[show abstract][hide abstract] ABSTRACT: Ocular infections are one of the most frequent causes of ailments among the patients coming to ophthalmologic offices. This article presents one of the physical medicine's methods--magnetotherapy--which uses the alternating low frequency magnetic fields in the therapy of viral conjunctivitis and keratitis in a 49-year-old female patient. Basing on the obtained results it was stated that this method broadens the treatment possibilities becoming a precious supplement and support treatment method in ophthalmology.
[show abstract][hide abstract] ABSTRACT: Numerous neurotransmitters and neuromodulators operating on all levels of the visual system, influence the parameters of cortical evoked response. The aim of this study was to find the influence of dopamine (DA) injected into the lateral geniculate body (nucleus) on flash visual evoked response (FVEP).
The experiments were performed on adult Wistar rats. They were implanted with 1 caniula conducted into the lateral geniculate body and 2 electrodes: active under the skull on dura mater in occipital region of brain and reference one on the skull in the interorbital region. FVEPs curve before and after injection into the lateral geniculate body 0.9% NaCl and DA were analyzed.
DA in the lateral geniculate body causes increasing latency and amplitude of FVEP peaks.
Dopamine in the lateral geniculate body can improve visual perception in the occipital cortex.
[show abstract][hide abstract] ABSTRACT: The topic of this paper is to define the influence of stimulation dopaminergic D1 i D2 receptors in lateral geniculate body by flash visual evoked potentials (FVEP).
Wistar rats were examined. There were stereotaxically implanted with guide caniula into the lateral geniculate body to inject substances and with VEPs electrodes on the skull and on the surface of visual cortex. VEPs curve before and after injection into the lateral geniculate body: 0.9% NaCl, agonists of dopamine receptors D1 - SKF 38393, and D2 Quinpirole and also the same agonist after antagonists D1 - SCH 23390, i D2 Sulpiride were analyzed.
Stimulating receptors D1 in the lateral geniculate body cause amplitude increase and shortness of latency. Quinpirole, agonist of D2 receptor do not significant change FVEPs curve.
Stimulation of D1 receptors in the lateral geniculate body can improve visual transmission throught it and response in the occipital cortex.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to find the relationship between lead level in blood (Pb-B) and visual evoked potentials (VEP) in children, environmentally exposed to lead.
32 children (64 eyes) with no clinical signs of lead poisoning were examined. Corrected visual acuity was 5/5 in all eyes. Age of the children was 2-15.5 years (mean 8), Pb-B ranged from 150 to 486 (mean 262) microg/l. For pattern VEP LKC equipment, UTAS E-2000 program and stimulations of 13', 26', 52', 105' were used. P100 amplitude and latency were calculated.
P100 latency was significantly delayed in children at the age of seven, with Pb-B above 150 microg/l. The latencies were more delayed in children with higher than in lower Pb-B, but the relation was not linear. P100 amplitudes did not differ significantly from the control group. In some children VEP had abnormal morphology, double P100 peak or P100 without sharp, but extended peak.
Delayed P100 PVEP latency occurred in children with blood lead level higher than 150 microg/l, after at least 7 years of environmental exposure. Changes in VEP are similar to those which are caused by demyelinization and are found in multiple sclerosis.
[show abstract][hide abstract] ABSTRACT: Selenium is an essential trace element in lower concentration and toxic in higher one. The aim of the study was to find out if the small doses of selenium taken by pregnant rats change the visual evoked potential (FVEP) curve in newborns. The FVEP was done in 4-6 month old white, Wistar, offsprings rats. 8 rats were from the mothers which drank water solution of natrium selenosum in dose 1.5 ppm through the whole pregnant time ( selen group) and 8 rats were from the pure farm (control group). The shortened of the latencies and increased of the amplitudes of N1 and P1 waves were observed in the selenium exposed group in comparison to the control, but only the changes between amplitudes of N1 and P1 were statistically significant. The small doses of selenium by improving the VEP may probably change for the better vision too.
[show abstract][hide abstract] ABSTRACT: A case of patient with metallic intraorbital foreign body, was described. The foreign body went trough the eye and finally was situated close to the optic nerve. After three years, no signs of siderosis were found (ERG). The patient is still under control.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to present similarities and differences of electroretinograms in early stages of retinal diseases with nyctalopia.
Flash full-field electroretinography was done according to ISCEV standards and also with chromatic stimulations in patients with nyctalopia, who were diagnosed as various forms of congenital stationary night blindness and various types of retinitis pigmentosa, choroideremia, gyrate atrophy and also in patients with nyctalopia, because of unknown reason. ERG results were compared with normal values and with each other.
In diseases with nyctalopia the function of peripheral retina is markedly abnormal and scotopic ERG is significantly reduced or even absent. In retinitis pigmentosa a-wave is small or absent especially scotopic but photopic ERG is also abnormal. Well preserved a-wave distinguished ERG of patients with stationary night blindness from the other progressive diseases of retina or choroid.
In patients with nyctalopia using ERG is possible to obtain which retinal elements do not work but it is only start point to following diagnostic examinations, to make proper final diagnosis.
[show abstract][hide abstract] ABSTRACT: Idiopathic retroperitoneal fibrosis is a rare collagen vascular disease of still unclear, immunological etiology. One of the first descriptions of this pathology was derived from Ormond and the Ormond's disease became its second name. It is characterized by a chronic, non-specific inflammation of the retroperitoneum, which obstructs retroperitoneal structures. The most frequent complication is the ureteric obstruction with hydronephrosis and renal failure. The fibrotic process may develop in different, even remote sites, including ophthalmic system. We have presented a 50-year-old woman with Ormond's disease and anterior uveitis. We have also described the other ocular complications of this disease.
[show abstract][hide abstract] ABSTRACT: To find out, if any and how deep alterations in visual tract are due to prenatal intoxication by heavy metals such as: cadmium (Cd), lead (Pb), mercury (Hg) and manganese (Mn). The measure of these alterations were the changes in flash visual evoked potentials after prenatal intoxication.
The experiments were carried out on 55 white newborns Wistar rats, which were divided into 5 groups: control group (14 rats), Cd group (12), Pb (6), Hg (14) and Mn (9). The method of the FVEP study was described by Pojda et al.
The latencies of the peaks N1 and P1 were prolonged in the Mn group till 113-118% (p< 0.05). Slight prolongation of N1 latencies about 1% in Cd and Hg groups and of 4% in Pb group were not statistically significant. The differences of P1 latencies were not statistically significant in these groups, compared to the control group. The amplitude of N1 wave decreased in Cd group about 63% and in Mn group of 32% compared to the control (p<0.05). In Hg intoxicated group the N1 amplitude decreased to 56% (p< 0.01). The amplitude of P1 decreased in all intoxicated groups (Hg of 56%, Cd 55%, Mn 49%) statistically significant, except the Pb one, in which even 21% decrease was not significant.
The heavy metals prolonged the latencies and diminished the amplitudes of flash visual evoked potentials, so may be, they are not only neurotoxic but also "ophthalmotoxic" factors.
[show abstract][hide abstract] ABSTRACT: The authors described serious irreversible ophthalmic and orbital complications (blindness and total ophthalmoplegia) which occurred during maxillary sinus surgery (Caldwell-Luc) in two patients.
Otolaryngologia polska. The Polish otolaryngology 02/2005; 59(6):893-4.
[show abstract][hide abstract] ABSTRACT: To find out if blood lead level (Pb-B) changes have influence on visual evoked potentials.
18 children (36 eyes) treated with CaNa2EDTA because of chronic environmental lead poisoning were examined two times: first at age 2-15.5 (mean 8) years and second 4 years later. For pattern VEP LKC equipment, UTAS E-2000 program and stimulations of 13', 26', 52', 105' were used. P100 amplitude and latency were calculated.
Pb-B was decreased from 150-486 (mean 262) microg/l to 42-248 (mean 103) microg/l. After 4 years, P100 latency was significantly delayed in children with Pb-B above 100 microg/l at second examination. In children with Pb-B below 100 microg/l no significant differences between two consecutive examinations were observed. There were no significant differences in P100 amplitude.
Delayed P100 latency of PVEP in children is permanent but non-progressive if Pb-B is lower than 100 microg/l.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to find the relationship between visual function changes and vigabatrin treatment continuation or discontinuation.
19 patients (11 males, 8 females) from 8 to 20 years old, treated with vigabatrin because of partial epilepsy, were examined. Best corrected visual acuity, contrast sensitivity and static visual field were done. The examinations were repeated after 1-2 months and after 1-2 years. The longest follow-up was about three years (one girl). In some children from this group additional elctrophysiologic tests (ERG, EOG according to ISCEV standards), were done.
Corrected visual acuity was 5/5 in all eyes. Contrast sensitivity was normal and it was not changed in follow-up period. Abnormal visual field was found in more than half of examined patients. The improvement of visual field occurred after vigabatrin discontinuation, but in one patient the improvement occurred although vigabatrin treatment was continued. Most of the patients refused control ERG and EOG, but in first examination decreased or border b-wave amplitude after "flicker 30Hz" was found.
In some patients treated with vigabatrin reversible visual field changes occurred. Multicentre study should be performed, to solve the problem of relationship between visual field changes, vigabatrin and other antiepileptic treatment. All tests in group of epileptic patients are difficult because of poor cooperation.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to present rare retinal disease of unknown origin.
27-years-old man was diagnosed because of poor vision in the left eye, which lasted 4-5 weeks. Following examinations were performed: Visual acuity, contrast sensitivity, color perception, visual field, fluorescein angiography (AF), visual evoked potentials (VEP), full-field flash electroretinography (flash ERG), focal-foveal electroretinography (focal ERG), multifocal electroretinography (multifocal ERG). Follow-up 1.5 year.
Visual acuity of right eye was 1.25 (-0.1 log MAR) and left eye 1.0 (0.0 log MAR). In left eye between optic disc and macula irregular lesion with dots of retinal pigment epithelium atrophy and little edema was seen. AF revealed small "window" defects. In visual field of the left eye paracentral relative scotoma occurred and in stereokampimetry central relative scotoma was found about 5 degrees from the fixation point. In VEP latency of P100 was delayed and amplitude was reduced in both eyes. In flash as well as focal ERG small reduction of cone function and delayed implicit time of b-wave were found in left eye. In general examination no focal inflammation and no abnormalities in laboratory tests were found. The patient was treated with steroids for 3 weeks. After ten days of general steroid treatment visual acuity improved to 1.25 and subjective improvement of vision occurred. Control examination after 1.5 year revealed no patient's complains, visual acuity 1.25, no change in visual field, VEP improvement. In left eye flat irregular area with pigment epithelium atrophy was seen.
Acute macular neuroretinopathy may be diagnosed after detail examination. Prognosis is generally good, recovery is slow, but despite of local retinal atrophy subjective complains disappear completely.
[show abstract][hide abstract] ABSTRACT: To direct attention on every-day problems in choroideremia, which are not a barrier in patients occupation.
Two cases of patients with choroideremia which was diagnosed when they were 30 and 54 are described. In spite of widespread visual field changes patients with good visual acuity did not have to change their lifestyles or their jobs (miner and mechanic). Visual acuity, visual field, mesoptometry, adaptometry, electroretinography, electrooculography were done. The mother of the younger patient was also examined. Her fundus of the eye showed typical changes for carriers. In the older patient's family among 41 family members 7 men were affected in 3 generations. Follow-up was 6 years.
In ERG rod activity was very low or abolished and cone activity was reduced, more in older patient. In the younger patient visual acuity and mesoptometry were normal, rod adaptation was very low. The patient was able to work as a miner due to good mesopic vision. In follow-up no significant progression of the disease was observed. The older patient had previously been treated for retinitis pigmentosa for a few years. Diagnosis of choroideremia was made when visual acuity of the patient declined. It was impossible to perform mesoptometry and adaptometry because of advanced night blindness. In the dark room the patient found it very difficult to move. In follow-up lowering of the visual acuity, progression of visual field as well as electroretinographic changes occurred.
Patients with choroideremia may be professionally engaged despite of every-day problems connected with widespread scotomas in visual field and nyctalopia. They should not become pensioners too early. The disease progression is faster in older than in younger patients.
[show abstract][hide abstract] ABSTRACT: The aim of this study was to remind the symptoms and diagnostic methods helpful to recognize Arnold Chiari syndrome.
We have presented a 53-year-old woman with papilledema who was operated and treated oncologically because of right breast tumor - four years ago. As a result of diagnostic research which took into consideration a brain magnetic resonance imaging (MRI), the suspicion of metastatic cerebral tumor was excluded and Arnold - Chiari malformation was diagnosed.
The intracranial hypertension and it's ocular manifestation - papilloedema may be caused by different, also congenital, reasons. The brain MRI is the mainly procedure to diagnose the Arnold - Chiari malformation.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to present dramatic ocular manifestation of acute lymphoblastic leukemia.
15-year old boy was hospitalized due to acute leukemia at the Department and Clinic of Pediatric Hematology and was referred to ophthalmologist because of strong pain and decreased visual acuity of the left eye. General ophthalmic examination and electrophysiology were done. These procedures were repeated after 1, 2, 5 and 11 weeks and also after 6 and 9 months.
Acute uveitis with cellular exudation to the vitreous, papilledema, swelling of the macula and green-yellowish infiltration which elevated the temporal part of the retina, were noticed. Swelling of the iris and miosis were observed. After one week of local anti-inflammatory treatment the eye became painless with little deep injection only. Simultaneously causal treatment of basic disease was continued. Control examinations revealed step by step improvement of ocular changes. After 6 months in the place of retinal infiltration choroidoretinal atrophy was seen. The functional deficits in visual field and electrophysiological examinations were found, too. One year later, the patient came again because of recurrence. Involvement of the central nervous system with signs of meningitis occurred. Visual acuity was normal and no infiltration of eyes was found, but there was papilledema in both eyes.
In acute leukemia ocular manifestation may be highly expressed. The patients require local symptomatic and general causal treatment in cooperation of ophthalmologist with hematologist.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to present dramatic ocular manifestation of acute lymphoblastic leukemia.
The 11 years old boy was hospitalized due to acute leukemia at the Department and Clinic of Pediatric Hematology, and was referred to ophthalmic examination because of sudden blindness of the right eye. General ophthalmic examination and electrophysiological tests were done.
No light perception of right eye, and markedly reduced visual evoked responses were caused by infiltration with great edema in optic nerve and its surrounding of retina. In spite of the fact, that the infiltrations disappeared after general therapy, the vision did not recover at all.
Even intensive treatment may be ineffective in blindness prevention in severe course of acute leukemia.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to present the earliest functional changes in Stargardt disease in family with three affected and one unaffected children.
Four children: three girls (4, 7, 10, year old) and one boy (13 year old) and their parents (34 rear old mother and 36 year old father) were examined. Visual acuity (Snellen card), color perception (Ishihara's cards), electroretinography (flash full-field ERG--standard and chromatic) and electrooculography (EOG) were done. For ERG and EOG LKC equipment and UTAS E-2000 program was used.
13 year old boy has had visual acuity about 5/50 for about 3 years, nystagmus and no color perception. On his ocular fundus abnormal macular reflex (like beaten metal) was seen. Visual acuity about 5/12 was found in 7 year old girl during routine examination at school, but color perception and ocular fundus were normal. The others examined family members had visual acuity 5/5 without correction and no changes on ocular fundus. Color perception was normal in girls and mother. The father had red-green deficiency. Arden ratio in EOG was below normal (1.4) only in boy but dark trough and light peak amplitudes were lower than normal also in girls 4 and 7 year old and these two girls were also suspected of Stargardt's disease. ERG was nearly abolished in boy and markedly abnormal in his 7 year old sister. In father's ERG small reduction of cone function especially after chromatic stimulations was found. ERG was normal and similar in mother and 10 year old daughter. ERG was not done in the youngest girl. Two years later loss of visual acuity to 4/50 occurred in girl previously 7 and to 5/6 in the youngest sister.
Detail analysis of EOG and ERG results may lead to diagnose retinal dystrophy in preclinical stadium.
[show abstract][hide abstract] ABSTRACT: The aim of the study is to present objective estimation of visual function in eyes affected by leukemia.
The boy who was described in the first part of this study was examined. Visual evoked potential (VEP), full-field flash electroretinography (FERG), electrooculography (EOG), were done according to ISCEV standards.
The function of retina was decreased proportionally to the areas of infiltration. The amplitude of VEP peaks was lowered when the involvement of the central nervous system occurred. In the eye with retinal infiltration abnormal EOG was present a few months earlier than pigment epithelium destruction was seen in ocular fundus.
Functional deficits may be irreversible.
[show abstract][hide abstract] ABSTRACT: Optic disc drusen make examination towards glaucoma difficult to interpret. They change nerve head morphology and visual field defects can resembling glaucomatous damage. Patient with strong headache was examined and we found drusen on both optic nerve heads and intraocular pressure about 27 mmHg. Visual fields demonstrated scotomas--in lower half and the enlargement of the blind spot. After topical treatment and intraocular pressure normalization, the patient's complaints had gone. Control examination after one year revealed progression of visual field changes. Electrophysiological examination showed abnormalities typical for glaucoma.