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Roskal-Wałek J, Gołębiewska J, Mackiewicz J, Bociek A, Wałek P, Biskup M, Bołtuć-Dziugieł K, Starzyk K, Odrobina D, Wożakowska-Kapłon B, Jaroszyński A. The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology. Diagnostics (Basel) 2024; 14:331. [PMID: 38337847 PMCID: PMC10855457 DOI: 10.3390/diagnostics14030331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The aim of the study was to assess the influence of a single haemodialysis (HD) session on the retinal and optic nerve morphology in end-stage kidney disease (ESKD) patients. METHODS It is a prospective study including only the right eye of 35 chronic kidney disease (CKD) patients subjected to HD. Each patient underwent a full eye examination 30 min before HD (8 a.m.) and 15 min after HD. Optical coherence tomography (OCT) was used to assess the peripapillary retinal nerve fibre layer (pRNFL) thickness, macular nerve fibre layer (mRNFL) thickness, ganglion cell layer with inner plexiform layer thickness (GCL+), GCL++ (mRNFL and GCL+) thickness, total retinal thickness (RT) and total macular volume (TMV). The correlation was tested between such systemic parameters changes as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body weight, plasma osmolarity and ocular perfusion pressure (OPP) and ultrafiltration volume with total RT and pRNFL thickness changes during HD. RESULTS In the results of a single HD session, we could observe a statistically significant increase in the total RT thickness (pre-HD 270.4 ± 19.94 μm, post-HD 272.14 ± 20.11 μm; p = 0.0014), TMV (pre-HD 7.48 ± 0.53 mm3, post-HD 7.52 ± 0.55 mm3; p = 0.0006), total pRNFL thickness (pre-HD 97.46 ± 15.71 μm, post-HD 100.23 ± 14.7 μm; p = 0.0039), total GCL+ thickness (pre-HD 70.11 ± 9.24 μm, post-HD 70.6 ± 9.7 μm; p = 0.0044), and GCL++ thickness (pre-HD 97.46 ± 12.56 μm, post-HD 97.9 ± 12.94 μm; p = 0.0081). We observed a significant correlation between the change in total RT and DBP change, as well as between body weight change and the change in total pRNFL thickness. There was also a correlation between total pRNFL thickness change and the presence of diabetes mellitus. CONCLUSION Even a single HD session affects the retinal and pRNFL thickness, which should be taken into account when interpreting the OCT results in patients subjected to HD. The impact of changes after a single HD session on selected parameters requires further assessment in subsequent studies, including long-term observation.
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Affiliation(s)
- Joanna Roskal-Wałek
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
- Medical Faculty, Lazarski University, 02-662 Warsaw, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University of Lublin, 20-079 Lublin, Poland
| | - Agnieszka Bociek
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
| | - Paweł Wałek
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Michał Biskup
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland
| | | | - Katarzyna Starzyk
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Dominik Odrobina
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
- Ophthalmology Clinic Boni Fratres Lodziensis, 93-357 Łódź, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University, 25-516 Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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Roskal-Wałek J, Gołębiewska J, Mackiewicz J, Wałek P, Bociek A, Biskup M, Odrobina D, Jaroszyński A. The Haemodialysis Session Effect on the Choroidal Thickness and Retinal and Choroidal Microcirculation-A Literature Review. J Clin Med 2023; 12:7729. [PMID: 38137798 PMCID: PMC10743986 DOI: 10.3390/jcm12247729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Haemodialysis (HD) is currently the most commonly used method of renal replacement therapy. The process of dialysis involves numerous changes that affect many systems, including the eye. The changes occurring in the course of HD may affect the ocular parameters, such as intraocular pressure, central corneal thickness, retinal thickness, retinal nerve fibre layer thickness, and choroidal thickness (CT). The choroid, being one of the most vascularized tissues, is characterized by the highest ratio of blood flow to tissue volume in the entire body, may be particularly susceptible to changes occurring during HD, and at the same time reflect the microcirculatory status and its response to HD. Patients with end-stage renal disease subjected to dialysis are highly susceptible to systemic microvascular dysfunction. Moreover, it is considered that the process of HD itself contributes to vascular dysfunction. Nowadays, thanks to the development of imaging techniques, the widely available optical coherence tomography (OCT) tests allow for the assessment of CT, while OCT-angiography allows for a quick, non-invasive, and repeatable assessment of the condition of retinal and choroidal microcirculation, which significantly expands our knowledge regarding the reaction of ocular microcirculation due to HD. The assessment of both retinal and choroidal circulation is even more attractive because retinal circulation is autoregulated, while choroidal circulation is mainly controlled by extrinsic autonomic innervation. Thus, assessment of the choroidal response to an HD session may provide the possibility to indirectly evaluate the functions of the autonomic system in patients subjected to HD. At a time when the importance of microcirculation in systemic and renal diseases is becoming increasingly evident, the assessment of ocular microcirculation appears to be a potential biomarker for assessing the condition of systemic microcirculation. In this work, we present a review of the literature on the effect of the HD session on CT and the retinal and choroidal microcirculation.
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Affiliation(s)
- Joanna Roskal-Wałek
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland;
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (A.B.); (D.O.); (A.J.)
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland;
- Medical Faculty, Lazarski University, 02-662 Warsaw, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Paweł Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (A.B.); (D.O.); (A.J.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Agnieszka Bociek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (A.B.); (D.O.); (A.J.)
| | - Michał Biskup
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland;
| | - Dominik Odrobina
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (A.B.); (D.O.); (A.J.)
- Ophthalmology Clinic Boni Fratres Lodziensis, 93-357 Łódź, Poland
| | - Andrzej Jaroszyński
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (A.B.); (D.O.); (A.J.)
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Wałek P, Roskal-Wałek J, Dłubis P, Wożakowska-Kapłon B. Echocardiographic Evaluation of Atrial Remodelling for the Prognosis of Maintaining Sinus Rhythm after Electrical Cardioversion in Patients with Atrial Fibrillation. J Clin Med 2023; 12:5158. [PMID: 37568560 PMCID: PMC10419596 DOI: 10.3390/jcm12155158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
Atrial fibrillation (AF) is the most common atrial tachyarrhythmia. One of the methods of AF treatment is direct current cardioversion (DCCV), but in the long-term follow-up we observe quite a high percentage of AF recurrences after this procedure. In order to assess the prognosis of DCCV effectiveness, we use clinical, biochemical and echocardiographic parameters. The objective of this review is to systematise the current knowledge on echocardiographic measurements in patients with persistent AF used to assess the progress of remodelling of the atrial wall, which affects the likelihood of maintaining sinus rhythm after DCCV. In this article, echocardiographic parameters for the evaluation of remodelling of the atrial wall are divided into groups referring to structural, mechanical, and electrical remodelling, as well as parameters for the evaluation of left ventricular filling pressure. The article aims to draw attention to the clinical value of echocardiographic measurements, which is the selection of patients who will maintain sinus rhythm after DCCV in the long-term follow-up, which will allow to avoid unnecessary risks associated with the procedure and enable the selection of the appropriate treatment strategy.
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Affiliation(s)
- Paweł Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (P.D.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Joanna Roskal-Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (P.D.); (B.W.-K.)
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland
| | - Patryk Dłubis
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (P.D.); (B.W.-K.)
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (P.D.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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Roskal-Wałek J, Mackiewicz J, Wałek P, Sidło J, Biskup M, Wożakowska-Kapłon B, Odrobina D. Long-term mortality after retinal artery occlusion - a single centre study. Ann Agric Environ Med 2023; 30:252-258. [PMID: 37387374 DOI: 10.26444/aaem/167379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
INTRODUCTION AND OBJECTIVE Retinal artery occlusion (RAO) is an ophthalmic and systemic emergency requiring urgent diagnosis and treatment. Data regarding mortality in this group, especially in the European population, are modest. The aim of this study is to assess all-cause mortality in post-RAO patients. MATERIAL AND METHODS This is a retrospective, single-centre study involving 198 patients following RAO diagnosed in 2004-2020. The control group included 198 patients after cataract surgery matched for gender and age, with the date of cataract surgery corresponding to the date of the RAO. RESULTS The average follow-up of the study population was 6.32±2.15 years. Post-RAO patients had significantly higher risk of all-cause mortality (Log-rank test p = 0.001), also when stratified for ages below 75 years (Log-rank test p = 0.016) and those aged 75 and over (Log-rank test p = 0.001). In the group of patients without cardiovascular events before RAO/cataract surgery, post-RAO patients were also at higher risk of all-cause mortality (Log-rank test p = 0.011), but when stratified according to age, those observations were borderline significant (Log-rank test p = 0.083 for a group of patients aged less than 75 years, and p = 0.051 for patients aged 75 and over). Cox analysis showed that in the group of post-RAO patients, the main risk factors for all-cause mortality were age (HR 1.07, 95%CI 1.04-1.1; p < 0.001), ischemic heart disease (HR 1.72; 95%CI 1.08-2.72; p = 0.022), and permanent atrial fibrillation (HR 2.18, 95%CI 1.08-4.38; p = 0.029). CONCLUSIONS Regardless of age and previous cardiovascular events, post-RAO patients are at a higher risk of all-cause mortality than patients without a history of RAO.
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Affiliation(s)
- Joanna Roskal-Wałek
- Department of Ophthalmology, Regional Hospital, Kielce, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University, Lublin, Poland
| | - Paweł Wałek
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Jacek Sidło
- Department of Ophthalmology, Regional Hospital, Kielce, Poland
| | - Michał Biskup
- Department of Ophthalmology, Regional Hospital, Kielce, Poland
| | - Beata Wożakowska-Kapłon
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Dominik Odrobina
- Ophthalmology Clinic Boni Fratres Lodziensis, Łódż, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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Wałek P, Roskal-Wałek J, Dłubis P, Tracz J, Wożakowska-Kapłon B. Left Atrial Wall Motion Velocity Assessed during Atrial Fibrillation Predicts Sinus Rhythm Maintenance after Electrical Cardioversion in Patients with Persistent Atrial Fibrillation. Int J Environ Res Public Health 2022; 19:15508. [PMID: 36497585 PMCID: PMC9740887 DOI: 10.3390/ijerph192315508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Reduced left atrial wall motion velocity measured during AF (LAWMV) indicates left atrial remodeling. The aim of this study was to investigate whether LAWMV assessed with tissue Doppler imaging during atrial fibrillation (AF) predicts sinus rhythm (SR) maintenance after direct current cardioversion (DCCV) for persistent AF. The study included 126 patients who underwent DCCV and were followed for 12 months. At 12 months, maintained SR was reported in 55 patients (43.7%). We noted that LAWMV was higher in patients with maintained SR at 12 months than in those with recurrent AF (3.69 ± 0.84 vs. 2.86 ± 1.09; p < 0.001). In the multivariable regression model containing echocardiographic variables, LAWMV was an independent predictor of SR maintenance at 12 months (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.1-2.69; p = 0.017). Similarly, LAWMW was an independent predictor of SR maintenance at 12 months (OR 1.81, 95% CI 1.19-2.77; p = 0.006) in the multivariate regression model containing both echocardiographic and clinical variables. LAWMV predicts SR maintenance after DCCV for persistent AF. Echocardiographic markers of left atrial mechanical remodeling are better at predicting SR maintenance than markers of structural remodeling.
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Affiliation(s)
- Paweł Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Joanna Roskal-Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland
| | - Patryk Dłubis
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
| | - Justyna Tracz
- Clinic of Neurology, Swietokrzyskie Neurology Center, 25-736 Kielce, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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Roskal-Wałek J, Wałek P, Biskup M, Sidło J, Cieśla E, Odrobina D, Mackiewicz J, Wożakowska-Kapłon B. Retinal Artery Occlusion and Its Impact on the Incidence of Stroke, Myocardial Infarction, and All-Cause Mortality during 12-Year Follow-Up. J Clin Med 2022; 11:jcm11144076. [PMID: 35887842 PMCID: PMC9324734 DOI: 10.3390/jcm11144076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of the study was to evaluate the incidence of ischemic stroke, myocardial infarction, and all-cause mortality in patients with retinal artery occlusion (RAO). This single-center retrospective study included 139 patients diagnosed with RAO between 2009 and 2020. The control group included 139 age- and sex-matched patients without RAO who underwent cataract surgery. The year of the surgery corresponded to the year of RAO onset. During the 12-year follow-up, patients with RAO had a shorter time to death (49.95 vs. 15.74 months; p = 0.043), a higher all-cause mortality rate (log-rank p = 0.026, and a higher rate of the composite endpoint, including ischemic stroke, myocardial infarction, and all-cause mortality (log-rank p = 0.024), as compared with controls. Patients with RAO younger than 75 years showed a higher risk of cerebral ischemic stroke (log-rank p = 0.008), all-cause mortality (log-rank p = 0.023), and the composite endpoint (log-rank p = 0.001) than controls. However, these associations were not demonstrated for patients aged 75 years or older. Our study confirms that patients with RAO have a higher risk of all-cause mortality than those without RAO. Moreover, patients with RAO who are younger than 75 years are significantly more likely to experience ischemic stroke, death, or the composite endpoint after an occlusion event, as compared with individuals without RAO.
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Affiliation(s)
- Joanna Roskal-Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (E.C.); (D.O.); (B.W.-K.)
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland; (M.B.); (J.S.)
| | - Paweł Wałek
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (E.C.); (D.O.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
- Correspondence: ; Tel.: +48-413-671-440; Fax: +48-413-671-510
| | - Michał Biskup
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland; (M.B.); (J.S.)
| | - Jacek Sidło
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland; (M.B.); (J.S.)
| | - Elżbieta Cieśla
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (E.C.); (D.O.); (B.W.-K.)
| | - Dominik Odrobina
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (E.C.); (D.O.); (B.W.-K.)
- Ophthalmology Clinic Boni Fratres Lodziensis, 93-357 Łódź, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (J.R.-W.); (E.C.); (D.O.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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Roskal-Wałek J, Mackiewicz J, Wypchło Ł, Biskup M, Odrobina D. Susac's syndrome - the crucial role of imaging tests for proper diagnosis. Ann Agric Environ Med 2022; 29:190-200. [PMID: 35767750 DOI: 10.26444/aaem/149954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Susac's syndrome (SS) is a rare, autoimmune-mediated endoteliopathy characterized by a clinical triad of encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss. SS is also characterized by a neuroimaging triad consisting of white matter lesions, grey matter lesions, and leptomeningeal enhancement on magnetic resonance imaging (MRI). Considering the rarity of SS, as well as certain similarity to other, more frequent neurological diseases, such as multiple sclerosis (MS), this syndrome is sometimes incorrectly diagnosed and treated. OBJECTIVE The aim of the study is to present the current state of knowledge on SS, with particular consideration for the differential diagnostics between SS and MS, using the latest available imaging techniques, such as brain MRI, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FA). REVIEW METHODS The major electronic databases (PubMed, Google Scholar) were searched manually in order to identify the relevant studies published on SS. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE Distinguishing SS from MS is a diagnostic challenge. In the majority of cases, patients with SS do not present the complete clinical or neuroimaging triad, and a delay in making the correct diagnosis exposes the patient to the occurrence of complications, resulting from the development of the underlying disease, or/and the application of improper treatment. In the case of SS the results of brain MRI and FA are essential for making the correct diagnosis as they may reveal pathognomonic changes. SUMMARY Imaging examinations, such as brain MRI, FA, and OCT complement each other, due to which the diagnosis of SS may be simpler, irrespective of the stage of the disease.
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Affiliation(s)
- Joanna Roskal-Wałek
- Department of Ophthalmology, Voivodeship Regional Hospital, Kielce, Poland
- Jan Kochanowski University, Kielce, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University, Lublin, Poland
| | - Łukasz Wypchło
- Department of Imaging Diagnostics, Voivodeship Regional Hospital, Kielce, Poland
- Jan Kochanowski University, Kielce, Poland
| | - Michał Biskup
- Department of Ophthalmology, Voivodeship Regional Hospital, Kielce, Poland
| | - Dominik Odrobina
- Ophthalmology Clinic Boni Fratres Lodziensis, Poland
- Jan Kochanowski University, Kielce, Poland
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Gregorczyk M, Roskal-Wałek J. [Ocular symptoms in SARS-CoV-2 infection]. Pol Merkur Lekarski 2022; 50:86-93. [PMID: 35436269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
UNLABELLED The first cases of COVID-19 were reported in Wuhan city, Hubei province, China. Patients reported symptoms such as dry cough, dyspnea, fever. Bilateral infiltrates in the lung parenchyma could be seen in imaging studies. Two years after the diagnosis of the first case of COVID-19, we are confident that symptoms manifest in every organ, including the eyes. Ocular manifestations may result from the COVID- 19 infection itself as well as from associated treatment, including mechanical ventilation or drug therapy. Ocular manifestations may be the first signs of COVID-19, so this knowledge is essential for making a prompt and correct diagnosis. It is important to be aware of the risks associated with the possibility of infection during the ophthalmic examination of these patients. AIM The aim of the analysis was to perform a literature review systematizing the knowledge on ocular manifestations in the course of the COVID-19 infection with particular emphasis on the relation between the occurrence of ocular symptoms and the age of patients as well as the severity of the COVID-19 course. The review also included studies that evaluated the detection of the SARS-CoV-2 virus in tears or conjunctival sac swabs of patients with COVID-19. MATERIALS AND METHODS Articles for the literature review were collected from the PubMed database. The expression "COVID-19 ocular manifestations" was used as the selection criteria. Finally, fifteen papers published in 2020 and fifteen papers published in 2021 were included in the review. Nineteen of these were original papers, two were meta-analyses, and nine were classified as review papers. RESULTS The most commonly reported ocular manifestations include dry eye or foreign body sensation, conjunctival hyperaemia, tearing, itching, and eye pain. Conjunctivitis was the most commonly diagnosed ophthalmic disease among COVID-19 patients. The SARS-CoV-2 infection is also associated with a risk of a significant decrease in visual acuity due to retinal vascular occlusion, ischemic optic neuropathy, inflammation of the choroid, retina and the optic nerve. The incidence of the most common ocular surface-related symptoms was higher in children than in adults. In several studies it has been shown that patients with more severe COVID-19 infection are more likely to have ocular symptoms. CONCLUSIONS Physicians, especially ophthalmologists, should be aware of the link between SARS-CoV-2 infection and the possibility of ocular symptoms and should recommend testing for COVID-19 if SARS-CoV-2 infection is suspected to reduce the possibility of infection spread.
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Roskal-Wałek J, Wałek P, Sidło J, Biskup J, Mackiewicz J, Wożakowska-Kapłon B. Relationship between atrial fibrillation and retinal artery occlusion: what we know now and how we can use it in clinical practice? Folia Cardiologica 2021. [DOI: 10.5603/fc.2021.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Roskal-Wałek J, Wałek P, Biskup M, Odrobina D, Mackiewicz J, Głuszek S, Wożakowska-Kapłon B. Central and Branch Retinal Artery Occlusion-Do They Harbor the Same Risk of Further Ischemic Events? J Clin Med 2021; 10:jcm10143093. [PMID: 34300257 PMCID: PMC8307136 DOI: 10.3390/jcm10143093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose: Retinal artery occlusion (RAO) is associated with an increased risk of cardiovascular events such as ischemic stroke and myocardial infarction, but whether different RAO subtypes such as central retinal artery occlusion (CRAO) or branch retinal artery occlusion (BRAO) carry similar risk of these events is unclear. Our aim was to determine whether the risk of cardiovascular events differs between CRAO and BRAO. Methods: This single-center, retrospective study included 131 patients hospitalized in our clinic in 2010–2020 with CRAO or BRAO confirmed by ophthalmic examination. Data on demographics, previous ischemic stroke and myocardial infarction, comorbidities, the results of echocardiographic and ultrasound carotid artery examinations and laboratory tests were assessed. Data on ischemic stroke, myocardial infarction, and all-cause mortality occurring after RAO were obtained from the Polish National Health Service, which collects data on all publicly funded hospitalizations. Using these data, Kaplan-Meier analyses and Cox proportional hazard regression were performed. Results: Ischemic stroke occurred in 9.9% of patients after RAO: 10.6% in the CRAO group and 8.1% in the BRAO group (p = 0.662). Myocardial infarction occurred in 2.3% of patients after RAO: 2.1% in the CRAO group and 2.7% in the BRAO group (p = 0.843). All-cause mortality occurred in 22.9% of patients after RAO: 25.5% in the CRAO group and 16.2% in the BRAO group (p = 0.253). The composite endpoint of ischemic stroke, myocardial infarction, and all-cause mortality after RAO occurred in 28.2% of patients: 30.9% in the CRAO group and 21.6% in the BRAO group (p = 0.338). There was no difference between CRAO and BRAO in median time to ischemic stroke (32 vs. 76.4 months; p = 0.352), all-cause mortality (35.9 vs. 36.3 months; p = 0.876) or composite endpoint (37.5 vs. 41.5 months; p = 0.912) after RAO. The Kaplan-Meier analysis showed no differences between CRAO and BRAO in ischemic stroke, myocardial infarction, all-cause mortality, or the composite endpoint; similar results were obtained in analyses of patients with and without cardiovascular events before RAO. Conclusions: The prognosis for ischemic stroke, myocardial infarction, and all-cause mortality is similar in patients with CRAO and BRAO. Ischemic strokes occur with a similar frequency before and after RAO. Myocardial infarctions are observed significantly more frequently before an episode of RAO than after. The results of our study indicate that both CRAO and BRAO require expanded diagnostics to assess the risk of recurrent cardiovascular events, especially ischemic strokes, to implement appropriate prophylaxis and reduce mortality.
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Affiliation(s)
- Joanna Roskal-Wałek
- Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (D.O.); (S.G.); (B.W.-K.)
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland;
- Correspondence: ; Tel.: +48-413-671-440; Fax: +48-413-671-510
| | - Paweł Wałek
- Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (D.O.); (S.G.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Michał Biskup
- Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland;
| | - Dominik Odrobina
- Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (D.O.); (S.G.); (B.W.-K.)
- Ophthalmology Clinic Boni Fratres Lodziensis, 93-357 Łódź, Poland
| | - Jerzy Mackiewicz
- Department of Vitreoretinal Surgery, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Stanisław Głuszek
- Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (D.O.); (S.G.); (B.W.-K.)
- Oncological, Endocrinological and General Surgery Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland; (P.W.); (D.O.); (S.G.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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Roskal-Wałek J, Wałek P, Gorczyca-Michta I, Kal M, Sielski J, Gierada M, Mackiewicz J, Wożakowska-Kapłon B. Czynniki ryzyka sercowo-naczyniowego w grupie 100 pacjentów z zatorem tętnic siatkówki — rejestr jednoośrodkowy. Folia Cardiologica 2017. [DOI: 10.5603/fc.2017.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wałek P, Roskal-Wałek J, Gierada M, Mackiewicz J, Wożakowska-Kapłon B. Retinal artery occlusion as an announcement of stroke and myocardial infarction? Kardiol Pol 2016; 74:797. [DOI: 10.5603/kp.2016.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 01/21/2016] [Indexed: 11/25/2022]
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Wałek P, Roskal-Wałek J, Sielski J, Gierada M, Mackiewicz J, Wożakowska-Kapłon B. Choroby układu sercowo-naczyniowego u pacjenta z zatorem tętnicy siatkówki. Folia Cardiologica 2016. [DOI: 10.5603/fc.2016.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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