Joanna Dolar-Szczasny

Macular Integrity Assessment and Fixation Analysis in Chronic Central Serous Chorioretinopathy

Purpose To investigate retinal sensitivity characteristics associated with morphologic changes in the eyes exhibiting chronic central serous chorioretinopathy (CSC), using macular integrity assessment (MAIA) microperimetry. Methods A retrospective, cross-sectional, observational study was constructed. The eyes of patients classified as chronic CSC, according to the onset of subjective symptoms with serous retinal detachment, as confirmed by optical coherence tomography examination, were included in the study. Retinal sensitivity and fixation were analyzed by performing microperimetry examinations using the MAIA instrument. Results We reviewed microperimetry examinations of 15 eyes of 15 patients (age: 28–51 years) with chronic CSC and mean best-corrected visual acuity of −0.2 logMAR units. The mean retinal integrity in the chronic CSC group was 49.0 ± 27.6, which was significantly different from the control eyes. The mean average threshold in the eyes with chronic CSC was 24.7 ± 5.8 dB, which also was significantly different from the control eyes. Fixation stability was significantly different between the CSC and control eyes for the P1 parameter (90.1 ± 13.7 versus 99.3 ± 1.5), and for the P2 parameter (97.4 ± 4.0 versus 100.0 ± 0.0). Conclusion New microperimetry technology may provide valuable information regarding the visual status of chronic CSC cases. Our findings suggest that retinal sensitivity and fixation stability in chronic CSC eyes may serve as useful indicators for assessing the effectiveness of clinical treatments.

Intravitreal anti-VEGF therapy in macular oedema secondary to racemose haemangiomatosis of the retina

Racemose haemangiomatosis of the retina is a sporadic, mostly unilateral, congenital arteriovenous malformation (AVM), comprising abnormal junctions between arteries and veins that omit capillaries. Typically, vascular malformations are asymptomatic and incidentally discovered. Advanced changes may be related to the presence of subretinal fluid and exudates, even though these lesions are classified as benign. Many complications can lead to severe or permanent visual impairment. Direct methods of treatment of primary retinal vascular anomalies have not been developed yet. The aim of this case report is to present the anti-VEGF therapy in the treatment macular oedema secondary to racemose haemangioma.

Nasally located congenital optic disc pit with concomitant maculopathy

Optic disc pit is a congenital optic disc anomaly, which can be associated with maculopathy. The case of an unusually nasally located pit with concomitant maculopathy in a 64-year-old woman is presented.

Innovation in retinal diseases – ultra-widefield imaging

Abstract The understanding of retinal disease has evolved rapidly with a growing number of clinical evidence supplied by ultrawidefield retinal imaging. Optos 200Tx ultra-widefield retinal imaging system uses a scanning laser ophthalmoscope, as well as an ellipsoid mirror. This creates a possibility of making a virtual focal point inside the eye and, in turn, enables the system to simultaneously make a single capture of the central retina and periphery. This system offers multimodal ultra-widefield imaging, including color photographs, fundus autofluorescence images, red-free images and fluorescein angiography (FA), allowing visualization of the retinal circulation. For color photographs, green and red lasers are used simultaneously to allow visualization of retinal substructures from the sensory retina and retinal pigment epithelium to the choroid. In our clinic ultra-widefield fluorescein angiography has became an elegant diagnostic imaging modality that has improved our ability to diagnose and plan treatment strategies. In the future widefield imaging will probably be coupled with OCT (optical coherence tomography) option to better evaluate retinal pathologies in the periphery.

Retinal Embolization Syndrome as a Perioperative Complication of Surgical Restoration of Internal Carotid Artery - Case Report

Embolization of cholesterol material from atherosclerotic plaques lining the walls of major arteries causes different types of cholesterol embolization syndromes (CES), depending on the organs being involved. CES is most frequently found after cardiovascular procedures and less common after carotid surgery. We describe a case of a 65 –year old heavily smoker male patient of Caucasian origin with high grade symptomatic carotid stenosis. Duplex Doppler examination and angio-CT showed more than 90% unstable plaque in the right carotid artery. Clinically, he presented three transient ischemic attacks (TIA) in the past 2 years, the last one two months before surgical procedure. Carotid endarterectomy (CEA) was performed in local anaesthesia without using shunt and primary closure. Postoperative period was complicated in the second day by important visual deterioration in the right eye and the patient was referred to the Ophthalmological Department. In the indirect ophthalmoscopy of the right eye, a whitening of the superior retinal artery area and many cholesterol plaques was noted. Additionally, performed OCT and fluorescein angiography confirmed a diagnosis of retinal embolization syndrome. The present case report shows that there is a rare possibility of embolic retinal arteries occlusion (RAO) due to CES as a complication of the surgical restoration of internal carotid artery.