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Purpose: To report 12-month outcomes of a Polish National Treatment Program using aflibercept and ranibizumab in eyes with wet, age-related macular degeneration in routine clinical practice., Material and Methods: This was a non-randomized, retrospective, observational multicenter study. Anonymous data contained in the electronic Therapeutic Program Monitoring System were utilized in this study., Results: The study population consisted of 2828 eyes from 2718 patients. The median age was 76.0 [70.0, 81.0] years; 61.7% were female. Best corrected visual acuity increased from 58.86 [50.05, 69.95] letters to 65.1 [50.1, 73.9] letters (p < 0.001). The median change in best corrected visual acuity was 0.0 [-4.0, 12.2] letters: 2.9 [-2.9, 15.1] letters for treatment-naïve eyes and 0.0 [-4.0, 8.8] letters for those continuing treatment (p < 0.001). The median central retinal thickness was significantly reduced from 341.0 [281.0, 422.0] to 275.0 [221.0, 344.0] μm (p < 0.001). The median number of visits was 9.0 [8.0, 9.0]. The median number of injections was 7.0 [6.0, 8.0]: 8.0 [7.0, 8.0] for treatment-naïve eyes and 6.0 [5.0, 7.0] for those continuing treatment (p < 0.001)., Conclusion: Eyes treated as part of the Polish therapeutic program gained functional stability and morphological improvement. Treatment-naïve eyes showed the greatest functional benefit.

The anatomic structures of the anterior segment of the eye enable correct reception of stimuli by the retina, which contains receptors that receive light impulses and transmit them to the visual cortex. The aim of this study was to assess the effect of the size of the sampling window in an adaptive optics (AO) flood-illumination retinal camera (rtx1) on cone density measurements in the eyes of healthy individuals and to investigate the differences in cone density and spacing in different quadrants of the retina. Thirty-three subjects with no ophthalmic or systemic disease underwent a detailed ophthalmologic examination. Photographs of retinal fragments 3 degrees from the fovea were taken using the rtx1 AO retinal camera. We used sampling windows with 3 sizes (50 × 50, 100 × 100, and 250 × 250 μm). Cone density, spacing, and shape were determined using AOdetect software. The median (interquartile range) cone density was 19,269 (4964) cones/mm. There were statistically significant differences between measurements taken with the 50/50 and 250/250-m windows. There were no significant differences in the cone spacing results between any of the windows examined, but the measurements differed according to location between the superior and temporal quadrants. The most common cone shape was hexagonal (47.6%) for all window sizes and locations. These findings may help in the development of a normative database for variation in cone density in healthy subjects and to allow the best window to be chosen for obtain the most correct values for eccentricity measurements of 3 degrees. In our study, the optimal sampling window was 100 × 100 μm.

Objective: The aim of study was to evaluate the ability of the enzymatic antioxidant barrier to protect against peroxidation in patients with wet age-related macular degeneration, as compared to healthy subjects., Material and Methods: Hemolysate blood samples collected from 25 patients with wet form age-related macular degeneration and 25 healthy controls were analysed to determine the activity of superoxide dismutase (using Misra and Fridovich method), catalase (using Beers and Sizer method), glutathione peroxidase (using Sedlak and Lindsay method modified by Little and O’Brien), and malondialdehyde concentration (using Placer method)., Results: We observed a statistically significant decrease in the activity of following enzymes in patients with wet age-related macular degeneration, as compared to controls: superoxide dismutase (2086.3 vs. 2348.5 U/gHb/100 ml; p ≤ .05), catalase (6.9 vs. 7.6 BU/gHb, p ≤ .05) and glutathione peroxidase (36.3 vs. 45.8 U/gHb; p ≤ .05). At the same time, an increase in age-related macular degeneration thiobarbituric acid reactive substance concentration was demonstrated in patients with wet age-related macular degeneration, as compared to healthy subjects (.119 vs. .286 µmol/gHb; p ≤ .001)., Conclusion: The obtained results indicate inefficient enzymatic antioxidant system which manifests as intense peroxidation in patients with age-related macular degeneration.

Metastatic choroidal tumours are the most common type of intraocular neoplasms in adults. Currently choroidal metastases are being diagnosed more frequently, generally due to the higher incidence of carcinomas, longer survival of cancer patients and better diagnostic possibilities. The most common primary cancers locations are breasts in women and lungs in men. These tumours are usually symptomatic and only in very rare cases metastases are the first symptom of carcinoma. We present such an atypical case of a 53-year-old female patient with bilateral exudative retinal detachment, which was the first symptom of a generalized malignancy originating in the mammary gland. Primary tumours and metastatic lesions both require a meticulous interdisciplinary examination, as well as the interdisciplinary treatment. Close liaison between oncologists and other specialists can result in faster diagnosis and improve treatment outcomes. Moreover, public health programs aimed at early detection of the most common tumours may help achieve better treatment results.

Acute retinal necrosis is a rare manifestation of viral chorioretinitis, accompanied by occlusive vasculitis, which is associated with poor visual prognosis. The main causal factors include varicella-zoster virus in older patients and herpes simplex in younger ones. The disease typically manifests as a reactivation of latent infections. We present a case of a 57-year-old female with atypical clinical manifestation of acute retinal necrosis secondary to the primary viral infection with herpes simplex. The serology panel of vitreous tap and blood sample confirmed viral aetiology (H. simplex). The initial clinical signs included optic disc edema with retinitis presenting as self-limiting, slowly progressing, peripheral lesions, later followed by uveitis. The antiviral therapy resolved the symptoms of uveitis and enabled healing of retinal lesions, however the natural course of disease was later complicated with retinal detachment. It was successfully treated with vitreoretinal surgery. Despite aggressive treatment, the final visual outcome was unfavourable, due to optic nerve atrophy.

Oxidative stress is a major factor in the pathogenesis of age-related macular degeneration (AMD). Retinal pigment epithelial (RPE) cells are prone to reactive oxygen species (ROS) arising during the stress due to intense oxygen metabolism and a high oxygen pressure. Additionally, the cells can be exposed to ROS as a consequence of accumulation of iron ions in these cells, sunlight exposure and tobacco smoke. There are several defense systems against RTF in the cell, including antioxidant enzymes, low-molecular weight antioxidants and DNA repair pathways. RPE cells display phagocytic activity towards outer segments of photoreceptors and this activity can be associated with additional oxidative stress since the segments are rich in long chain, polyunsaturated fatty acids (PUFA). The oxidation of PUFA leads to the production of additional ROS. Moreover, oxidized PUFA are not correctly cleaved in the lysosomes of RPE and are accumulated in the form of lipofuscin, which is deposited in Bruch's membrane in the form of drusen and in this way it stimulates immune responses, including phagocytosis, associated with the recruiting of macrophages and dendritic cells. In this time, RPE cells are exposed to ROS, produced in oxygen burst associated with phagocytosis. Further studies, both clinical/epidemiological and in vitro, are needed to better understand relationship between AMD and oxidative stress.

Iron can be involved in the pathogenesis of age-related macular degeneration (AMD) through the oxidative stress. In siderosis, exogenous iron can cause retinal degeneration which can be also associated with elevated retinal iron levels resulting in hereditary defects in iron homeostasis. Iron is transported into the retina by the endocytosis of iron complexed with transferrin and stored in complex with ferritin. The retinal pigmented epithelium and the neuroretinal vasculature serve as blood-retina barriers and disruption of homeostasis at these barriers may result in iron overload. There is firm experimental evidence that retinas of AMD patients contain more iron than retinas of the healthy subjects, but the question whether it is the reason or a consequence of AMD remains open. Excessive iron can cause damage to protein, lipids and DNA through the generation of free radicals in the Fenton reaction. Therefore, iron may play a role in the pathogenesis of AMD as a source of free radical damage but this hypothesis has not been verified experimentally and further studies are needed to establish the relationship between disturbance in iron homeostasis and AMD.

Friedrich Best described in 1905 for the first time a genetic disease which is subject to autosomal dominant inheritance. Yellow material is assembled under pigment epithelium, especially in the macula. Afterwards pigment epithelium and choroid become involved in the process and visual acuity decreases. In the last phase the fibrotic scar appears in the macula with deterioration of visual acuity. In some late cases choroidal neovascularization develops too. We present a two-generation-family which suffers from Best's disease. Our patients: mother, her daughter and her son demonstrate changes in different phases of development. In mother's case we found fibrotic scar and atrophy of pigment epithelium, which is typical of the late phase of the disease. Daughter complained of decrease in visual acuity, the subretinal neovascularisation was found in the macula and photodynamic therapy was performed. Visual acuity improved from 0.5 to 0.8 and has been stable for 11 months. Son did not report any symptoms. Some yellow material was found under the macula in both eyes without decrease of visual acuity. Described case shows importance of the whole family members' examination in case of Best's disease. Early diagnosis of this serious disease makes possibility of proper treatment.

Age-related macular degeneration (AMD) is a progressive disease characterized in macula photoreceptors degeneration that leads to loss of central vision in elderly people, especially in developed countries. Many environmental and genetic factors have influence on the occurrence and progression of AMD as well as its form: either dry or exudative. Despite of the extensive research, etiology and molecular background of AMD are poorly understood. Due to advanced biochemical and biophysical techniques some clinical aspects of AMD have been described in details, however, the genetic basis of AMD is still under investigation. The results of some research indicate that the genes, which products may play a role in the pathogenesis of AMD could be CFB, C2, CFHR1, CFHR3, C3, ABCR, APOE, CCL2, CFH, CX3CR1, ERCC6, FSCN2, HMCN1, HTRA1, LOC387715, PLEKHA1, TIMP3 and VEGF-A. The variability of these genes, expressed by their polymorphisms, may also contribute to thye occurrence and progression of AMD. Studying of genetic aspects of AMD many bring results playing a role in the prevention, diagnostics and treatment of this disease.

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.

Taking into consideration that the advanced stage of Age related Macular Degeneration is a very common cause of social blindness and present results of laser photocoagulation, PDT treatment and TTT are not satisfying, it seems to be of huge importance to look for new types of treatment, to improve visual outcomes. Repeated intravitreal injection of pegaptanib sodium (a VEGF aptamer) is a modern procedure which may not only give stabilization of visual acuity, but it may also lead to the improvement in high percentage. In this paper there is a short update on the epidemiology and the symptoms of the disease and the role of VEGF and its isoforms expression in the development of wet AMD. The presentation of pegaptanib sodium (Macugen) focus on its mechanism of action. Finally V.I.S.I.O.N. trial results are presented to show encouraging efficacy of the procedure.

The authors present a case of 34-years-old man with retrobulbar hematoma caused by blunt injury accompanied by partial palsy of the oculomotor nerve and ischemia of the optic nerve and retina. Fractures of the orbit were excluded using computer tomography. Surgical decompression of the orbit was performed. The authors obtained quick and marked improvement with normal visual acuity and limitation of adduction.

A case of the tumor of the orbita is presented. It caused large exophthalmus and partial damage of orbital bones without any loss in the visual acuity in the 20-year period of increasing. Before operation a tumor of the lacrimal gland or an angioma was suspected. A histopathological examination of the whole removed tumor revealed the presence of mixed tumor cells.