of 36 patients were involved into the study, 52 eyes (76.5%) with macular edema and 16 eyes (23.5%) without macular edema. Posterior vitreous detachment (PVD) was present in 62.5% of cases without macular edema, and only 30.77% of cases had macular edema. Laser treatment applied in accordance to general standards cased resolution of macular edema in all cases with posterior vitreous detachment. In group with no spontaneous posterior vitreous detachment, macular edema resolved only in 19.23% of cases. CONCLUSIONS: Diabetic macular edema is less common in eyes with spontaneous posterior vitreous detachment. This observation shows, that not only vascular factor but also vitreo-macular tractions are responsible for macular pathology in diabetic macular edema. The efficacy of standard argon laser treatment depends also on vitreo-macular relation--presence of PVD, and is more sufficient in eyes with posterior vitreous detachment.

• [Vitrectomy in diabetic macular edema]

  Authors: Agnieszka Nowosielska, Jacek Robaszkiewicz, Ewa Graczyńska, Wojciech Czarnecki, Andrzej Stankiewicz

  Klinika oczna. 02/2003; 105(6):421-4.

  Macular edema remains one of the important therapeutic issues. Vitero-macular tractions are said, to be the cause of persistent, non responding to laser treatment diabetic macular edema. SurgicalMacular edema remains one of the important therapeutic issues. Vitero-macular tractions are said, to be the cause of persistent, non responding to laser treatment diabetic macular edema. Surgical removal of these tractions is used in treatment of non resolving macular edema. However, vitrectomy in treatment of diabetic macular edema remains the experimental, method requiring further studying.

• [Terson syndrome]

  Authors: Agnieszka Nowosielska, Wojciech Czarnecki

  Klinika oczna. 02/2003; 105(1-2):79-81.

  The syndrome of intra-vitreous bleeding in association with subarachnoid haemorrhage (SAH) was first describe by French ophthalmologist Albert Terson in 1900. In last 10 years only a few cases wereThe syndrome of intra-vitreous bleeding in association with subarachnoid haemorrhage (SAH) was first describe by French ophthalmologist Albert Terson in 1900. In last 10 years only a few cases were recorded. Early recognition of TS is of high importance, since diminution of visual acuity even to functional blindness, can hamper the rehabilitative process. The treatment methods are various, based on clinical manifestation. The surgical procedure of choice is the pars plana vitrectomy (PPV). The importance of being aware of the syndrome is very crucial, both in order to provide the adequate nursing care and to be able to perform early vitrectomy, to restore the visual function.

• [Terson syndrome in a course of cerebral aneurysm--clinical assessment]

  Authors: Agnieszka Nowosielska, Wojciech Czarnecki, Mirosław Zabek

  Klinika oczna. 02/2003; 105(1-2):49-51.

  40 patients with ruptured cerebral aneurysm were screened by an ophthalmologist for the presence of Terson syndrome (TS) and other forms of ocular haemorrhages. Terson syndrome was found in 10% of40 patients with ruptured cerebral aneurysm were screened by an ophthalmologist for the presence of Terson syndrome (TS) and other forms of ocular haemorrhages. Terson syndrome was found in 10% of cases and 37.5% of cases presented other forms of ocular bleeding. The most significant neurological symptom leading to diagnose TS, was coma episode occurring in any moment of clinical observation.