BACKGROUND: There are insufficient data covering retinal and choroidal microcirculation in eyes with lattice retinal degeneration. AIM: To investigate retinal and choroidal circulation in eyes with lattice retinal degeneration using optical coherence tomography-angiography (OCTA). MATERIALS AND METHODS: The study included 10 patients with lattice retinal degeneration and 12 healthy individuals. All subjects underwent OCTA examination of the macula. Additionally, in four patients, OCTA within the area of lattice retinal degeneration was performed. RESULTS: Retinal capillary non-perfusion, disorganization of retinal layers, a decrease of choriocapillaris perfusion, and choroidal thinning were found within the area of lattice degeneration in all cases. In the macula, the perfusion area in the choriocapillaris slab in the eyes with lattice degeneration and controls was 6.40 0.21 and 6.19 0.21 mm2 (p 0.05), respectively. The number of flow voids in the choriocapillaris in the eyes with lattice degeneration and controls eyes was 40.6 23.0 and 65.1 25.7 (p 0.05), respectively. The total area of flow voids in the choriocapillaris slab in the eyes with lattice degeneration and in controls eyes was 0.49 0.04 and 0.54 0.04 mm2 (p 0.05), respectively. CONCLUSIONS: The status the choroidal and choriocapillaris perfusion may play an important role in pathophysiology of the lattice retinal degeneration.
{"title":"Retinal and choroidal circulation in patients with lattice retinal degeneration: optical coherence tomography-angiography study","authors":"M. Burnasheva, D. Maltsev, A. Kulikov","doi":"10.17816/ov110752","DOIUrl":"https://doi.org/10.17816/ov110752","url":null,"abstract":"BACKGROUND: There are insufficient data covering retinal and choroidal microcirculation in eyes with lattice retinal degeneration. \u0000AIM: To investigate retinal and choroidal circulation in eyes with lattice retinal degeneration using optical coherence tomography-angiography (OCTA). \u0000MATERIALS AND METHODS: The study included 10 patients with lattice retinal degeneration and 12 healthy individuals. All subjects underwent OCTA examination of the macula. Additionally, in four patients, OCTA within the area of lattice retinal degeneration was performed. \u0000RESULTS: Retinal capillary non-perfusion, disorganization of retinal layers, a decrease of choriocapillaris perfusion, and choroidal thinning were found within the area of lattice degeneration in all cases. In the macula, the perfusion area in the choriocapillaris slab in the eyes with lattice degeneration and controls was 6.40 0.21 and 6.19 0.21 mm2 (p 0.05), respectively. The number of flow voids in the choriocapillaris in the eyes with lattice degeneration and controls eyes was 40.6 23.0 and 65.1 25.7 (p 0.05), respectively. The total area of flow voids in the choriocapillaris slab in the eyes with lattice degeneration and in controls eyes was 0.49 0.04 and 0.54 0.04 mm2 (p 0.05), respectively. \u0000CONCLUSIONS: The status the choroidal and choriocapillaris perfusion may play an important role in pathophysiology of the lattice retinal degeneration.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44815819","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}
BACKGROUND: Postoperative fibrinoid syndrome (PFS) is an early complication of phacoemulsification, manifested by fibrin deposition on the iris and the intraocular lens surface, which leads to visual acuity decrease. AIM: To assess the rate and the treatment efficacy (by YAG laser, enzymatic, medicalmentous) in PFS after phacoemulsification. MATERIALS AND METHODS: Retrospective analysis of 56,019 cataract surgery cases of 20172021. There were 49 patients with PFS divided into 3 groups according to treatment approaches: 1st group medicamentous treatment (MT) + YAG laser destruction of the fibrin film (n = 6); 2nd MT + prourokinase injection into the anterior chamber (n = 6); 3rd MT only (n = 37). RESULTS: There was no difference between groups in best-corrected visual acuity (BCVA) before the PFS development. There was a more rapid increase in BCVA in the 1st and the 2nd groups compared with the 3rd one on the third day (0.20 0.09 and 0.21 0.08 versus 0.09 0.08 for groups respectively, p = 0.001) and on the fifth day of treatment (0.25 0.10 and 0.27 0.13 versus 0.16 0.14, p = 0.029). Nevertheless, in one week, there was no difference in BCVA between groups. Unfortunately, BCVA did not return to baseline in any group. CONCLUSION: The incidence of PFS after phacoemulsification is relatively low and amounts to 0.093%. The most rapid BCVA recovery was observed in the 1st and the 2nd groups.
{"title":"Treatment approaches to postoperative fibrinoid syndrome after phacoemulsification","authors":"D. Belov, V. P. Petukhov","doi":"10.17816/ov109480","DOIUrl":"https://doi.org/10.17816/ov109480","url":null,"abstract":"BACKGROUND: Postoperative fibrinoid syndrome (PFS) is an early complication of phacoemulsification, manifested by fibrin deposition on the iris and the intraocular lens surface, which leads to visual acuity decrease. \u0000AIM: To assess the rate and the treatment efficacy (by YAG laser, enzymatic, medicalmentous) in PFS after phacoemulsification. \u0000MATERIALS AND METHODS: Retrospective analysis of 56,019 cataract surgery cases of 20172021. There were 49 patients with PFS divided into 3 groups according to treatment approaches: 1st group medicamentous treatment (MT) + YAG laser destruction of the fibrin film (n = 6); 2nd MT + prourokinase injection into the anterior chamber (n = 6); 3rd MT only (n = 37). \u0000RESULTS: There was no difference between groups in best-corrected visual acuity (BCVA) before the PFS development. There was a more rapid increase in BCVA in the 1st and the 2nd groups compared with the 3rd one on the third day (0.20 0.09 and 0.21 0.08 versus 0.09 0.08 for groups respectively, p = 0.001) and on the fifth day of treatment (0.25 0.10 and 0.27 0.13 versus 0.16 0.14, p = 0.029). Nevertheless, in one week, there was no difference in BCVA between groups. Unfortunately, BCVA did not return to baseline in any group. \u0000CONCLUSION: The incidence of PFS after phacoemulsification is relatively low and amounts to 0.093%. The most rapid BCVA recovery was observed in the 1st and the 2nd groups.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44067125","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}
Tatiana D. Sizova, V. Khokkanen, N. G. Zumbulidze, E. Boiko
BACKGROUND: Cytomegalovirus damage to the eye is the leading cause of loss of visual functions associated with HIV. Effective treatment of HIV-infected patients has changed the understanding of the clinical picture of cytomegalovirus uveitis (CMV-uveitis). AIM: The aim of the work is to determine the prevalence, the structure of clinical forms and to evaluate visual functions in HIV-infected patients with CMV-uveitis. MATERIALS AND METHODS: The study group consisted of 66 HIV-infected patients with CMV-uveitis (97 eyes), of which there were 27 men (40.9%), 39 women (59.1%). The average age was 39.6 3.91 years. All patients had stage 4B of HIV infection according to V.V. Pokrovskys classification (2006). During the work, visometry, perimetry, biomicroscopy, ophthalmoscopy were used. RESULTS: The main form of the disease is chorioretinitis, diffuse and generalized forms of the disease are diagnosed in 68.0% of cases. In predicting visual acuity, the leading regression criterion was the clinical form of the disease. CONCLUSIONS: Diffuse and generalized forms of the disease prevailed in clinical practice. Localization of the chorioretinal process of a predominantly diffuse nature predetermined visual acuity, which in more than a third of cases met the criteria for blindness according to the WHO classification (1977).
{"title":"Visual functions in patients with cytomegalovirus uveitis and HIV infection","authors":"Tatiana D. Sizova, V. Khokkanen, N. G. Zumbulidze, E. Boiko","doi":"10.17816/ov110957","DOIUrl":"https://doi.org/10.17816/ov110957","url":null,"abstract":"BACKGROUND: Cytomegalovirus damage to the eye is the leading cause of loss of visual functions associated with HIV. Effective treatment of HIV-infected patients has changed the understanding of the clinical picture of cytomegalovirus uveitis (CMV-uveitis). \u0000AIM: The aim of the work is to determine the prevalence, the structure of clinical forms and to evaluate visual functions in HIV-infected patients with CMV-uveitis. \u0000MATERIALS AND METHODS: The study group consisted of 66 HIV-infected patients with CMV-uveitis (97 eyes), of which there were 27 men (40.9%), 39 women (59.1%). The average age was 39.6 3.91 years. All patients had stage 4B of HIV infection according to V.V. Pokrovskys classification (2006). During the work, visometry, perimetry, biomicroscopy, ophthalmoscopy were used. \u0000RESULTS: The main form of the disease is chorioretinitis, diffuse and generalized forms of the disease are diagnosed in 68.0% of cases. In predicting visual acuity, the leading regression criterion was the clinical form of the disease. \u0000CONCLUSIONS: Diffuse and generalized forms of the disease prevailed in clinical practice. Localization of the chorioretinal process of a predominantly diffuse nature predetermined visual acuity, which in more than a third of cases met the criteria for blindness according to the WHO classification (1977).","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45295431","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}
BACKGROUND: Nonspecific angio- and retinopathy is one of the clinical manifestations of a new coronavirus infection. The frequency of occurrence of these changes in people with severe COVID-19 does not exceed 55%. The causes, course and consequences of these microcirculatory disorders of the retina are currently not well understood. AIM: To study and compare of retinal morphometric parameters and systemic endothelial dysfunction markers, as well as the main clinical and laboratory parameters in patients with moderate and severe coronavirus infection during convalescence. MATERIALS AND METHODS: The study involved 44 patients (86 eyes) who had COVID-19 during the previous 3 months, who were divided into 2 groups: with moderate and severe disease. The control group consisted of 18 healthy volunteers (36 eyes). All patients underwent a standard ophthalmological examination and optical coherence tomography, which included an assessment of the choroidal thickness (CT) and measurement of the mean diameter of the peripapillary arteries (MAD) and veins (MVD). During hospitalization, all patients underwent a laboratory study of venous blood parameters, as well as an assessment of the microcirculation of the sublingual plexus by examining the density of the endothelial glycocalyx (PBR) using the GlycoCheck. RESULTS: In patients who underwent COVID-19, there was a significant increase in CT relative to the control group, amounting to 308, 344 and 392 m, respectively. The most pronounced difference was observed between MVD in patients with severe infection and the control group (119.1 m vs. 99.2 m). In patients with moderate and severe COVID-19, MAD and MVD were positively correlated with TC, with r = 0.389 and r = 0.584, respectively. MVD also correlated with the level of leukocytes (r = 0.504), the ESR value (r = 0.656). Correlations between MVD and data characterizing the state of the glycocalyx in the sublingual vascular plexus were revealed: the filling of small capillaries with erythrocytes (r = 0.587), as well as the marginal perfusion value in large capillaries 2025 m (r = 0.479) and PBR (r = 0.479). Only significant differences and correlations are shown (p 0.005). CONCLUSIONS: In patients who underwent moderate and severe COVID-19 during the convalescence period (up to 30 days), an increase in the diameter of peripapillary vessels and TC is observed, proportional to the severity of COVID-19, laboratory markers of systemic inflammation and hypercoagulation (the number of leukocytes, the ESR value, D-dimer and prothrombin), which indicates the inflammatory nature of the changes. The severity of postcovid retinal microangiopathy correlates with indicators detecting a decreasing of the endothelial glycocalyx thickness in the sublingual capillary plexus, which indirectly indicates a connection with systemic endotheliopathy.
{"title":"Relationship of the main indicators of systemic COVID-associated endotheliopathy with the morphofunctional state and hemodynamics of the retina and chorioid in the acute period of the disease","authors":"V. A. Turgel, S. N. Tultseva","doi":"10.17816/ov110727","DOIUrl":"https://doi.org/10.17816/ov110727","url":null,"abstract":"BACKGROUND: Nonspecific angio- and retinopathy is one of the clinical manifestations of a new coronavirus infection. The frequency of occurrence of these changes in people with severe COVID-19 does not exceed 55%. The causes, course and consequences of these microcirculatory disorders of the retina are currently not well understood. \u0000AIM: To study and compare of retinal morphometric parameters and systemic endothelial dysfunction markers, as well as the main clinical and laboratory parameters in patients with moderate and severe coronavirus infection during convalescence. \u0000MATERIALS AND METHODS: The study involved 44 patients (86 eyes) who had COVID-19 during the previous 3 months, who were divided into 2 groups: with moderate and severe disease. The control group consisted of 18 healthy volunteers (36 eyes). All patients underwent a standard ophthalmological examination and optical coherence tomography, which included an assessment of the choroidal thickness (CT) and measurement of the mean diameter of the peripapillary arteries (MAD) and veins (MVD). During hospitalization, all patients underwent a laboratory study of venous blood parameters, as well as an assessment of the microcirculation of the sublingual plexus by examining the density of the endothelial glycocalyx (PBR) using the GlycoCheck. \u0000RESULTS: In patients who underwent COVID-19, there was a significant increase in CT relative to the control group, amounting to 308, 344 and 392 m, respectively. The most pronounced difference was observed between MVD in patients with severe infection and the control group (119.1 m vs. 99.2 m). In patients with moderate and severe COVID-19, MAD and MVD were positively correlated with TC, with r = 0.389 and r = 0.584, respectively. MVD also correlated with the level of leukocytes (r = 0.504), the ESR value (r = 0.656). Correlations between MVD and data characterizing the state of the glycocalyx in the sublingual vascular plexus were revealed: the filling of small capillaries with erythrocytes (r = 0.587), as well as the marginal perfusion value in large capillaries 2025 m (r = 0.479) and PBR (r = 0.479). Only significant differences and correlations are shown (p 0.005). \u0000CONCLUSIONS: In patients who underwent moderate and severe COVID-19 during the convalescence period (up to 30 days), an increase in the diameter of peripapillary vessels and TC is observed, proportional to the severity of COVID-19, laboratory markers of systemic inflammation and hypercoagulation (the number of leukocytes, the ESR value, D-dimer and prothrombin), which indicates the inflammatory nature of the changes. The severity of postcovid retinal microangiopathy correlates with indicators detecting a decreasing of the endothelial glycocalyx thickness in the sublingual capillary plexus, which indirectly indicates a connection with systemic endotheliopathy.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43003784","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}
Alexander N. Samoylov, P. A. Samoylova, Nail R. Ahmetov, Viktor A. Usov, R. F. Gainutdinova, G. Z. Zakirova
This review of the literature is devoted to the comparison of tonometers based on various operating principles, their advantages and disadvantages. The principles of operation of each considered in the review tonometer are discussed. The features of the structure and mechanisms for measuring the intraocular pressure of various tonometers are highlighted, on the basis of which the anatomical features and other factors that have the greatest impact on the reliability of measurement and accounting of the data obtained in clinical practice are determined.
{"title":"Methods for measuring intraocular pressure: disadvantages and advantages","authors":"Alexander N. Samoylov, P. A. Samoylova, Nail R. Ahmetov, Viktor A. Usov, R. F. Gainutdinova, G. Z. Zakirova","doi":"10.17816/ov106140","DOIUrl":"https://doi.org/10.17816/ov106140","url":null,"abstract":"This review of the literature is devoted to the comparison of tonometers based on various operating principles, their advantages and disadvantages. The principles of operation of each considered in the review tonometer are discussed. The features of the structure and mechanisms for measuring the intraocular pressure of various tonometers are highlighted, on the basis of which the anatomical features and other factors that have the greatest impact on the reliability of measurement and accounting of the data obtained in clinical practice are determined.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43301243","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}
Peripapillary retinoschisis is a rare condition and is detected more often in patients with glaucoma or glaucoma suspects, while data on the pathophysiological mechanisms of development and the effect on the course of glaucoma are limited. The article presents two clinical cases of unilateral peripapillary retinoschisis detected accidentally during a routine examination of patients with glaucoma.
{"title":"Peripapillary retinoschisis associated with glaucomatous optic neuropathy (clinical cases)","authors":"T. Doktorova, Aleksei A. Suetov, E. Boiko","doi":"10.17816/ov107586","DOIUrl":"https://doi.org/10.17816/ov107586","url":null,"abstract":"Peripapillary retinoschisis is a rare condition and is detected more often in patients with glaucoma or glaucoma suspects, while data on the pathophysiological mechanisms of development and the effect on the course of glaucoma are limited. The article presents two clinical cases of unilateral peripapillary retinoschisis detected accidentally during a routine examination of patients with glaucoma.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44834054","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}
P. A. Kacherovich, A. Kulikov, N. Lapina, A. Bespalov, K. A. Krasnov, N. N. Kharitonova, R. L. Troyanovskiy
The article presents the pathogenetic mechanisms of eye damage by gas self-defense weapons in detail. We discuss the mechanisms of eye damage and structural changes of the tissues after gas-trauma. The causes of these changes and the main clinical manifestations accompanying them are analyzed. We analyzed the factors, influencing the development of dystrophic changes of the ocular surface in detail. The information on various techniques for self-assistance, mutual aid and earlier specific treatment of this injury was summarized. An aqueous solution of pediphene substance promising for use is considered, which has a number of pharmacological properties that fundamentally affect the pathogenetic mechanisms of gas-weapon trauma. Its effectiveness was shown in the experiment in comparison with the control group without treatment and the group using the combined drug-dexamethasone in combination with an antibiotic.
{"title":"Pathogenesis and treatment principles ocular damage by self-defense gas weapons","authors":"P. A. Kacherovich, A. Kulikov, N. Lapina, A. Bespalov, K. A. Krasnov, N. N. Kharitonova, R. L. Troyanovskiy","doi":"10.17816/ov105683","DOIUrl":"https://doi.org/10.17816/ov105683","url":null,"abstract":"The article presents the pathogenetic mechanisms of eye damage by gas self-defense weapons in detail. We discuss the mechanisms of eye damage and structural changes of the tissues after gas-trauma. The causes of these changes and the main clinical manifestations accompanying them are analyzed. We analyzed the factors, influencing the development of dystrophic changes of the ocular surface in detail. The information on various techniques for self-assistance, mutual aid and earlier specific treatment of this injury was summarized. An aqueous solution of pediphene substance promising for use is considered, which has a number of pharmacological properties that fundamentally affect the pathogenetic mechanisms of gas-weapon trauma. Its effectiveness was shown in the experiment in comparison with the control group without treatment and the group using the combined drug-dexamethasone in combination with an antibiotic.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44915475","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}
A. V. Tereshchenko, S. K. Demyanchenko, Y. M. Trifanenkova, Y. Golubeva, E. N. Vishnyakova
BACKGROUND: Bullous keratopathy is a chronic edema of the cornea, accompanied by a significant visual acuity loss and pain. The cause of bullous keratopathy is a pathological irreversible decrease in the number of endothelial cells, in which the endothelial layer cannot perform its main barrier and pumping functions. AIM: To evaluate the reproducibility and functional results of femto-assisted posterior lamellar keratoplasty using intraoperative OCT at the stage IVV of bullous keratopathy. MATERIALS AND METHODS: The study was conducted on 23 eyes of 23 patients diagnosed with stage IVV of bullous keratopathy. The mean age of patients was 69 12 years, there were 14 male patients and 9 female patients. Before surgery, light perception with correct light projection was recorded in 15 cases, in 5 cases the count of fingers at the face (0.005), in 3 cases visual acuity was 0.01. The central corneal thickness varied from 981 m to 1960 m and averaged 1008 96 m. Femto LDV Z8 femtosecond laser (Ziemer, Switzerland) was used to form an endothelial graft. All surgeries were performed using the Hi-R Neo 900 operating microscope with an integrated third-generation OCT module (Haag-Streit Surgical, Germany). RESULTS: No intraoperative complications were noted. The presence of objective control in the form of intraoperative OCT made it possible in all cases to clearly differentiate stromal and endothelial surfaces of the posterior layered graft located in the anterior chamber of the eye. The postoperative course was standard for posterior lamellar keratoplasty, accompanied by resorption of corneal edema with restoration of its transparency. The normalization of corneal thickness was noted by 1 month after surgery, and the restoration of corneal optical properties was noted by 36 months and was accompanied by gradual increase in visual acuity. Corrected visual acuity by 1 month was 0.05 0.03, by 3, 6, 12 months 0.1 0.05, 0.15 0.05 and 0.15 0.04, respectively. By 12 months after surgery, the central corneal thickness was 596 42 m, the thickness of the ultrathin graft tended to decrease somewhat to 67 8 m, the loss of endothelial cells was 59.3%. Endothelial graft survival was achieved in 82.6% of cases. CONCLUSIONS: The use of intraoperative OCT allows expanding the indications for posterior lamellar keratoplasty in bullous keratopathy, including the stage IVV of the disease.
{"title":"Femtoassisted posterior lamellar keratoplasty in bullous keratopathy of stage IV–V (clinical application experience)","authors":"A. V. Tereshchenko, S. K. Demyanchenko, Y. M. Trifanenkova, Y. Golubeva, E. N. Vishnyakova","doi":"10.17816/ov106579","DOIUrl":"https://doi.org/10.17816/ov106579","url":null,"abstract":"BACKGROUND: Bullous keratopathy is a chronic edema of the cornea, accompanied by a significant visual acuity loss and pain. The cause of bullous keratopathy is a pathological irreversible decrease in the number of endothelial cells, in which the endothelial layer cannot perform its main barrier and pumping functions. \u0000AIM: To evaluate the reproducibility and functional results of femto-assisted posterior lamellar keratoplasty using intraoperative OCT at the stage IVV of bullous keratopathy. \u0000MATERIALS AND METHODS: The study was conducted on 23 eyes of 23 patients diagnosed with stage IVV of bullous keratopathy. The mean age of patients was 69 12 years, there were 14 male patients and 9 female patients. Before surgery, light perception with correct light projection was recorded in 15 cases, in 5 cases the count of fingers at the face (0.005), in 3 cases visual acuity was 0.01. The central corneal thickness varied from 981 m to 1960 m and averaged 1008 96 m. Femto LDV Z8 femtosecond laser (Ziemer, Switzerland) was used to form an endothelial graft. All surgeries were performed using the Hi-R Neo 900 operating microscope with an integrated third-generation OCT module (Haag-Streit Surgical, Germany). \u0000RESULTS: No intraoperative complications were noted. The presence of objective control in the form of intraoperative OCT made it possible in all cases to clearly differentiate stromal and endothelial surfaces of the posterior layered graft located in the anterior chamber of the eye. The postoperative course was standard for posterior lamellar keratoplasty, accompanied by resorption of corneal edema with restoration of its transparency. The normalization of corneal thickness was noted by 1 month after surgery, and the restoration of corneal optical properties was noted by 36 months and was accompanied by gradual increase in visual acuity. Corrected visual acuity by 1 month was 0.05 0.03, by 3, 6, 12 months 0.1 0.05, 0.15 0.05 and 0.15 0.04, respectively. By 12 months after surgery, the central corneal thickness was 596 42 m, the thickness of the ultrathin graft tended to decrease somewhat to 67 8 m, the loss of endothelial cells was 59.3%. Endothelial graft survival was achieved in 82.6% of cases. \u0000CONCLUSIONS: The use of intraoperative OCT allows expanding the indications for posterior lamellar keratoplasty in bullous keratopathy, including the stage IVV of the disease.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48808209","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}
Ekaterina V. Сhentsova, N. Borovkova, T. V. Tselaya, M. Storozheva, I. N. Ponomarev, M. S. Makarov
BACKGROUND: Corneal epithelialization occurs due to proliferation and differentiation of limbal stem epithelial cells. Death of these cells or damage of its microenvironment leads to limbal stem cell deficiency. In bilateral total limbal damage (both eyes), autologues limbal stem cells transplantation becomes impossible. So, it is revalent to find new sources of autologous progenitor cells. One of such sources are buccal cells from cheek mucosa. AIM: To study the reparative effect of buccal cells in oral mucosa autologous epithelial layer in a mechanical limbal stem cell deficiency model. MATERIALS AND METHODS: The study was conducted on 7 Chinchilla rabbits (14 eyes). At the first stage, rabbits underwent bilateral total limbectomy and mechanical de-epithelialization of the cornea resulted in fibrovascular pannus development. Then, a full-layer flap of the cheek mucosa measuring 5 5 mm was taken, and epithelial layer was separated by 0.5% dispase solution. After superficial keratectomy to transparent layers, a layer of buccal epithelium was placed to the cornea and covered with a soft contact lens. In controls soft contact lens, was placed on the cornea. Temporary tarsorrhaphy was performed for 5 days. In the postoperative period, the area of the deepithelized surface, neovascularization and corneal transparency were evaluated. RESULTS: On the 7th30th day, a reduction of erosion was noted in experimental and control eyes, but the dynamics of recovery processes did not significantly differ. On day 60, the area of erosion in the experimental eyes was significantly less than in the control (p = 0.038). Recurrence of erosion was noted in 4 control and 3 experimental eyes. CONCLUSIONS: In our model of limbal stem cell deficiency, the use of a buccal epithelium layer did not reveal a pronounced reparative effect.
{"title":"Transplantation of the oral mucosa epithelial layer in the treatment of corneal defects with limbal stem cell deficiency","authors":"Ekaterina V. Сhentsova, N. Borovkova, T. V. Tselaya, M. Storozheva, I. N. Ponomarev, M. S. Makarov","doi":"10.17816/ov108732","DOIUrl":"https://doi.org/10.17816/ov108732","url":null,"abstract":"BACKGROUND: Corneal epithelialization occurs due to proliferation and differentiation of limbal stem epithelial cells. Death of these cells or damage of its microenvironment leads to limbal stem cell deficiency. In bilateral total limbal damage (both eyes), autologues limbal stem cells transplantation becomes impossible. So, it is revalent to find new sources of autologous progenitor cells. One of such sources are buccal cells from cheek mucosa. \u0000AIM: To study the reparative effect of buccal cells in oral mucosa autologous epithelial layer in a mechanical limbal stem cell deficiency model. \u0000MATERIALS AND METHODS: The study was conducted on 7 Chinchilla rabbits (14 eyes). At the first stage, rabbits underwent bilateral total limbectomy and mechanical de-epithelialization of the cornea resulted in fibrovascular pannus development. Then, a full-layer flap of the cheek mucosa measuring 5 5 mm was taken, and epithelial layer was separated by 0.5% dispase solution. After superficial keratectomy to transparent layers, a layer of buccal epithelium was placed to the cornea and covered with a soft contact lens. In controls soft contact lens, was placed on the cornea. Temporary tarsorrhaphy was performed for 5 days. In the postoperative period, the area of the deepithelized surface, neovascularization and corneal transparency were evaluated. \u0000RESULTS: On the 7th30th day, a reduction of erosion was noted in experimental and control eyes, but the dynamics of recovery processes did not significantly differ. On day 60, the area of erosion in the experimental eyes was significantly less than in the control (p = 0.038). Recurrence of erosion was noted in 4 control and 3 experimental eyes. \u0000CONCLUSIONS: In our model of limbal stem cell deficiency, the use of a buccal epithelium layer did not reveal a pronounced reparative effect.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42168360","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}
N. Gavrilova, Nuria S. Gadzhieva, Elena A. Subbota
At the moment, there are no effective methods of treatment for age-related macular degeneration at its early stages. The perspective of treatment for age-related macular degeneration may be a method using subthreshold laser radiation. In the present review of literature, analysis is represented of using both subthreshold micro- and nanosecond laser radiation on the retina in intermediate AMD stage. Subthreshold diode micro-pulse laser exposure of the retina in AMD has proven to be a safe procedure that allows for the regression of macular drusen. While some authors noted an improvement in visual functions and a decrease in the probability of developing choroidal neovascularization with such treatment, multicenter trials have not yet confirmed the effectiveness of micro-pulse therapy as a method to prevent the neovascular AMD development. Subthreshold nanosecond laser impact on the retina is safe for the structures of the eye fundus, theoretically more selective stimulates the natural biological and regenerative potential in the pigment epithelium and neuroepithelium due to remodeling of extracellular matrix, restores the thickness of the Bruchs membrane and metabolism between external retinal layers and choriocapillaris. Encouraging results have been achieved from the use of nanopulse therapy as a method of preventing the development of advanced stage AMD in the absence of reticular pseudodrusen, however, it seems premature to recommend this technology for widespread clinical use - further research is needed. The prospects of invading in wide clinical practice of subthreshold nanosecond laser impact on the intermediate stage of AMD on the basis of the obtained clinical research results are encouraging (regression of drusen, preventing of AMD progression in absence of reticular pseudodrusen), but there is currently no evidence base. It is required to conduct further researches.
{"title":"Exposure of the retina to subthreshold micro- and nanosecond laser at early stages of age-related macular degeneration","authors":"N. Gavrilova, Nuria S. Gadzhieva, Elena A. Subbota","doi":"10.17816/ov105081","DOIUrl":"https://doi.org/10.17816/ov105081","url":null,"abstract":"At the moment, there are no effective methods of treatment for age-related macular degeneration at its early stages. The perspective of treatment for age-related macular degeneration may be a method using subthreshold laser radiation. \u0000In the present review of literature, analysis is represented of using both subthreshold micro- and nanosecond laser radiation on the retina in intermediate AMD stage. Subthreshold diode micro-pulse laser exposure of the retina in AMD has proven to be a safe procedure that allows for the regression of macular drusen. \u0000While some authors noted an improvement in visual functions and a decrease in the probability of developing choroidal neovascularization with such treatment, multicenter trials have not yet confirmed the effectiveness of micro-pulse therapy as a method to prevent the neovascular AMD development. \u0000Subthreshold nanosecond laser impact on the retina is safe for the structures of the eye fundus, theoretically more selective stimulates the natural biological and regenerative potential in the pigment epithelium and neuroepithelium due to remodeling of extracellular matrix, restores the thickness of the Bruchs membrane and metabolism between external retinal layers and choriocapillaris. \u0000Encouraging results have been achieved from the use of nanopulse therapy as a method of preventing the development of advanced stage AMD in the absence of reticular pseudodrusen, however, it seems premature to recommend this technology for widespread clinical use - further research is needed. \u0000The prospects of invading in wide clinical practice of subthreshold nanosecond laser impact on the intermediate stage of AMD on the basis of the obtained clinical research results are encouraging (regression of drusen, preventing of AMD progression in absence of reticular pseudodrusen), but there is currently no evidence base. It is required to conduct further researches.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42702450","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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