Bozena Romanowska-Dixon

Publications of Bozena Romanowska-Dixon

• [Malherbe's calcifying epithelioma (pilomatrixoma)].

  Authors: Ewa Czerniawska, Arkadiusz Pogrzebielski, Bozena Romanowska-Dixon

  Klinika oczna. 01/2011; 113(7-9):274-6.

  Malherbe's calcifying epithelioma (pilomatrixoma)--is a rare, benign tumor of hair matrix. Of this study is to present the clinical variability of epithelioma, pathomorfological appearance of theMalherbe's calcifying epithelioma (pilomatrixoma)--is a rare, benign tumor of hair matrix. Of this study is to present the clinical variability of epithelioma, pathomorfological appearance of the tumor and the views on its pathogenesis. Malherbe's calcifying epithelioma has a very different, sometimes unusual appearance, similar to other, more frequent laesions. Due to this fact and the rarity of the tumor it is sometimes overlooked in diagnostic considerations, or confused with more common tumors. Genetic analysis at this stage, allows to establish a probable causal relationship between mutations in the beta-catenins coding gene and development of pilomatrixoma. Extremely rare epithelioma may undergo transformation into pilomatrix carcinoma. The only reliable criterion of diagnosis remains pathological evaluation which despite the deceptive macroscopic appearance of the tumor provides correct diagnosis.

• [Malherbe's calcifying epithelioma (pilomatrixoma)--own experience].

  Authors: Ewa Czerniawska, Arkadiusz Pogrzebielski, Bozena Romanowska-Dixon, Jolanta Orłowska-Heitzman

  Klinika oczna. 01/2011; 113(7-9):237-42.

  Malherbe's calcifying epithelioma is a rare hair matrix tumor. The objective is to present clinical cases and to analyze the variability of its image. Among nearly 3500 patients with ocular tumorsMalherbe's calcifying epithelioma is a rare hair matrix tumor. The objective is to present clinical cases and to analyze the variability of its image. Among nearly 3500 patients with ocular tumors operated during the last 10 years in the Department of Ophthalmology and Ocular Oncology in Krakow we identified a group of 7 patients with histologically confirmed pilomatrixoma. A retrospective evaluation of their medical history was performed, paying particular attention to the co-existence of other diseases, form of growth and location of tumors, as well as treatment methods and their effectiveness. The results were compared with other clinical studies. Malherbe's calcifying epithelioma is characterized by clinical polymorphism and similarity to other much more frequent eyelid tumors. It usually has the form of a single, small, movable, slowly growing nodule covered by intact skin. In addition to the classic form described there are pediculated tumors, huge, fast-growing, perforating, as well as tumors in unusual locations and multiple lesions. The consequences of variation pilomatrixoma are clinical diagnostic errors. The one, sure and reliable criterion is a histopathology evaluation.

• Microcirculation patterns in indocyanine green angiography and the results of plaque therapy in choroidal melanoma.

  Authors: Agnieszka Kubicka-Trzaska, Bozena Romanowska-Dixon

  Klinika oczna. 01/2011; 113(10-12):307-13.

  To determine the effect of radioactive plaque therapy on blood vessel behaviour in choroidal melanomas using indocyanine green (ICG) angiography. Fifty-five patients with choroidal melanoma wereTo determine the effect of radioactive plaque therapy on blood vessel behaviour in choroidal melanomas using indocyanine green (ICG) angiography. Fifty-five patients with choroidal melanoma were studied. Ruthenium-106 plaques were used in 30 eyes, in 11 the "sandwich method" (Ruthenium-106 plaque with transpupillary thermotherapy), was applied and 14 tumours were treated with Iodine-125. In all cases ICG angiography was performed prior to treatment and 12 months after, and at different time afterwards. Baseline tumour microcirculation patterns (MCPs) were studied prior to treatment and post-treatment blood vessels changes were evaluated. Total follow-up period ranged from 14-22 months (mean: 16 months). Pre-treatment ICG angiography revealed complex MCPs, combining parallel with cross-linking, arcs with branching, loops and networks patterns in 23 (41.8%) and non-complex MCPs, including straight, parallel without cross-linking and arcs without branching patterns in 32 (58.2%) melanomas. Twelve months after treatment, 38 tumours (69.1%) showed a significant changes in their MCPs. The mean ultrasonographic regression rate in tumours with complex MCPs was 57.4% as opposed to 36.2% in the group with non-complex MCPs (p = 0.01). No statistically significant correlation in the height regression rate was found among the various methods of therapy, however a significant difference between the type of therapy and MCPs changes was observed (p < 0.001). Melanomas treated with Ruthenium-106 and TTT demonstrated slight or no MCPs changes, while tumours treated with Ruthenium-106 and Iodine-125 plaques alone showed a significant MCPs changes (p < 0.001). The statistical analysis showed the correlation between the type of baseline MCPs and the degree of their changes after treatment (p < 0.001). Tumours with networks, loops, arcs with branching and parallel with crossing showed an increased regression as compared to other MCPs. Twelve patients whose tumours contained complex MCPs developed metastatic disease. This study suggests that the response of choroidal melanoma to irradiation is related to MCPs as identified by ICG angiography; the presence of complex MCPs is associated with a high regression rate after plaque therapy and a high risk of development of systemic metastatic disease.

• [Transpupillary thermotherapy (TTT) for intraocular metastases in choroid].

  Authors: Bozena Romanowska-Dixon, Joanna Kowal, Arkadiusz Pogrzebielski, Anna Markiewicz

  Klinika oczna. 01/2011; 113(4-6):132-5.

  Uveal metastases are the most common intraocular malignant tumors. Most patients who develop metastatic carcinoma to the choroid are managed by radiation or chemotherapy. Since TTT is an optionalUveal metastases are the most common intraocular malignant tumors. Most patients who develop metastatic carcinoma to the choroid are managed by radiation or chemotherapy. Since TTT is an optional treatment for choroidal melanomas and hemangiomas, we ought to determine whether TIT is suitable for treatment of solitary choroidal metastasis at the posterior pole. To evaluate effectivenes of TTT treatment for intraocular metastases. 45 patients (59 eyes) with intraocular metastases were treated in the Ophthalmological Department of Jagiellonian University in Kraków. There were 30 women and 15 man, at the age 31-84 years (av. 57.5). The primary tumor was a breast cancer in 22 women, lung cancer in 5 men and 2 women, kidney (3), colon (2), uterus (1), larynx (1), testicle (1), esophagus (1). 10 patients had also metastases in other organs. TTT was performed in all treated eyes, in 11 combined with 106Ru brachytherapy (BT). Chemotherapy as adjuvant treatment was performed in 18 patients. The results of treatment were evaluated in mean 14.5 months (1-61) follow-up. After TTT, tumor shrinking was observed in most treated tumors (in 37 eyes, 62.7%), inhibition of tumor growth in 5 (8.4%), and in 4 cases (6.7%) progression of tumor growth. In 3 cases (5.1%) with flat scar and intraocular tumor shrinking, extrascleral extension located close to the tumor base appeared after treatment (TTT in 2 eyes, TTT combined with BT in one case). TTT is an effective treatment method for small choroidal metastases located in the posterior pole. TTT combined with 106Ru brachytherapy can be useful treatment in medium sized choroidal metastases. Efficient results encourage further application of thermotherapy in the treatment of intraocular metastases. It allows for the conservative treatment of the eyeball and also useful visual acuity. Extraocular extension appearing after TT needs further study.

• Macular microcirculation blood flow after pars plana vitrectomy with silicone oil tamponade.

  Authors: Agnieszka Kubicka-Trzaska, Joanna Kobylarz, Bozena Romanowska-Dixon

  Klinika oczna. 01/2011; 113(4-6):146-8.

  To assess the macular microcirculation blood flow with Doppler laser scanning (HRF-Heidelberg Retinal Flowmeter), in patients with complicated rhegmatogenous retinal detachment (RRD), after parsTo assess the macular microcirculation blood flow with Doppler laser scanning (HRF-Heidelberg Retinal Flowmeter), in patients with complicated rhegmatogenous retinal detachment (RRD), after pars plana vitrectomy (PPV), with silicone oil tamponade. Eleven patients (6 males and 5 females), aged 38-64 years, mean age: 52.4 years, with unilateral macula-on complicated RRD were included in a study. In all cases conventional (20-gauge) pars plana vitectomy with silicone oil tamponade was performed. Control group consists of the fellow eyes. In the early postoperative period (1-3 days after surgery), in all operated eyes the mean values of macular microcirculation blood flow were significantly reduced in the comparison with those of the control eyes (p = 0.01). The reduction of mean values of macular microcirculation blood flow was still observed in all silicone-oil-filled eyes one month after surgery as compared to the contralateral eyes (p = 0.01). There was no correlation between the values of macular microcirculation blood flow and the duration of RRD, baseline BCVA, refractive error, number of retinal tears, and the patient age. The preliminary results of this study suggest that PPV with silicone oil tamponade influences over the retinal blood flow. We have observed that silicone oil may have a negative long-term effect on the retinal microcirculation as it was noted one month after surgery.

• Acute retinal necrosis--a case report.

  Authors: Piotr Oleksy, Izabella Karska-Basta, Agnieszka Kubicka-Trzaska, Bozena Romanowska-Dixon

  Klinika oczna. 01/2011; 113(4-6):165-7.

  We present a case of acute retinal necrosis (ARN) which is a rare but devastating and rapidly progressive viral retinitis. It is caused mainly by Herpes simplex virus (HSV) or Varicella zoster virusWe present a case of acute retinal necrosis (ARN) which is a rare but devastating and rapidly progressive viral retinitis. It is caused mainly by Herpes simplex virus (HSV) or Varicella zoster virus (VZV) (2), but also Cytomegalovirus (CMV) and Epstein-Barr virus infections may be aethiological factors of ARN. A 17-year-old male patient was referred with history of painful sudden worsening of visual acuity in the left eye and the presence of floaters in the visual field of the right eye. Based on the ophthalmological examination the diagnosis of bilateral ARN was established. Aqueous humor aspirates were analyzed using polymerase chain reaction (PCR) for Herpes simplex virus (HSV), Varicella zoster virus (VZV), Cytomegalovirus (CMV) and Epstein-Baar virus (EBV). PCR confirmed the presence of Varicella zoster virus in aqueous humor samples. Prompt systemic antiviral therapy combined with steroids was initiated. Since a rapid and accurate diagnosis is crucial for prompt administration of antiviral therapy, PCR-based analysis of intraocular fluids orovides a valuable tool in the establishina an etiologic factor in patients with retinitis caused by herpesvirus.

• [Abnormal pupils' reactions].

  Authors: Joanna Kowal, Anna Strzałka, Agnieszka Kubicka-Trzaska, Bozena Romanowska-Dixon

  Klinika oczna. 01/2010; 112(4-6):156-60.

  Examination of the pupils' light reaction and estimation of the pupils' diameter are the components of the routine physical examination of a patient. Disturbances in pupils' light reaction, unequalExamination of the pupils' light reaction and estimation of the pupils' diameter are the components of the routine physical examination of a patient. Disturbances in pupils' light reaction, unequal size of the pupils indicate damage of the nervous system and require careful diagnosis, both neurological and ophthalmological. Different aspects of anatomy, physiology and the most common pathological syndromes associated with disturbed pupils' light reaction and unequal diameters of the pupils were presented in the article. Early diagnosis and proper treatment can allow to improve prognosis in the analyzed patient group.

• [Results of combined chemotherapy and local ophtalmic therapy for intraocular retinoblastoma].

  Authors: Walentyna Balwierz, Danuta Pietrys, Bozena Romanowska-Dixon, Joanna Kobylarz, Katarzyna Pawińska-Wasikowska, Angelina Moryl-Bujakowska

  Przegla̧d lekarski. 01/2010; 67(6):404-8.

  Until recently chemotherapy was used as adjuvant therapy after enucleation in cases with extraretinal spread of the disease (uveal extension, orbital extension, neoplastic infiltrates of the opticUntil recently chemotherapy was used as adjuvant therapy after enucleation in cases with extraretinal spread of the disease (uveal extension, orbital extension, neoplastic infiltrates of the optic nerve at resection line, intracranial metastasis, generalized disease). Recent experience has proved that use of chemotherapy for intraocular retinoblastoma before local treatment (so called "chemoreduction") has allowed not only to decrease number of enucleations and indications for external beam irradiation or limit the extension of local therapy, but also increase chances for vision preservation and decrease the risk of severe complications. Seventy five children (with 106 involved eyes) aged 0.2 - 106 months with intraocular retinoblastoma diagnosed between January 1996 and June 2009 were the subject of this study. Among 106 involved eyes, in 70 (66%) the V stage according to Reese-Ellsworth classification (R-E) was established. Enucleation before chemotherapy was necessary in 9 (8.5%) cases, and in 22 more children the eye had to be removed after 1-2 courses of chemotherapy. In 68 remaining children (with 70 involved eyes) VEC (vincristine, etoposide, carboplatin) chemotherapy combined with delayed local therapy (cryotherapy, photocoagulation, brachytherapy) was employed. Out of 84 eyes treated by combined methods eye enucleation could be avoided in 47 (67%), including 18 (90%), 13 (87%) and 16 (46%) qualified to R-E group I-II, III-IV and V, respectively. First-line chemotherapy combined with the local treatment should be standard treatment for intraocular retinoblastoma groups I - IV. More effective therapy is required for R-E eye group V cases.

• A case of choroidal metastasis in a male breast cancer.

  Authors: Piotr Oleksy, Arkadiusz Pogrzebielski, Izabella Karska-Basta, Bozena Romanowska-Dixon

  Klinika oczna. 01/2010; 112(10-12):311-3.

  We present a case of male patient under therapy due to breast cancer with choroid metastasis and exudative retinal detachment in right eye. A 59 years old male patient was referred with diagnosis ofWe present a case of male patient under therapy due to breast cancer with choroid metastasis and exudative retinal detachment in right eye. A 59 years old male patient was referred with diagnosis of intraocular tumor in right eye Three years ago radical right-side mastectomy was performed (T2N1M0). The medical history revealed that the patient was under chemo- and hormontherapy due to right breast cancer with lungs, liver and mediastinum metastases. Based on the ophthalmological examination the diagnosis of intraocular tumor was established--choroidal metastasis with exudative retinal detachment. Due to tumor size and general dissemination external beam irradiation of tumor was performed. The majority of choroidal metastases in males are secondary to lung carcinoma, however in differential diagnosis it is necessary to consider also rare cases of breast carcinoma metastases. Treatment strategy should be considered individual depending on size, localization, presence of metastases to other organs and general condition of the patient.

• [Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)--a therapeutic dilemma].

  Authors: Agnieszka Kubicka-Trzaska, Piotr Oleksy, Izabella Karska-Basta, Bozena Romanowska-Dixon

  Klinika oczna. 01/2010; 112(4-6):127-30.

  To present a rare idiopathic inflammation of the posterior segment of the eye - acute posterior multifocal placoid pigment epitheliopathy (APMPPE). A 17 years old male patient was referred to theTo present a rare idiopathic inflammation of the posterior segment of the eye - acute posterior multifocal placoid pigment epitheliopathy (APMPPE). A 17 years old male patient was referred to the Department of Ophthalmology of Medical College, Jagiellonian University in Krakow with the diagnosis of bilateral choroiditis of unknown etiology. The patient underwent the basic ophthalmological examination followed by fluorescein (FA) and indocyanine green (ICGA) angiography. Laboratory testing for Lyme disease, sarcoidosis and syphilis, as well as genetic testing, to determine the presence of HLA antigen complex, were performed Based on the outcomes of performed investigations the definitive diagnosis of APMPPE was established. Systemic steroidotherapy was initiated due to rapid progression of the inflammatory changes, progression of the central visual field changes and profound visual acuity deterioration. APMPPE is a rare, inflammatory and idiopathic eye disease with no clear indications for pharmacological therapy. However decision about necessity and sort of pharmacological therapy should be taken under consideration individually for each patient. ostra tylna wieloogniskowa plackowata epiteliopatia barwnikowa, steroidoterapia. acute posterior multifocal placoid pigment epitheliopathy, steroidotherapy.

• [Ocular masquerade syndrome in a patient with chronic lymphocytic leukemia].

  Authors: Agnieszka Kubicka-Trzaska, Monika Gedliczka, Bozena Romanowska-Dixon

  Klinika oczna. 01/2010; 112(10-12):314-7.

  To report a rare case of a masquerading syndrome in a course of chronic lymphocytic leukemia (CLL). A 57 years old woman with bilateral lacrimal glands enlargement and chronic uveitis unresponsive toTo report a rare case of a masquerading syndrome in a course of chronic lymphocytic leukemia (CLL). A 57 years old woman with bilateral lacrimal glands enlargement and chronic uveitis unresponsive to local steroids, was studied. Patient's general history was positive for chronic lymphocytic leukemia, B cell (B-CLL); actually remission. The patient underwent complete ophthalmic examination with additional A and B-scan ultrasonography (USG), computed tomography (CT) and nuclear magnetic resonance (NMR) imaging of orbital cavities and also biopsy of both lacrimal glands was performed. USG, CT and NMR scans revealed the intraocular inflammation and inflammatory enlargement of both lacrimal glands. The histopathological examination of lacrimal glands showed the presence of lymphocytic infiltrations within the glands' tissue. The patient started with chemotherapy: Fludarabin and Cyclophosphamide. Within weeks the intraocular inflammation was under control and the resolution of lacrimal glands edema was noted. Malignancy should be considered in cases of chronic uveitis that do not respond to steroid therapy. Chronic lymphocytic leukemia rarely masks as chronic intraocular inflammation, in a sporadic cases however it may herald the relapse of the disease.

• [Hymenoptera stings in eyeball--clinical symptoms, patomechanism and treatment]

  Authors: Ewa Cichocka-Jarosz, Monika Weglarz, Bozena Romanowska-Dixon

  Klinika oczna. 02/2009; 111(1-3):80-3.

  Eyeball is a rare stings location additionally with very special immunology response, with no systemic anaphylactic reactions. The ACAID (Anterior Chamber Associated Immune Deviation) phenomenonEyeball is a rare stings location additionally with very special immunology response, with no systemic anaphylactic reactions. The ACAID (Anterior Chamber Associated Immune Deviation) phenomenon causes a special immunology privilege of the eyeball, which prevents late immunological answer reaction and destruction processes of the anterior part of the eye. In case that sting penetrates the eyeball local allergic reaction can appear despite ACAID phenomenon. Adequate treatment is necessary for those patients. It can lead to permanent visual acuity deterioration.

• [Photothrombosis in choroidal melanoma mediated by indocyanine green]

  Authors: Bozena Romanowska-Dixon, Agnieszka Kubicka-Trzqska

  Klinika oczna. 02/2009; 111(1-3):37-41.

  PURPOSE: To assess the distant results of choroidal melanoma treatment with indocyanine green induced photothrombosis (iMP). MATERIAL AND METHODS: The study comprised 57 patients (57 eyes) at the agePURPOSE: To assess the distant results of choroidal melanoma treatment with indocyanine green induced photothrombosis (iMP). MATERIAL AND METHODS: The study comprised 57 patients (57 eyes) at the age 39 to 68 yrs (mean age: 57.4 yrs), with choroidal melanoma. In all cases basic ophthalmic examination with ultrasonography and indocyanine green angiography (ICGA) were performed. IMP was performed with diode laser at 810 nm wave length 15 minutes after intravenous indocyanine dye injection as a bolus (50 mg/5 ml). The main criteria for assessment of treatment efficacy included changes in tumor thickness measured by ultrasonography and microcirculation changes in ICGA. The follow-up period ranged from 37 to 59 months (mean: 45.5 month). RESULTS: Before iMP plaque therapy with 106Ru was performed in 18 eyes, and with 125l in 5, transpupillary thermotherapy (TTT) or xenon arc photocoagulation was used in 5 eyes and "sandwich method" (106Ru + TTT) in 16 eyes. Only in 13 eyes the primary treatment consisted of iMP. IMP was performed twice in 4 patients and three times in 2. After iMP the total regression of tumor microcirculation was observed in 36 cases, in 14 the partial regression was noted and in 7 the inner microcirculation remained unchanged. Ultrasonography showed the mean reduction of tumor thickness by 47.3% in 37 eyes, among which the flat scar was present in 12. Stabilization was observed in 15 cases while in 5 the further progression of the tumor was detected in spite of performed therapies. The additional treatment was performed in 20 cases. Six eyes was enucleated; in one case because of neovascular glaucoma, and in 5 because of no positive reaction to performed conservative treatment. CONCLUSIONS: IMP can be an effective method of therapy in some cases of small choroidal melanoma. In medium size and in large melanomas iMP can serve only as the additional method adjunctive to plaque therapy and TTT.

• [Punctate inner choroidopathy--a case report and literature review]

  Authors: Karolina Ziaja, Agnieszka Kubicka-Trzaska, Izabella Karska-Basta, Bozena Romanowska-Dixon

  Klinika oczna. 02/2009; 111(4-6):142-4.

  We present the case of punctate inner choroidopathy in a 45 years old woman B.S. In the case of PIC we should perform special tests, that may confirm diagnosis, help in the appropriate treatment andWe present the case of punctate inner choroidopathy in a 45 years old woman B.S. In the case of PIC we should perform special tests, that may confirm diagnosis, help in the appropriate treatment and avoid complications.

• [Polypoidal choroidal vasculopathy--a rare form of choroidal neovascularization]

  Authors: Monika Weglarz, Izabella Karska-Basta, Agnieszka Kubicka-Trzaska, Bozena Romanowska-Dixon

  Klinika oczna. 02/2009; 111(4-6):145-8.

  PURPOSE: To present two cases of polypoidal choroidal vasculopathy (PCV). MATERIAL AND METHODS: Two 85- and 76-years old female patients were enrolled in the study. One patient was referred to thePURPOSE: To present two cases of polypoidal choroidal vasculopathy (PCV). MATERIAL AND METHODS: Two 85- and 76-years old female patients were enrolled in the study. One patient was referred to the Ophthalmology Clinic in Krakow with the presumptive diagnosis of the choroid tumor in the left eye. The other one was suspected of choroidal neovascularization (CNV) in the course of age-related macular degeneration (AMD) in the left eye. Both patients underwent the basic ophthalmic examination, fluorescein (FA) and indocyanine green (ICGA) angiography. Additionally ocular ultrasonography and MRI of the head and orbits were performed in the patient suspected of the choroid tumor. RESULTS: Performed investigations, especially the results of ICGA allowed to establish the definitive diagnosis of polypoidal choroidal vasculopathy in both cases. CONCLUSIONS: Our study shows potential diagnostic difficulties occurring in patients with PCV and indicate ICGA as the method of choice confirming the diagnosis.

• [Signs of retinoblastoma].

  Authors: Joanna Kobylarz, Anna Napora-Krawiec, Małgorzata Anzel, Dawid Kulec, Anna Michalik-Wójcik, Bozena Romanowska-Dixon

  Przegla̧d lekarski. 01/2009; 66(11):937-9.

  Retrospective analysis of retinoblastoma symptoms in patients treated in Ophthalmological Clinic in Krakow. A retrospective chart review was conducted of 293 retinoblastoma patients from our centerRetrospective analysis of retinoblastoma symptoms in patients treated in Ophthalmological Clinic in Krakow. A retrospective chart review was conducted of 293 retinoblastoma patients from our center (1969-2008). A total of 170 (58%) of 293 patients presented with leukocoria, 81 (27.6%) patients had strabismus, 22 (7.5%) had atypical sings, 12 (4.1%) was detected by chance. Eight (2.8%) patients who had a family history of retinoblastoma and were clinically screened for retinal tumors from birth were diagnosed younger. We recommend routine dilated fundoscopic examination by an ophthalmologist for early detection of retinoblastoma before leukocoria and strabismus.

• [Dry eye syndrome and allergic conjunctivitis--epidemics of XXI century--diagnostic problems and management].

  Authors: Agnieszka Kubicka-Trzaska, Bozena Romanowska-Dixon

  Przegla̧d lekarski. 01/2009; 66(11):967-71.

  Recently, allergic conjunctivitis and dry eye syndrome have been thought to be the epidemics of XXI century. Allergic conjunctivitis is the commonest form of allergy worldwide. Clinical symptoms ofRecently, allergic conjunctivitis and dry eye syndrome have been thought to be the epidemics of XXI century. Allergic conjunctivitis is the commonest form of allergy worldwide. Clinical symptoms of dry eye are the most common cause of patients complains in out-patient ophthalmological clinics. Both, allergic conjunctivitis and dry eye syndrome, may be associated with some systemic diseases. Thus, it is crucial to perform complete allergic tests in patients suspected of allergic conjunctivitis. The assessment of IgE in tears is a very sensitive test in these cases because physiologically this immunoglobulin is not detectable in tear film. In cases of dry eye syndrome the measurement of tear osmolarity has been is thought to be the most specific and sensitive test, recently.

• [Guidance for the treatment of neovascular age-related macular degeneration (AMD)].

  Authors: Izabella Karska-Basta, Agnieszka Kubicka-Trzaska, Piotr Oleksy, Bozena Romanowska-Dixon

  Przegla̧d lekarski. 01/2009; 66(11):972-5.

  Neovascular age-related macular degeneration (AMD) is becoming an increasing socio-medical problem as the proportion of the aged population is continuously increasing. However, new researches in theNeovascular age-related macular degeneration (AMD) is becoming an increasing socio-medical problem as the proportion of the aged population is continuously increasing. However, new researches in the pathogenesis of the disease offer the opportunity to develop more effective therapies of AMD. This article will focus on the options in the management of neovascular age-related macular degeneration and recent therapeutic options. The recent development of anti-VEGF (vascular endothelial growth factor) substances for use in clinical routine has markedly improved the prognosis of patients with neovascular AMD. Intravitreal treatment with substances targeting all isotypes of Vascular Endothelial Growth Factor (VEGF), for the first time results in a significant increase in visual acuity in patients with neovascular AMD. The combination with occlusive therapies like photodynamic therapy (PDT) potentially offers a reduction of re-treatment frequency and long-term maintenance of the treatment benefit. Further developments interacting with various steps in the angiogenic cascade are under clinical or preclinical evaluation and may soon become available. Nevertheless, the growing number of novel therapeutic options will have to provide proof of concept in randomized controlled clinical trials.

• [Mesectodermal leiomyoma of the ciliary body--case report].

  Authors: Paulina Sojka, Arkadiusz Pogrzebielski, Jolanta Orłowska-Heitzman, Bozena Romanowska-Dixon

  Klinika oczna. 01/2009; 111(10-12):350-3.

  The aim of this report is to present a case of mesectodermal leiomyoma of the ciliary body. In the left eye of the 15 years old female patient presenting 2 months history of deterioration of visualThe aim of this report is to present a case of mesectodermal leiomyoma of the ciliary body. In the left eye of the 15 years old female patient presenting 2 months history of deterioration of visual acuity a medium-pigmented, dome-shaped tumor at the inferotemporal side was detected. It measured 21.6 mm in base diameter 11.2 mm in thickness and was revealed with imaging techniques such as ultrasound, MRI and orbital radiography. Taking into consideration all clinical features, despite patients' young age, malignant melanoma of the ciliary body was suspected. Due to the size of the tumor and the impossibility of conducting conservative treatment the globe was eventually enucleated. The final diagnosis was established on the basis of histopathological microscopic examination and immunohistochemical stains. The co-expression of muscular (SMA, caldesmon, desmin), as well as neural markers (S-100 protein and synaptophysin), has been proved. Mesectodermal leiomyoma of the ciliary body is an extremely rare benign tumor, which originates from neural crests. It exhibits features of both muscular and neural differentiation.

• [Ocular outcomes in 3-year-old premature infants with retinopathy treated with cryotherapy and laser photocoagulation].

  Authors: Joanna Kobylarz, Dawid Kulec, Anna Michalik-Wójcik, Anna Napora-Krawiec, Małgorzata Anzel, Bozena Romanowska-Dixon

  Przegla̧d lekarski. 01/2009; 66(11):940-3.

  The aim of the study was to compare functional and structural outcomes in 3-year-old premature children treated in acute phase of retinopathy of prematurity with diode laser photocoagulation andThe aim of the study was to compare functional and structural outcomes in 3-year-old premature children treated in acute phase of retinopathy of prematurity with diode laser photocoagulation and cryotherapy. We examined 106 premature children aged 3 years, treated for retinopathy of prematurity, by transpupillary diode laser photocoagulation (group II) or cryotherapy (group I). Functional (visual acuity using Snellen charts or preferential looking test - Teller acuity Card) and structural (anterior segment slit lamp and indirect Fison fundus examination) outcome and cycloplegic refraction using 1% Tropicamide were examined in all children. Favorable functional results occurred in 81.9% of eyes in patients after cryotherapy and in 83.9% of eyes in patients after diode laser photocoagulation. Structural outcome was favorable in 90.1% of eyes treated with cryotherapy and in 95.3% of eyes treated with diode laser photocoagulation. Diode laser photocoagulation appliance in retinopathy of prematurity treatment allows to obtain better functional and structural outcomes than cryotherapy.