Ceska a Slovenska Oftalmologie最新文献

{"title":"Evaluation of Optic Disc Drusen Using Modern Imaging Paraclinical Methods.","authors":"Michal Březík, Adam Kopecký, Oldřich Chrapek, Juraj Timkovič, Jan Němčanský","doi":"10.31348/2024/39","DOIUrl":"https://doi.org/10.31348/2024/39","url":null,"abstract":"<p><strong>Purpose: </strong> To analyze patients with optic disc drusen (ODD), with emphasis on modern diagnostics.</p><p><strong>Materials and methods: </strong> Research of the literature was conducted, together with a retrospective statistical analysis of patients with ODD. The group included individuals with ODD diagnosed using at least one of the following (ultrasound - USG, optical coherence tomography - OCT, fundus autofluorescence - FAF).</p><p><strong>Results: </strong> The group consisted of 12 patients (23 eyes), 7 women and 5 men. The mean age was 25 years. The mean observation period was 73 months. In total, 11 patients (22 eyes) had a bilateral finding and 1 patient (1 eye) had a unilateral finding. The mean age was 25 years. Buried drusen were confirmed in 69.6% of cases (8 patients, 16 eyes), superficial drusen were confirmed in 30.4% of cases (4 patients, 7 eyes). Mean best corrected visual acuity (BCVA) and mean intraocular pressure were stable over time (BCVA p = 0.236, IOP p = 0.855). The aforementioned diagnostic methods proved to be equally effective (p = 0.768). In 11 patients (21 eyes) a depression of the retinal nerve fiber layer (RNFL) was recorded. We found a statistically significant decrease of the RNFL over time in reference to the normative database in the superior temporal (p = 0.015), temporal (p = 0.026) and nasal segments (p = 0.011). After separation of superficial and buried drusen the same significant change was found in nasal segment in superficial drusen (p = 0,031). We found no statistically significant difference over time between superficial and buried drusen (p = 0.109-0.999 for individual segments).</p><p><strong>Conclusion: </strong> ODD are common and visual functions remain stable. Their presence can be confirmed using modern paraclinical methods.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 6","pages":"324-330"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leiomyoma - Ciliary Body Tumor. A Case Report.","authors":"Karolína Černá, Zuzana Hlinomazová, Johana Glezgová, Kateřina Ambrosová","doi":"10.31348/2024/30","DOIUrl":"10.31348/2024/30","url":null,"abstract":"<p><strong>Aim: </strong>To demonstrate a rare case of ciliary body leiomyoma in our patient Case report: A 72-year-old female reported to our clinic for a preventive examination, upon which we found a dome-shaped grey-brownish mass on the retinal periphery. After completing gonioscopic and ultrasound examinations, we referred the patient to a specialist facility. Due to a finding of suspicious malignant melanoma, we completed the MRI scan and recommended enucleation of the eyeball. A histopathological examination showed a leiomyoma of the ciliary body.</p><p><strong>Conclusion: </strong>The aim of this case report is to demonstrate the difficulty of intraocular leiomyoma diagnosis. Only immunohistochemical examination differentiated the tumor from malignant melanoma and determined the diagnosis of ciliary body leiomyoma. Perhaps because of the extreme rarity of this type of tumor, we often neglect to consider a diagnosis of leiomyoma.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"273-278"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current State of Artificial Intelligence in Neuro-Ophthalmology. A Review","authors":"M Lapka, Z Straňák","doi":"10.31348/2023/33","DOIUrl":"10.31348/2023/33","url":null,"abstract":"<p><p>This article presents a summary of recent advances in the development and use of complex systems using artificial intelligence (AI) in neuro-ophthalmology. The aim of the following article is to present the principles of AI and algorithms that are currently being used or are still in the stage of evaluation or validation within the neuro-ophthalmology environment. For the purpose of this text, a literature search was conducted using specific keywords in available scientific databases, cumulatively up to April 2023. The AI systems developed across neuro-ophthalmology mostly achieve high sensitivity, specificity and accuracy. Individual AI systems and algorithms are subsequently selected, simply described and compared in the article. The results of the individual studies differ significantly, depending on the chosen methodology, the set goals, the size of the test, evaluated set, and the evaluated parameters. It has been demonstrated that the evaluation of various diseases will be greatly speeded up with the help of AI and make the diagnosis more efficient in the future, thus showing a high potential to be a useful tool in clinical practice even with a significant increase in the number of patients.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"179-186"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapy for Vitreous Seeding Caused by Retinoblastoma. A Review.","authors":"M Kodetová, K Švojgr, J Širc, J Vaněček, P Pochop","doi":"10.31348/2023/35","DOIUrl":"10.31348/2023/35","url":null,"abstract":"<p><p>Retinoblastoma is the most common primary malignant intraocular tumor in children. Seeding, specifically the dispersion of the tumor into the adjacent compartments, represents a major parameter determining the degree of retinoblastoma according to the International Classification of Retinoblastoma. In this article we focused on vitreous seeding, one of the main limiting factors in the successful \"eye preservation treatment\" of retinoblastoma. This article presents an overview of the history of vitreous seeding of retinoblastoma, established treatment procedures and new-research modalities. The introduction of systemic chemotherapy in the treatment of retinoblastoma at the end of the 1990s represented a significant breakthrough, which enabled the progressive abandonment of radiotherapy with its attendant side effects. However, the attained concentrations of chemotherapeutics in the vitreous space during systemic chemotherapy are not sufficient for the treatment of vitreous seeding, and the toxic effects of systemic chemotherapy are not negligible. A significant change came with the advent of chemotherapy in situ, with the targeted administration of chemotherapeutic drugs, namely intra-arterial and intravitreal injections, contributing to the definitive eradication of external radiotherapy and a reduction of systemic chemotherapy. Although vitreous seeding remains the most common reason for the failure of intra-arterial chemotherapy, this technique has significantly influenced the original treatment regimen of children with retinoblastoma. However, intravitreal chemotherapy has made the greatest contribution to increasing the probability of preservation of the eyeball and visual functions in patients with advanced findings. Novel local drug delivery modalities, gene therapy, oncolytic viruses and immunotherapy from several ongoing preclinical and clinical trials may represent promising approaches in the treatment of vitreous retinoblastoma seeding, though no clinical trials have yet been completed for routine use.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges of Ocular Rosacea.","authors":"Simona Motešická","doi":"10.31348/2024/3","DOIUrl":"10.31348/2024/3","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to address the issues surrounding the diagnosis of ocular rosacea and to evaluate the development of the patients’ condition after treatment, as well as to distinguish between healthy and diseased patients using a glycomic analysis of tears.</p><p><strong>Methodology: </strong>A prospective study was conducted to assess a total of 68 eyes in 34 patients over a six-week period. These patients were diagnosed with ocular rosacea based on subjective symptoms and clinical examination. The study monitored the development of objective and subjective values. The difference between patients with the pathology and healthy controls was established by means of analysis of glycans in tears.</p><p><strong>Results: </strong>Skin lesions were diagnosed in 94% of patients with ocular rosacea, with the most commonly observed phenotype being erythematotelangiectatic (68.8%). The mean duration of symptoms was 29.3 months (range 0.5–126 months) with a median of 12 months. Throughout the study, an improvement in all monitored parameters was observed, including Meibomian gland dysfunction, bulbar conjunctival hyperemia, telangiectasia of the eyelid margin, anterior blepharitis, uneven and reddened eyelid margins, and corneal neovascularization. The study also observed improvements in subjective manifestations of the disease, such as foreign body sensation, burning, dryness, lachrymation, itching eyes, photophobia, and morning discomfort. The analysis of glycans in tears partially separated tear samples based on their origin, which allowed for the differentiation of patients with rosacea from healthy controls. In the first sample, the pathology was determined in a total of 63 eyes (98.4%) of 32 patients, with further samples showing a change in the glycomic profile of patients’ tears during treatment.</p><p><strong>Conclusion: </strong>The study demonstrated objective and subjective improvements in all the patients. Tear sampling and analysis could provide a means of timely diagnosis of ocular rosacea.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"76-86"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Heterophoria on the Size of Distance and Near Fusion Vergence.","authors":"Petr Veselý, Pavel Beneš, Jana Šidlová Sokolová, Petra Záděrová, Hana Došková","doi":"10.31348/2024/5","DOIUrl":"10.31348/2024/5","url":null,"abstract":"<p><strong>Aims: </strong>To demonstrate changes in distance and near fusional vergence measured with prism bars, while compensating for present heterophoria using current ametropia correction. In addition, to determine the differences in values of the AC/A ratio determined by the heterophoric (calculation) and gradient methods.</p><p><strong>Material and methods: </strong>The basic sample includes 19 subjects with a mean age of 21.5 ±3.0 years (min. 18, max. 27). We used the Von Graefe technique for examination of distance and near phoria, and prism bars for examination of fusion vergences measured in prism diopters. We divided the basic cohort into six research sets according to the size of distance and near heterophoria. This was a cohort of patients with distance (D OR) and near orthophoria (N OR), a cohort of patients with distance (D EX) and near exophoria (N EX) and a set of patients with distance (D ES) and near esophoria (N ES).</p><p><strong>Results: </strong>In the case of both groups with exophoria (distance, near) we found a statistically significant result only for negative fusion vergence (NFV). There was a statistically significant increase in NFV in the sample with distance and near exophoria (D EX, p = 0.01 and B EX, p = 0.02, respectively). In our study, we also demonstrated a statistically significant difference (p &lt; 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method.</p><p><strong>Conclusion: </strong>By comparing fusion vergence values in patients with exophoria and orthophoria, we demonstrated that in the presence of distance or near exophoria there is an increase in ipsilateral fusion vergence. In the case of an increase in ipsilateral fusion vergence, the finding was statistically significant both distance and near (p = 0.01 and p = 0.02, respectively). By contrast, we were unable to prove this fact in the group of patients with esophoria. In our study, we also demonstrated a statistically significant difference (p &lt; 0.001) in the values of the AC/A ratio measured by the gradient and heterophoric methods. The values determined by the gradient method are lower (3.0 ±1.1 pD/D versus 5.8 ±0.9 pD/D) than by the heterophoric method.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumatic Vitreolysis using C3F8 Gas in Treatment Naive Patients with Vitreomacular Traction.","authors":"Kateřina Marková, Pavel Němec, Petr Červený, Jan Havlik, Leoš Rejmont, Jan Tesař, Hana Morin, Martin Šín","doi":"10.31348/2024/34","DOIUrl":"10.31348/2024/34","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of the effectiveness of pneumatic vitreolysis in disrupting vitreomacular traction in our own cohort of patients.</p><p><strong>Methodology: </strong>Prospective follow-up of 21 eyes of 18 patients with focal VMT (adhesion width &lt; 1500 µm) who underwent intravitreal injection of 0.3 ml of 100% perfluoropropane between January 2015 and December 2020. The patients were observed for 90 days.</p><p><strong>Results: </strong>Release of VMT was achieved on the 28th day of observation in 15 out of 21 eyes (71.4%), and by the 90th day in 19 out of 21 eyes (90.5%). The average width of adhesion in our patients was 382 µm (±212 µm). Average best corrected visual acuity in our cohort was initially 0.77 (±0.21), after 28 days 0.74 (±0.30), and after 3 months 0.82 (±0.21). At the end of the follow-up period, we did not observe a statistically significant improvement in vision. Macular holes developed in two eyes, but spontaneously closed within 1 month of observation, and no more complications were observed in the cohort.</p><p><strong>Conclusion: </strong>Pneumatic vitreolysis by intravitreal injection of C3F8 gas is an effective and inexpensive option for the management of symptomatic vitreomacular traction. The incidence of serious adverse events in our follow-up was significantly lower than in recently published series. The method of management should be selected individually according to the parameters of adhesion, macular hole and associated ocular pathologies.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"256-263"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Techniques: Inverted Flap and Conventional Internal Limiting Membrane Removal in Idiopathic Macular Hole Surgery","authors":"Vladimír Ďurana, Michal Hrevuš, Jan Havrda, Jiří Řehák, Klára Marešová, Marta Karhanová","doi":"10.31348/2024/31","DOIUrl":"10.31348/2024/31","url":null,"abstract":"<p><strong>Aim: </strong>To compare functional and anatomical outcomes between the inverted flap technique and conventional removal of the internal limiting membrane (ILM) in the surgical management of idiopathic macular hole (IMH).</p><p><strong>Material and methods: </strong>We retrospectively evaluated the anatomical and functional results in 67 eyes of 65 patients operated on for IMH. The patients were operated on either using the conventional ILM peeling technique (first group) or with the inverted ILM flap technique (second group). 43 eyes of 41 patients were included in the first group, 24 eyes of 24 patients in the second group. We indicated for surgery only patients with IMH stage 2-4 according to the Gasse classification. Best corrected visual acuity (VA) was always determined before and two months after surgery. Furthermore, a comparison of both techniques was made according to the average letter gain after surgery, and the effect of surgery was evaluated using OCT with regard to whether IMH closure succeeded. For both techniques, 25G PPV with SF6 tamponade was performed.</p><p><strong>Results: </strong>Hole closure took place in 41 eyes with conventional ILM removal. In one eye, the hole did not close even after reoperation with the same technique. Median ETDRS letter gain was 7.0. VA remained the same in 2 eyes (4.7%), worsened in 7 cases (16.2%), and improved in all other cases (79.0%). In 16 eyes (37.2%), VA improved by 2 or more lines of ETDRS charts. Using the inverted flap technique, the hole was closed in all 24 monitored eyes. Median ETDRS letter gain was 9.5. VA remained the same in 2 eyes (8.3%), worsened in 2 cases (8.3%), and improved in all other cases (83.3%). In 12 eyes (50.0%), VA improved by 2 or more lines of ETDRS charts. There were no serious complications intraoperatively or postoperatively.</p><p><strong>Conclusion: </strong>Our study demonstrated the safety and efficacy of both methods. Although the results were not statistically significant, the inverted flap technique recorded a greater ETDRS letter gain (9.5 vs. 7.0) and proportion of closed holes (100% vs. 95.3%) compared to the conventional ILM peeling technique in our set of eyes.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"240-245"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleral Grafts in Ophthalmic Surgery. A Review.","authors":"Jakub Dítě, Magdalena Netuková, Alexandra Procházková, Martina Poláchová, Katarína Krivosheev, Pavel Studený","doi":"10.31348/2024/11","DOIUrl":"10.31348/2024/11","url":null,"abstract":"<p><strong>Aim: </strong>To summarize the history and current trends in the use of scleral grafts in ophthalmology.</p><p><strong>Materials and methods: </strong>We conducted a review of the literature through the MEDLINE and Cochrane Library databases. The search terms were \"sclera\", \"graft\", and \"surgery\". The search resulted in 1596 articles, of which we evaluated 192 as relevant. The relevant articles were sorted chronologically and according to the method of using scleral grafts, which enabled the development of a review article.</p><p><strong>Results: </strong>The sclera has been routinely used in ophthalmology since the 1950s in many different indications. Some of these indications have become practically obsolete over time (for example, use in the surgical management of retinal detachment), but a large number still find application today (especially use in glaucoma or oculoplastic surgery, or as a patch for a defect in the sclera or cornea).</p><p><strong>Conclusion: </strong>Even though allogeneic sclera is currently used less frequently in ophthalmology compared to other tissue banking products and the range of its indications has partially narrowed, it remains a useful material due to its availability and properties.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Visual Field Defects after Neuroembolization Treatment of Intracranial Aneurysms. Case Reports.","authors":"Nora Majtánová, Petr Kolář, Petra Krišková, Petra Kéri, Tibor Balazs, Dalibor Cholevík, Veronika Kurilová","doi":"10.31348/2024/8","DOIUrl":"10.31348/2024/8","url":null,"abstract":"<p><strong>Purpose: </strong>Intracranial aneurysms and their hemorrhagic and thromboembolic complications represent a serious nosological unit that significantly endangers those afflicted. They are mostly asymptomatic until rupture occurs. In two case reports, we present our observations of young patients with impaired vision and headaches, in whom we found the presence of intracranial aneurysms.</p><p><strong>Observations: </strong>Presentation of two case reports of patients who came to our department with impaired vision and headaches. The patients underwent a complete eye examination at our center, including a visual field examination. Based on the results of the examination, they were referred for  an imaging examination of the brain, which revealed the presence of intracranial aneurysms. The patients were subsequently sent to the interventional neuroradiology center, where they underwent a noninvasive endovascular neuroembolization procedure with flow diverter implantation. We continued to monitor the patients after the procedure and document the examination results up to 1 year after the procedure.</p><p><strong>Conclusions and significance: </strong>Thanks to the fast detection, diagnosis, and management of both patients, we prevented the occurrence of aneurysm rupture, thus a life-threatening complication. After endovascular procedures with flow diverter implantation, we observed a significant improvement in visual acuity as well as perimetric findings in both patients. When intracranial aneurysms are found within a week of the onset of eye symptoms and treated within three months, defects in the visual fields improved in our two patients within 6-12 months, and in one of the two patients the defects almost completely disappeared.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 1","pages":"42-51"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}