Jurgelevičienė, Ieva

Background: This study retrospectively analyzed outcomes for patients undergoing Gamma Knife radiosurgery (GKR) for uveal melanoma (UM). Methods: Patients who underwent GKR for UM between 24 07 2019 and 01 06 2022 at Lithuanian University of Health Sciences Kaunas Clinics, were retrospectively analyzed. Results: Twenty-two patients (22 eyes) had UM. Patients with UM were followed for a mean of 14,18 ± 1,31 months and evaluated every 6 months up to 24 months after GKR treatment. Median of visual acuity (VA) (0,3 [0,04 - 0,65] vs. 0,23 [0,01 – 0,5]), intraocular pressure (IOP) (12,3 [11,2 - 14,7] vs. 13,9 [13,2 – 18,0] mmHg) and UM diameter (12,87 [11,33 - 16,09] vs. 11,91 [10,67 – 16,41] mm) were not significantly different between preoperative and postoperative measurements, respectively. However, a median of tumor thickness (6,54 [5,15 - 8,77] vs. 4,96 [4,21 – 6,09] mm, p=0,001) also evaluated 6-12 months after GKR (6,54 [5,15 - 8,77] vs. 6,04 [4,50 – 7,50] mm, p=0,016), and UM diameter evaluated 6-12 months after GKR (12,87 [11,33 - 16,09] vs. 11,90 [10,15 – 15,19] mm, p=0,035), were significantly different between preoperative and postoperative measurements, respectively. Four and a half percent (1/22 patients) required enucleation. Complications experienced by patients with UM include secondary glaucoma (4/22), increased secondary retinal detachment (5/22), cystoid macular edema (2/22), choroidal detachment (1/22), vitreous hemorrhage (1/22). Two patients experienced metastases (1/22 lungs and 1/22 to the kidney) and one patient died (1/22). Conclusions: Reduction of UM thickness and diameter was observed after Gamma Knife radiosurgery treatment, especially 6-12 months after. Radiosurgery with Gamma Knife is a promising and advanced treatment for uveal melanoma, but requires a larger number of patients and a longer follow-up period.

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in people aged 50 and older in the developed world. Early detection and treatment of AMD play the key role in helping patients at high risk for developing exudative to maintain their vision or slow down the progression of the disease. In this paper, the new technique for AMD evaluation using ultrasound spectral analysis is presented. Our aim was to compare B scan ultrasound signals backscattered from healthy tissues of macular area with signals from nonexudative and exudative AMD areas. In case-control study of 64 patients (144 tissues) we compared 82 cases of healthy tissue of macular area (I group) with 35 cases of nonexudative AMD (II group) and 30 cases of exudative AMD (III group) using B scan ultrasound. Estimated results showed that B scan amplitude and spectral intercept are informative to distinguish healthy tissues of macular area from AMD and spectral slope spectral, momentary bandwidth allow us to distinguish forms of AMD (nonexudative and exudative).We suggest that ultrasound spectral analysis is noninvasive, widely available, easy-to-use and less expensive method which can be used as an additional diagnostic tool in AMD detecting and differentiating when there are no possibilities to use more specific examination.

Introduction: Vertebral arteries (VA) are the only arteries in human body that have such a strong skeletal environment. That surround of vertebral artery is significant from the evolutionary perspective because vertebral artery plays important role in the supply of the brain. Bony socket on the posterior arch of atlas provides passage to the VA as it courses toward the brain through the foramen magnum. In some cases this socket of VA is converted into a groove or foramen (Kimmerle‘s anommaly) by anomalous ossification known as Ponticulus Posticus (PP). Aim of the study: To investigate the prevalence of bony socket variations of the vertebral artery on the posterior arch of atlas among lithuanians of various age and both genders analysing dried specimens. Material and methods: Our study comprised of 533 dried macerated atlas vertebrae of XIV–XVII cnt. Only specimens which were of exceptionally good quality and had good visualization of the superior surface of the atlas posterior arch were chosen for the investigation. The vertebrae were observed with naked eye by two researchers. According to the degree of depth of the bony socket, we categorized bony specimens into four variations: sulcus, open groove, semi-open groove and bony ring. Age group was categorized into two ranges: ≤20 and >20 years. Results: The overall prevalence of PP was 21% (112 cases). Although we examined 533 specimens, in some analyses double number of cases (1066) due to examination of left and right sides was used. As suspected, analysis of the results revealed predominance of sulcus (79.2%) of bony socket variations. Some degree of ossification was present in 150 cases (14.1%) and it involved open groove in 8.1%, semi-open groove in 2.0% and bony ring in 4.0% cases. The analysis of age groups revealed PP was significantly more common in age group of >20 years (p=0.003). There was significant difference in the prevalence between men a[...].

Introduction. Age-related macular degeneration (ARMD) is progressive disease of the central retina and a major cause of blindness worldwide. Visual loss from this condition is uncommon among persons under the age of 50, but its prevalence is likely to increase in absolute numbers globally as a consequence of population ageing. It is very important to use diagnostic tools that can define early or preclinical stages of the disease because if untreated it can cause blindness in late stages of the disease. One common approach in assessing retinal function is measuring visual acuity (VA). Although acuity testing is sample to implement in a clinical setting, it does not give exclusive information on retinal function in early ARMD when changes in visual acuity are minimal (two letter loss or longMAR 0.04). So testing basic aspects of vision , such as color perception, contrast sensitivity, and visual adaption, is more likely to reflect an alteration of retinal function in early ARMD. Visual acuity tests by the typical Snellen chart using the Landolt rings (C optotypes) alone is insufficient because it provides limited information about the central vision and it is difficult to evaluate in patients with macular abnormalities because the reduction in acuity shows that foveal acuity is lower than peripheral acuity. Aim. Evaluation of differences in visual acuity variations of eyes with early ARMD compared to healthy eyes under different contrast conditions using Freiburg Visual Acuity Test (FrACT). [...].

Introduction. Age-related macular degeneration (ARMD) is the cause of irreversible vision loss in people aged 50 and older in the developed world. The early clinical changes seen in ARMD, such as drusen and pigmentary abnormalities in the macula, are thought to be clinical markers of the risk of developing the late ARMD. In assessment of the structural changes in retina there are some methods such as autofluorescence imaging or optical coherence tomography. However, sometimes there are no possibilities to use these diagnostic tools. Ultrasonic methods stand out in opthalmology with good informative value among the noninvasive methods. Early detection of lesions and accurate diagnosis leads to effective assistance. in the last decade, ultrasound probes with higher frequency and higher resolution have been commercialized, such as the 20 MHz probe used for eye posterior pole studies. Frequency is important in ultrasound because it is directly related to resolution and inversely related to penetration of ultrasonographic images. Aim. Our aim was to compare B scan ultrasound signals backscattered from healthy tissues with signals from nonexudative (dry) and exudative (wet) ARMD areas. [...].

Introduction. Contrast sensitivity has an important role in ophthalmological examination because this diagnostic tool gives us an exclusive information on retinal function when changes in visual acuity are minimal (two letter loss, or longMAR 0.04). Deficient contrast sensitivity may arise from dysfunction at multiple points along the visual pathhways, from the lens and retina to primary visual cortex and higher cortical areas. Contrast sensitivity is strongly associated with daily functioning among older adults, but the genetic and environmental contributions to this ability are unknown. If there is evidence of genetic influence on contrast sensitivity, this could indicate that contrast sensitivity may be considered a possible endophenotype for some disorders. Aim. To determine colour perception differences between monozygotic and dizygotic twins by the maximum color contrast sensitivity (MCCS) test. Materials and methods. Visual function was assessed in 15 participants which comparised of 5 monozygotic twin pairs and 3 dizygotic twin pairs. (6 males and 10 females, 36.75±12.98 years; one participant was excluded due to severe retinal disease). All patients underwent a comprehensive ophthalmic examination followed by biomicroscopy and fundus photography. [...].

It is assumed that pathophysiology of age-related macular degeneration (AMD) is related to inflammation. In order to support the hypothesis of AMD as an inflammatory disease we evaluated and compared interleukin 1β (IL-1β) concentration in blood serum samples of patients. We designed three groups in our study: the first group consisted of patients with early (nonexudative) AMD (n=27), the second group - of patients with late (exudative) AMD (n=30) and the third group was the control group (n=21). From blood serum samples, taken from 78 patients, interleukin IL-1β (pg/ml) was determined by ELISA method. Serum concentration of IL-1β was found to be higher in II group than in the I and III groups, but but there was no significant difference (p=0.618 and p=0.615 respectively). Our results demonstrate that elevation of IL-1β in the blood serum of AMD patients was stastistically non-significant. Further research is required.

Early diagnostics of age-related macular degeneration (AMD) is very important because if untreated it can cause blindness in late stages of the disease. Our aim was to evaluate visual acuity variations in eyes with early and late AMD compared to normal eyes under different contrast conditions using the Freiburg Visual Acuity Test (FrACT). We performed 87 patients (165 eyes) case-control study. We examined 60 eyes with early (nonexudative) AMD (I group), 30 eyes with late (exudative) AMD (II group) and 75 eyes without AMD as a control group (III group). General ophthalmological examination, color fundus photography, optical coherence tomography imaging was used to evaluate AMD. 3 different Michelson contrasts (100%, 50% and 3%) were used to evaluate differences in visual acuities with FrACT. We estimated that best-corrected visual acuity significantly reduced with decreasing contrast (from 100% to 3%) in II group comparing to I (p=0.027) and III group (p=0.002). No significant differences were observed between I group and III group (p=0.143). We suggest that FrACT might be one of sensitive diagnostic criteria to detect progress from early to late AMD.

The aim of the study. To investigate the prevalence of skeletotopy variations of the posterior arch and vertebral artery among Lithuanian orthodontic patients of various age and gender. Material and methods. We randomly selected 870 digital lateral cephalograms of Lithuanian orthodontic patients of various age and gender. 706 images with good visualization of VA bony socket on the superior surface of the atlas posterior arch were chosen for the investigation. According to the degree of depth of the bony socket we categorized them into three variations: sulcus, groove and bony ring. If contours around VA of bony arch were equal or greater than 180° we included those cases into the group of bony groove. Results. We estimated predominance of sulcus (67,6%) of bony socket variations - it was present in 477 (67,6%) cases. A bony groove of various depth was found in 25,0% and a bony ring was found in 7,5% of the subjects studied. Vertebral artery groove was found to be more prevalent in females than in males (25,737 and 23,4% respoectively) and bony ring was more common in males than in females (9,5% and 6,5% respectively), but there was no significant difference (p>0,05). Statistically significant predominace of body ring in the age group of 17-20 years (13,2%) was noticed and it was higher than in the age group of 8-16 years (5,1%) (p<0,05). Conclusions. 1. Bony socket variation is a relatively common anomaly in Lithuanians. 2. Variations of bony socket including sulcus, groove, and bony ring (kimmerle's anomaly) develop in adolescence when ossification is most active. 3. The bony ring, which is limiting mobility of distal part of the vertebral artery, can be a risk factor of physical medicine procedures, epspecially in the elderly, whose artery walls are less elastic. 4. Vertebral artery relation with atlas anatomical variations also can lead to sensomotor disorders of head and neck, and vertebrobasilar insufficiency.