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Our Eye Centre provides diagnosis and treatment of retina and vitreous disorders. All examinations and surgery are performed on an outpatient basis. Surgeries are done during weekdays as well as at weekends – depending on availability and patient’s wishes.

We provide following services:

• Diagnostics of retina disorder
• Conservative treatment of vitreo-retinal disorders
• Surgical treatment of retina and vitreous
• Surgical methods of therapy of vitreo-retinal disorders

Avastin application treatment– information, use:

Avastin is a drug which generally suppresses growth factor that leads to the creation of blood vessels. It’s injected, after local anesthesia, with a thin syringe directly into the eye.

We apply it in three major cases when we want to suppress the growth of blood vessels and the subsequent retina swelling:

1. Wet form of macular degeneration when the delicate newly created blood vessels form under the centre of the retina and lead to swelling and bleeding in the retina which cause rapid vision deterioration and image deformation
2. In more advanced stages of eyes that are affected by diabetes, when there is swelling in the retinal centre and a reduction of vision acuity. And also when newly formed blood vessels appear on the surface of the optic nerve and retina and then penetrate into the vitreous. Bleeding from some of these vessels into the vitreous can then cause a sudden drop in vision.

3. In other cases when there is any cause of reduced oxygen supply to the retina (most frequently retinal vein thrombosis, embolism or other vascular disease).  The retina then tries to help itself by the creation of ‘new blood vessels’ which finally leads to its devastation and deterioration or a complete loss of vision.

Age-related macular degeneration

is a disease which, in developed countries, is the most common cause of severe eyesight disease for people over 55 years old.

Because our general population is aging, the number of patients affected by this disease is increasing year on year.

This disease affects the central part of the retina – the yellow spot which allows us to distinguish details. By the degree of the disease patients gradually lose the ability to read, recognise colours, faces and drive a car.

We distinguish two main forms of age-related macular degeneration:

1. dry form - is the most common, affecting about 90% of patients. The deterioration of eyesight is usually slow and gradual under the influence of gradual retinal meronecrosis (dying of retinal cells)
2. wet form - affects about 10% of patients but the deterioration of the eyesight can happen very quickly. The cause of the visual damage in this case are newly formed blood vessels, which begin to grow under the centre of the retina, causing it to swell and bleed into or under the retina and thus sudden deterioration of vision occurs.

Risk factors for age-related macular degeneration:

1. genetic factors - heredity - that means that those whose ancestors were affected by macular degeneration have a higher risk of developing this disease
2. smoking
3. excessive solar radiation
4. dietary factors
5. other total vascular disease

Prevention:

At present we can't influence genetic factors but what we can change is our way of life, smoking, abiding by the proper treatment of overall diseases, diet – a sufficient intake of antioxidants and carotenoids in our daily intake, whether in the form of fruits and vegetables which are rich in these substances or in the form of various dietary supplements.

Quality sunglasses are important at any age, especially with people after cataract surgery. If undergoing the cataract surgery it’s recommended to have a yellow intraocular lens implanted which filters out unwanted high-energy blue light.

Just like sunglasses or the yellow intraocular lens help, it is also possible to further aid the help with dietary supplements that have lutein and zeaxanthin - so called inner sunglasses. These substances, after being taken, accumulate in the retinal cells and protect inner cells against blue light.

Diagnosis:

With each patient we examine their near vision as well as distance vision, and the possible presence of deformation on the Amsler grid.

After an application of drops that expand the pupil we examine biomicroscopically the state of the retina – there are visible possible swelling, bleeding, retina pigmentation changes or scars.

Each patient also has their retina examined with an OCT device which can display the retina in very detailed optical sections so precisely that we can evaluate individual layers of retinal cells and their pathology, cell loss and thinning of the retina at the dry form of macular degeneration, swelling and presence of membrane from newly formed blood vessel at wet form.

The automatic measurement of retinal thickness on the OCT device is an accurate indicator of the disease process and the treatments success or failure.

Treatment:

There is at present no effective treatment for the dry form that would improve eyesight. We recommend patients to follow all the above mentioned preventive measures, with regular usage of dietary supplements that have antioxidants, lutein and zeaxanthin.

Over the past few years the wet form has been treated by substances acting against vascular growth factors. These substances are applied after a local anesthesia by a thin needle directly into the eye where they suppress the growth of newly formed blood vessels which leads to a regression in swelling of the retina and also reducing the risk of further bleeding. Injections are usually repeated two to three times at monthly intervals. After such treatment most patients have their vision improved or at least stabilized as well as objective findings on the retina. It's also necessary to mention that there is a small percentage of patients for whom not even this treatment is effective.

For wet form of macular degeneration treatment we use at our clinic substance Avastin. The price of one injection is 3500 CZK.

How a patient recognises when to see a doctor:

At the early stages of macular degeneration text reading gets worse, patients need more intensive lighting, some letters in the text 'come out', lines of the text are distorted.

Each of us can test themselves using the Amsler grid - a square network with deeper central fixation point. With glasses for farsightedness each of the eyes looks separately at the central point and watch if all lines are straight and same deep. In case of distortion or the disappearance of some lines there is a need to undergo a medical examination.