Zsuzsa Récsán

Effect of Essential Oils on the Lipids of the Retina in the Ageing Rat: A Possible Therapeutic Use

Abstract A study has been made on the effects of the dietary administration of a selection of volatile oils from medicinal plants on the polyunsaturated fatty acid composition in the retina of aged (28 month old) rats. Polyunsaturated fatty acids comprised by far the major proportion of the total unsaturated content within the retinal phospholipids with docosahexaenoic acid predominating. The administration daily of 3-9 mg of the essential oils from clove, nutmeg, pepper and thyme over a period of 17 months resulted in the maintenance of very much higher levels of polyunsaturated fatty acids, in particular docosahexaenoic acid, within the retinal phospholipids. This increase occurred mainly at the expense of a reduction in the level of oleic acid. The possible efficacy for the application of the oils from such medicinal plants through their antioxidant capacities in the prevention of age-related macular degeneration is discussed.

Laser Treatment of Zone I Prethreshold and Stage 3 Threshold Retinopathy of Prematurity

PURPOSE To analyze the structural outcomes of zone I prethreshold and stage 3 threshold retinopathy of prematurity following laser ablation. PATIENTS AND METHODS This nonrandomized observational case series evaluated 71 eyes of 36 infants who weighed less than 1,250 g at birth. Infants were treated at either prethreshold or threshold severity. The structural outcomes were compared using Fishers exact test. RESULTS The structural outcome was favorable in 96% and 80% of the prethreshold and threshold groups, respectively (P = .069). When an unfavorable outcome was defined as dragging of the temporal vessels, the difference was significant (P = .0257). CONCLUSION Early treatment of zone I disease may result in a better structural outcome.

Scheimpflug imaging for long-term evaluation of optical components in Hungarian children with a history of preterm birth.

PURPOSE To determine ocular geometry and refraction in children with a history of preterm birth, and compare them to age-matched full-term children. METHODS In a prospective case-control study, 50 eyes of 27 premature patients 7 to 14 years of age were evaluated with Scheimpflug camera after cycloplegia. Age-matched full-term children comprised the control group (68 eyes of 34 children). All of the eligible eyes had a normal-appearing posterior pole. Anterior segment parameters such as keratometry, anterior chamber volume or thickness, and lens thickness were measured. Corneal thickness, lower- and higher-order aberrations refractive errors of the cornea (root mean square of lower- and higher-order aberrations: RMS LOA, RMS HOA) were also assessed and exported for further analysis. RESULTS In the premature eyes, anterior chamber depth was marginally smaller (P = .06), the lens was significantly thicker (P = .03), and axial length was significantly shorter (P < .001). Scheimpflug imaging showed a significant difference in corneal RMS (P = .03) and an increase in corneal RMS HOA (P = .002) in the premature group. Preterm birth showed significant impact on axial length (P < .01) and lens thickness (P = .05); at the same time, anterior chamber depth was more influenced by retinopathy of prematurity stage (P = .01). Laser treatment showed marginally significant impact (P = .06) on anterior chamber depth. CONCLUSIONS In premature eyes with or without mild retinopathy of prematurity, anterior segment anatomy is slightly different and they have more higher-order corneal aberrations compared to the eyes of term-born children.

Preliminary studies of the effects of vascular adhesion protein-1 inhibitors on experimental corneal neovascularization

Vascular adhesion protein-1 (VAP-1) controls the adhesion of lymphocytes to endothelial cells and is upregulated at sites of inflammation. Moreover, it expresses amine oxidase activity, due to the sequence identity with semicarbazide-sensitive amine oxidase. Recent studies indicate a significant role for VAP-1 in neovascularization, besides its contribution to inflammation. Pathological blood vessel development in severe ocular diseases (such as diabetes, age-related macula degeneration, trauma and infections) might lead to decreased visual acuity and finally to blindness, yet there is no clear consensus as to its appropriate treatment. In the present case study, the effects of two VAP-1 inhibitors on experimentally induced corneal neovascularization in rabbits were compared with the effects of a known inhibitor of angiogenesis, bevacizumab, an anti-vascular endothelial growth factor antibody. In accordance with recent literature data, the results of the preliminary study reported here indicate that the administration of VAP-1 inhibitors is a potentially valuable therapeutic option in the treatment of corneal neovascularization.

Intrasession and Between-Visit Variability of Retinal Vessel Density Values Measured with OCT Angiography in Diabetic Patients

In clinical practice the measurement error of an instrument has special importance in analyzing and interpreting data, and acknowledging limitations. The purpose of this study was to evaluate intrasession and between-visit reproducibility of OCT angiography measurements in diabetic patients. A total of 54 eyes of 27 diabetic patients underwent OCT angiography imaging. Foveal avascular zone (FAZ) area and superficial retinal vessel density (VD) at 3 mm were calculated using the AngioAnalytics software. Three consecutive images were acquired at first visit and one image 1 month later. Intrasession and between-visit reproducibility of parameters were characterized by intraclass correlation coefficient (ICC), coefficient of variation (CV), and coefficient of repeatability (CR) values. We measured excellent (>0.90) ICC values both in intrasession and between-visit comparisons. CV was higher for the FAZ area compared to VD both in intrasession (7.79% vs. 2.87%) and in between-visit (12.33% vs. 2.95%) comparisons. Between-visit CR value for VD was 4.53% (95% CI: 3.72–5.79%). These data suggest that OCT angiography shows excellent repeatability in diabetic patients, indicating that this non-invasive technology might be suitable for longitudinal assessment of microvascular complications.

Spontán suprachorioidealis vérzés okozta vakság véralvadásgátló kezelésben részesült időskori makuladegenerációs betegeken

We present cases of blinding spontaneous suprachoroidal haemorrhage in anticoagulant taking wet-AMD patients. A retrospective study has been performed to present the clinical course, management and final outcome of spontaneous suprachoroidal haemorrhage in 7 eyes of six age-related macular degeneration patients seen in our clinic from January 2016 to April 2017. All patients were on chronic oral anticoagulant therapy because of cardiovascular disorder. In one patient, haematological disorder was also present modifying significantly the haemostasis. All eyes received prior anti-VEGF treatment for exsudative AMD. Acute angle closure glaucoma - with no response to topical and oral IOP lowering therapy - was the most frequent ocular complication in our cases. The final visual prognosis was usually very poor. The risk of spontaneous suprachoroidal haemorrhage is increased in wet-AMD patients who are on anticoagulant therapy. To prevent this blinding condition, a stronger communication between ophthalmologists and cardiologists would be beneficial, with an ophthalmological check-up in this group of patients before and during the use of anticoagulants. Orv Hetil. 2018, 159(24): 985-990.

Diabeteses kisér-károsodás vizsgálata optikai koherencia tomográfián alapuló angiográfiával

Absztrakt: Bevezetes: Az optikai koherencia tomografian alapulo angiografia uj noninvaziv eszkoz, amely lehetőve teszi a retinalis erhalozat vizsgalatat, es segitseget nyujthat a microangiopathiaval jaro szemfeneki betegsegek nyomon koveteseben. Celkitűzes: Diabeteses betegek mindket szemen optikai koherencia tomografias angiografiaval meghatarozni a retinalis kiser-karosodas merteket az altalanos rizikofaktorok fuggvenyeben. Modszer: Optikai koherencia tomografias angiografia soran 36 diabeteses, valamint 45 kontrollszemely mindket szemen meghataroztuk a retinalis erhalozat sűrűseget. Rogzitettuk a magas vernyomast, a diabetes fennallasi idejet, az inzulinkezelest, a HbA1c-szintet, a dyslipidaemia es a diabeteses retinopathia jelenletet, tovabba a szem tengelyhosszat. A rizikofaktoroknak az erhalozat-sűrűsegre es a ket szem kozotti aszimmetriara kifejtett hatasat tobbvaltozos regresszios modellekben vizsgaltuk. Eredmenyek: Diabeteses betegekben a retinalis erhalozat sűrűsege szignifikansan alacsonyabb vo...INTRODUCTION Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. AIM To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. METHOD Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA1c, dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. RESULTS Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (p<0.05). Both vessel density and between-eye asymmetry significantly correlated with diabetes duration (p<0.05) after controlling for the effect of risk factors. The between-eye asymmetry in vessel density was significantly higher in patients without clinically detectable diabetic retinopathy compared to control subjects (p<0.001). CONCLUSIONS There is a decrease in retinal vessel density and an increase in between-eye asymmetry in patients with diabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320-326.

The Role of Fluorescein Angiography and Optical Coherence Tomography in the Examination of Circulatory Disorders of the Optic Disc

The retina is supplied by a double circulatory system: the outer layers of the retina (the photoreceptors and the pigment epithelium) are avascular and supplied by the choriocapillary network via diffusion. The inner layers of the retina are supplied by the central retinal artery. An anastomosis between the two circulatory systems is rare. The submacular and the peripapillary regions are supplied by the short posterior ciliary arteries. Both circulatory systems belong to the system of the ophthalmic artery. The blood from the choroidea is drained through the vortex veins. The vortex veins open into the inferior and the superior ophthalmic veins. The inferior ophthalmic vein ends in the pterygoid venous plexus, whereas the superior ophthalmic vein opens into the cavernous sinus. There is collateral circulation between the inferior and superior ophthalmic veins. The central retinal vein drains blood from the retina and the prelaminar part of the optic nerve, and opens into the cavernous sinus. Therefore, on the venous side, there is communication between the retinal and the choroidal circulation.

Posterior hyaloid peeling in advanced stages of aggressive posterior ROP

Purpose TO evaluate the indications and timing of surgical intervention on eyes with aggressive posterior retinopathy of prematurity (ROP). Methods Retrospective review of a consecutive case series of 9 eyes of 7 children, with aggressive posterior ROP, who underwent early lens-sparing vitrectomy. Preoperative retinal and vitreal features, intraoperative and postoperative complications, postoperative anatomic status, and fixation behavior 1 year after surgery were investigated. Results Vitreous hemorrhage and recurrence of plus disease with retinal detachment were the main indications for surgery. Vitrectomy was performed from the 37th to the 44th postmenstrual week (mean 40th week). In 7 eyes, vitrectomy could stop the disease progression. In all of these cases, posterior hyaloid could be peeled together with the proliferative tissue. Conclusions Lens-sparing vitrectomy with posterior hyaloid peeling at early postmenstrual ages (37–40 postmenstrual weeks) seems to be advantageous in infants with aggressive posterior ROP. The formation of a gliotic membrane growing ahead to the posterior surface of the lens resulted in unfavorable outcomes in our cases.