Macular Degeneration: Zagórski Z

Dolar-Szczasny J, Mackiewicz J, Bindewald A, Holz FG, Zagórski Z. · Z Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #16417019 No free full text.

Abstract: PURPOSE: To present application of a confocal Scanning Laser Ophthalmoscope (cSLO) for fundus autofluorescence examination, as a new method of visualization of retinal pigment epithelium and its possible significance in the diagnosis of different retinal diseases. MATERIAL AND METHODS: Typical autofluorescence images in age-related macular degeneration (AMD), Stargardt disease, Best disease and pattern dystrophies are presented, based on the own experience and literature data. Autofluorescence images were obtained with a cSLO using an argon laser for generation of excitation light at 488 nm and a barrier filter >500 nm for the detection of the emitted signals. RESULTS: A variety of autofluorescence patterns, associated with the accumulation of lipofuscin in RPE cells, was found in the above entities. CONCLUSIONS: Presented method of fundus autofluorescence examination gives new possibilities in studying the pathogenetic mechanisms in various retinal diseases and may be useful in monitoring the follow-up and the effects of the treatment.

Dolar-Szczasny J, Mackiewicz J, Biziorek B, Zagórski Z. · Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #17725280 No free full text.

Abstract: PURPOSE: To identify patterns of fundus autofluorescence (AF) in patients with Stargardt dystrophy and fundus flavimaculatus. MATERIAL AND METHODS: 20 patients in age 7 to 47 years with Stargardt dystrophy and fundus flavimaculatus, were examined. Ophthalmic evaluation included nonstandarized Snellen visual acuity, complete ophthalmic examination, fluorescein angiography and color fundus photographs. The autofluorescence images were obtained using a confocal scanning laser ophthalmoscope HRA2. RESULTS: In 15 patients lack or decreased AF signal in a foveal region with punctate diffuse spots with increased and decreased AF signal extending far from the macular region were observed. In 4 patients apart from lack of the AF signal in the central area punctate spots were restricted to the macular region. In 1 patient AF image was copletely normal. CONCLUSIONS: Autofluorescence imaging allows for evaluation of the area with changes on the RPE level typical for this disease and is helpful, noninvasive examination for diagnostic process in such patients. A wide variation in clinical phenotype can occur in patients with Stargardt disease and fundus flavimaculatus. Obtained different phenotypes in autofluorescence imaging may correlate with different clinical types of this disease, described in the literature.

Mackiewicz J, Mańkowska A, Dolar-Szczasny J, Zubilewicz A, Oleszczuk A, Nowomiejska K, Rejdak R, Zagórski Z. · Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #17725273 No free full text.

Abstract: PURPOSE: To evaluate effects of intravitreal bevacizumab on visual acuity and angiographic lesions characteristics in patients with neovascular AMD and to report safety of such treatement. MATERIAL AND METHODS: 32 patients with confirmed choroidal neovascularisation (CNV) and AMD were treated. Patients received 2 intravitreal bevacizumabu (1.25 mg) iniections on 1-3 months basis. Control ophthalmic evaluations included visual acuity measurements with EDTRS charts, intraocular pressure measurements, complete ophthalmic examination in slit lamp, fluorescein angiography and blond pressure measurements. RESULTS: In 18 patients (56%) visual acuity improvement at a mean 3 lines on EDTRS charts was observed, in 9 patients (28%) visual acuity did not change and in 5 (16%) cases decreased visual acuity (about 1,5 lines in EDTRS charts) was noted. Mean follow-up period was 3 months after second injection. In most study eyes fluorescein angiography revealed a marked reduction in leakage from CNV. Apart from one case with endophthalmitis symptoms after second bevacizumab injection, we did not observed systemic or ocular adverse effects of the applied treatment. CONCLUSIONS: Short-term results suggest that intravitreal bevacizumab is relatively safe form of AMD treatement and is associated with improvement in visual acuity and reduction in angiographic leakage in most patients with neovascular AMD. Further evaluation of the long-term effectiveness of this treatment is warranted.

Nowomiejska K, Oleszczuk A, Zubilewicz A, Krukowski J, Mańkowska A, Rejdak R, Zagórski Z. · Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #17725269 No free full text.

Abstract: PURPOSE: To compare the visual field results obtained by static perimetry, microperimetry and rabbit perimetry in patients suffering from dry age related macular degeneration (AMD). MATERIAL AND METHODS: Fifteen eyes with dry AMD (hard or soft macula drusen and RPE disorders) were enrolled into the study. Static perimetry was performed using M2 macula program included in Octopus 101 instrument. Microperimetry was performed using macula program (14-2 threshold, 10dB) within 10 degrees of the central visual field. The fovea program within 4 degrees was used while performing rarebit perimetry. RESULTS: The mean sensitivity was significantly lower (p<0.001) during microperimetry (13.5 dB) comparing to static perimetry (26.7 dB). The mean deviation was significantly higher (p<0.001) during microperimetry (-6.32 dB) comparing to static perimetry (-3.11 dB). The fixation was unstable in 47% and eccentric in 40% while performing microperimetry. The median of the "mean hit rate" in rarebit perimetry was 90% (range 40-100%). The mean examination duration was 6.5 min. in static perimetry, 10.6 min. in microperimetry and 5,5 min. in rarebit perimetry (p<0.001). Sensitivity was 30%, 53% and 93% respectively. CONCLUSIONS: The visual field defects obtained by microperimetry were more pronounced than those obtained by static perimetry. Microperimetry was the most sensitive procedure although the most time-consuming. Microperimetry enables the control of the fixation position and stability, that is not possible using the remaining methods. Rarebit perimetry revealed slight reduction of the integrity of neural architecture of the retina. Microperimetry and rarebit perimetry provide more information in regard to the visual function than static perimetry, thus are the valuable method in the diagnosis of dry AMD.