Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-392-396
O. V. Kolenko, M. V. Pshenichnov, O.I. Kasura, E. L. Sorokin
Purpose. To evaluate the anti-VEGF therapy efficacy for treatment aggressive posterior retinopathy of prematurity (AP-ROP). Material and methods. 14 children (28 eyes) with APROP, mean gestational age of 27.4 weeks. Birth weight were from 480 to 1360 grams, on average – 972.8 grams. AP-ROP were developed children post-conceptual age (PCA) from 31 to 34 weeks, with an average of 32.2 weeks. Intravitreal injection of ranibizumab was performed no later than one day after the detection of AP-ROP. Results. In 22 (78.5 %) of 28 eyes, only one injection of ranibizumab was required, of which, in 6 eyes, additional laser photocoagulation of the retina was performed after the injection in a period of 14 to 21 days. In the remaining 6 eyes (21.5 %), 2 injections of ranibizumab were required 4 to 8 weeks after the first injection. All 34 injections were completed without complications and were not accompanied by any adverse events in the treated children. Retinal detachment developed in 2 children in 3 eyes (10.7 %): in one child – in both eyes (stage 4A ROP – in one of the eyes, 4B – in the paired one); the second child has stage 4B ROP in one of the eyes. All children after anti-VEGF therapy had not complete fundus vascularization to 65 weeks of PCA. As a rule, the 3rd zone of the fundus remained avascular, but no signs of angiogenesis were observed, which we regarded as regression of disease without complete retinal vascularization. Conclusion. The efficacy of treatment of AP-ROP with anti-VEGF therapy was high and amounted to 89.3 %. In 78.5% of cases, one injection of ranibizumab is sufficient for regression of disease. Given the absence of complete retinal vascularization at 65 weeks of PCA, children undergoing anti-VEGF therapy require longer follow-up due to the possibility of reactivation of ROP later in PCA. Keywords: aggressive posterior retinopathy of prematurity, anti-VEGF therapy
{"title":"Anti-VEGF treatment efficacy for aggressive posterior retinopathy of prematurity","authors":"O. V. Kolenko, M. V. Pshenichnov, O.I. Kasura, E. L. Sorokin","doi":"10.25276/2312-4911-2023-1-392-396","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-392-396","url":null,"abstract":"Purpose. To evaluate the anti-VEGF therapy efficacy for treatment aggressive posterior retinopathy of prematurity (AP-ROP). Material and methods. 14 children (28 eyes) with APROP, mean gestational age of 27.4 weeks. Birth weight were from 480 to 1360 grams, on average – 972.8 grams. AP-ROP were developed children post-conceptual age (PCA) from 31 to 34 weeks, with an average of 32.2 weeks. Intravitreal injection of ranibizumab was performed no later than one day after the detection of AP-ROP. Results. In 22 (78.5 %) of 28 eyes, only one injection of ranibizumab was required, of which, in 6 eyes, additional laser photocoagulation of the retina was performed after the injection in a period of 14 to 21 days. In the remaining 6 eyes (21.5 %), 2 injections of ranibizumab were required 4 to 8 weeks after the first injection. All 34 injections were completed without complications and were not accompanied by any adverse events in the treated children. Retinal detachment developed in 2 children in 3 eyes (10.7 %): in one child – in both eyes (stage 4A ROP – in one of the eyes, 4B – in the paired one); the second child has stage 4B ROP in one of the eyes. All children after anti-VEGF therapy had not complete fundus vascularization to 65 weeks of PCA. As a rule, the 3rd zone of the fundus remained avascular, but no signs of angiogenesis were observed, which we regarded as regression of disease without complete retinal vascularization. Conclusion. The efficacy of treatment of AP-ROP with anti-VEGF therapy was high and amounted to 89.3 %. In 78.5% of cases, one injection of ranibizumab is sufficient for regression of disease. Given the absence of complete retinal vascularization at 65 weeks of PCA, children undergoing anti-VEGF therapy require longer follow-up due to the possibility of reactivation of ROP later in PCA. Keywords: aggressive posterior retinopathy of prematurity, anti-VEGF therapy","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83510040","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-160-166
Y. Khzardzhan, M.A. Balalina, A. S. Balalin, I. A. Melikhova
Purpose. To present an overview of a choroideremia clinical case. Material and Methods. The article presents a clinical case of a 19-year-old patient with complaints of low distance vision, narrowing of the visual field and nictalopia since childhood. The patient underwent complex ophthalmological examination including visometry, autorefractometry, tonometry, biomicro-ophthalmoscopy with Goldman lens, computer perimetry, optical biometry, optical coherence tomography with angiography function (AngioOCT), fundus photoregistration with autofluorescence, electrophysiological examination (EP). The patient was consulted by a geneticist to confirm the basic diagnosis. Results. Visual acuity: OD = 0.1 Sph -2.0 = 1.0; OS = 0.15 Sph -1.5 = 1.0. The anterior-posterior eyeball size: OD – 24.98 mm, OS – 25.0 mm. Computer perimetry revealed narrowing of visual fields up to 10 degrees in both eyes, which correlated with changes in autofluorescence. According to EP, electrical sensitivity threshold: OD 198 µA, OS 202 µA, electrical lability: OD 37 Hz, OS 35 Hz. High visual acuity with correction in patient C. is caused by the macula condition, according to the results of AngioOCT. The retinal pigment epithelium and chorioid are thin. Chorioid outside the macular area lacks the Sattler's layer. Based on the results of a consultation with a geneticist, a pathogenic variant of the nucleotide sequence was detected in the CHM gene (chrX:85213886). Conclusion. Choroideremia is a rare genetic disease with a specific clinical picture and progressive development of visual disorder. Proper and early diagnosis allows the prevention of the disease, including prenatal diagnosis, and the development of new therapies. Keywords: choroideremia, genetic choroidal diseases, optical coherence tomography, autofluorescence, electrophysiological examination
{"title":"A clinical case of choroideremia","authors":"Y. Khzardzhan, M.A. Balalina, A. S. Balalin, I. A. Melikhova","doi":"10.25276/2312-4911-2023-1-160-166","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-160-166","url":null,"abstract":"Purpose. To present an overview of a choroideremia clinical case. Material and Methods. The article presents a clinical case of a 19-year-old patient with complaints of low distance vision, narrowing of the visual field and nictalopia since childhood. The patient underwent complex ophthalmological examination including visometry, autorefractometry, tonometry, biomicro-ophthalmoscopy with Goldman lens, computer perimetry, optical biometry, optical coherence tomography with angiography function (AngioOCT), fundus photoregistration with autofluorescence, electrophysiological examination (EP). The patient was consulted by a geneticist to confirm the basic diagnosis. Results. Visual acuity: OD = 0.1 Sph -2.0 = 1.0; OS = 0.15 Sph -1.5 = 1.0. The anterior-posterior eyeball size: OD – 24.98 mm, OS – 25.0 mm. Computer perimetry revealed narrowing of visual fields up to 10 degrees in both eyes, which correlated with changes in autofluorescence. According to EP, electrical sensitivity threshold: OD 198 µA, OS 202 µA, electrical lability: OD 37 Hz, OS 35 Hz. High visual acuity with correction in patient C. is caused by the macula condition, according to the results of AngioOCT. The retinal pigment epithelium and chorioid are thin. Chorioid outside the macular area lacks the Sattler's layer. Based on the results of a consultation with a geneticist, a pathogenic variant of the nucleotide sequence was detected in the CHM gene (chrX:85213886). Conclusion. Choroideremia is a rare genetic disease with a specific clinical picture and progressive development of visual disorder. Proper and early diagnosis allows the prevention of the disease, including prenatal diagnosis, and the development of new therapies. Keywords: choroideremia, genetic choroidal diseases, optical coherence tomography, autofluorescence, electrophysiological examination","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88765105","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-387-391
O.V. Vaserchuck, Y. V. Mikhelsone, Y. S. Livadarova, T. Y. Dorofeeva, Y.G. Osipova
Toxoplasmosis is one of the problems of medicine, which has serious socio-economic significance. Congenital toxoplasmosis is manifested by severe fetal damage, its chronic course with lifelong preservation of the parasite in various organs and tissues, as well as the possibility of adverse perinatal outcomes. Purpose. To present a clinical case of congenital toxoplasmosis in a child: intrauterine chorioretinitis, meningoencephalitis in combination with HIV infection and current cytomegalovirus infection. Material and methods. A patient transferred from the Ust-Ilimsky maternity hospital to the city of Ivano-Matreninsky Children's Clinical Hospital in Irkutsk. Clinical data: in an HIV-infected mother, from 4 pregnancies, 4 births, a child was born at 39–40 weeks, 2930 gr. Results. Based on the conducted studies and examinations, the child was diagnosed with: Basic: Congenital toxoplasmosis: transferred intrauterine chorioretinitis, meningoencephalitis with the formation of calcifications of cerebral vessels, ventriculomegaly. Related: 1) HIV infection, stage 2 B, progression phase on ART, IC+2, moderate immunodeficiency; 2) Congenital cytomegalovirus infection; 3) UPU. Muscular DMZHP. Ltd. CH0; 4) Normochromic anemia of moderate severity. Conclusions. Congenital toxoplasmosis remains one of the serious problems and requires in-depth study. As a prevention of the development of congenital toxoplasmosis, it is necessary to diagnose infection with toxoplasmosis in women of fertile age during family planning. Keywords: congenital toxoplasmosis, chorioretinitis, meningoencephalitis, HIV infection, CMV infection
{"title":"A clinical case of a combination of congenital toxoplasmosis associated with HIV and cytomegalovirus infections","authors":"O.V. Vaserchuck, Y. V. Mikhelsone, Y. S. Livadarova, T. Y. Dorofeeva, Y.G. Osipova","doi":"10.25276/2312-4911-2023-1-387-391","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-387-391","url":null,"abstract":"Toxoplasmosis is one of the problems of medicine, which has serious socio-economic significance. Congenital toxoplasmosis is manifested by severe fetal damage, its chronic course with lifelong preservation of the parasite in various organs and tissues, as well as the possibility of adverse perinatal outcomes. Purpose. To present a clinical case of congenital toxoplasmosis in a child: intrauterine chorioretinitis, meningoencephalitis in combination with HIV infection and current cytomegalovirus infection. Material and methods. A patient transferred from the Ust-Ilimsky maternity hospital to the city of Ivano-Matreninsky Children's Clinical Hospital in Irkutsk. Clinical data: in an HIV-infected mother, from 4 pregnancies, 4 births, a child was born at 39–40 weeks, 2930 gr. Results. Based on the conducted studies and examinations, the child was diagnosed with: Basic: Congenital toxoplasmosis: transferred intrauterine chorioretinitis, meningoencephalitis with the formation of calcifications of cerebral vessels, ventriculomegaly. Related: 1) HIV infection, stage 2 B, progression phase on ART, IC+2, moderate immunodeficiency; 2) Congenital cytomegalovirus infection; 3) UPU. Muscular DMZHP. Ltd. CH0; 4) Normochromic anemia of moderate severity. Conclusions. Congenital toxoplasmosis remains one of the serious problems and requires in-depth study. As a prevention of the development of congenital toxoplasmosis, it is necessary to diagnose infection with toxoplasmosis in women of fertile age during family planning. Keywords: congenital toxoplasmosis, chorioretinitis, meningoencephalitis, HIV infection, CMV infection","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75205802","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-241-245
Hemophthalmos is one of the urgent conditions in ophthamology. Diagnosis of acute vitreous hemorrhage includes an examination of the fundus, however, a decrease in the transparency of optical media makes it difficult to establish the cause and choose the appropriate management method. OCT allows, mutually with other methods, to visualize the necessary retina area with moderate or even severe opacities caused by hemophthalmos. Keywords: hemophthalmos, optical coherence tomography, peripheral retinas, retinal detachment
{"title":"Optical coherence tomography for differential diagnosis of retinal detachment in partial hemophhtalmos and assessment of disease dynamic","authors":"","doi":"10.25276/2312-4911-2023-1-241-245","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-241-245","url":null,"abstract":"Hemophthalmos is one of the urgent conditions in ophthamology. Diagnosis of acute vitreous hemorrhage includes an examination of the fundus, however, a decrease in the transparency of optical media makes it difficult to establish the cause and choose the appropriate management method. OCT allows, mutually with other methods, to visualize the necessary retina area with moderate or even severe opacities caused by hemophthalmos. Keywords: hemophthalmos, optical coherence tomography, peripheral retinas, retinal detachment","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73624408","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-294-297
M. Budzinskaya, A. Plyukhova, O. A. Savochkina, M. A. Afanasiev, P. A. Sorokin
The exudative form of AMD can develop suddenly, leading within a few weeks or months to the death of photoreceptors, a sharp decrease in BCVA and persistent central scotoma. Despite significant progress in the treatment of neovascular AMD associated with the introduction of anti-VEGF drugs into clinical practice, a number of patients have an insufficient response or its absence with standard administration regimens, and sometimes a decrease in the therapeutic effect after repeated intravitreal injections [1, 2]. Purpose. To development management tactics for patients resistant to one of the anti-VEGF drugs. Material and мethod. This study included 25 patients with a diagnosis of exudative AMD who received Aflibercept in the treat & extend regimen for a year, without a significant effect (persistence of intraretinal, subretinal and/or fluid under RP). Patients were switched to brolucizumab. The mean maximum correctable visual acuity in patients treated with aflibercept before switching drugs was 0.41 ± 0.11. The mean number of injections during the first year in the aflibercept group was 7.1 and 6.8 after switching to brolucizumab. The maximum correctable visual acuity at the end of 1 year of treatment with brolucizumab was 0.47 ± 0.1. Before the start of treatment with aflibercept, the mean CRT was 435.2 ± 119.8, at the end of the first year of treatment 403.3 ± 115.9, before 1 intravitreal injection of brolucizumab 407.2 ± 119.3 and 1 year after the start of therapy 357.6 ± 111.4 (p = 0.042). A statistical difference was found between the preparations and the height of the detachment of the retinal pigment epithelium at the end of the first year of treatment. Changes in the height of detachment of the retinal pigment epithelium in 3 eyes (12 %) were not observed when changing the drug. A positive response to drug switching should be noted, although it cannot be overlooked that there are patients who are resistant to anti-VEGF therapy per se. Keywords: the exudative form of AMD, anti-VEGF drugs, neovascular AMD.
{"title":"Algorithm of managing patients with exudative form of age-related macular degeneration with resistance to one of the anti-VEGF drugs","authors":"M. Budzinskaya, A. Plyukhova, O. A. Savochkina, M. A. Afanasiev, P. A. Sorokin","doi":"10.25276/2312-4911-2023-1-294-297","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-294-297","url":null,"abstract":"The exudative form of AMD can develop suddenly, leading within a few weeks or months to the death of photoreceptors, a sharp decrease in BCVA and persistent central scotoma. Despite significant progress in the treatment of neovascular AMD associated with the introduction of anti-VEGF drugs into clinical practice, a number of patients have an insufficient response or its absence with standard administration regimens, and sometimes a decrease in the therapeutic effect after repeated intravitreal injections [1, 2]. Purpose. To development management tactics for patients resistant to one of the anti-VEGF drugs. Material and мethod. This study included 25 patients with a diagnosis of exudative AMD who received Aflibercept in the treat & extend regimen for a year, without a significant effect (persistence of intraretinal, subretinal and/or fluid under RP). Patients were switched to brolucizumab. The mean maximum correctable visual acuity in patients treated with aflibercept before switching drugs was 0.41 ± 0.11. The mean number of injections during the first year in the aflibercept group was 7.1 and 6.8 after switching to brolucizumab. The maximum correctable visual acuity at the end of 1 year of treatment with brolucizumab was 0.47 ± 0.1. Before the start of treatment with aflibercept, the mean CRT was 435.2 ± 119.8, at the end of the first year of treatment 403.3 ± 115.9, before 1 intravitreal injection of brolucizumab 407.2 ± 119.3 and 1 year after the start of therapy 357.6 ± 111.4 (p = 0.042). A statistical difference was found between the preparations and the height of the detachment of the retinal pigment epithelium at the end of the first year of treatment. Changes in the height of detachment of the retinal pigment epithelium in 3 eyes (12 %) were not observed when changing the drug. A positive response to drug switching should be noted, although it cannot be overlooked that there are patients who are resistant to anti-VEGF therapy per se. Keywords: the exudative form of AMD, anti-VEGF drugs, neovascular AMD.","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85304899","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-438-441
A clinical case of patient K., 12 years old, with a diagnosis of anisometropia, anisometropic amblyopia, mixed astigmatism of the right eye, mild myopia, complex myopic astigmatism of the left eye is presented. Due to the intolerance of eyeglass and contact correction, the preservation of residual amblyopia against the background of regularly performed pleoptic treatment, the patient underwent laser refractive surgery of the amblyopic eye by Femto LASIK method in order to eliminate aniseikonia, which made it possible to successfully select glasses for permanent wearing with correction of the myopic eye and carry out further treatment in conditions of free haploscopy on a binarimeter with obtaining a high functional result. When observed in dynamics after 1 month and six months, the stability of anatomical and functional indicators was noted, which makes it possible to consider a highly effective combined approach in the treatment of anisometropic form of amblyopia in children. Keywords: amblyopia, children, anisometropia, FemtoLASIK, binarimetry
{"title":"Combined approach to the treatment of anisometropic amblyopia in children (a clinical case)","authors":"","doi":"10.25276/2312-4911-2023-1-438-441","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-438-441","url":null,"abstract":"A clinical case of patient K., 12 years old, with a diagnosis of anisometropia, anisometropic amblyopia, mixed astigmatism of the right eye, mild myopia, complex myopic astigmatism of the left eye is presented. Due to the intolerance of eyeglass and contact correction, the preservation of residual amblyopia against the background of regularly performed pleoptic treatment, the patient underwent laser refractive surgery of the amblyopic eye by Femto LASIK method in order to eliminate aniseikonia, which made it possible to successfully select glasses for permanent wearing with correction of the myopic eye and carry out further treatment in conditions of free haploscopy on a binarimeter with obtaining a high functional result. When observed in dynamics after 1 month and six months, the stability of anatomical and functional indicators was noted, which makes it possible to consider a highly effective combined approach in the treatment of anisometropic form of amblyopia in children. Keywords: amblyopia, children, anisometropia, FemtoLASIK, binarimetry","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83801882","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-235-240
ROP in the developing retina of premature infants is unique because of the coexistence of physiological and pathological angiogenesis. The type of structure of the vascular nodes is the way to understand the selective treatment of ROP. Purpose. Identification of criteria for the selective ROP treatment choice using the type of pathological vasculogenesis. Material and methods. The study included 279 patients with ROP – 1 group (stage I), 152 (304 eyes); group 2 (stage II) – 45 (90 eyes); 3 group (III stage) – 8 (12 eyes); group 4 (IVA stage) –7 (8 eyes); 5 group (posterior aggressive ROP) – 7 (14 eyes); group 6 (immature retina) 60 (120 eyes) – control; 231 (188 eyes) patients with ROP referred for surgical treatment, divided into subgroups before and after lasercoagulation of the retina. Fractal dimension (Df) and complexity of vascular system (СVS) on wide-field images were assessed. Results. In the group before treatment Df 1.4374 ± 0.03, CVS 2.8 ± 0.14, in the group after treatment Df 1.3756 ± 0.03, CVS 2.3 ± 0.21. According to the morphometric data of 12 images, Df (p = 0.004) and CCC (p = 0.02) values were statistically different in subgroups before and after treatment. Low values of Df (< 1.34) may indicate a more pronounced shift of angiogenesis towards pathological, since normally Df of the formed vasculature is 1.7. In this case, it is preferable to use anti-VEGF therapy. Conclusion. The Df and CVS are indicators are relevant parameters for evaluating the effectiveness of laser treatment in patients with ROP. Vascular patterns are unique for each post-conceptual age, CVS and Df are potential markers of the balance between pathological and physiological angiogenesis for the selective choice of ROP therapy. Keywords: retinopathy of prematurity, retinal laser photocoagulation, retinal vascular system, antiVEGF
{"title":"Unique Pathological and Physiological Angiogenesis of ROP in Safety Aspects of Selective Anti-VEGF Therapy","authors":"","doi":"10.25276/2312-4911-2023-1-235-240","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-235-240","url":null,"abstract":"ROP in the developing retina of premature infants is unique because of the coexistence of physiological and pathological angiogenesis. The type of structure of the vascular nodes is the way to understand the selective treatment of ROP. Purpose. Identification of criteria for the selective ROP treatment choice using the type of pathological vasculogenesis. Material and methods. The study included 279 patients with ROP – 1 group (stage I), 152 (304 eyes); group 2 (stage II) – 45 (90 eyes); 3 group (III stage) – 8 (12 eyes); group 4 (IVA stage) –7 (8 eyes); 5 group (posterior aggressive ROP) – 7 (14 eyes); group 6 (immature retina) 60 (120 eyes) – control; 231 (188 eyes) patients with ROP referred for surgical treatment, divided into subgroups before and after lasercoagulation of the retina. Fractal dimension (Df) and complexity of vascular system (СVS) on wide-field images were assessed. Results. In the group before treatment Df 1.4374 ± 0.03, CVS 2.8 ± 0.14, in the group after treatment Df 1.3756 ± 0.03, CVS 2.3 ± 0.21. According to the morphometric data of 12 images, Df (p = 0.004) and CCC (p = 0.02) values were statistically different in subgroups before and after treatment. Low values of Df (< 1.34) may indicate a more pronounced shift of angiogenesis towards pathological, since normally Df of the formed vasculature is 1.7. In this case, it is preferable to use anti-VEGF therapy. Conclusion. The Df and CVS are indicators are relevant parameters for evaluating the effectiveness of laser treatment in patients with ROP. Vascular patterns are unique for each post-conceptual age, CVS and Df are potential markers of the balance between pathological and physiological angiogenesis for the selective choice of ROP therapy. Keywords: retinopathy of prematurity, retinal laser photocoagulation, retinal vascular system, antiVEGF","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80959748","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-312-318
I. Kornilovskiy
Purpose. To substantiate the pathogenetic orientation of staged light immobilization in macular and vitreoretinal surgery. Material and methods. Literature data and own longterm clinical observations of the results of vitreoretinal, optoreconstructive, microsurgical and laser therapeutic, optical and refractive operations were analyzed. Particular emphasis was placed on the results of photostress-testing and differential aberrometry in macular and vitreoretinal pathology in combination with ametropia (150 eyes, 96 patients). Results. Studies have shown that changes in the retina and surgical operations for macular and vitreoretinal pathology create conditions, when the usual physiological light load begins to have a damaging effect on the retina and aggravate the course of the disease. The latter indicates the expediency of using various techniques for limiting the light load on the retina. This requires a gradual smooth transition from complete to various options for partial light immobilization. In all cases, optical photoprotection from external UV radiation, complete correction of ametropia and associated optical aberrations were shown This was indicated by a positive correlation between defocus and higher-order aberrations with an increase in visual acuity recovery time after a photostress-test. The timing of such immobilization should take into account the severity of the pathological process and the specific type of surgical intervention. This can be realized with a large arsenal of spectacle, contact, intraocular photochromic and spectral lenses that block the violet rays of visible light and attenuate the flow of rays of the blue spectral range. If full optical correction of ametropia, induced irregular astigmatism and higher order aberrations is impossible, their personalized laser correction is shown according to keratotopography and aberrometry data. This is indicated by the revealed positive correlation between the recovery time of visual acuity after the photostress-test, defocus, and higher-order aberrations. Conclusion. Gradual light immobilization in macular and vitreo-retinal surgery has a pathogenetic focus and should be more widely used in ophthalmic practice. Keywords: light immobilization, deprivation, photoprotection, macular and vitreo-retinal surgery
{"title":"Substantiation of pathogenetic orientationtion of staged light immobilization in macular and vitreoretilinal surgery","authors":"I. Kornilovskiy","doi":"10.25276/2312-4911-2023-1-312-318","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-312-318","url":null,"abstract":"Purpose. To substantiate the pathogenetic orientation of staged light immobilization in macular and vitreoretinal surgery. Material and methods. Literature data and own longterm clinical observations of the results of vitreoretinal, optoreconstructive, microsurgical and laser therapeutic, optical and refractive operations were analyzed. Particular emphasis was placed on the results of photostress-testing and differential aberrometry in macular and vitreoretinal pathology in combination with ametropia (150 eyes, 96 patients). Results. Studies have shown that changes in the retina and surgical operations for macular and vitreoretinal pathology create conditions, when the usual physiological light load begins to have a damaging effect on the retina and aggravate the course of the disease. The latter indicates the expediency of using various techniques for limiting the light load on the retina. This requires a gradual smooth transition from complete to various options for partial light immobilization. In all cases, optical photoprotection from external UV radiation, complete correction of ametropia and associated optical aberrations were shown This was indicated by a positive correlation between defocus and higher-order aberrations with an increase in visual acuity recovery time after a photostress-test. The timing of such immobilization should take into account the severity of the pathological process and the specific type of surgical intervention. This can be realized with a large arsenal of spectacle, contact, intraocular photochromic and spectral lenses that block the violet rays of visible light and attenuate the flow of rays of the blue spectral range. If full optical correction of ametropia, induced irregular astigmatism and higher order aberrations is impossible, their personalized laser correction is shown according to keratotopography and aberrometry data. This is indicated by the revealed positive correlation between the recovery time of visual acuity after the photostress-test, defocus, and higher-order aberrations. Conclusion. Gradual light immobilization in macular and vitreo-retinal surgery has a pathogenetic focus and should be more widely used in ophthalmic practice. Keywords: light immobilization, deprivation, photoprotection, macular and vitreo-retinal surgery","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82709326","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-42-47
Perpose. To present a method of two-port vitrectomy in treatment of patients with epiretinal fibrosis. Material and methods. Two-port vitrectomy method was used to treat patients with idiopathic epiretinal fibrosis. The group included 25 patients (25 eyes) – 16 (64 %) women and 9 (36 %) men. The mean age of the patients was 61 ± 6.4 years. Exclusion criteria were glaucoma and concomitant retinal pathology. The mean value of best corrected visual acuity was 0.28 ± 0.07. The mean retinal thickness in the fovea was 417 ± 70 µm. Vitrectomy was performed with installation of two ports in the opposite quadrants – in the lower half for high-flow cannula (illuminator-chandelier built with infusion cannula), in the upper half for vitrectomy cutter and instruments. The High-Flow infusion cannula (Synergetics) integrated with the mercury vapor illuminator-chandelier is connected to the Photon II illumination system (Synergetics). Surgery was performed classically: central vitrectomy, separation of posterior hyaloid membrane, staining of membranes with vitral dye, membrane removal, tamponade ⅓ of vitreous cavity with sterile air. The average operation time was 18 minutes. Results. Six months after the operative treatment all patients noted reduction of visual discomfort and severity of metamorphopsies. Best corrected visual acuity was increased – 0.58 ± 0.1 (p ≤ 0,05 vs. preoperative values). Average retinal thickness in the fovea after surgical treatment decreased to 261 ± 25 µm according to macular OCT chart (p = 0.03). FCM readings were consistent with preoperative 5.1 ± 2.3 f/ms (p ≤ 0.01). Conclusion. The method of two-port vitrectomy with the use of mercury vapor chandeleur in the treatment of vitreomacular pathology allows safe and effective macular surgery. Keywords: retinophototoxicity, vitrectomy, epiretinal fibrosis
{"title":"Two-port vitreomacular surgery in the treatment of patients with epiretinal fibrosis","authors":"","doi":"10.25276/2312-4911-2023-1-42-47","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-42-47","url":null,"abstract":"Perpose. To present a method of two-port vitrectomy in treatment of patients with epiretinal fibrosis. Material and methods. Two-port vitrectomy method was used to treat patients with idiopathic epiretinal fibrosis. The group included 25 patients (25 eyes) – 16 (64 %) women and 9 (36 %) men. The mean age of the patients was 61 ± 6.4 years. Exclusion criteria were glaucoma and concomitant retinal pathology. The mean value of best corrected visual acuity was 0.28 ± 0.07. The mean retinal thickness in the fovea was 417 ± 70 µm. Vitrectomy was performed with installation of two ports in the opposite quadrants – in the lower half for high-flow cannula (illuminator-chandelier built with infusion cannula), in the upper half for vitrectomy cutter and instruments. The High-Flow infusion cannula (Synergetics) integrated with the mercury vapor illuminator-chandelier is connected to the Photon II illumination system (Synergetics). Surgery was performed classically: central vitrectomy, separation of posterior hyaloid membrane, staining of membranes with vitral dye, membrane removal, tamponade ⅓ of vitreous cavity with sterile air. The average operation time was 18 minutes. Results. Six months after the operative treatment all patients noted reduction of visual discomfort and severity of metamorphopsies. Best corrected visual acuity was increased – 0.58 ± 0.1 (p ≤ 0,05 vs. preoperative values). Average retinal thickness in the fovea after surgical treatment decreased to 261 ± 25 µm according to macular OCT chart (p = 0.03). FCM readings were consistent with preoperative 5.1 ± 2.3 f/ms (p ≤ 0.01). Conclusion. The method of two-port vitrectomy with the use of mercury vapor chandeleur in the treatment of vitreomacular pathology allows safe and effective macular surgery. Keywords: retinophototoxicity, vitrectomy, epiretinal fibrosis","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85943513","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}
Pub Date : 2023-03-28DOI: 10.25276/2312-4911-2023-1-331-337
S. Naidenova, E. Lutsai, I. V. Astafyev
Central serous chorioretinopathy is most often found in able-bodied men of young and middle age. The aim of the study: to improve the quality and efficiency of medical care for patients with chronic central serous chorioretinopathy. A clinical example. Patient D., 46 years old, applied in May 2022. Treatment of this pathology is carried out according to the standards of specialized medical care in the field of ophthalmology, approved by the Ministry of Health of the Russian Federation. The clinical anatomy of the posterior segment of the eyeball is the basis for assessing various types of pathology, including chronic central serous chorioretinopathy. Diagnostics with visualization of layers in the area of the posterior segment of the eyeball is predominant among the research methods. Treatment in accordance with the standards of medical care leads to the restoration of the anatomical noma of the structures of the posterior segment of the eyeball. Keywords: posterior segment of the eyeball, human anatomy, central serous chorioretinopathy
{"title":"Posterior segment of the eyeball: clinical case of chronic central serous chorioretinopathy","authors":"S. Naidenova, E. Lutsai, I. V. Astafyev","doi":"10.25276/2312-4911-2023-1-331-337","DOIUrl":"https://doi.org/10.25276/2312-4911-2023-1-331-337","url":null,"abstract":"Central serous chorioretinopathy is most often found in able-bodied men of young and middle age. The aim of the study: to improve the quality and efficiency of medical care for patients with chronic central serous chorioretinopathy. A clinical example. Patient D., 46 years old, applied in May 2022. Treatment of this pathology is carried out according to the standards of specialized medical care in the field of ophthalmology, approved by the Ministry of Health of the Russian Federation. The clinical anatomy of the posterior segment of the eyeball is the basis for assessing various types of pathology, including chronic central serous chorioretinopathy. Diagnostics with visualization of layers in the area of the posterior segment of the eyeball is predominant among the research methods. Treatment in accordance with the standards of medical care leads to the restoration of the anatomical noma of the structures of the posterior segment of the eyeball. Keywords: posterior segment of the eyeball, human anatomy, central serous chorioretinopathy","PeriodicalId":18609,"journal":{"name":"Modern technologies in ophtalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88741255","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}
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