Pub Date : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-142-147
V. Neroev, O. V. Zaytseva, A. I. Ushakov
Vitrectomy followed by endotamponade of the vitreal cavity with silicone oil (SO) is one of the main techniques of treating severe forms of regmatogenic retinal detachment (RRD). Endotamponade with SO, having numerous advantages and a huge potential, carries the risk of a number of complications arising at various times of application. The literature review analyzes the published data on the effect of tamponade SO on the retina and the function of central vision in RRD surgery: visual acuity, indicators of light and color sensitivity, data of electrophysiological test results. Possible causes of deteriorated central vision functions directly or indirectly related to tamponade with SO are discussed: changes in the thickness and structure of the retina or its individual layers as shown by optical coherence tomography (OCT) data, microcirculation disorders according to OCT angiography, fluorescein angiography, Doppler laser scanning, as well as pathohistological findings related to SO migration into the fundus of eye tissues.
{"title":"The effect of silicone oil on the anatomical and functional parameters of the retina during surgery of regmatogenic retinal detachment","authors":"V. Neroev, O. V. Zaytseva, A. I. Ushakov","doi":"10.21516/2072-0076-2024-17-2-142-147","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-142-147","url":null,"abstract":"Vitrectomy followed by endotamponade of the vitreal cavity with silicone oil (SO) is one of the main techniques of treating severe forms of regmatogenic retinal detachment (RRD). Endotamponade with SO, having numerous advantages and a huge potential, carries the risk of a number of complications arising at various times of application. The literature review analyzes the published data on the effect of tamponade SO on the retina and the function of central vision in RRD surgery: visual acuity, indicators of light and color sensitivity, data of electrophysiological test results. Possible causes of deteriorated central vision functions directly or indirectly related to tamponade with SO are discussed: changes in the thickness and structure of the retina or its individual layers as shown by optical coherence tomography (OCT) data, microcirculation disorders according to OCT angiography, fluorescein angiography, Doppler laser scanning, as well as pathohistological findings related to SO migration into the fundus of eye tissues.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"16 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684933","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 : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-148-153
O. I. Orenburkina, A. Babushkin, S. M. Shamsutdinov
Nowadays, glaucoma is viewed as a multifactorial neurodegenerative condition that involves many factors affecting different cell types in a human body. As is known, increased intraocular pressure (IOP) is not the only threatening factor of ganglion cell apoptosis and glaucomatous optic neuropathy development; IOP can be associated with other factors, such as vascular, metabolic, neurotrophic, immune, inflammatory, etc. However, the treatment of glaucoma remains largely symptomatic, aimed almost exclusively at reducing IOP. Microbiotic dysbiosis is a newly developing research direction of the glaucomatous progress, showing that this mechanism may turn out to be an important factor of glaucoma development. There are reasons to believe that treatment strategies aimed at microbiota damage correction may contribute to a better efficiency of glaucoma management.
{"title":"Is microbiota a factor in the mechanism of glaucoma development?","authors":"O. I. Orenburkina, A. Babushkin, S. M. Shamsutdinov","doi":"10.21516/2072-0076-2024-17-2-148-153","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-148-153","url":null,"abstract":"Nowadays, glaucoma is viewed as a multifactorial neurodegenerative condition that involves many factors affecting different cell types in a human body. As is known, increased intraocular pressure (IOP) is not the only threatening factor of ganglion cell apoptosis and glaucomatous optic neuropathy development; IOP can be associated with other factors, such as vascular, metabolic, neurotrophic, immune, inflammatory, etc. However, the treatment of glaucoma remains largely symptomatic, aimed almost exclusively at reducing IOP. Microbiotic dysbiosis is a newly developing research direction of the glaucomatous progress, showing that this mechanism may turn out to be an important factor of glaucoma development. There are reasons to believe that treatment strategies aimed at microbiota damage correction may contribute to a better efficiency of glaucoma management. ","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"23 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684767","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 : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-160-165
A. V. Tereshchenko, S. K. Demyanchenko, Y.D. Erina, A. Pashtaev, K. I. Katmakov, Y. M. Trifanenkova, A. Gelyastanov, A. A. Lugovaya
The review presents methods for performing endothelial keratoplasty (EK) in patients with endothelial corneal dysfunction, combined with discontinuities of the iridolenticular diaphragm as reflected in the PubMed, Scopus and eLibrary reference databases for the period ending in 2022. EK performed according to a variety of techniques allows achieving good clinical and functional results and reducing the risk of complications at different stages of treatment of patients with endothelial insufficiency. Another important advantage of EK as compared to penetrating keratoplasty is the fact that it can be repeated multiple times, which is relevant for patients with severe combined pathologies. Considering the plethora of modifications of posterior lamellar keratoplasty and transplantation of the Descemet's membrane and endothelium for cases with combined damages of the integrity of the iridolenticular diaphragm, the number of affected patients may be even more numerous than presented in the publications reviewed. The variety of literature data shows that the search for a universal technique of EK to be performed on patients with various disorders of the iridolenticular diaphragm is likely to continue.
这篇综述介绍了对角膜内皮功能不全并伴有虹膜横隔不连续的患者实施内皮角膜成形术（EK）的方法，相关信息已在截至2022年的PubMed、Scopus和eLibrary参考文献数据库中有所反映。根据不同的技术进行角膜屈光手术可以获得良好的临床和功能效果，并降低内皮功能不全患者在不同治疗阶段出现并发症的风险。与穿透性角膜移植术相比，EK 的另一个重要优势是可以多次重复进行，这对于合并严重病变的患者非常重要。考虑到后板层角膜移植术和德赛美膜及内皮移植术对合并虹膜隔膜完整性损伤的病例有大量的改良方法，受影响的患者人数可能比所查阅的出版物中介绍的还要多。各种文献资料表明，为患有各种虹膜隔膜疾病的患者寻找一种通用的 EK 技术的工作可能会继续下去。
{"title":"Endothelial keratoplasty in integrity-damaged iridolenticular diaphragm","authors":"A. V. Tereshchenko, S. K. Demyanchenko, Y.D. Erina, A. Pashtaev, K. I. Katmakov, Y. M. Trifanenkova, A. Gelyastanov, A. A. Lugovaya","doi":"10.21516/2072-0076-2024-17-2-160-165","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-160-165","url":null,"abstract":"The review presents methods for performing endothelial keratoplasty (EK) in patients with endothelial corneal dysfunction, combined with discontinuities of the iridolenticular diaphragm as reflected in the PubMed, Scopus and eLibrary reference databases for the period ending in 2022. EK performed according to a variety of techniques allows achieving good clinical and functional results and reducing the risk of complications at different stages of treatment of patients with endothelial insufficiency. Another important advantage of EK as compared to penetrating keratoplasty is the fact that it can be repeated multiple times, which is relevant for patients with severe combined pathologies. Considering the plethora of modifications of posterior lamellar keratoplasty and transplantation of the Descemet's membrane and endothelium for cases with combined damages of the integrity of the iridolenticular diaphragm, the number of affected patients may be even more numerous than presented in the publications reviewed. The variety of literature data shows that the search for a universal technique of EK to be performed on patients with various disorders of the iridolenticular diaphragm is likely to continue.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"25 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684528","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 : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-154-159
S. Petrov, O. M. Fillipova, T. N. Malishevskaya, O. I. Markelova
Glaucoma is one of the world’s primary causes of blindness. Russia is following the global increasing trends of glaucoma and its leading position among ophthalmic pathologies that cause irreversible loss of vision. Elevated intraocular pressure (IOP) is the only modifiable risk factor of glaucoma, so treatment strategies specifically focus on reducing IOP by suppressing the production of intraocular fluid and boosting its outflow. The current review presents new medications aimed at glaucoma and high IOP control that have recently appeared at the international market as well as the drugs under the different stages of development, from experimental to clinical studies. These include both the developments of agents belonging to the existing classes and of entirely new drugs intended to control IOP. In an attempt to reduce the side effects of locally administered drugs and prolong their action, in parallel with the development of new drugs, there is also evidence of alternative methods of drug delivery: intraocular implants, injectable forms and obturators, combinations of polymers and colloidal systems.
{"title":"Current trends and prospects of the local antihypertensive drugs development for the glaucoma treatment","authors":"S. Petrov, O. M. Fillipova, T. N. Malishevskaya, O. I. Markelova","doi":"10.21516/2072-0076-2024-17-2-154-159","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-154-159","url":null,"abstract":"Glaucoma is one of the world’s primary causes of blindness. Russia is following the global increasing trends of glaucoma and its leading position among ophthalmic pathologies that cause irreversible loss of vision. Elevated intraocular pressure (IOP) is the only modifiable risk factor of glaucoma, so treatment strategies specifically focus on reducing IOP by suppressing the production of intraocular fluid and boosting its outflow. The current review presents new medications aimed at glaucoma and high IOP control that have recently appeared at the international market as well as the drugs under the different stages of development, from experimental to clinical studies. These include both the developments of agents belonging to the existing classes and of entirely new drugs intended to control IOP. In an attempt to reduce the side effects of locally administered drugs and prolong their action, in parallel with the development of new drugs, there is also evidence of alternative methods of drug delivery: intraocular implants, injectable forms and obturators, combinations of polymers and colloidal systems.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"13 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685987","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 : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-128-134
E. Iomdina, E. Tarutta, G. A. Markosyan, V. N. Papyan, S. Milash
The review presents recent research works on new technologies of scleral collagen crosslinking, a promising approach to sclerastrengthening treatment of progressive myopia. We assess the advantages and limitations of a number of experimental techniques of photochemical and medicinal crosslinking of the sclera, as well as donor tissue crosslinking aimed at optimizing the plastic material for sclera-strengthening surgery. Successful experiments and effective first clinical implementation results of the approach can be viewed as the basis for its further improvement and wider introduction of the technology into ophthalmological practice.
{"title":"Scleral collagen crosslinking as a promising direction of sclera-strengthening treatment of progressive myopia","authors":"E. Iomdina, E. Tarutta, G. A. Markosyan, V. N. Papyan, S. Milash","doi":"10.21516/2072-0076-2024-17-2-128-134","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-128-134","url":null,"abstract":"The review presents recent research works on new technologies of scleral collagen crosslinking, a promising approach to sclerastrengthening treatment of progressive myopia. We assess the advantages and limitations of a number of experimental techniques of photochemical and medicinal crosslinking of the sclera, as well as donor tissue crosslinking aimed at optimizing the plastic material for sclera-strengthening surgery. Successful experiments and effective first clinical implementation results of the approach can be viewed as the basis for its further improvement and wider introduction of the technology into ophthalmological practice.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"6 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684685","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 : 2024-07-02DOI: 10.21516/2072-0076-2024-17-2-135-141
V. Neroev, O. V. Zaytseva, S. Petrov, A. A. Bragin
The medical industry is undergoing an active digital transformation, including the creation of electronic databases, cloud security systems, mobile health monitoring devices, and telemedicine tools. Artificial intelligence (AI), one of the most important technological achievements of the last decade, is gradually gaining momentum in various areas of practical medicine. The cutting edge of AI, neural networks, offers promising approaches to the improvement of clinical examination quality. The review presents data of studies focusing on the use of AI tools in the diagnosis of the most common ophthalmic diseases: diabetic retinopathy, macular degeneration, retinopathy of prematurity, glaucoma, cataracts, and ophthalmic oncology. We discuss both the advantages of neural networks in the diagnosis and monitoring of eye diseases, and outline the difficulties of their implementation, including ethical and legal conflicts.
{"title":"Artificial intelligence in ophthalmology: the present and the future","authors":"V. Neroev, O. V. Zaytseva, S. Petrov, A. A. Bragin","doi":"10.21516/2072-0076-2024-17-2-135-141","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-135-141","url":null,"abstract":"The medical industry is undergoing an active digital transformation, including the creation of electronic databases, cloud security systems, mobile health monitoring devices, and telemedicine tools. Artificial intelligence (AI), one of the most important technological achievements of the last decade, is gradually gaining momentum in various areas of practical medicine. The cutting edge of AI, neural networks, offers promising approaches to the improvement of clinical examination quality. The review presents data of studies focusing on the use of AI tools in the diagnosis of the most common ophthalmic diseases: diabetic retinopathy, macular degeneration, retinopathy of prematurity, glaucoma, cataracts, and ophthalmic oncology. We discuss both the advantages of neural networks in the diagnosis and monitoring of eye diseases, and outline the difficulties of their implementation, including ethical and legal conflicts.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"354 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686837","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 : 2024-07-01DOI: 10.21516/2072-0076-2024-17-2-55-61
T. Pavlenko, N. Chesnokova, O. Beznos, A. V. Grigoryev, T. D. Okhotsimskaya, N. N. Shikareva
Purpose: to develop a model of the early stage of retinal neurodegeneration via an intravitreal injection of the dopaminergic neurotoxin. Material and methods. The experiment was carried out on 20 Chinchilla rabbits. The experimental groups received intravitreal injection of 0.1 ml of 6-hydroxydopamine (6-OHDA) in NaCl 0.9 % with 0.5 % ascorbate, containing 0.25 or 0.5 mg 6-OHDA. The control group received injections of 0.1 ml of NaCl-ascorbate solution without neurotoxin. On the 7th and the 14th days after the injection, intraocular pressure (IOP), pupillary light reaction and ocular blood flow were estimated and the fundus was examined. On the 7th day after an injection of 0.25 mg 6-OHDA, we used ELISA to measure dopamine concentration in retinal homogenates, while on the 14th day after an injection of 0.5 mg 6-OHDA, the concentrations of dopamine, norepinephrine, TNF-a and endothelin-1 were measured by the same method. Results. On the 7th day after a 0,25 mg injection of neurotoxine, we revealed a decrease of dopamine in the retina (0.043 ± 0.130 pg/mg protein compared with 0.10 ± 0,03 pg/mg protein in the controls, р < 0.01). On the 14th day, dopamine and norepinephrine levels showed a fourfold increase (р < 0.05). An injection of 0.5 mg of 6-OHDA caused a threefold increase of dopamine (р < 0.05) and a fivefold increase of norepinephrine (р < 0.01) concentration in comparison with the controls. On the 14th day, endotheline-1 level was 65 % higher than in the controls after a 0.25 mg 6-OHDA injection (р < 0.01) and 45 % higher after a 0,5 mg injection (р<0.05). At the same time, TNF-α levels increased by 43 % (р < 0.05) and 20 % (р < 0.05) respectively. We also revealed a dose-dependent change of IOP, a disturbance of pupillary light reaction and decreased ocular blood flow after an injection of neurotoxin. Conclusion. A single intravitreal injection of dopaminergic neurotoxin 6-OHDA in the amount of 0.25 or 0.5 mg per eye leads to a neuroinflammation and vascular disorders, which are the main pathogenetic pathways of neurodegeneration. To model its early phase, the 0.25 mg dose is preferable as it causes less dramatic functional disorders. The latter model can be useful for the investigation of retinal neurodegeneration pathogenesis, the search for early diagnostic and prognostic markers thereof and the estimation of therapy effectiveness.
{"title":"Modelling of the early stage of retinal neurodegeneration via a topical injection of dopaminergic neurotoxin","authors":"T. Pavlenko, N. Chesnokova, O. Beznos, A. V. Grigoryev, T. D. Okhotsimskaya, N. N. Shikareva","doi":"10.21516/2072-0076-2024-17-2-55-61","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-55-61","url":null,"abstract":"Purpose: to develop a model of the early stage of retinal neurodegeneration via an intravitreal injection of the dopaminergic neurotoxin. Material and methods. The experiment was carried out on 20 Chinchilla rabbits. The experimental groups received intravitreal injection of 0.1 ml of 6-hydroxydopamine (6-OHDA) in NaCl 0.9 % with 0.5 % ascorbate, containing 0.25 or 0.5 mg 6-OHDA. The control group received injections of 0.1 ml of NaCl-ascorbate solution without neurotoxin. On the 7th and the 14th days after the injection, intraocular pressure (IOP), pupillary light reaction and ocular blood flow were estimated and the fundus was examined. On the 7th day after an injection of 0.25 mg 6-OHDA, we used ELISA to measure dopamine concentration in retinal homogenates, while on the 14th day after an injection of 0.5 mg 6-OHDA, the concentrations of dopamine, norepinephrine, TNF-a and endothelin-1 were measured by the same method. Results. On the 7th day after a 0,25 mg injection of neurotoxine, we revealed a decrease of dopamine in the retina (0.043 ± 0.130 pg/mg protein compared with 0.10 ± 0,03 pg/mg protein in the controls, р < 0.01). On the 14th day, dopamine and norepinephrine levels showed a fourfold increase (р < 0.05). An injection of 0.5 mg of 6-OHDA caused a threefold increase of dopamine (р < 0.05) and a fivefold increase of norepinephrine (р < 0.01) concentration in comparison with the controls. On the 14th day, endotheline-1 level was 65 % higher than in the controls after a 0.25 mg 6-OHDA injection (р < 0.01) and 45 % higher after a 0,5 mg injection (р<0.05). At the same time, TNF-α levels increased by 43 % (р < 0.05) and 20 % (р < 0.05) respectively. We also revealed a dose-dependent change of IOP, a disturbance of pupillary light reaction and decreased ocular blood flow after an injection of neurotoxin. Conclusion. A single intravitreal injection of dopaminergic neurotoxin 6-OHDA in the amount of 0.25 or 0.5 mg per eye leads to a neuroinflammation and vascular disorders, which are the main pathogenetic pathways of neurodegeneration. To model its early phase, the 0.25 mg dose is preferable as it causes less dramatic functional disorders. The latter model can be useful for the investigation of retinal neurodegeneration pathogenesis, the search for early diagnostic and prognostic markers thereof and the estimation of therapy effectiveness.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715985","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 : 2024-07-01DOI: 10.21516/2072-0076-2024-17-2-116-120
A. Babushkin, L. I. Gilemzianova, I. P. Ponomarev
COVID-19 causes an immunosuppressive condition and increases the risk of secondary infections, including fungal diseases such as mucormycosis (MM), so doctors should be aware of the possibility of MM development in COVID-19 patients. Since no specific complaints or clinical symptoms exist and the disease is rare, especially in developed countries with a moderate climate, it is often impossible to diagnose MM at the initial examination. Therefore, the detection of the pathogen (mycelium zygomycetes) plays a key role in the diagnosis. Over 70 % of MM patients experience eye damages. According to the literature, the most common manifestations thereof are blepharoptosis, ophthalmoplegia, exophthalmos, injection and conjunctival chemosis. Quite often, the patients have eye pains, orbital cellulitis or phlegmon of the orbit, accompanied by a decrease in vision. For the effective treatment of this severe infectious COVID-19 complication, which takes the form of deep and aggressive mycosis, an interdisciplinary approach is necessary. The complex treatment should make use of antimycotic agents and symptomatic therapy, and, essentially, surgical rehabilitation of infection foci by removing the affected necrotic tissues. The prognosis is always very serious.
COVID-19 会导致免疫抑制，增加继发感染的风险，包括真菌病，如粘孢子菌病（MM），因此医生应注意 COVID-19 患者发生 MM 的可能性。由于没有特殊的主诉或临床症状，而且这种疾病很少见，尤其是在气候温和的发达国家，因此在初次检查时往往无法诊断出 MM。因此，病原体（子囊菌丝体）的检测在诊断中起着关键作用。超过 70% 的 MM 患者的眼睛会受到损害。根据文献记载，最常见的表现是眼睑下垂、眼肌麻痹、眼球外翻、注射和结膜化脓。患者通常会出现眼痛、眼眶蜂窝织炎或眼眶痰，并伴有视力下降。为了有效治疗这种严重的感染性 COVID-19 并发症（表现为深部和侵袭性霉菌病），必须采取跨学科的方法。综合治疗应使用抗真菌药物和对症疗法，主要是通过手术切除受影响的坏死组织，使感染灶恢复正常。预后总是非常严重。
{"title":"Mucormycosis as a complication of COVID-19 coronavirus infection: eye symptoms","authors":"A. Babushkin, L. I. Gilemzianova, I. P. Ponomarev","doi":"10.21516/2072-0076-2024-17-2-116-120","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-116-120","url":null,"abstract":"COVID-19 causes an immunosuppressive condition and increases the risk of secondary infections, including fungal diseases such as mucormycosis (MM), so doctors should be aware of the possibility of MM development in COVID-19 patients. Since no specific complaints or clinical symptoms exist and the disease is rare, especially in developed countries with a moderate climate, it is often impossible to diagnose MM at the initial examination. Therefore, the detection of the pathogen (mycelium zygomycetes) plays a key role in the diagnosis. Over 70 % of MM patients experience eye damages. According to the literature, the most common manifestations thereof are blepharoptosis, ophthalmoplegia, exophthalmos, injection and conjunctival chemosis. Quite often, the patients have eye pains, orbital cellulitis or phlegmon of the orbit, accompanied by a decrease in vision. For the effective treatment of this severe infectious COVID-19 complication, which takes the form of deep and aggressive mycosis, an interdisciplinary approach is necessary. The complex treatment should make use of antimycotic agents and symptomatic therapy, and, essentially, surgical rehabilitation of infection foci by removing the affected necrotic tissues. The prognosis is always very serious.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"88 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714282","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 : 2024-07-01DOI: 10.21516/2072-0076-2024-17-2-93-98
J. Issakhanova, A. K. Duisenova, A. Z. Kurmasheva, D. E. Zhumabek
A clinical case of bilateral descending optic neuritis in a 63-year-old patient is presented. The patient, whose age is beyond the normal limit for this pathology, was previously treated for neuritis of the right eye, which had no effect and led to a complete atrophy of the optic nerve (ON). A timely correct diagnostics of the left eye, which revealed structural disorders of the optic nerve accompanied by inflammatory viral changes of brain tissue, was a key factor in choosing an adequate treatment, which helped retain visual functions. The clinical observation illustrates the polyetiological nature of inflammation of the ON, the viral agent playing a leading role. Importantly, ophthalmic manifestations of the herpesvirus infection may remain the only sign of this pathology for a long time, so the ophthalmologist must always be on the alert regarding the viral genesis of the disease.
{"title":"Diagnosis and treatment of optic neuritis as a manifestation of persistent herpesvirus infection: a clinical case","authors":"J. Issakhanova, A. K. Duisenova, A. Z. Kurmasheva, D. E. Zhumabek","doi":"10.21516/2072-0076-2024-17-2-93-98","DOIUrl":"https://doi.org/10.21516/2072-0076-2024-17-2-93-98","url":null,"abstract":"A clinical case of bilateral descending optic neuritis in a 63-year-old patient is presented. The patient, whose age is beyond the normal limit for this pathology, was previously treated for neuritis of the right eye, which had no effect and led to a complete atrophy of the optic nerve (ON). A timely correct diagnostics of the left eye, which revealed structural disorders of the optic nerve accompanied by inflammatory viral changes of brain tissue, was a key factor in choosing an adequate treatment, which helped retain visual functions. The clinical observation illustrates the polyetiological nature of inflammation of the ON, the viral agent playing a leading role. Importantly, ophthalmic manifestations of the herpesvirus infection may remain the only sign of this pathology for a long time, so the ophthalmologist must always be on the alert regarding the viral genesis of the disease.","PeriodicalId":21436,"journal":{"name":"Russian Ophthalmological Journal","volume":"2002 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707541","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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