This article reviews various ophthalmic diseases in the most famous historical paintings. Sometimes, the ophthalmic diseases might also substantially affect the vision of artists and we can deduct from their paintings what ophthalmic problems could have influenced these painters. They have their own painting, which is greatly influenced not only by their brain but also by their actual visual acuity. The most important ophthalmic diseases, which might affect vision and styles of painting, are refractive errors, cataract, glaucoma, ocular inflammations like uveitis; corneal opacities; haemorrhage in the vitreous, macular, and retinal degenerations; and retinal detachment. In the history of the painting, the different styles can be recognised and very often the question raised is whether this style is influenced by the visual acuity of the artists or visual acuity has nothing to do with the different styles. The aim of this study is to demonstrate how ophthalmic problems might have influenced final arts during the past centuries.
Background: Monitoring the retinal nerve fibre layer thickness (RNFLT) is essential in the diagnosis and treatment of glaucoma. In a previous study we found that a decrease of the polarimetric RNFLT observed in the early period after laser-assisted in situ keratomileusis (LASIK) disappears or tends to disappear by the third post-LASIK month. Purpose: To study the stability of the “recovered” polarimetric retardation values between the third and twelfth month after LASIK. Methods: Scanning laser polarimetry (SLP) with the classic GDx Nerve Fiber Analyzer was performed on 13 consecutive healthy subjects with no eye disease who underwent LASIK for ametropia correction. Measurements were performed preoperatively, then at 3 and 12 months postoperatively. Results: Inferior, temporal and nasal average thickness as well as ellipse average thickness and average thickness showed no difference among the three time points (ANOVA, p ? 0.05). Superior average thickness was significantly smaller both at three months (Sheffe test, p = 0.008) and 12 months (p = 0.006) than before LASIK. However, no difference was seen between the values measured at three months and at 12 months after LASIK (p = 0.997). A statistically significant interaction between treatment type (myopic or hyperopic correction) and the change of retardation was found for the superior average thickness (two-way ANOVA, p = 0.016). In this quadrant the RNFLT values of the myopic eyes decreased between the baseline and the month 3 measurements but became stable after that; the retardation of the hyperopic eyes remained unchanged throughout. Conclusion: RNFLT measured with the classic GDx device after LASIK shows transient changes probably due to the LASIK-induced alteration of the polarization and the healing process. The polarimetric RNFLT values, however, become stable by the third post-LASIK month, and show no further change until the end of the first year after LASIK. Baseline SLP measurements for long-term glaucoma follow-up can be obtained from the third post-LASIK month onwards.
This study aimed to examine the effectiveness of CO2 laser-assisted sclerectomy surgery (CLASS) in eyes with primary open-angle glaucoma (POAG) showing progression in spite of maximal local antiglaucomatous therapy.
Materials and methods
Patients with progressive POAG received CLASS treatment. We performed CLASS on 15 eyes (eight males and seven females). The primary endpoint was the change in the intraocular pressure (IOP), and additionally best spectacle-corrected visual acuity (BSCVA), C/D ratio (cup-to-disc), as well as use of antiglaucomatous drops were also investigated. Following the preoperative assessment, measurements were performed at 6-month follow-up.
The average preoperative IOP was 26.13 ± 6.79 mmHg that dropped to 9.57 ± 4.09 mmHg at 1 day. IOP was stable at 1 month, 3 months, and 6 months. The BSCVA decreased to the 1-day and 1-week follow-up but returned to its original value to the 1-month check-up. Preoperatively, all patients were on maximal antiglaucoma drop therapy, after CLASS none of the patients needed antiglaucomatous treatment at 1 month. However, at 3 months, one of them needed antiglaucoma drops. C/D ratio showed non-significant changes.
CLASS procedure was found to be effective in decreasing IOP in POAG patients whose IOP was not compensated with maximal antiglaucomatous local therapy; patients needed significantly less local therapy following the CO2 laser surgery.
Authors:Zs Somogyvári, E Maka, J Németh, and ZZ Nagy
Remote screening for retinopathy of prematurity by wide-field digital imaging and network telemedicine is increasingly used to prevent blindness without the unnecessary transport of infants. Our purpose was to train and license dedicated neonatal transport nurses to do this in Hungary.
Materials and methods
We developed a complex, four-step curriculum in mobile retinotelemetry. Using a robust selection process, we invited eight transport nurses (NtNP/RtN) to receive training during the 2008–2017 project. The curriculum started with the basics of ophthalmology. Using an artificial eye, it continued with the theory and practice of ophthalmologic exams. Then, supervised by an ophthalmologist, each nurse performed 50 video recordings of anaesthetized and non-anaesthetized infants.
After demonstrating their competence, five of the eight candidate nurses received a license for retinotelemetry. During their subsequent practice, they had to undergo case reviews half-yearly by a specialist and renew their license every 2–3 years. During the 2008–2016 period, we analysed 7,177 remote screenings from a training perspective. During January 1–August 31 in 2017 period, we analysed extra data from 795 remote screenings of 332 infants from specific prevention perspectives.
With the cooperation of preexisting neonatal transport service and the ophthalmological reading centre of a university hospital, a mobile telemedicine screening network was successfully developed in Hungary. Our results demonstrate how retinotelemetry can support different levels of prevention medicine. The network should work effectively and efficiently with continuous professional development.
Epidemics and pandemics have happened throughout the history of mankind. Before the end of the 20th century, scientific progress successfully eradicated several of the pathogens. While no one has to be afraid of smallpox anymore, there are some new pathogens that have never caused human disease before. Coronaviruses are a family of enveloped RNA viruses. In the 21st century, three of them have caused serious pandemics, including severe acute respiratory syndrome in 2002 and Middle East Respiratory Syndrome in 2012. In 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease-19 (COVID-19) pandemic, which has destroyed hundreds of thousands of lives and continues to rage.
Authors:A. Gyenes, G.L. Sándor, B. Csákány, Zs. Récsán, G. Rudas, Z.Z. Nagy, and E. Maka
A case of a 13-year-old girl after being injured on the left eyeball by a stick from a cage, is presented. Along vitreous haemorrhage, retinal oedema and ischaemia, the disc was replaced by a cavity. Multimodal imaging was performed, which confirmed the optic nerve damage. The eye had no light perception anymore. Our case is a demonstration for complete avulsion of the optic nerve after blunt injury.
Authors:G. Tóth, N. Szentmáry, G.L. Sándor, B. Csákány, Z. Antus, M.T. Pluzsik, O. Lukáts, and Z.Z. Nagy
Our aims were to evaluate the primary and clinical evisceration indications and to analyse orbital implant related complications.
We included in our retrospective review all eviscerations between 2006 and 2016 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary. Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases. Clinical immediate evisceration indications were also classified into six groups: painful blind eye due to glaucoma, atrophia/phthisis bulbi, endophthalmitis, cosmetic reasons, acute trauma and expulsive bleeding.
Evisceration was performed in 46 eyes of 46 patients (54.3% males, age 43.0 ± 18.6 years). The most common primary evisceration indications were trauma (37%), surgical diseases (34.8%), infection or inflammation (10.9%), systemic diseases (6.5%), tumours (8.7%) and unclassifiable diseases (2.2%). Painful blind eye due to glaucoma (34.8%) was the most common clinical indication for evisceration, followed by atrophia/phthisis bulbi (26.1%), endophthalmitis (17.4%), cosmetic reasons (13.0%), acute trauma (6.5%) and expulsive bleeding (2.2%). After evisceration, 91.3% of the patients received orbital implant and during 26.8±28.9 months follow-up implant related complications were found in 14.3% of the cases, including implant extrusion (4.8%), partial wound dehiscence (4.8%), implant exposure (2.4%) and orbital inflammation (2.4%).
Painful blind eye and atrophia/phthisis bulbi due to ocular trauma and surgical diseases represent the most common indications for ocular evisceration. If malignant intraocular tumours can be excluded, evisceration surgery combined with a silicon-based orbital implant is a safe and effective procedure.