Biomedical subjects

E Ríhová

Publications and source records attributed to E Ríhová.

At least 19 recordsLinked to original sources

PubMed2006

[Sympathetic ophthalmia].

PURPOSE: To evaluate the efficacy of treatment on prevention of disease development and protection of visual outcomes in patients suffering from sympathetic ophthalmia. METHODS: Retrospective case. RESULTS: Four patients with sympathetic ophthalmia were treated in our department from 1999 to 2004. All patients were men with the mean age 27.5 years (15-49 years). In two patients, there was a history of penetrating eye injury prior to the onset of sympathetic ophthalmia, in other two patients sympathetic ophthalmia occurred after eye surgery (pars plana vitrectomy), with no previous ocular trauma. Two patients were treated with monotherapy of corticosteroids; other two patients were commenced on combined immunosuppression. In all these cases, the therapy was effective. CONCLUSION: Sympathetic ophthalmia is a rare, sight-threatening eye disease. Among the triggering factors dominates penetrating eye injury, however, there is currently an increase in the number of cases with sympathetic ophthalmia following eye surgery, mainly pars plana vitrectomy. Early introduction of immunosuppressive treatment can get the disease under control, prevent the development of intraocular inflammation and improve visual outcomes.

Adolescent↗

PubMed2006

[TINU syndrome].

PURPOSE: To evaluate our experience with the diagnosis and the treatment of the TINU syndrome. The term TINU syndrome means the intraocular inflammation occurring in association with tubulointerstitial nephritis. The predominance of younger females was established. The uveitis is frequently chronic, moderate, and bilateral. The treatment with immunosuppressive drugs often has positive clinical response. METHODS: A retrospective study. RESULTS: Five patients, 4 women and 1 man, have been examined and treated for the TINU syndrome in our Department for Diagnosis and Treatment of Uveitis. The age ranged from 8 to 62 years. The treatment with immunosuppressive drugs caused reduction of the inflammatory reaction and visual acuity improvement. CONCLUSION: Immunosuppressive drugs were effective in all of our patients suffering from the TINU syndrome. The cooperation between ophthalmologist and nephrologist is crucial for the effective control of the disease activity and for drug regimen optimization.

Adolescent↗

PubMed2006

[Infliximab in the treatment of Wegener's granulomatosis: case report].

PURPOSE: to evaluate the efficacy of monoclonal anti-tumor necrosis factor alpha antibody infliximab in treatment of refractory Wegene's granulomatosis. Clinical manifestations of Wegener's granulomatosis at the time of infliximab initiation were: proptosis of both eyes due to progressive retrobulbar granulomas, visual impairment, optic disc edema, progressive diplopia, sinus and renal involvement. The disease was refractory to a treatment with various immunosuppressants, including intravenous cyclophosphamide or high doses of mycophenolate mofetil in combination with corticosteroids. METHODS: Observational case report. RESULTS: the patient received six infusions of infliximab (3 mg/kg) in addition to low doses of oral cyclophosphamide and corticosteroids. The interval between the first two infusions was 1 week. The interval between the second and third infusions was 4 weeks, thereafter 8, 12 and 34 weeks. Following the third infusion of infliximab the remission of Wegener's granulomatosis was seen. After the regression of retrobulbar granulomas visual acuity increased, ocular motility improved, diplopia and optic disc edema decreased. Remission has been maintained for 17 months. Infliximab was well tolerated during the short-term follow-up. CONCLUSION: Infliximab successfully induced remission in case of sight-threatening Wegener's granulomatosis in our patient. It seems that infliximab provides more effective therapeutic option in treatment of Wegener's granulomatosis refractory to standard immunosuppression and offers better perspectives for patients with previously poor prognosis. Furthermore, it enables reducing the exposure to immunosuppressive drugs.

Antibodies, Monoclonal↗

PubMed2005

[Perforating pars plana sclerotomy in idiopathic uveal effusion syndrome].

PURPOSE: To evaluate anatomical and functional results of perforating pars plana sclerotomy in 2 patients with the idiopathic uveal effusion syndrome (IUES). METHODS: In two patients with IUES the perforating pars plana sclerotomy was performed. During the surgery samples of the suprachoroidal fluid for biochemical analysis of protein fractions were taken. RESULTS: During the follow-up period (average 4 years) the retina and the choroid attached, and the central visual acuity (VA) improved as well in both patients. CONCLUSION: In IUES, the conservative treatment is not effective. Perforating pars plana sclerotomy is treatment of choice and it had positive anatomical and functional effect in both our patients with IUES.

Adult↗

PubMed2005

[Uvetitis and multiple sclerosis].

AIM: To evaluate the type of uveitis, the time of the duration between the first ocular signs and establishing of the diagnosis of multiple sclerosis (MS), effect of the treatment, and the final visual acuity (VA). METHODS: In a retrospective study, medical records of 41 patients (82 eyes) from the total of 1267 patients with uveitis treated at the Center for uveitis diagnosis and treatment at the Department of Ophthalmology of the Faculty Hospital and 1st Medical faculty, Charles University in Prague, Czech republic, during the period 1986-2003 were evaluated. The cohort consisted of 32 females and 9 males, mean age of 27 years (8-46 years). The mean follow-up period was 8 years (1-17 years). RESULTS: The cohort consisted of 41 patients (82 eyes), 32 females and 9 males. The mean age at the beginning of the uveitis was 27 years, at the time of the diagnosis of the MS 29.5 years. In 19 patients the starting of the uveitis preceded the manifestation of the systemic disease. In 23 patients, the uveitis was the first manifestation of MS. The most common type of uveitis in patients with MS was the intermediate uveitis (IMU) and vasculitis of retinal vessels. In 82% of patients, we were able during the follow-up period to stabilize the VA, or even to improve it. The systemic immunosuppressive treatment was necessary in 83 % of patients. SUMMARY: The MS was the second most common systemic disease in uveitis patients. It is necessary to follow-up young patients with unclear etiology of IMU or vasculitis, because the systemic disease may develop even few years after the first sings of uveitis. The collaboration between the neurologist and the ophthalmologist is of a great importance.

Adolescent↗

PubMed2004

[Intraocular lymphoma--a clinical study of 14 patients with non-Hodgkin's lymphoma].

AIM: To evaluate the course of clinical picture of intraocular lymphoma, possibilities of examination of this disease and the association with general symptoms of the non-Hodgkin lymphoma (NHL) in patients with manifestations of uveitis. PATIENTS AND METHODS: A retrospective study in 14 patients followed in the period of 1996-2001 in the Center for Diagnostics and Therapy of Uveitis, Ocular Clinic of General Faculty Hospital and 1st Medical Faculty, Charles University in Prague. RESULTS: The group included 7 women and 7 men at the average age of 57.3 years (18-82) with clinical picture of uveitis. The time period from the first symptoms to the diagnosis of NHL was 5-38 months (mean, 14.6 month). In two patients the diagnosis of systemic NHL preceded ocular symptoms, in four other patients the diagnosis of systemic or central nervous system NHL (CNS NHL) was established during ocular manifestations of uveitis. Intraocular lymphoma was the only first manifestation of CNS NHL in six patients for the period of 9-34 months (mean, 15.2). Two patients have been so far affected by primary intraocular lymphoma (PIL) for 8 and 14 months respectively, and presently do not display any signs of systemic or CNS NHL. Clinical signs of intraocular inflammation of both eyes were encountered in 71.4% of patients. Vitritis (85.7%) and tumor infiltration of retina (65.3%) were the most frequent manifestations of NHL. Intraocular NHL was diagnosed on the basis of cytological examination of samples of intraocular fluids in 8 patients (57.1%). In four patients radiotherapy was applied onto 5 eyes and in 5 patients radiotherapy of CNS was used. Nine patients were treated with chemotherapy. 50% of patients died until the end of 2001, the survival from the establishment of diagnosis was 20.6 months on the average. CONCLUSIONS: Intraocular lymphoma should be considered as the eye and life-threatening disease. Cytological examination of intraocular fluids in patients with uveitis who do not respond to the therapy with steroids in the usual way may give more precision and shorten the establishment of diagnosis in this masquerade syndrome. Early diagnosis and therapy may improve the prognosis of NHL.

Adolescent↗

PubMed2004

[The frosted retinal vascular branch syndrome].

In January 2002, thirty-eight years old healthy man with unusual clinical signs of vasculitis was examined in the Center for Diagnosis and Treatment of Uveitis in our Department of Ophthalmology. The patient had a flu-like disease one month before the signs of the eye disease started. In the beginning of the disease, the visual acuity (VA) was 6/12 (20/40 or 0.5) for distance and Jaeger 8 for near and 6/6 (20/20 or 1.0) and Jaeger 1 respectively. The clinical appearance was similar to this of frosted branch angiitis. The thorough medical examination did not discover link between vasculitis and any systemic disease. Serologic examination discovered positivity of IgG immunoglobulin antibody against cytomegalovirus (CMV) only. The intraocular fluid sampling to confirm CMV antibody presence was denied by the patient. After starting the treatment with gancyclovirus and corticosteroids, the considerable improvement of clinical signs of the frosted branch angiitis was noticed. VA improved after five days of treatment. During one-year follow-up, neither recurrence of vasculitis nor the decline of VA of both eyes was marked. In Czech ophthalmologic literature, we did not find any article referring to frosted branch angiitis, so we took the liberty of offering the Czech term "syndrom omrzlých vĕtví retinálních cév".

Adult↗

PubMed2003

[Endogenous mycotic endophthalmitis and pars plana vitrectomy (PPV)].

PURPOSE: To report clinical findings, diagnostic and treatment possibilities of patients with endogenous fungal endophthalmitis (EFE). METHODS: Retrospective study of 13 patients (19 eyes) with EFE diagnosed and treated in the Dept. of Ophthalmology, 1st Medical Faculty, Charles University in Prague. A detailed personal medical history was taken in all patients. Standard ophthalmic examinations were performed in all cases. RESULTS: All of our patients had one or more of known risk factors for ocular fungal infections. There were intravenous drug users, immunosuppressed patients, postoperative patients receiving broad-spectrum antibiotics in our investigated group. The mean age of the patients was 39 years (from 19 to 68 years), the interval between the first ocular symptoms and correct diagnosis was up to 7 months (mean 2.1 months). Pars plana vitrectomy (PPV) was performed in 15 eyes and Amphotericin B was instilled into vitreous cavity at the end of the procedure. Amphotericin B was injected into vitreous without PPV in two eyes. All patients were treated with systemic antifungal agents. Only Candida albicans was the cause of EFE in 10 patients. Microscopic examination and culture were positive in 9 patients, 1 patient had positive serum antibodies against Candida albicans in significant titres. Final visual acuity improved in 47% of the eyes, stabilized in 36% of the eyes, and decreased in 17% of the eyes. CONCLUSION: Endogenous fungal endophthalmitis was seen as an opportunistic disease in all patients. Candida albicans was the only evidenced cause of fungal endophthalmitis. If prompt antifungal treatment after clinical suspicion of EFE begins, successful visual outcome is possible.

Adult↗

PubMed2003

[Importance of pars plana vitrectomy in the diagnosis of ocular toxocariasis].

A retrospective study evaluates the importance of pars plana vitrectomy (PPV) in four patients with ocular form of toxocarosis. The results of laboratory determination of the titres of antibodies against Toxocara canis (the ELISA method) in samples of vitreous body were compared with those in the serum of the patient. The individual cases exemplify the problems in interpretation of laboratory findings and document the authors' experience in considering the diagnosis of ocular toxocarosis in individual cases. The authors' experience indicates that PPV is of diagnostic as well as of therapeutic significance.

Animals↗

PubMed2003

[Importance of diagnostic and therapeutic pars plana vitrectomy in endogenous uveitis].

OBJECTIVE: To evaluate the importance of diagnostic-therapeutic pars plana vitrectomy in patients with clinical manifestations of endogenous uveitis. PATIENTS AND METHODS: The diagnostic-therapeutic pars plana vitrectomy (DT PPV) has been performed at the Eye Clinic of General Faculty Hospital and 1st Medical Faculty on Prague on 62 eyes in 49 patients at the mean age of 45 years. The DT PPV was indicated in patients with uveitis of unusual clinical picture or poorly reacting to treatment, suspected infection or tumor etiology. In the beginning of PPV, 0.5 to 1.5 ml of undiluted vitreous body was samples and subsequently examined by microbiology, immunology and molecular genetic methods. PPV was performed on both eyes in 10 patients, on one eye twice in each of three patients. The authors evaluated 62 samples of vitreous body on the whole. The patients were observed for up to 96 months. RESULTS: Laboratory examination of the samples of vitreous body from 22 eyes (35.4%) supported our notion on infection etiology of intraocular inflammation, manifestations of intraocular tumor were in 12 eyes (19.3%), vascular or vitreoretinal pathology was present in 6 eyes (9.6%). Nonspecific inflammatory changes were detected in 22 eyes (35.4%). Drugs were administered into the vitreous body in 16 eyes. In the observation period the authors detected marked late complications in connection with DD PPV in 18 eyes (29%). Visual acuity improved by two or more lines of the Snellen optotypes in 43 eyes (69.3%), remained unchanged in 11 (17.7%) eyes. The vision deteriorated in 8 eyes (12.9%). CONCLUSION: Based on this experience the authors are of the opinion that DT PPV is indicated in patients with uveitis for giving more precision to the diagnosis of intraocular inflammation or a masking syndrome. DT PPV also represents a therapeutic procedure to cure complications connected with a severe form of inflammation and makes it possible to save central visual acuity.

Adolescent↗

PubMed2000

[The idiopathic uveal effusion syndrome].

The authors describe two cases of idiopathic uveal effusion syndrome, in one instance affecting consecutively both eyes, in the second patient the finding is unilateral so far. In the female patient with the bilateral finding reattachment of the retina and improvement of the visual acuity developed only after surgery (sclerotomy). The second patient, where the disease was detected only accidentally, is so far only under observation. The authors discuss the causes of this rare disease, the variability of clinical symptoms, diagnostic and therapeutic possibilities.

Female↗

PubMed1997

[Masquerading syndromes].

Masquerade syndromes comprise a number of diseases imitating as to their clinical picture inflammation of the eye. These diseases comprise also malignant tumours. The authors present three patients where intraocular tumours (lymphoma, leukaemia, melanoma of the choroid) reminded of chronic uveitis.

Aged↗

PubMed1997

[Acute anterior uveitis, systemic diseases and HLA-B27].

The author investigated the rate of phenotype HLA-B27 and systemic diseases in patients with acute anterior uveitis (AAU) in our geographical area. The evaluated clinical differences of AAU manifestations in HLA-B27 positive and HLA-B27 negative patients in a group of 104 subjects followed up for a 10-year period. The patients were under 40 years of age. Men were affected twice as frequently as women. HLA B27 positive AAU is manifested above all by serofibrous exsudation into the anterior chamber and by more frequent relapses. In patients with early treatment there were fewer complications and the prognosis was favourable. AAU in HLA-B27 positive patients is associated in 65% with rheumatic disease. In our population it is above all ankylosing spondylitis and Reiter's disease. In 71% rheumatic diseases were manifested in men. Despite the different clinical course of AAU HLA-B27 positive and negative patients, during long-term follow up the visual acuity is not markedly altered in any of the investigated groups.

Adolescent↗

PubMed1997

[Diagnosis and therapy of Wegener's granulomatosis based on ocular changes].

The authors draw attention to the different ophthalmological manifestations of Wegener's granulomatosis in two patients examined at the First Ophthalmological Clinic of the First Medical Faculty, Charles University, Prague. The patients complaints led later to establishment of the diagnosis of WG or its relapse. Combined immunosuppressive treatment with steroids and cyclophosphamide relieved the ocular as well as general manifestations of WG.

Aged↗

PubMed1997

[Behcet's disease].

The author evaluates diagnostic and therapeutic results in nine patients with Behcet's disease investigated at the uveological ambulance of the First Ophthalmological Clinic, Medical Faculty Charles University in Prague during 1987-1996. Anterior uveitis with hypopyon was recorded twice as frequently as retinal vasculitis. Chronic CME, secondary glaucoma and occlusive vasculitis were the most serious complications of ophthalmological manifestations of BD. Ulcerations of connective tissue and skin manifestations of BD were found most frequently in the authors patients. In two thirds of the patients also the risk phenotype HLA B5 was recorded.

Adult↗

PubMed1996

[Treatment of herpes simplex keratouveitis with systemic and local administration of acyclovir].

Sixteen patients with relapsing or chronic HSV keratouveitis were treated during a new attack by acyclovir 15 mg/kg/day by the i.v. route for 5 days with local combination of acyclovir 3% ung. and steroids. In all 16 patients improvement of signs of keratouveitis occurred on the fourth day of therapy, in 10 patients with improvement of visual acuity. In 5 patients perforating keratoplasty was performed on account of turbidity of the cornea. The authors observed four relapses of the disease in the course of 12 months after termination of treatment.

Acyclovir↗

PubMed1996

[Cataract surgery in patients with endogenous uveitis].

The authors present an account of surgery of complicated cataract in 20 patients with anterior and intermediate uveitis. During a one-year follow-up period they evaluate the difference of postoperative development and visual acuity in extracapsular extraction without or with implantation of an intraocular lens. In 10 patients (5x m. Fuchs, 3x anterior uveitis, 2x intermediate uveitis) they performed only ECCE. In 10 patients with the same diagnosis an intraocular lens was implemented. The authors did not find marked differences between the ECCE operation and ECCE operation with an intraocular lens in patients with uveitis. The visual acuity improved in all 20 patients, a marked inflammatory reaction in the anterior chamber was observed in both groups only during the first days after surgery. The two groups did not differ markedly as regards late complications. From the investigation ensues that implantation of an intraocular lens is well tolerated in patients with anterior and intermediate uveitis assuming a minimum 12-week remission of the disease.

Adult↗

PubMed1996

[Keratomycoses].

Mycotic inflammations of the anterior segment of the eye are relatively rare in our geographical zone. The clinical picture, isolation of the pathogenic organism and possible treatment are discussed with reference to three patients with keratomycosis treated at the First Ophthalmological Clinic of the First Medical Faculty, Charles University Prague. Microscopic examination of the affected tissue revealed Fusarium 1x and Candida alb. also on cultivation. Natamycin 5.0% suspension cured Fusarium keratitis and improved the symptoms of Candida infection. In two patients perforating keratoplasty was necessary in one instance because of imminent perforation of a posterior mycotic corneal abscess and in the second patient because of subsequent bacterial reinfection.

Adult↗