Background: Age-related macular degeneration (AMD) is one of the most common disorders that can lead to total central vision loss after choroidal neovascularization or geographic atrophy (GA). Because the genetic component of the disease plays an important role in the pathogenesis, has an impact on the clinical presentation, and determines the response to treatment, studies on the genetic component of AMD are relevant for better understanding the molecular mechanisms underlying the pathogenesis. Purpose: To investigate associations among TGFβ1 C509T (rs1800469) and CFH T1277С (rs1061170) polymorphisms, their gene-to-gene interactions and the risks of various forms of AMD. Material and Methods: This was a case-control study. The case group included 61 patients with AMD. Of these, 31 were diagnosed with late dry AMD (GA), and 30, with wet AMD (neovascular AMD or nAMD). Patients with nAMD were divided into two subgroups of 14 patients with type 1 or occult subretinal neovascular membrane (SNM), the SNM1 subgroup and 16 patients with type 2 or classical SNM, the SNM2 subgroup. The control group was composed of 50 individuals with no eye disease and of an age distribution similar to that of the case group. Polymerase chain reaction (PCR) and restriction analysis of gene amplification products were performed to determine TGFβ1 rs1800469 and CFH rs1061170. Results: We found a significant effect of TGFβ1 C509T (rs1800469) and CFH T1277C (rs1061170) gene variants on the risks of various forms of AMD. CFH 1277TT genotype was associated with decreased AMD risk, whereas 1277CC genotype, with increased AMD risk (first and foremost, increased GA risk) (р less 0.05). TGFβ1 509CC genotype was associated with increased risk, whereas TGFβ1 509TT genotype, with decreased risk of both GA and SNM2. Conclusion: For the first time, a combined effect of gene variants of interest on the susceptibility to the development of AMD has been investigated, and synergism between these variants in increasing the risk of certain forms of the disease (e.g., GA) established. The results obtained create prerequisites for developing individualized prediction of risk and novel treatment strategies for the disease.
{"title":"Combined effect of carrying both CFH (rs1061170) and TGFβ1 (rs1800469) gene variants on the risks of various forms of age-related macular degeneration","authors":"Дар'я Перетягіна, Надія Ульянова, Л.Є. Фіщук, З.І. Россоха","doi":"10.31288/oftalmolzh202342633","DOIUrl":"https://doi.org/10.31288/oftalmolzh202342633","url":null,"abstract":"Background: Age-related macular degeneration (AMD) is one of the most common disorders that can lead to total central vision loss after choroidal neovascularization or geographic atrophy (GA). Because the genetic component of the disease plays an important role in the pathogenesis, has an impact on the clinical presentation, and determines the response to treatment, studies on the genetic component of AMD are relevant for better understanding the molecular mechanisms underlying the pathogenesis.\u0000\u0000Purpose: To investigate associations among TGFβ1 C509T (rs1800469) and CFH T1277С (rs1061170) polymorphisms, their gene-to-gene interactions and the risks of various forms of AMD.\u0000\u0000Material and Methods: This was a case-control study. The case group included 61 patients with AMD. Of these, 31 were diagnosed with late dry AMD (GA), and 30, with wet AMD (neovascular AMD or nAMD). Patients with nAMD were divided into two subgroups of 14 patients with type 1 or occult subretinal neovascular membrane (SNM), the SNM1 subgroup and 16 patients with type 2 or classical SNM, the SNM2 subgroup. The control group was composed of 50 individuals with no eye disease and of an age distribution similar to that of the case group. Polymerase chain reaction (PCR) and restriction analysis of gene amplification products were performed to determine TGFβ1 rs1800469 and CFH rs1061170.\u0000\u0000Results: We found a significant effect of TGFβ1 C509T (rs1800469) and CFH T1277C (rs1061170) gene variants on the risks of various forms of AMD. CFH 1277TT genotype was associated with decreased AMD risk, whereas 1277CC genotype, with increased AMD risk (first and foremost, increased GA risk) (р less 0.05). TGFβ1 509CC genotype was associated with increased risk, whereas TGFβ1 509TT genotype, with decreased risk of both GA and SNM2.\u0000\u0000Conclusion: For the first time, a combined effect of gene variants of interest on the susceptibility to the development of AMD has been investigated, and synergism between these variants in increasing the risk of certain forms of the disease (e.g., GA) established. The results obtained create prerequisites for developing individualized prediction of risk and novel treatment strategies for the disease.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48255204","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 : 2023-06-30DOI: 10.31288/oftalmolzh202333437
Б.Б. Жупан, І. А. Лурін, Н.В. Медведовська, І.І. Храмов
Introduction. The analysis of experience in changing approaches to organizing medical care for combat eye injuries, changing treatment tactics for such patients during armed conflicts in the 20th and 21st centuries, domestic experience in providing medical care for eye and its adnexal injuries, highlights the search for informative methods of predicting long-term outcomes of the applied treatment methods. The aim of the study was to determine the informativeness of constructing a forecast of functional changes of the visual analyzer based on the results of treatment of patients with eye injuries during dynamic retrospective observation. Materials and Methods: The primary material for the study was medical documentation of combat eye injury patients (data from medical histories, outpatient cards, and discharge summaries) for the period of 2014-2015, who were treated at the National Military Medical Clinical Center "Main Military Clinical Hospital" (NMMCC "MMCH"). Indicators of the functional state of the visual analyzer were evaluated upon admission to the NMMCC "MMCH" and after 180 days following the injury. The study used the proposed F. Kuhn and colleagues' scale for evaluating long-term treatment outcomes (OTS-Ocular Trauma Score). Results. It was found that overall, the results of treatment for combat eye injuries and their adnexa at the NMMCC "MMCH" during the study period of 2014-2015 showed a high correlation with the calculated values of the probability of preserving visual functions according to the OTS scale. Almost all patients with a case of blindness remained blind in the injured eye six months later. In the group with light projection and movement of the hand near the face, an improvement in visual function in most cases (65%) was noted, while, according to the OTS scale, these patients in most cases remain in this group or move to the group with blindness. Cases with visual acuity of 0.005-0.1 after 6 months improve visual acuity with the transition in most cases to 0.1 and above. The same trend, but, as expected, with a higher probability in groups with visual acuity of 0.1-0.4 and above 0.5. The identified discrepancies justify the need for adaptation of the OTS scale for predicting functional changes in combat eye injuries, as it has been developed for use in eye injuries during peacetime. Conclusion: Considering the large number of wounded soldiers with severe eye injuries during the war with rf, scientific research on the implementation of a system for predicting long-term functional outcomes of the treatment of combat eye trauma based on clinical data at the time of initial examination remains relevant. The results obtained with the OTS (Ocular Trauma Score) assessment scale in most cases correspond to the results of the treatment of injured patients in the ophthalmology clinic of the NMMCC "MMCH" in 2014-2015. Further development of the existing OTS system and its adaptation to domestic conditions and the realities of p
{"title":"Prospects for predicting long-term treatment outcomes in patients with combat ocular trauma","authors":"Б.Б. Жупан, І. А. Лурін, Н.В. Медведовська, І.І. Храмов","doi":"10.31288/oftalmolzh202333437","DOIUrl":"https://doi.org/10.31288/oftalmolzh202333437","url":null,"abstract":"Introduction. The analysis of experience in changing approaches to organizing medical care for combat eye injuries, changing treatment tactics for such patients during armed conflicts in the 20th and 21st centuries, domestic experience in providing medical care for eye and its adnexal injuries, highlights the search for informative methods of predicting long-term outcomes of the applied treatment methods.\u0000\u0000The aim of the study was to determine the informativeness of constructing a forecast of functional changes of the visual analyzer based on the results of treatment of patients with eye injuries during dynamic retrospective observation. \u0000\u0000Materials and Methods: The primary material for the study was medical documentation of combat eye injury patients (data from medical histories, outpatient cards, and discharge summaries) for the period of 2014-2015, who were treated at the National Military Medical Clinical Center \"Main Military Clinical Hospital\" (NMMCC \"MMCH\"). Indicators of the functional state of the visual analyzer were evaluated upon admission to the NMMCC \"MMCH\" and after 180 days following the injury. The study used the proposed F. Kuhn and colleagues' scale for evaluating long-term treatment outcomes (OTS-Ocular Trauma Score).\u0000\u0000Results. It was found that overall, the results of treatment for combat eye injuries and their adnexa at the NMMCC \"MMCH\" during the study period of 2014-2015 showed a high correlation with the calculated values of the probability of preserving visual functions according to the OTS scale. Almost all patients with a case of blindness remained blind in the injured eye six months later. In the group with light projection and movement of the hand near the face, an improvement in visual function in most cases (65%) was noted, while, according to the OTS scale, these patients in most cases remain in this group or move to the group with blindness. Cases with visual acuity of 0.005-0.1 after 6 months improve visual acuity with the transition in most cases to 0.1 and above. The same trend, but, as expected, with a higher probability in groups with visual acuity of 0.1-0.4 and above 0.5. The identified discrepancies justify the need for adaptation of the OTS scale for predicting functional changes in combat eye injuries, as it has been developed for use in eye injuries during peacetime.\u0000\u0000Conclusion: Considering the large number of wounded soldiers with severe eye injuries during the war with rf, scientific research on the implementation of a system for predicting long-term functional outcomes of the treatment of combat eye trauma based on clinical data at the time of initial examination remains relevant. The results obtained with the OTS (Ocular Trauma Score) assessment scale in most cases correspond to the results of the treatment of injured patients in the ophthalmology clinic of the NMMCC \"MMCH\" in 2014-2015. Further development of the existing OTS system and its adaptation to domestic conditions and the realities of p","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47263830","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 : 2023-06-30DOI: 10.31288/oftalmolzh202333841
Л.В. Венгер, Олексій Ковтун, В.В. Савко
Background: An objective assessment of factors for ocular inflammation and its sequelae and diagnostic assessment of possible development of the sequelae in early phases of uveitis are essential for early and effective treatment of endogenous uveitis. Purpose: To determine whether it is possible to predict optic atrophy in patients with anterior uveitis using computed tomography (CT)-based assessment of optic nerve diameter. Material and Methods: Patients with anterior uveitis underwent a routine eye examination (ophthalmoscopy, biomicroscopy, intraocular pressure (IOP) measurement, and Humphrey perimetry). In addition, they underwent CT-based assessment of optic disc diameter at 3-5 mm from the entrance into the orbit in the affected eye and the contralateral healthy eye. Patients received treatment as per the protocol. Results: The percentage difference in optic nerve diameter between patients with uveitis complicated by optic neuritis and those with uveitis only for affected eyes was large (33.1%) and statistically significant. At 3 months and 6 months after initiation of treatment, mean optic disc diameter in patients with optic neuritis decreased by 37.2% and 49.1%, respectively, compared to baseline values. At 6 months, a decrease in optic nerve diameter among optic neuritis patients was observed both in those who received treatment and in those who failed to receive treatment, but was less marked in the former patients. Particularly, from 3 months to 6 months, optic nerve diameter decreased by 17.3% in treated optic neuritis patients versus 23.5% in those who remained untreated. Conclusion: CT-based data on the change in the optic nerve diameter at the entrance into the orbit in patients with optic neuritis is an objective characteristic of the presence and grade of atrophic process. Early identification of the potential for development of optic atrophy in individuals with optic neuritis will make it possible to treat them early and, consequently, to prevent or stabilize the process.
{"title":"Predicting optic atrophy in patients with anterior uveitis by computed tomography-based assessment of optic nerve diameter","authors":"Л.В. Венгер, Олексій Ковтун, В.В. Савко","doi":"10.31288/oftalmolzh202333841","DOIUrl":"https://doi.org/10.31288/oftalmolzh202333841","url":null,"abstract":"Background: An objective assessment of factors for ocular inflammation and its sequelae and diagnostic assessment of possible development of the sequelae in early phases of uveitis are essential for early and effective treatment of endogenous uveitis.\u0000\u0000Purpose: To determine whether it is possible to predict optic atrophy in patients with anterior uveitis using computed tomography (CT)-based assessment of optic nerve diameter.\u0000\u0000Material and Methods: Patients with anterior uveitis underwent a routine eye examination (ophthalmoscopy, biomicroscopy, intraocular pressure (IOP) measurement, and Humphrey perimetry). In addition, they underwent CT-based assessment of optic disc diameter at 3-5 mm from the entrance into the orbit in the affected eye and the contralateral healthy eye. Patients received treatment as per the protocol.\u0000\u0000Results: The percentage difference in optic nerve diameter between patients with uveitis complicated by optic neuritis and those with uveitis only for affected eyes was large (33.1%) and statistically significant. At 3 months and 6 months after initiation of treatment, mean optic disc diameter in patients with optic neuritis decreased by 37.2% and 49.1%, respectively, compared to baseline values. At 6 months, a decrease in optic nerve diameter among optic neuritis patients was observed both in those who received treatment and in those who failed to receive treatment, but was less marked in the former patients. Particularly, from 3 months to 6 months, optic nerve diameter decreased by 17.3% in treated optic neuritis patients versus 23.5% in those who remained untreated.\u0000\u0000Conclusion: CT-based data on the change in the optic nerve diameter at the entrance into the orbit in patients with optic neuritis is an objective characteristic of the presence and grade of atrophic process. Early identification of the potential for development of optic atrophy in individuals with optic neuritis will make it possible to treat them early and, consequently, to prevent or stabilize the process.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46003481","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 : 2023-06-30DOI: 10.31288/oftalmolzh20233914
Juraj Sekáč, Silvia Ferkova, I. Popov, J. Valášková, R. Furda, D. Lysková, P. Plesníková, J. Rybar, Angelika Puzserova, A. Furdová
Purpose Implementation of quality-of-life standards for patients with secondary glaucoma after surgery. Material and methods Data analysis included secondary surgical glaucoma patients with a time interval of 4 years. Patients were followed up to 3 years after surgery to answer questions related to subjective perceptions after the surgical intervention (pain, discomfort, near vision, distance vision, intermediate vision, and normal activity). We were also interested in the overall quality of life and the effect on the patient's psyche when performing certain surgical techniques. Results As part of the questionnaire, patients were asked 36 questions. Responses were received from 98 patients. Thirty-five respondents (97.2%) of patients who underwent cyclocryopexy reported tolerable, minimal, or no pain during and immediately after surgery, with the majority of patients reporting minimal pain. Twenty-one patients (58.3%) did not complain of pain until one year after surgery. According to the survey, 16 respondents (25%) had undergone trabeculectomy. Most respondents reported tolerable pain during surgery, minimal pain for 2 weeks after surgery, and no or minimal pain 2 years after surgery. Eleven respondents (68.8%) answered that their eyesight improved in daily life, but the majority of nine (56.3%) did not notice any change in their vision during short-distance movement, short-distance work, or reading. Most serious problems had patients after cyclocryocoagulation or enucleation of the eye globe. Conclusion Secondary glaucoma surgery for every patient should be personalized and tailored to the patient's every need, taking into account the patient's current health status, knowledge and skills as well as socioeconomic circumstances.
{"title":"Analysis of subjective signs in patients after secondary glaucoma surgeries","authors":"Juraj Sekáč, Silvia Ferkova, I. Popov, J. Valášková, R. Furda, D. Lysková, P. Plesníková, J. Rybar, Angelika Puzserova, A. Furdová","doi":"10.31288/oftalmolzh20233914","DOIUrl":"https://doi.org/10.31288/oftalmolzh20233914","url":null,"abstract":"Purpose\u0000Implementation of quality-of-life standards for patients with secondary glaucoma after surgery.\u0000Material and methods\u0000Data analysis included secondary surgical glaucoma patients with a time interval of 4 years. Patients were followed up to 3 years after surgery to answer questions related to subjective perceptions after the surgical intervention (pain, discomfort, near vision, distance vision, intermediate vision, and normal activity). We were also interested in the overall quality of life and the effect on the patient's psyche when performing certain surgical techniques.\u0000Results\u0000As part of the questionnaire, patients were asked 36 questions. Responses were received from 98 patients. Thirty-five respondents (97.2%) of patients who underwent cyclocryopexy reported tolerable, minimal, or no pain during and immediately after surgery, with the majority of patients reporting minimal pain. Twenty-one patients (58.3%) did not complain of pain until one year after surgery.\u0000According to the survey, 16 respondents (25%) had undergone trabeculectomy. Most respondents reported tolerable pain during surgery, minimal pain for 2 weeks after surgery, and no or minimal pain 2 years after surgery. Eleven respondents (68.8%) answered that their eyesight improved in daily life, but the majority of nine (56.3%) did not notice any change in their vision during short-distance movement, short-distance work, or reading. Most serious problems had patients after cyclocryocoagulation or enucleation of the eye globe.\u0000Conclusion\u0000Secondary glaucoma surgery for every patient should be personalized and tailored to the patient's every need, taking into account the patient's current health status, knowledge and skills as well as socioeconomic circumstances.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47563701","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 : 2023-06-30DOI: 10.31288/oftalmolzh202334955
Орест Ігорович Паламар, А. П. Гук, Д. І. Оконський, О. С. Усатов, Б.О. Давиденко
Purpose: To identify extension routes of craniofacial malignancies and formulate a surgical treatment plan based thereupon. Material and Methods: We retrospectively reviewed the medical records of 253 patients with craniofacial malignancies who underwent surgical treatment at the Romodanov Neurosurgery Institute from 2002 through 2022. Of the 253 patients, 112 had a primary tumor, and 141, a secondary tumor. Preoperative Karnofsky performance scores ranged from 50 to 70 points. Patients underwent neurological and ophthalmological status assessment, as per routine protocols. Results: Epithelial malignancies were the most common (53.7%), whereas anaplastic meningioma and embryonal malignancies were rather uncommon (1.2% and 0.4%, respectively) craniofacial malignancies. The presence of certain clinical symptoms was associated primarily with tumor origin and extension. A high rate of general brain and rhinological symptoms in our study sample was caused by a high percentage of intracranial and paranasal sinus tumors. Craniofacial malignancies most commonly originate from the midline (particularly, anterior midline skull base). Ethmoidal labyrinth was the most common site of origin (45.0%), followed by a sphenoid sinus (12.2%), pterygopalatine and infratemporal fossae (9.9%), whereas the cavernous sinus and olfactory fossa were the least common sites of origin (0.4% and 1.2%, respectively). Craniofacial tumors extended most commonly intracranially (transdurally, epidurally, via adhesion to the dura mater, and/or cavernous sinus growth) or intraorbitally. Anterior craniofacial resection (bifrontal craniotomy with combined with either lateral rhinotomy or supraorbital advancement; or a subcranial approach) was the most common surgical treatment. Postoperative cerebrospinal fluid rhinorrhea and infectious complications (meningitis and meningoencephalitis) were the most frequent complications. The overall postoperative mortality rate was 2.0%. Conclusion: First, compared to the transcranial and facial approaches, the craniofacial resection is advantageous in terms of the radicality of tumor excision. Second, the subcranial approach is preferable to the bifrontal approach in the presence of marked extracranial tumor component, whereas the transbasal Derome approach is effective in the presence of marked extracranial and/or intracranial tumor components. Finally, both the orbitozygomatic and infratemporal approaches allow for the radicality of excision of lateral skull base malignancies, but the latter approach is associated with a lower rate of complications.
{"title":"Craniofacial malignant tumors, their extensions, and surgical strategy for their treatment","authors":"Орест Ігорович Паламар, А. П. Гук, Д. І. Оконський, О. С. Усатов, Б.О. Давиденко","doi":"10.31288/oftalmolzh202334955","DOIUrl":"https://doi.org/10.31288/oftalmolzh202334955","url":null,"abstract":"Purpose: To identify extension routes of craniofacial malignancies and formulate a surgical treatment plan based thereupon.\u0000\u0000Material and Methods: We retrospectively reviewed the medical records of 253 patients with craniofacial malignancies who underwent surgical treatment at the Romodanov Neurosurgery Institute from 2002 through 2022. Of the 253 patients, 112 had a primary tumor, and 141, a secondary tumor. Preoperative Karnofsky performance scores ranged from 50 to 70 points. Patients underwent neurological and ophthalmological status assessment, as per routine protocols.\u0000\u0000Results: Epithelial malignancies were the most common (53.7%), whereas anaplastic meningioma and embryonal malignancies were rather uncommon (1.2% and 0.4%, respectively) craniofacial malignancies. The presence of certain clinical symptoms was associated primarily with tumor origin and extension. A high rate of general brain and rhinological symptoms in our study sample was caused by a high percentage of intracranial and paranasal sinus tumors. Craniofacial malignancies most commonly originate from the midline (particularly, anterior midline skull base). Ethmoidal labyrinth was the most common site of origin (45.0%), followed by a sphenoid sinus (12.2%), pterygopalatine and infratemporal fossae (9.9%), whereas the cavernous sinus and olfactory fossa were the least common sites of origin (0.4% and 1.2%, respectively). Craniofacial tumors extended most commonly intracranially (transdurally, epidurally, via adhesion to the dura mater, and/or cavernous sinus growth) or intraorbitally. Anterior craniofacial resection (bifrontal craniotomy with combined with either lateral rhinotomy or supraorbital advancement; or a subcranial approach) was the most common surgical treatment. Postoperative cerebrospinal fluid rhinorrhea and infectious complications (meningitis and meningoencephalitis) were the most frequent complications. The overall postoperative mortality rate was 2.0%.\u0000\u0000Conclusion: First, compared to the transcranial and facial approaches, the craniofacial resection is advantageous in terms of the radicality of tumor excision. Second, the subcranial approach is preferable to the bifrontal approach in the presence of marked extracranial tumor component, whereas the transbasal Derome approach is effective in the presence of marked extracranial and/or intracranial tumor components. Finally, both the orbitozygomatic and infratemporal approaches allow for the radicality of excision of lateral skull base malignancies, but the latter approach is associated with a lower rate of complications.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69355807","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 : 2023-06-30DOI: 10.31288/oftalmolzh2023338
D. Tuychibaeva
Relevance. Age-related macular degeneration (AMD) and glaucoma are currently the main causes of irreversible vision loss in developed countries. Purpose. To study the epidemiological and clinical-functional aspects of the combined course of age-related macular degeneration and primary glaucoma and to assess the quality of life of these patients. Material and Methods. The analysis of 5,000 outpatient records of patients over 35 years of age who were observed in the consultative polyclinic of the multidisciplinary clinic of the Tashkent Medical Academy in the period 2011-2022 was carried out. All patients were divided into three groups: group 1 - glaucoma, group 2 - AMD, group 3 - glaucoma + AMD. Results. A retrospective analysis of 5,000 outpatient records of patients older than 35 years revealed the presence of glaucoma in 30.3% of cases, AMD - in 37.94%, their combination - in 20.3%. At the same time, in the structure of AMD, signs of the dry form of the disease were diagnosed in 74% of cases, geographical atrophy - in 12% and wet form - in 14%. However, it requires careful monitoring of the dynamics of visual-functional and structural changes in the retina and optic nerve, as well as timely correction of therapy. Conclusion. The combined course of diseases having a neurodegenerative nature of the lesion leads to a decrease in not only visual, but also cognitive functions, significantly affects the quality of life of patients of the older age group and their adaptation in society.
{"title":"EPIDEMIOLOGICAL AND CLINICAL-FUNCTIONAL ASPECTS OF THE COMBINED COURSE OF AGE-RELATED MACULAR DEGENERATION AND PRIMARY GLAUCOMA","authors":"D. Tuychibaeva","doi":"10.31288/oftalmolzh2023338","DOIUrl":"https://doi.org/10.31288/oftalmolzh2023338","url":null,"abstract":"Relevance. Age-related macular degeneration (AMD) and glaucoma are currently the main causes of irreversible vision loss in developed countries.\u0000Purpose. To study the epidemiological and clinical-functional aspects of the combined course of age-related macular degeneration and primary glaucoma and to assess the quality of life of these patients.\u0000Material and Methods. The analysis of 5,000 outpatient records of patients over 35 years of age who were observed in the consultative polyclinic of the multidisciplinary clinic of the Tashkent Medical Academy in the period 2011-2022 was carried out. All patients were divided into three groups: group 1 - glaucoma, group 2 - AMD, group 3 - glaucoma + AMD.\u0000Results. A retrospective analysis of 5,000 outpatient records of patients older than 35 years revealed the presence of glaucoma in 30.3% of cases, AMD - in 37.94%, their combination - in 20.3%. At the same time, in the structure of AMD, signs of the dry form of the disease were diagnosed in 74% of cases, geographical atrophy - in 12% and wet form - in 14%. However, it requires careful monitoring of the dynamics of visual-functional and structural changes in the retina and optic nerve, as well as timely correction of therapy.\u0000Conclusion. The combined course of diseases having a neurodegenerative nature of the lesion leads to a decrease in not only visual, but also cognitive functions, significantly affects the quality of life of patients of the older age group and their adaptation in society.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44729786","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 : 2023-06-30DOI: 10.31288/oftalmolzh202335660
Ірина Михайлівна Бойчук, Бадрі Ваєл
Background: Analysis of electroencephalogram (EEG) visual-evoked potentials (VEPs) is important for assessing the general integrity of the visual pathway. Pathology in any portion of the visual pathway causes changes in VEP. Percentages of alpha, beta, delta and theta rhythms in the EEG record, frequencies and amplitudes of these waves, and the level of alpha-rhythm suppression are essential for characterizing the state of the visual system. Purpose: To indentify the features of the state of the visual system and changes in the background EEG in response to activation procedures in strabismic amblyopes depending on type of fixation in the amblyopic eye. Material and Methods: Fifty-two strabismic amblyopic patients aged 5-8 years and 15 healthy children of the same age underwent an examination. Of the amblyopic children, 32 had unilateral amblyopia with esotropia (6-15 degrees). Of these 32 children, 20 had eccentric fixation and 12 children, central fixation. The 10–20 system of electrode placement was employed to perform EEG in all children. Rhythms of the background EEG, interhemispheric asymmetry and alpha, theta and delta wave percentages were assessed. Brain potentials were recorded using standard activation procedures to activate deep brain structures. Results: Alpha rhythm was not discernable in the background EEG in the occipital areas in 3.0 ± 2.6 % of cases, and the alpha index was below the normal range in 48.6 ± 8.2 % of patients with a visual acuity worse than 0.3. Delta index was above the normal range (25%-45%) in 48.6 ± 8.2 %, and theta index was above the normal range (with a mean value of 48.4 ± 8.2 %) in 48.6 ± 8.2 % of children. Reduced percentage of alpha activity was found in almost half of strabismic amblyopic children, indicating immaturity of the synchronizing system and impaired oculomotor tuning in the eyes of these children. Abnormal bilateral EEG response to eye-opening stimulation and abnormal bilateral EEG rhythmic driving response (RDR) were seen in most children with eccentric fixation, but not in most children with central fixation. Photic stimulation in strabismic amblyopic children resulted in bilaterally asymmetrical and synchronous theta and delta waves in symmetric frontal (theta and delta percent time of 46.0 ± 8.4%) and occipital (theta and delta percent time of 50.0 ± 8.4%) responses. Conclusion: Increased theta and delta wave percentages in frontal and occipital derivations were found in strabysmic amblyopes (irrespective of type of fixation in the amblyopic eye) compared to healthy controls. Abnormal EEG response to eye opening and abnormal EEG RDR were found in strabysmic amblyopes. This indicates the presence of functional changes in the midline brain structures including the corpus callosum, which impedes the development of binocular vision in strabismic amblyopes.
{"title":"Особливості зміни фонової енцефалограми у відповідь на функціональні навантаження у хворих на дисбінокулярну амбліопію залежно від фіксації амбліопічного ока","authors":"Ірина Михайлівна Бойчук, Бадрі Ваєл","doi":"10.31288/oftalmolzh202335660","DOIUrl":"https://doi.org/10.31288/oftalmolzh202335660","url":null,"abstract":"Background: Analysis of electroencephalogram (EEG) visual-evoked potentials (VEPs) is important for assessing the general integrity of the visual pathway. Pathology in any portion of the visual pathway causes changes in VEP. Percentages of alpha, beta, delta and theta rhythms in the EEG record, frequencies and amplitudes of these waves, and the level of alpha-rhythm suppression are essential for characterizing the state of the visual system. Purpose: To indentify the features of the state of the visual system and changes in the background EEG in response to activation procedures in strabismic amblyopes depending on type of fixation in the amblyopic eye. Material and Methods: Fifty-two strabismic amblyopic patients aged 5-8 years and 15 healthy children of the same age underwent an examination. Of the amblyopic children, 32 had unilateral amblyopia with esotropia (6-15 degrees). Of these 32 children, 20 had eccentric fixation and 12 children, central fixation. The 10–20 system of electrode placement was employed to perform EEG in all children. Rhythms of the background EEG, interhemispheric asymmetry and alpha, theta and delta wave percentages were assessed. Brain potentials were recorded using standard activation procedures to activate deep brain structures. Results: Alpha rhythm was not discernable in the background EEG in the occipital areas in 3.0 ± 2.6 % of cases, and the alpha index was below the normal range in 48.6 ± 8.2 % of patients with a visual acuity worse than 0.3. Delta index was above the normal range (25%-45%) in 48.6 ± 8.2 %, and theta index was above the normal range (with a mean value of 48.4 ± 8.2 %) in 48.6 ± 8.2 % of children. Reduced percentage of alpha activity was found in almost half of strabismic amblyopic children, indicating immaturity of the synchronizing system and impaired oculomotor tuning in the eyes of these children. Abnormal bilateral EEG response to eye-opening stimulation and abnormal bilateral EEG rhythmic driving response (RDR) were seen in most children with eccentric fixation, but not in most children with central fixation. Photic stimulation in strabismic amblyopic children resulted in bilaterally asymmetrical and synchronous theta and delta waves in symmetric frontal (theta and delta percent time of 46.0 ± 8.4%) and occipital (theta and delta percent time of 50.0 ± 8.4%) responses. Conclusion: Increased theta and delta wave percentages in frontal and occipital derivations were found in strabysmic amblyopes (irrespective of type of fixation in the amblyopic eye) compared to healthy controls. Abnormal EEG response to eye opening and abnormal EEG RDR were found in strabysmic amblyopes. This indicates the presence of functional changes in the midline brain structures including the corpus callosum, which impedes the development of binocular vision in strabismic amblyopes.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43103997","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}
This case is presented to (1) improve the efficacy of the identification and differential diagnosis and to avoid mistreatment of the skin manifestations of ocular rosacea exhibiting a clinical appearance of those of other disorders and (2) explore opportunities for building dermatologic and ophthalmologic collaboration in the management of patients with ocular symptoms of rosacea. A 33-year-old female patient was diagnosed with acne vulgaris and seborrhea oleosa by a dermatologist. She received a secondary diagnosis of adrenal hyperandrogenism, iron deficiency anemia and selenium and iodine deficiency. The patient underwent facial skin peeling and was prescribed dermatological treatment. Thereafter, she presented to an ophthalmologist and complained of gritty eyes and blurred vision which she had never before experienced. Ocular manifestations included macerated skin of the eyelid angles, palpebral edema, crusts at the eyelid margin and eyelid telangiectasia. The patient was diagnosed with ocular rosacea, dry eye and keratoconjunctivitis sicca, and obtained the prescribed ophthalmological treatment which resulted in an improvement in her ocular symptoms. Therefore, ocular rosacea should be treated through the cooperative efforts of dermatologists and ophthalmologists based on the constellation of clinical findings and symptoms in a particular case.
{"title":"Dermatologic and ophthalmologic collaboration in the management of skin manifestations of ocular rosacea","authors":"Н.В. Малачкова, Т.М. Жмудь, Н.В. Кривецька, І.Ю. Пшенічна","doi":"10.31288/oftalmolzh202337478","DOIUrl":"https://doi.org/10.31288/oftalmolzh202337478","url":null,"abstract":"This case is presented to (1) improve the efficacy of the identification and differential diagnosis and to avoid mistreatment of the skin manifestations of ocular rosacea exhibiting a clinical appearance of those of other disorders and (2) explore opportunities for building dermatologic and ophthalmologic collaboration in the management of patients with ocular symptoms of rosacea. A 33-year-old female patient was diagnosed with acne vulgaris and seborrhea oleosa by a dermatologist. She received a secondary diagnosis of adrenal hyperandrogenism, iron deficiency anemia and selenium and iodine deficiency. The patient underwent facial skin peeling and was prescribed dermatological treatment. Thereafter, she presented to an ophthalmologist and complained of gritty eyes and blurred vision which she had never before experienced. Ocular manifestations included macerated skin of the eyelid angles, palpebral edema, crusts at the eyelid margin and eyelid telangiectasia. The patient was diagnosed with ocular rosacea, dry eye and keratoconjunctivitis sicca, and obtained the prescribed ophthalmological treatment which resulted in an improvement in her ocular symptoms. Therefore, ocular rosacea should be treated through the cooperative efforts of dermatologists and ophthalmologists based on the constellation of clinical findings and symptoms in a particular case.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49532040","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 : 2023-06-30DOI: 10.31288/oftalmolzh202331723
Ігор Аліфанов
Purpose: To determine ocular blood flow parameters by Doppler ultrasound scanning in type 2 diabetic patients with different stages of diabetic retinopathy. Material and Methods: In this prospective study, forty-five patients (90 eyes) with type 2 diabetes mellitus were divided into three groups of 15 patients each: no diabetic retinopathy group (DR0), non-proliferative retinopathy (NPDR), and proliferative retinopathy (PDR) groups. Doppler indices such as systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd), time-averaged maximum velocity (TAMXV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCA) were determined. ANOVA was used for quantitative comparisons between the three groups. Results: There was a significant (р less 0.05) decrease in (a) the Vs from 71.1 +- 20.6 cm/s in the DR0 group to 59.9 +- 16.7 cm/s in the NPDR group and 47.4 +- 16.4 cm/s in the PDR group, (b) Vd from 22.1 +- 6.9 cm/s to 17.0 +- 6.6 cm/s and 12.3 +- 5.9 cm/s, respectively; and (c) TAMXV from 37.2 +- 11.3 cm/s to 31.9 +- 9.1 cm/s and 25.3 +- 9.7 cm/s, respectively, and an increase in the RI from 0.69 +- 0.06 cm/s to 0.71 +- 0.09 cm/s and 0.75 +- 0.08 cm/s, respectively, in the OA. In addition, there was a significant decrease in the Vd from 9.9 +- 5.4 cm/s in the DR0 group to 8.1 +- 3.8 cm/s in the NPDR group and 5.5 +- 3.1 cm/s in the PDR group, and an increase in the PI from 1.34 +- 0.16 cm/s to 1.46 +- 0.28 cm/s and 1.54 +- 0.24 cm/s, respectively, and in the RI from 0.71 +- 0.06 cm/s to 0.75 +- 0.07 cm/s and 0.80 +- 0.05 cm/s, respectively, in the CRA. Moreover, there was a significant decrease in the Vd from 4.3 +- 1.6 cm/s in the DR0 group to 3.2 +- 2.0 cm/s in the NPDR group and 3.1 +- 2.2 cm/s in the PDR group, and an increase in the PI from 1.32 +- 0.21 cm/s to 1.37 +- 0.24 cm/s and 1.54 +- 0.26 cm/s, respectively, and in the RI from 0.76 +- 0.04 cm/s to 0.82 +- 0.06 cm/s and 0.82 +- 0.06 cm/s, respectively, in the SPCA. Conclusion: We found that the arteries examined in patients with diabetic retinopathy tended to have decreased blood flow velocities and increased resistivity and pulsatility indices, with the greatest changes observed in patients with PDR. In addition, the difference in mean values of most Doppler indices between the PDR and NPDR groups was larger than that between the NPDR and DR0 groups.
{"title":"Doppler ocular ultrasound in patients with type 2 diabetes mellitus","authors":"Ігор Аліфанов","doi":"10.31288/oftalmolzh202331723","DOIUrl":"https://doi.org/10.31288/oftalmolzh202331723","url":null,"abstract":"Purpose: To determine ocular blood flow parameters by Doppler ultrasound scanning in type 2 diabetic patients with different stages of diabetic retinopathy.\u0000\u0000Material and Methods: In this prospective study, forty-five patients (90 eyes) with type 2 diabetes mellitus were divided into three groups of 15 patients each: no diabetic retinopathy group (DR0), non-proliferative retinopathy (NPDR), and proliferative retinopathy (PDR) groups. Doppler indices such as systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd), time-averaged maximum velocity (TAMXV), pulsatility index (PI) and resistivity index (RI) in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCA) were determined. ANOVA was used for quantitative comparisons between the three groups.\u0000\u0000Results: There was a significant (р less 0.05) decrease in (a) the Vs from 71.1 +- 20.6 cm/s in the DR0 group to 59.9 +- 16.7 cm/s in the NPDR group and 47.4 +- 16.4 cm/s in the PDR group, (b) Vd from 22.1 +- 6.9 cm/s to 17.0 +- 6.6 cm/s and 12.3 +- 5.9 cm/s, respectively; and (c) TAMXV from 37.2 +- 11.3 cm/s to 31.9 +- 9.1 cm/s and 25.3 +- 9.7 cm/s, respectively, and an increase in the RI from 0.69 +- 0.06 cm/s to 0.71 +- 0.09 cm/s and 0.75 +- 0.08 cm/s, respectively, in the OA. In addition, there was a significant decrease in the Vd from 9.9 +- 5.4 cm/s in the DR0 group to 8.1 +- 3.8 cm/s in the NPDR group and 5.5 +- 3.1 cm/s in the PDR group, and an increase in the PI from 1.34 +- 0.16 cm/s to 1.46 +- 0.28 cm/s and 1.54 +- 0.24 cm/s, respectively, and in the RI from 0.71 +- 0.06 cm/s to 0.75 +- 0.07 cm/s and 0.80 +- 0.05 cm/s, respectively, in the CRA. Moreover, there was a significant decrease in the Vd from 4.3 +- 1.6 cm/s in the DR0 group to 3.2 +- 2.0 cm/s in the NPDR group and 3.1 +- 2.2 cm/s in the PDR group, and an increase in the PI from 1.32 +- 0.21 cm/s to 1.37 +- 0.24 cm/s and 1.54 +- 0.26 cm/s, respectively, and in the RI from 0.76 +- 0.04 cm/s to 0.82 +- 0.06 cm/s and 0.82 +- 0.06 cm/s, respectively, in the SPCA.\u0000\u0000Conclusion: We found that the arteries examined in patients with diabetic retinopathy tended to have decreased blood flow velocities and increased resistivity and pulsatility indices, with the greatest changes observed in patients with PDR. In addition, the difference in mean values of most Doppler indices between the PDR and NPDR groups was larger than that between the NPDR and DR0 groups.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42737930","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 : 2023-06-30DOI: 10.31288/oftalmolzh202331518
I. Saliev
Purpose: to determine the consistency of HVID/WTW measurements on 5 devices, and their correspondence to the distance from angle to angle (ATA). Methods The relevant information on 30 right eyes was obtained from 30 volunteers. A prospective study was conducted using Wavelight Topolayzer Vario (Alcon), IOL Master 700 (Zeiss), OA2000 (Tomey), AS-OCT Casia 2 (Tomey), Zeiss Atlas 9000 (Carl Zeiss) instruments. Agreement between the measurement s made by these devices in the HVID/WTW was analyzed, and the HVID/WTW scores of each device were compared with ATA scores. Results The average values of HVID/WTW in Wavelight Topolayzer Vario, IOL Master 700, OA2000, Zeiss Atlas 9000 devices were 11.73 ± 0.33 mm, 12.01 ± 0.34 mm, 12.01 ± 0.27 mm, and 12.2 ± 0.37 mm, respectively. The mean ATA was 11.68 mm on the AS-OCT Casia2 device. The smallest difference in ATA and HVID/WTW was observed on the Wavelight Topolyzer Vario instrument which averaged 0.05±0.102mm 95% LoA (-0.41 to 0.32) (p < 0.05). The largest difference was observed between AS-OCT Casia 2 and Atlas 9000 which averaged 0.52±0.234mm 95% LoA (from-1.21 to 0.17) (p < 0.05). Conclusion Our study found that the results of measurements of HVID/WTW on the Wavelight Topolayzer Vario device are optimal when compared with ATA.
{"title":"Agreement of HVID/WTW measurements made by 5 devices and their correspondence to the distance from angle to angle (ATA)","authors":"I. Saliev","doi":"10.31288/oftalmolzh202331518","DOIUrl":"https://doi.org/10.31288/oftalmolzh202331518","url":null,"abstract":"Purpose: to determine the consistency of HVID/WTW measurements on 5 devices, and their correspondence to the distance from angle to angle (ATA).\u0000Methods\u0000The relevant information on 30 right eyes was obtained from 30 volunteers. A prospective study was conducted using Wavelight Topolayzer Vario (Alcon), IOL Master 700 (Zeiss), OA2000 (Tomey), AS-OCT Casia 2 (Tomey), Zeiss Atlas 9000 (Carl Zeiss) instruments. Agreement between the measurement s made by these devices in the HVID/WTW was analyzed, and the HVID/WTW scores of each device were compared with ATA scores.\u0000Results\u0000The average values of HVID/WTW in Wavelight Topolayzer Vario, IOL Master 700, OA2000, Zeiss Atlas 9000 devices were 11.73 ± 0.33 mm, 12.01 ± 0.34 mm, 12.01 ± 0.27 mm, and 12.2 ± 0.37 mm, respectively. The mean ATA was 11.68 mm on the AS-OCT Casia2 device. The smallest difference in ATA and HVID/WTW was observed on the Wavelight Topolyzer Vario instrument which averaged 0.05±0.102mm 95% LoA (-0.41 to 0.32) (p < 0.05). The largest difference was observed between AS-OCT Casia 2 and Atlas 9000 which averaged 0.52±0.234mm 95% LoA (from-1.21 to 0.17) (p < 0.05).\u0000Conclusion\u0000Our study found that the results of measurements of HVID/WTW on the Wavelight Topolayzer Vario device are optimal when compared with ATA.","PeriodicalId":19419,"journal":{"name":"Oftalmologicheskii zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43065371","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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