PRAHA, 27. \u010cERVENCE 2020 \u2013 Makul\u00e1rn\u00ed degenerace \u2013 z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed zraku, kter\u00e9 ro\u010dn\u011b v \u010cesku postihne tis\u00edce lid\u00ed. S jeho l\u00e9\u010dbou je nutn\u00e9 za\u010d\u00edt v\u010das, pokud nemoc propukne naplno, po\u0161kozen\u00ed zraku je nevratn\u00e9. Kv\u016fli mezer\u00e1m v z\u00e1kon\u011b se ale \u0159ada \u010desk\u00fdch pacient\u016f k l\u00e9\u010db\u011b v\u016fbec nedostane.<\/p>\n\n\n\n
V \u010cesku postihne vlhk\u00e1 forma v\u011bkem podm\u00edn\u011bn\u00e9 makul\u00e1rn\u00ed degenerace asi 1500 pacient\u016f ro\u010dn\u011b. Lid\u00ed se suchou formou onemocn\u011bn\u00ed je zhruba desetin\u00e1sobek.<\/p>\n\n\n\n
\u201eMakul\u00e1rn\u00ed degenerace je onemocn\u011bn\u00ed centra s\u00edtnice, zodpov\u011bdn\u00e9ho za nejost\u0159ej\u0161\u00ed vid\u011bn\u00ed. P\u0159\u00ed\u010diny mohou b\u00fdt r\u016fzn\u00e9, nej\u010dast\u011bj\u0161\u00ed je takzvan\u00e1 v\u011bkem podm\u00edn\u011bn\u00e1 makul\u00e1rn\u00ed degenerace, to znamen\u00e1 opot\u0159eben\u00ed o\u010dn\u00edho pozad\u00ed souvisej\u00edc\u00ed s v\u011bkem a civiliza\u010dn\u00edmi faktory. Rozli\u0161uje se such\u00e1 forma, kdy nen\u00ed p\u0159\u00edtomen otok a sl\u00e1bnut\u00ed zraku postupuje pozvolna. Ta se ale m\u016f\u017ee zm\u011bnit ve vlhkou formu, kdy je n\u00e1lez komplikov\u00e1n otokem a krv\u00e1cen\u00edm do o\u010dn\u00edho pozad\u00ed. Pak zrak sl\u00e1bne velice rychle,\u201c popsal Pavel Stod\u016flka, p\u0159ednosta s\u00edt\u011b o\u010dn\u00edch klinik Gemini.<\/p>\n\n\n\n
Makul\u00e1rn\u00ed degenerace zpravidla nevede k \u00fapln\u00e9 slepot\u011b, zp\u016fsobuje ale z\u00e1va\u017en\u00e9 zrakov\u00e9 obt\u00ed\u017ee, kter\u00e9 se u\u017e nedaj\u00ed vyl\u00e9\u010dit. \u201eZpo\u010d\u00e1tku se zhor\u0161uje ostrost vid\u011bn\u00ed, n\u00e1sledn\u011b za\u010d\u00ednaj\u00ed probl\u00e9my s rozpozn\u00e1v\u00e1n\u00edm detail\u016f. Nejv\u00edce to lid\u00e9 poznaj\u00ed p\u0159i \u010dten\u00ed, kdy mohou vypad\u00e1vat p\u00edsmenka nebo \u010d\u00e1sti slov. Postupn\u011b vid\u011bn\u00ed zesl\u00e1bne natolik, \u017ee \u010dten\u00ed mo\u017en\u00e9 nen\u00ed a pot\u00ed\u017ee \u010din\u00ed i rozpozn\u00e1v\u00e1n\u00ed obli\u010dej\u016f. V p\u0159\u00edpad\u011b vlhk\u00e9 formy m\u016f\u017ee \u010dlov\u011bk pozorovat deformace obrazu, nap\u0159\u00edklad zvln\u011bn\u00ed \u017ealuzi\u00ed, a tak\u00e9 tmav\u00e9 skvrny v centru zorn\u00e9ho pole. Toto onemocn\u011bn\u00ed v\u011bt\u0161inou nevede k \u00fapln\u00e9 slepot\u011b a lidem z\u016fst\u00e1v\u00e1 obvodov\u00e9 vid\u011bn\u00ed a ur\u010dit\u00e1 sob\u011bsta\u010dnost,\u201c popsal Jaroslav Poli\u0161ensk\u00fd, l\u00e9ka\u0159 o\u010dn\u00ed kliniky Gemini.<\/p>\n\n\n\n
Pr\u016fb\u011bh such\u00e9 formy se d\u00e1 zpomalit podp\u016frn\u00fdmi prepar\u00e1ty ve form\u011b kapsl\u00ed s obsahem luteinu, zeaxanthinu a antioxidant\u016f. Pokud makul\u00e1rn\u00ed degenerace p\u0159ejde do vlhk\u00e9 formy, je na m\u00edst\u011b l\u00e9\u010dba nitroo\u010dn\u00edmi injekcemi, kter\u00e9 mohou odvr\u00e1tit t\u011b\u017ek\u00e9 posti\u017een\u00ed zraku. L\u00e9\u010dba, kter\u00e1 je v \u010cesk\u00e9 republice povolen\u00e1, je ale drah\u00e1. Na trhu existuje levn\u011bj\u0161\u00ed p\u0159\u00edpravek. Ten ale nen\u00ed registrov\u00e1n pro l\u00e9\u010dbu zraku. O\u010dn\u00ed l\u00e9ka\u0159i jej proto nesm\u011bj\u00ed pou\u017e\u00edvat. O\u0161et\u0159en\u00ed se tak nedostane v\u0161em pacient\u016fm, kte\u0159\u00ed by jej pot\u0159ebovali. \u201ePro l\u00e9\u010dbu vlhk\u00e9 formy makul\u00e1rn\u00ed degenerace jsou v \u010cesku schv\u00e1leny a pou\u017e\u00edv\u00e1ny l\u00e9ky Lucentis a Eylea. D\u00e1le se pou\u017e\u00edv\u00e1 l\u00e9k Avastin, kter\u00fd ale nen\u00ed pro tuto nemoc v\u00fdrobcem ofici\u00e1ln\u011b ur\u010den. Avastin je l\u00e9k, kter\u00fd je v Evrop\u011b registrovan\u00fd od roku 2005, je ur\u010den k l\u00e9\u010db\u011b rakoviny tlust\u00e9ho st\u0159eva, l\u00e9ka\u0159i ho pou\u017e\u00edvaj\u00ed pr\u00e1v\u011b i k l\u00e9\u010db\u011b makul\u00e1rn\u00ed degenerace, co\u017e nen\u00ed leg\u00e1ln\u00ed. Rozd\u00edly mezi l\u00e9ky jsou p\u0159itom minim\u00e1ln\u00ed. V\u0161echny t\u0159i l\u00e9ky jsou b\u00edlkovinn\u00e9 povahy na b\u00e1zi protil\u00e1tek zastavuj\u00edc\u00edch chorobn\u00e9 procesy v oku. Rozd\u00edly v \u00fa\u010dinnosti jsou pom\u011brn\u011b mal\u00e9. Nejd\u00e9le p\u016fsob\u00ed v oku Eylea, proto nemus\u00ed b\u00fdt aplikov\u00e1na tak \u010dasto jako ostatn\u00ed, nejlevn\u011bj\u0161\u00edm l\u00e9kem je pr\u00e1v\u011b Avastin,\u201c \u0159ekl Pavel Stod\u016flka.<\/p>\n\n\n\n
Zdravotn\u00ed poji\u0161\u0165ovny vyd\u00e1vaj\u00ed za biologickou l\u00e9\u010dbu o\u010d\u00ed stovky milion\u016f korun ro\u010dn\u011b. \u201eCena l\u00e9k\u016f Lucentis a Eylea je srovnateln\u00e1, jsou ale p\u0159ibli\u017en\u011b 50x dra\u017e\u0161\u00ed ne\u017e Avastin. Cenov\u00fd rozd\u00edl je obrovsk\u00fd. Ro\u010dn\u011b se v \u010cesku na tyto l\u00e9ky vydaj\u00ed zbyte\u010dn\u011b stovky milion\u016f korun. Pokud by se v\u00edce pou\u017e\u00edval levn\u011bj\u0161\u00ed Avastin, ve\u0159ejn\u00e9 zdravotnictv\u00ed by u\u0161et\u0159ilo v\u00fdznamnou \u010d\u00e1stku a zdravotn\u00ed p\u00e9\u010de by se stala dostupn\u011bj\u0161\u00ed pro v\u00edc pacient\u016f. Farmaceutick\u00e9 firmy by ale p\u0159i\u0161ly o tu\u010dn\u00fd profit,\u201c vysv\u011btlil Pavel Stod\u016flka, pro\u010d v\u00fdrobce Avastinu, kter\u00fd je vlastnicky propojen s v\u00fdrobcem v\u00fdrazn\u011b dra\u017e\u0161\u00edho Lucentisu, nechce l\u00e9k zaregistrovat i k l\u00e9\u010db\u011b makul\u00e1rn\u00ed degenerace.<\/p>\n\n\n\n
Kv\u016fli vysok\u00e9 cen\u011b a p\u0159\u00edsn\u00fdm krit\u00e9ri\u00edm se k l\u00e9\u010db\u011b dostane jen zlomek nemocn\u00fdch. L\u00e9\u010dbu nav\u00edc nab\u00edz\u00ed jen n\u011bkolik center v \u010cesku. \u201eZ\u00e1konem je stanoveno, \u017ee enormn\u011b drah\u00e9 l\u00e9ky se mohou aplikovat jen v n\u011bkolika vybran\u00fdch centrech. Pacienti se zhor\u0161uj\u00edc\u00edm se vid\u011bn\u00edm musej\u00ed do center doj\u00ed\u017ed\u011bt a jejich o\u010dn\u00ed l\u00e9ka\u0159i v m\u011bstsk\u00fdch a okresn\u00edch nemocnic\u00edch nebo v men\u0161\u00edch klinik\u00e1ch u\u017e je l\u00e9\u010dit nemohou, jak tomu b\u00fdvalo d\u0159\u00edv. Vybran\u00fdch center je m\u00e1lo, obslou\u017eit pacienty nest\u00edhaj\u00ed a ti pak \u010dasto \u010dekaj\u00ed dlouho na term\u00edn n\u00e1v\u0161t\u011bvy a mezit\u00edm nemoc s\u00edtnice postupuje d\u00e1l a mnohdy nezvratn\u011b po\u0161kod\u00ed vid\u011bn\u00ed. T\u011bmto lidem u\u017e pak \u017e\u00e1dn\u00e9, ani ty drah\u00e9 l\u00e9ky nepomohou a vid\u011bn\u00ed jim nevr\u00e1t\u00ed,\u201c upozornil Pavel Stod\u016flka.<\/p>\n\n\n\n
Podle Pavla Stod\u016flky je situace kolem Avastinu v \u010cesku jedna z nejhor\u0161\u00edch v Evrop\u011b. \u201eVe v\u011bt\u0161in\u011b vysp\u011bl\u00fdch zem\u00ed se Avastin pro l\u00e9\u010dbu s\u00edtnice pou\u017e\u00edv\u00e1, proto\u017ee je prok\u00e1z\u00e1no, \u017ee je stejn\u011b \u00fa\u010dinn\u00fd i bezpe\u010dn\u00fd jako mnohem dra\u017e\u0161\u00ed l\u00e9ky. Byl dokonce jedn\u00edm z prvn\u00edch l\u00e9k\u016f pro l\u00e9\u010dbu makul\u00e1rn\u00ed degenerace,\u201c doplnil o\u010dn\u00ed chirurg.<\/p>\n\n\n\n
Jedin\u00fdm \u0159e\u0161en\u00edm je zm\u011bna z\u00e1kona. \u201eU\u017e na podzim roku 2017 rozhodl Evropsk\u00fd soudn\u00ed dv\u016fr, \u017ee takzvan\u00e1 off label l\u00e9\u010dba, tedy l\u00e9\u010dba nemoc\u00ed neuveden\u00fdch v\u00fdrobcem v p\u0159\u00edbalov\u00e9 informaci o l\u00e9ku, je mo\u017en\u00e1 a \u017ee ji lze i propl\u00e1cet ze zdravotn\u00edho poji\u0161t\u011bn\u00ed. Ke zm\u011bn\u011b situace v\u00a0\u010cesku je tedy pot\u0159ebn\u00e9, aby i \u010de\u0161t\u00ed z\u00e1konod\u00e1rci rozhodli, \u017ee Avastin je mo\u017en\u00e9 pou\u017e\u00edvat pro l\u00e9\u010dbu o\u010d\u00ed a propl\u00e1cet ze zdravotn\u00edho poji\u0161t\u011bn\u00ed. T\u00edm by bylo po probl\u00e9mu – l\u00e9ka\u0159i by mohli op\u011bt leg\u00e1ln\u011b pou\u017e\u00edvat bezpe\u010dn\u00fd, \u00fa\u010dinn\u00fd a mnohem levn\u011bj\u0161\u00ed l\u00e9k. U\u0161et\u0159ily by se tak stovky milion\u016f korun ro\u010dn\u011b, a proto\u017ee tento l\u00e9k by se mohl pou\u017e\u00edvat na o\u010dn\u00edm odd\u011blen\u00ed ka\u017ed\u00e9 m\u011bstsk\u00e9 nebo okresn\u00ed nemocnice, stala by se l\u00e9\u010dba s\u00edtnice op\u011bt dostupnou pro v\u0161echny pacienty s makul\u00e1rn\u00ed degenerac\u00ed v \u010cesku,\u201c uzav\u0159el Pavel Stod\u016flka.<\/p>\n\n\n\n
Tiskov\u00e1 zpr\u00e1va<\/p>\n\n\n\n
SOUKROM\u00c1\nO\u010cN\u00cd KLINIKA GEMINI, <\/strong>www.gemini.cz<\/strong><\/a><\/p>\n\n\n\n Soukrom\u00e1 o\u010dn\u00ed klinika Gemini rozv\u00edj\u00ed dlouholetou tradici zl\u00ednsk\u00e9\no\u010dn\u00ed chirurgie. Prvn\u00ed klinika byla otev\u0159ena ve Zl\u00edn\u011b v roce 2003 a v\nsou\u010dasnosti provozuje klinika v \u010cesk\u00e9 republice deset pracovi\u0161\u0165: ve Zl\u00edn\u011b, v\nPr\u016fhonic\u00edch u Prahy, Praze-Kr\u010di, \u010cesk\u00fdch Bud\u011bjovic\u00edch, Ostrav\u011b, Vy\u0161kov\u011b, Brn\u011b,\nNov\u00e9m Ji\u010d\u00edn\u011b a Liberci. Jako jedin\u00e1 \u010desk\u00e1 o\u010dn\u00ed klinika otev\u0159ela pracovi\u0161t\u011b tak\u00e9\nve V\u00eddni. Vedle operac\u00ed zbavuj\u00edc\u00edch pacienty pot\u0159eby nosit br\u00fdle a operac\u00ed\n\u0161ed\u00e9ho z\u00e1kalu se na klinik\u00e1ch prov\u00e1d\u011bj\u00ed i estetick\u00e9 z\u00e1kroky, jako nap\u0159\u00edklad\nplastika horn\u00edch a doln\u00edch v\u00ed\u010dek. V \u010dele t\u00fdmu operat\u00e9r\u016f stoj\u00ed sv\u011btov\u011b\nuzn\u00e1van\u00fd o\u010dn\u00ed chirurg prim. MUDr. Pavel Stod\u016flka, Ph.D., FEBOS-CR.<\/p>\n\n\n\n prim.\nMUDr. PAVEL STOD\u016eLKA, Ph.D.,FEBOS-CR, <\/strong>www.lasik.cz<\/strong><\/a><\/p>\n\n\n\n Studium medic\u00edny na Univerzit\u011b Palack\u00e9ho v Olomouci ukon\u010dil v roce\n1989 s vyznamen\u00e1n\u00edm a pochvalou rektora. V roce 2000 absolvoval postgradu\u00e1ln\u00ed\nstudium na L\u00e9ka\u0159sk\u00e9 fakult\u011b Univerzity Karlovy v Hradci Kr\u00e1lov\u00e9 s t\u00e9matem\ndisertace metoda LASIK, kterou v \u010cR zavedl. Zku\u0161enosti s o\u010dn\u00ed chirurgi\u00ed sb\u00edral\ni po sv\u011bt\u011b, hlavn\u011b v Kanad\u011b. P\u016fsobil jako p\u0159ednosta o\u010dn\u00edho odd\u011blen\u00ed Ba\u0165ovy\nnemocnice ve Zl\u00edn\u011b. V roce 2003 zalo\u017eil soukromou o\u010dn\u00ed kliniku Gemini \u2013\nnejv\u011bt\u0161\u00ed soukromou o\u010dn\u00ed kliniku v \u010cesku. N\u011bkolik o\u010dn\u00edch operac\u00ed, nap\u0159\u00edklad\ncentraci vych\u00fdlen\u00e9 lidsk\u00e9 \u010do\u010dky nebo implantaci presbyopick\u00e9 fakick\u00e9 \u010do\u010dky,\nprovedl jako prvn\u00ed o\u010dn\u00ed chirurg na sv\u011bt\u011b a \u0159adu o\u010dn\u00edch operac\u00ed zavedl jako\nprvn\u00ed v \u010cesku. Vyv\u00edj\u00ed nov\u00e9 lasery pro o\u010dn\u00ed chirurgii, jako nap\u0159. CAPSULaser.\nP\u0159edn\u00e1\u0161\u00ed na presti\u017en\u00edch mezin\u00e1rodn\u00edch o\u010dn\u00edch kongresech, vyu\u010duje v kurzech pro\nzahrani\u010dn\u00ed o\u010dn\u00ed l\u00e9ka\u0159e a byl zvolen prezidentem AECOS \u2013 Americko\u2013evropsk\u00e9ho\nkongresu o\u010dn\u00ed chirurgie. V roce 2019 si Pavel Stod\u016flka na sv\u00e9 konto\np\u0159ipsal dal\u0161\u00ed dv\u011b sv\u011btov\u00e1 prvenstv\u00ed \u2013 jako prvn\u00ed o\u010dn\u00ed chirurg na sv\u011bt\u011b provedl\noperaci \u0161ed\u00e9ho z\u00e1kalu nov\u00fdm femtomatrixov\u00fdm laserem, kter\u00fd jako jedin\u00fd\ndisponuje robotick\u00fdm ramenem a z\u00e1rove\u0148 je nejrychlej\u0161\u00edm na sv\u011bt\u011b. Druh\u00fdm\nprvenstv\u00edm byla operace, takzvan\u00e1 rotace lentikuly, kter\u00e1 sn\u00ed\u017e\u00ed astigmatismus\noka pacienta (nespr\u00e1vn\u00e9 zak\u0159iven\u00ed rohovky).<\/p>\n","protected":false},"excerpt":{"rendered":" PRAHA, 27. \u010cERVENCE 2020 \u2013 Makul\u00e1rn\u00ed degenerace \u2013 z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed zraku, kter\u00e9 ro\u010dn\u011b v \u010cesku postihne tis\u00edce lid\u00ed. S jeho l\u00e9\u010dbou je nutn\u00e9 za\u010d\u00edt v\u010das, pokud nemoc […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":34682,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-34681","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/34681","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=34681"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/34681\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/34682"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=34681"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=34681"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=34681"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}