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The article presents the results of studying the levels of amino acids in the vitreous body of rats with rhegmatogenous retinal detachment at different stages of modeling the pathology (on the 3rd, 5th and 7th day). In animals with modeling RRD, was observed a significant increase in the level of alanine, aspartate, glycine, glutamic acid compared with rats of conditionally intact group; maximum changes in indicators were observed on the 7th day of the study. The obtained data are explained by significant neurochemical changes of the glutamatergic system of the neural retina, which cause excitotoxicity (as a result of massive release of neuronal glutamate) and structural changes. In the study of the level of valine, histidine, tyrosine, phenylalanine and methionine, it was found that these amino acids are not involved in the pathogenesis of RRD, so their level does not change. The obtained experimental data deepen the existing pathophysiological data on the pathogenetic links of rhegmatogenous retinal detachment in the early stages of its progression, which is important for practical ophthalmology to develop effective pharmacotherapy of this disease.

Purpose: To measure central macular thickness change after Nd: YAG capsulotomy using optical coherence tomography (OCT)., Material and Methods: 55 patients (43 females and 12 males), mean age 65.1 +/- 13.9 years (range 21-87) who underwent Nd: YAG capsulotomy for posterior capsule opacification. Patients were examined preoperatively and one day, one week, one month, three months and six months after Nd: YAG capsulotomy. Central retinal thickness was measured by Stratus IV OCT Optical Coherence Tomography from Carl Zeiss Meditec, Inc. using "fast macular thickness" map protocol. All patients underwent ophthalmic examination including best-corrected visual acuity, fundus examination and intraocular pressure measurement., Results: The initial median and range of the central retinal thickness was 212 microm (168-228), after one day 207 microm (168-232), after one week 207 microm (166-241), after one month 207 microm (163-252), after 3 months 207 microm (171-242), and 210 microm (170-235) 6 months after treatment. Proportional changes of the central retinal thickness was after one day -0.5 (-13.3 to 5.6), after one week 0.5 (-11.6 to 8.1), after one month -0.4 (-8.3 to 14.5), after 3 months 0.5 (-8.7 to 10.0) and 6 months after capsulotomy 0.5 (-5.8 to 7.7). There was no statistically significant change of the central macular thickness in any time point. Cystoid macular edema was observed in three patients 9.0 and 14 weeks after treatment. No other complications were noticed., Conclusions: Laser capsulotomy should be considered as a safe procedure for the macula. Optical coherence tomography is a useful diagnostic method that can be used in qualification and monitoring of patients undergoing Nd: YAG capsulotomy.

Anti-vascular endothelial growth factor (anti-VEGF) therapies that inhibit choroidal angiogenesis and reduce vascular permeability have revolutionized clinical practices for neovascular eye diseases. Ranibizumab (Lucentis) is a Fab-antibody with high affinity for VEGF, and has a potential to bind to all VEGF isoforms. Diseases of retinal and choroidal vasculature are the most prevalent causes of vision loss in developed countries. Among them diabetic macular edema (DME) is the most common sight threatening complication of diabetes. VEGF plays a critical role in the pathogenesis of DME. Due to modest outcomes with macular photocoagulation, other treatment modalities for DME have been evaluated. The results of the pilot studies and preliminary results of multicenter randomized, controlled studies showed that intraocular injections of ranibizumab decrease the mean retinal thickness and improve the BCVA (best corrected visual acuity) in patients with DME.

Idiopathic choroidal neovascularization (CNV) in children is a rare, but important cause of visual impairment. Purpose of this paper is to report one year clinical observation of 4 children with idiopathic choroidal neovascularization. Authors present 4 cases of CNV in boys at 6-13 years old, with unilateral visual deterioration onset. All cases were diagnosed as idiopathic ones after pediatric and ophthalmological examination including fundus color photographs and optical coherence tomography (OCT) in all cases, fluorescein angiography (FA) in 2 cases, as well as laboratory tests to exclude the systemic diseases. All cases were left untreated. This presentation discusses therapeutic management according to the argon laser therapy, photodynamic therapy, submacular surgery and intravitreal injection of anti-VEGF.

Purpose: Myopia is the second most frequent cause of CNV after AMD. Since the introduction verteporfin photodynamic therapy and anti-angiogenic drugs into clinical practice, major changes occurred in the treatment of subfoveal exudative maculopathy associated with myopia.The aim of the paper is to present the effect of intravitreal injections ranibizumab (Lucentis) for myopic choroidal neovascularization., Material and Methods: The study included two patients (25 and 55 years old women) with high myopia. Diagnosis and monitoring of the treatment were based on fluorescein angiography and optical coherence tomography., Results: In 55-years old woman after two injections central retinal leakage decreased in fluorescein angiography and optical coherence tomography and visual acuity improved of two lines (10 letters). After 9 months follow-up in 25 years old woman's after three injections of Lucentis, visual acuity improved of three lines on ETDRS chart (15 letters). The leakage in fluorescein angiography was closed., Conclusions: Intravitreal injections therapy of ranibizumab may be a therapeutic option for CNV associated with myopia. It causes chance for decreased central retinal thickness and increased visual acuity, particularly in view of the young patients. One must take note of the other illness associated with CNV in myopic eyes like as epiretinal membranes or vitreoretinal tractions.

Age-related macular degeneration (AMD) is the leading cause of irreversible, severe loss of vision in the developed countries. One of the modern methods of treatment in neovascular form of AMD are repeated intravitreal injections of ranibizumab (Lucentis). Ranibizumab is a recombinant, humanized, monoclonal antibody that neutralizes all biologically active forms of vascular endothelial growth factor A (VEGF-A). The aim of the study was to analyze the results of intravitreal ranibizumab injections in wet AMD patients. There were 57 patients enrolled in the study. 87% of them avoided any loss of visual acuity and 47.3% gained at least one line at visual acuity chart. Authors conclude that treatment with repeated intravitreal injections of ranibizumab is effective in neovascular form of AMD.

Purpose: To appoint the most adequate follow-up parameter and to find the most reliable scheme of intravitreal TA injections in CME treatment in the course of CRVO and BRVO., Material and Methods: 18 eyes treated with intravitreal injection of 4 mg (in 0.1 ml) of crystalline TA., Results: There was improvement of BCVA for distance noticed in 38.9% of eyes and for near in 44.4% of cases. There was statistically significant difference in retinal thickness outcomes measured at baseline and at the end of the follow-up by both OCT and RTA. No correlation of BCVA changes and retinal thickness changes measured in OCT and RTA was found., Conclusions: The intravitreal TA injections should be considered as an effective method. Foveal morphology and thickness analysis performed by OCT is the most adequate method in follow-up monitoring of intravitreal TA injections in CME treatment in non-ischemic CRVO or BRVO. Central retinal thickness measured by RTA and FA changes analysis are alternative monitoring methods. Dosage of 4mg TA in 0.1 ml seems to be sufficient. In cases of CME recurrence of subsequent intravitreal injection in the first 6 month after initial injection seems to be unnecessary.

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.

The objective of these investigations was an in vitro evaluation whether silicone oil OXANE of viscosity 5700 cSt clinically used in eye surgery as a substitute of the vitreous body, being in contact with an artificial polymer lens used as an implant of human lens, causes the changes in its optical properties. The paper presents the results of spectral analysis of transmission of visible (VIS) radiation of three types of artificial lenses: hard PMMA, hydrogel, heparin surface modified (HSM) hard PMMA, and the same lenses damaged by YAG laser radiation with an energy increasing from 1.7 mJ to 3.7 mJ, exposed to clinically applied silicone oil. The studies were carried out, in two-week intervals, over a period of 20 weeks. Hard PMMA and HSM lenses were found not to have changed their optical properties after 20 weeks of exposure to silicone oil. The measured transmittance values were within the range of instrumental error (+/- 1%). Optical properties of hydrogel lenses exposed to silicone oils deteriorated with exposure and after 20-week exposure to silicone oil the average transmittance value decreased by about 18%, reaching its final value of 67.08 +/- 2.37% (RSD = 5.56%). A minimal decrease of the initial transmittance values was observed only for the lenses exposed to laser radiation of highest energy (3.7 mJ). After completed exposure to silicone oil, two kinds of lenses were found to have a slightly improved transmittance: hard PMMA lenses by about 4% and HSM lenses by about 2%. On the other hand, in case of hydrogel lenses the deterioration of optical properties to the extent comparable to that of hydrogel lenses not damaged by laser radiation was observed.

Purpose: To investigate the retinal toxicity of a vitreous substitute perfluorodecalin (PFD) in the rabbit eye up to 2 weeks after injection., Material and Methods: A space was created in the vitreous cavity by injecting 0.4 cc of perfluoropropane gas. After 3 days gas-fluid exchange was performed. Experimental eyes were injected with 1 cc of PFD and control eyes with 1 cc of Ringer solution. The eyes were enucleated 1, 3, 6 and 14 days after the procedure and histological studies were conducted., Results: Control samples showed almost normal histology. One day after PFD injection photoreceptor nuclei dropout and migration below the outer limiting membrane, pyknosis and occasional densification of cell bodies were observed. After 3 days glial cell hypertrophy and accumulation of macrophages above the inner limiting membrane was also noted. After 6 days necrosis was observed in the outer and inner retinal layers. Foci of cell death in the retina were also observed 14 days after PFD injection., Conclusion: PFD induced degenerative changes in the rabbit retina within the first 24 hours after administration. Structural alterations in the inner and outer retina persisted within the two weeks of observation. Our results support the removal of PFD at the end of the primary surgical procedure.

Purpose: To present our experiences in the management of intraocular lenses (IOLs) dislocated into the vitreous cavity., Material and Methods: The authors report three cases with posteriorly dislocated IOLs in which pars plana vitrectomy techniques and limbal incision were used for IOLs removal. In one of these eyes perifluorocarbon liquid was injected after vitrectomy to float the IOL off the retina to the retropupillary space and transclerally sutured ciliary sulcus fixation IOL was implanted simultaneously. Anterior chamber IOLs were implanted in the two other cases., Results: Best corrected postoperative visual acuity was between 5/5 and 5/10 in all eyes. No important complications were observed., Conclusions: Application of vitreoretinal microsurgical techniques allows for the safe removal of dislocated IOLs. Primary or secondary IOL re-implantation gives quick visual rehabilitation.

Background: The charts of 46 patients with dislocated lens particles during cataract surgery were reviewed. Forty patients had trans-pars plana vitrectomy; 5 were treated medically and one had retinal detachment repair only., Material and Methods: The following complications were associated with dislocated lens particles: uveitis 87%, glaucoma 66%, corneal edema 71%, retinal detachment 5%., Results: The vision on the initial visit was 20/200 or worse in 85%. After vitrectomy the final vision was 20/40 or better in 58%. Visual acuity of 20/40 or better was obtained in 72% of patients who had surgery the same day; in 55% who had surgery later and in 64% with initial IOL placement. Insertion of an intraocular lens at the time of cataract surgery is not contraindicated., Conclusion: The best visual acuity occurred in patients who had vitrectomy the same day as cataract surgery. Small lens particles may be left in the eye. Trans-pars plana vitrectomy is a successful method of treatment of dislocated lens particles during cataract surgery.

Removal of the lens dislocated to the vitreous body is one of the most difficult problems in ophthalmic surgery. The authors present 8 consecutive cases in which the lenses luxated to the vitreous were removed. Pars plana vitrectomy was used to free the lenses from the surrounding adhesions and to carry them over to the pupillary region. Then the limbal incision was performed to remove them from the eye. Good anatomical and functional results achieved in the described cases point to the suitability of this operative method.

Stickler's syndrome or congenital, progressive arthro-ophthalmopathy refers to disturbances of the connective tissue of the organism but mainly the osteoarticular and visual systems. In the visual system one discovers a congenital high myopia, pathological changes in the vitreous in the form of membranes and proliferative bands as well as retinal detachment. A metabolic defect concerning the hyaluronic acid and the collagen of the 2-d type is assumed to be the cause of this syndrome.

Presented are the contemporary opinions of the etiopathogenesis, signs, the clinical course as well as the differentiation and therapy of the familial exudative vitreoretinopathy. Attention is called to the variety of the clinical picture of this disease and the importance of fluorescein angiography in diagnosis.

The authors present four cases of familial exudative vitreoretinopathy observed in the course of the last years. Our cases appeared sporadically in families and showed a variable picture and clinical course. The accepted differential criterions and difficulties in differentiation are discussed.

Vitreous prolapse into the anterior chamber after cataract extraction is a severe complication in cases in which there is a contact between the vitreous and the cornea. The present paper discusses the result of treatment by vitrectomy in 15 patients with this complication. Anatomical and functional improvement was attained in 12 cases (89 p.c.) and in 5 among them--full visual acuity was obtained.