Kubiliūtė, Aleksandra

The aim: To investigate the role of Sirtuin 1 (SIRT1) level and SIRT1 (rs3818292, rs3758391, rs7895833) gene polymorphisms in patients with optic neuritis (ON) and multiple sclerosis (MS).Methods: 79 patients with ON and 225 healthy subjects were included in the study. ON patients were divided into 2 subgroups: patients with MS (n = 30) and patients without MS (n = 43). 6 ON patients did not have sufficient data for MS diagnosis and were excluded from the subgroup analysis. DNA was extracted from peripheral blood leukocytes and genotyped by real-time polymerase chain reaction. Results were analysed using the program "IBM SPSS Statistics 27.0".Results: We discovered that SIRT1 rs3758391 was associated with a twofold increased odds of developing ON under the codominant (p = 0.007), dominant (p = 0.011), and over-dominant (p = 0.008) models. Also, it was associated with a threefold increased odds of ON with MS development under the dominant (p = 0.010), twofold increased odds under the over-dominant (p = 0.032) models and a 1.2-fold increased odds of ON with MS development (p = 0.015) under the additive model. We also discovered that the SIRT1 rs7895833 was significantly associated with a 2.5-fold increased odds of ON development under the codominant (p = 0.001), dominant (p = 0.006), and over-dominant (p < 0.001) models, and a fourfold increased odds of ON with MS development under the codominant (p < 0.001), dominant (p = 0.001), over-dominant (p < 0.001) models and with a twofold increased odds of ON with MS development (p = 0.013) under the additive genetic model. There was no association between SIRT1 levels and ON with/without MS development. Conclusions: SIRT1 rs3758391 and rs7895833 polymorphisms are associated with ON and ON with MS development.

Introduction The aim of the accelerated corneal cross-linking (A-CXL) procedure is to halt the progression of keratoconus. Nonetheless, there is only a paucity of data reporting post-operative A-CXLinduced corneal topographic and endothelial changes in children. Our aim was to assess the 6-month changes in corneal topographic and endothelial values after A-CXL in paediatric patients with progressive keratoconus (PKC). Methods and MaterialIn this retrospective study 11 eyes of 7 paediatric patients with PKC, who received A-CXL from 2019 to 2022 at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Ophthalmology (Kaunas, Lithuania), were enrolled. Uncorrected visualacuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), parameters of corneal topography (Kmax, Kflat, Ksteep), thinnest corneal thickness (TCT) and endothelium (cell dencity (CD), coefficient of variation (CV), number of hexagonal cells (HEX) were evaluated at the baseline and 1, 3, 6 months after A-CXL. The statistic alanalysis was performed using IBM SPSS v. 25.0 software. Results There was a significant decrease of the mean UCVA (0,72±0,55logMAR) and an increase of IOP (14±5 mmHg) values atthe first postoperative month (PM) in relation to baseline results (0,48±0,48logMAR [p=0,007] and 11 ± 3 mmHg [p=0,016], respectively).The mean Kmax values were significantly lower only at 3PM (57,1±7,9D [p=0,021]) and 6PM (56,0±7,9D [p=0,005]) in respect of baseline results (58,2±7,9D). There was a significant decrease of the mean Ksteep at 6PM (48,8±4,3D) and an increase of Kflat (46,4±3,9D) values at 1PM in relation to baseline results (50,0±4,4D [p=0,004] and 45,9±3,7D [p=0,036], respectively). TCT was significantly lower at 3PM (455 ±44μm [p=0,009]) and 6PM (449±48μm [p=0,008]) in comparison with the preoperative data (474±41μm). Study results showed a significant decrease of the mean HEX at 1PM (61±7% [p=0,018]), 3PM (63±7% [p=0,050]) and 6PM (61±6% [p=0,050]), as well as an increase of CV values at 3PM (29±9 [p=0,017]) and 6 PM (31±9 [p=0,017]) in relation to baseline results (68±5%and 25±5, respectively).We found no statistically significant changes in the mean BCVA and endothelial CD values after A-CXL. Conclusion A-CXL induces variable corneal topographic and endothelial changes in paediatric patients with PKC 6 months after the procedure.

Įvadas. Per pastaruosius du dešimtmečius širdies magnetinio rezonanso tyrimas (ŠMRT) buvo sparčiai tobulinimas ir tapo svarbiu diagnostikos instrumentu kasdienėje kardiologijos praktikoje. ŠMRT yra neinvazinis tyrimo metodas, kurio pagalba galima tiksliai išmatuoti širdies ertmių tūrius, įvertinti miokardo funkciją bei charakterizuoti širdies audinius. Nepaisant plačių ŠMRT diagnostikos galimybių, šis tyrimo metodas yra toliau tobulinamas. Tikslas. Apžvelgti naujoves ŠMRT srityje bei pristatyti naujausius didelių imčių klinikinius tyrimus. Metodai. Literatūros apžvalga buvo atlikta naudojantis duomenų bazėmis: PubMed, ClinicalKey, ScienceDirect. Paieškai buvo naudojami specifiniai raktiniai žodžiai. Peržiūrėjus aktualiausias publikacijas buvo atrinkti, autorių nuomone, geriausiai temą atskleidžiantys straipsniai ir atlikta jų literatūros analizė. Išvados. Technologinės inovacijos ir naujausi klinikiniai tyrimai leido išplėsti ŠMRT panaudojimo galimybes bei sustiprinti šio tyrimo vaidmenį daugelio širdies ir kraujagyslių sistemos ligų diagnostikoje. Viena iš pagrindinių pastarųjų metų naujovių – tai T1 ar T2 relaksacijos laikų žymėjimo sekos, kurios leidžia detaliai vizualizuoti širdies audinių pokyčius, nulemtus infiltracijos, fibrozės ar edemos. Dar viena inovacija vertinant miokardo funkcinius pokyčius – miokardo įtampos rodiklių nustatymas, kuris suteikia galimybę aptikti ankstyvus širdies disfunkcijos požymius. Sparti dirbtinio intelekto pažanga vaizdinių tyrimų srityje leidžia tikėtis, jog netolimoje ateityje jis taps neatsiejama klinikinės praktikos dalimi.

Introduction: Optic disc pit (ODP) is a rare congenital cavitary anomaly of the optic nerve. Although ODP itself is mostly asymptomatic, visual disturbances can be caused by exudative retinal detachment (ERD) that forms due to intraretinal and subretinal fluid accumulation. Pars plana vitrectomy is considered the foremost ODP treatment tactic when maculopathy is present, however, some studies report that retinal changes can resolve spontaneously when laser photocoagulation is chosen. Case report: We present a case report of a 16-year-old female who experienced sudden vision loss in the right eye (RE) and diplopia without any trauma or systemic diseases. The best-corrected visual acuity (BCVA) with -2,25D lenses was 0,4 in RE and 1,0 in the left eye (LE). On slit-lamp fundus biomicroscopy, clear ODP in RE was present, ERD covered the center and stretched to the medial side beyond the optic nerve disc. ODP with an ERD of RE was diagnosed. Expecting spontaneous resorption, a follow-up was planned in two weeks. Unfortunately, ERD enlarged significantly. Laser photocoagulation (LP) was performed and repeated three times due to positive symptom regression. BCVA reached 1,0 in RE. Two years later, symptoms occurred again and BCVA in RE decreased to 0,6. A wide central ERD with macular and peripapillary sight involvement was detected on fundus examination. Retinal LP was repeated and after that BCVA in RE worsened to 0,3. A decreased ERD was observed and the patient was left for monitoring with prescribed glucocorticosteroid drops. During the follow-up seven months later, the patient’s BCVA improved to 1,0 in RE. ERD was absent and the patient’s condition was stable. Conclusions: Tactics for ODP maculopathy management should be selected individually after consulting a vitreoretinal surgeon. Although LP effectiveness described in the literature is controversial, our case report shows a significant visual improvement[...].

Introduction: Administration of questionnaires regarding health-related quality of life evaluation is a crucial step of the diagnostic process. Ocular Surface Disease Index (OSDI) is a worldwide accepted questionnaire for patients experiencing dry eye symptoms. Aim of the study: The purpose of this study is to complete the validation of Lithuanian Version of OSDI and make it available in Lithuanian ophthalmologists’ daily work and research while encountering dry eye disease (DED) patients. Methods: The translation process of original OSDI to Lithuanian language was made by the Mapi Research Trust according to the accepted rules for questionnaire validation. All included DED patients completed the Lithuanian Version of OSDI. Inclusion criteria: native Lithuanian speakers of 18 years or older, who had previously diagnosed DED and gave consent to participate in the study. Patients with ocular infection or vision less than 6/60 in Snellen chart were excluded. Randomly selected subjects were requested to refill the translated OSDI one month later for test-retest reliability evaluation. All participants underwent a comprehensive ophthalmological and specific examination for ocular dryness with non-anesthetic Schirmmer’s test, tear break up time (TBUT) test, fluorescein staining of the cornea. In a randomized manner, a part of subjects was selected to complete Visual Function Questionnaire (VFQ-25) which was compared to Lithuanian Version of OSDI. Results: The study included 90 DED patients of which 75 (83.3%) were female and 15 (16.7%) were male. The age mean (SD) was 65,87 (±17). The Cronbach’s alpha coefficient for the questionnaire was 0.87 and for the three subscales it was 0.78, 0.69 and 0.71, respectively. The translated OSDI and its’ subscales showed good internal consistency. A significant correlation was found for test-retest reliability (n=35). Correlations between Lithuanian Version of OSDI and V[...].

Tikslas - pristatyti klinikinį atvejį, kurio esmė - kartotiniai multidisciplininės reabilitacijos kursai po trijų Gijeno-Bare sindromo (GBS) epizodų. Klinikinis atvejis. Į Lietuvos sveikatos mokslų universiteto (LSMU) ligoninės Kauno klinikų Neurologijos kliniką buvo hospitalizuota 72 metų moteris, besiskundžianti prieš du mėnesius atsiradusiu juosmens skausmu, plintančiu į abiejų kojų lateralinius paviršius, pėdų tirpimu ir šalimu. Diagnozuota poūmė demielinizuojanti polineuropatija. Pacientė iš viso patyrė tris GBS epizodus, po kiekvieno iš jų praėjo multidisciplininės reabilitacijos kursą. Nepaisant to, jog pacientės būklė pablogėdavo GBS epizodo metu, po kiekvieno reabilitacijos kurso buvo stebimas Bartelio indekso, funkcinio nepriklausomumo testo, Lovett balų bei dinamometrijos rezultatų pagerėjimas. Buvo taikoma fizioterapija, ergoterapija, masažai, transkutaninė elektrinė nervų stimuliacija, kineziterapija, kalbos terapija, psichologo bei socialinio darbuotojo konsultacijos. Po paskutinio reabilitacijos kurso pacientė buvo savarankiška palatoje, gebėjo pavalgyti paduotą maistą, viršutinę kūno dalį apsirengti su minimalia, o apatinę – su vidutine pagalba. Kitoms veikloms buvo reikalinga vidutinė pagalba. Išvados. Pacientės būklė pagerėjo, praėjus multidisciplininės stacionarinės bei ambulatorinės reabilitacijos kursus. Šis atvejis pabrėžia ankstyvos stacionarinės bei tęstinės ilgalaikės reabilitacijos svarbą, norint pasiekti maksimalų funkcinį pasveikimą.

Optinio neurito ir išsėtinės sklerozės ryšys nagrinėjamas dėl abi šias patologijas siejančių centrinėje nervų sistemoje vyraujančių demielinizacijos ir neurodegeneracijos procesų. Tiek vienos, tiek kitos ligos atvejų vyksta imuninio atsako sukeltas mielininio dangalo, o vėliau ir aksonų, pažeidimas, lemiantis negrįžtamą neurologinių funkcijų sutrikimą. Šie procesai vyksta jauname amžiuje, todėl ankstyva ligos diagnostika ir jos suvaldymas turi reikšmės pacientų neurologinei funkcijai ir gyvenimo kokybei išsaugoti. Optinis neuritas gali pasireikšti kaip pirma išsėtinės sklerozės ataka, tad, tinkamai atpažinus jam būdingus simptomus ir nuodugniai įvertinus oftalmologinės bei neurologinės patologijos požymius, patikimiausiais tyrimo metodais galima ne tik nustatyti regos sutrikimų priežastį, bet ir numatyti tikimybę susirgti išsėtine skleroze. Deja, net ir išaiškinus, kad pacientas turi didelę riziką ateityje sirgti šia demielinizuojančia liga, nustačius optinį nervo uždegimą ar kitus išsėtinei sklerozei būdingus simptomus, priemonių sustabdyti ligos progresavimą kol kas nėra. Šiuo metu laikomasi principo ūmaus optinio neurito epizodui suvaldyti skirti intraveninius ir geriamuosius gliukokortikoidus, intraveninį imunoglobuliną, gydomąsias plazmaferezes. Tokio gydymo efektyvumas išlieka diskutuotinas, todėl tiriamos naujos medžiagos, kurių pritaikymas padėtų apsaugoti nuo tolesnio nervinio audinio pažeidimo ir skatintų remielinizacijos procesus. Šiame straipsnyje aptariama optinio neurito epidemiologija, etiologija, patogenezė, pagrindiniai klinikos aspektai, diagnostikos bei gydymo galimybės ir ryšio su išsėtinės sklerozės išsivystymu vertinimas.

Aim: Multiple myeloma is a cancerous disease caused by plasma cell proliferation and mainly affects people in their adulthood. Ophthalmic presentation of multiple myeloma is not typical and appropriate tactics of treatment rely on clinical variations. In this case, we discuss retinal involvement in multiple myeloma which was treated with systemic chemotherapy, plasmapheresis and intravitreal injections of anti-VEGF. Results: A 59-year-old woman with recently diagnosed multiple myeloma underwent ophthalmological examination due to decreased visual acuity. Edema of the optic nerve disc, multiple retinal hemorrhages, cottonwool spots and Roth spots were seen in both eyes on fundus examination and OCT revealed macular edema in both eyes. Systemic treatment with chemotherapy and two plasmapheresis reduced retinopathy symptoms, although macular edema remained clinically significant. To reduce macular edema by preventing angiogenesis and further hemorrhage formation intravitreal anti-vascular endothelial growth factor bevacizumab was decided to be used. Conclusions: Evaluation of multiple myeloma patients should be comprehensive in regard to their symptoms and complaints. Despite the rare ocular manifestations, multiple myeloma patients with decreased visual acuity have to be frequently examined by an ophthalmologist and eligible treatment should be selected to control ocular symptoms.