A. N. Bochkareva, O. V. Kolenko, V. Egorov, G. P. Smoliakova, P. Banshchikov
BACKGROUND: Despite the development of new methods for treatment of pterygium, the frequency of its recurrence ranges from 5 to 89%. AIM: Was to evaluate the effectiveness of ciclosporin for prevention of pterygium recurrence. MATERIALS AND METHODS: Under follow-up, there were 104 patients operated for pterygium, of which 26 had a high risk of recurrence, they were divided into 2 groups: the 1st group 13 patients received 0.05% ciclosporin in addition to basic therapy; the 2nd group 13 patients receiving only basic therapy. Patients of studied groups were under dynamic observation for 1 year. RESULTS: After 3 months, all patients of the 1st group showed normalization of the osmolarity of the lacrimal fluid (OLF) and the ocular surface disease index (OSDI). In patients of the 2nd group, elevated values of OLF and OSDI remained characterizing the persistence of an inflammatory reaction signs and a high risk of the disease recurrence, as well as the formation of a hypertrophic scar in 38.5% of cases. In one year after surgery, 3 patients of group 2 had a recurrent pterygium, which required surgical retreatment. CONCLUSIONS: We obtained results showing a positive effect of ciclosporin use on dynamics of inflammatory reactions of the ocular surface in postoperative period, which made it possible to prevent pterygium recurrence after its surgical treatment in patients with high risk of recurrence.
{"title":"Ciclosporin use for prevention of pterygium recurrence","authors":"A. N. Bochkareva, O. V. Kolenko, V. Egorov, G. P. Smoliakova, P. Banshchikov","doi":"10.17816/ov108645","DOIUrl":"https://doi.org/10.17816/ov108645","url":null,"abstract":"BACKGROUND: Despite the development of new methods for treatment of pterygium, the frequency of its recurrence ranges from 5 to 89%. \u0000AIM: Was to evaluate the effectiveness of ciclosporin for prevention of pterygium recurrence. \u0000MATERIALS AND METHODS: Under follow-up, there were 104 patients operated for pterygium, of which 26 had a high risk of recurrence, they were divided into 2 groups: the 1st group 13 patients received 0.05% ciclosporin in addition to basic therapy; the 2nd group 13 patients receiving only basic therapy. Patients of studied groups were under dynamic observation for 1 year. \u0000RESULTS: After 3 months, all patients of the 1st group showed normalization of the osmolarity of the lacrimal fluid (OLF) and the ocular surface disease index (OSDI). In patients of the 2nd group, elevated values of OLF and OSDI remained characterizing the persistence of an inflammatory reaction signs and a high risk of the disease recurrence, as well as the formation of a hypertrophic scar in 38.5% of cases. In one year after surgery, 3 patients of group 2 had a recurrent pterygium, which required surgical retreatment. \u0000CONCLUSIONS: We obtained results showing a positive effect of ciclosporin use on dynamics of inflammatory reactions of the ocular surface in postoperative period, which made it possible to prevent pterygium recurrence after its surgical treatment in patients with high risk of recurrence.","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":"43479189","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: Penetrating keratoplasty leads, on the one hand, in 100% of cases, to the formation of induced astigmatism of variable degree, on the other hand, to a decrease in the density of endothelial cells of the corneal graft, which can reach from 19.1 to 38.3%. Thus, today the task of safe cataract extraction with minimal loss of density of endothelial cells and maximal correction of corneal astigmatism by the aid of an implantation of a toric intraocular lens is paramount. AIM: The aim of the study is to conduct a clinical and functional analysis of cataract phacoemulsification with a toric intraocular lens implantation in patients after previously performed penetrating keratoplasty. MATERIALS AND METHODS: We performed phacoemulsification with implantation of a toric intraocular lens in 25 eyes (25 patients) having a history of penetrating keratoplasty. The 1st degree of the lens nucleus density (according to Buratto classification) was noted in 4 eyes, the 2nd degree in 17 eyes, the 3rd degree in 4 eyes. According to keratotopography, all patients had a symmetrical type of postkeratoplastic astigmatism. The average follow-up period was 1 year. RESULTS: Intra- and postoperative complications were noted. One month after surgery, uncorrected visual acuity increased from an average of 1.3 1.6 to 0.3 0.9 LogMAR, best corrected visual acuity increased from 1.0 1.18 to 0.1 0.9 LogMAR, refractive astigmatism decreased from 7.5 2.43 to 1.43 0.38 D, and did not change during 1 year of follow-up. The density of endothelial cells decreased by 9% 1 year after surgery. CONCLUSIONS: Cataract phacoemulsification with a toric intraocular lens implantation in patients after previously performed penetrating keratoplasty allows achieving high refractive results. Preoperative analysis of endothelial cell density, careful approach to the intraocular lens calculation, and standard protocol of phacoemulsification make this operation predictable and safe.
{"title":"Correction of postkeratoplastic ametropia in patients with cataract","authors":"M. Sinitsyn, N. Pozdeyeva","doi":"10.17816/ov109153","DOIUrl":"https://doi.org/10.17816/ov109153","url":null,"abstract":"BACKGROUND: Penetrating keratoplasty leads, on the one hand, in 100% of cases, to the formation of induced astigmatism of variable degree, on the other hand, to a decrease in the density of endothelial cells of the corneal graft, which can reach from 19.1 to 38.3%. Thus, today the task of safe cataract extraction with minimal loss of density of endothelial cells and maximal correction of corneal astigmatism by the aid of an implantation of a toric intraocular lens is paramount. \u0000AIM: The aim of the study is to conduct a clinical and functional analysis of cataract phacoemulsification with a toric intraocular lens implantation in patients after previously performed penetrating keratoplasty. \u0000MATERIALS AND METHODS: We performed phacoemulsification with implantation of a toric intraocular lens in 25 eyes (25 patients) having a history of penetrating keratoplasty. The 1st degree of the lens nucleus density (according to Buratto classification) was noted in 4 eyes, the 2nd degree in 17 eyes, the 3rd degree in 4 eyes. According to keratotopography, all patients had a symmetrical type of postkeratoplastic astigmatism. The average follow-up period was 1 year. \u0000RESULTS: Intra- and postoperative complications were noted. One month after surgery, uncorrected visual acuity increased from an average of 1.3 1.6 to 0.3 0.9 LogMAR, best corrected visual acuity increased from 1.0 1.18 to 0.1 0.9 LogMAR, refractive astigmatism decreased from 7.5 2.43 to 1.43 0.38 D, and did not change during 1 year of follow-up. The density of endothelial cells decreased by 9% 1 year after surgery. \u0000CONCLUSIONS: Cataract phacoemulsification with a toric intraocular lens implantation in patients after previously performed penetrating keratoplasty allows achieving high refractive results. Preoperative analysis of endothelial cell density, careful approach to the intraocular lens calculation, and standard protocol of phacoemulsification make this operation predictable and safe.","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":"46650643","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: Phacoemulsification, being the safest technique, is the golden standard of cataract surgery worldwide. However, as any surgery, it is accompanied by inevitable damage to intraocular structures. The most prevalent among them is the loss of corneal endothelial cells. In order to prevent these complications, various viscoelastics with particular features and characteristics are widely used. AIM: To compare the anatomical and functional state of ocular structures after standard phacoemulsification with monofocal posterior chamber intraocular lens (IOL) implantation using domestic (Kogevisc and Adgevisc) and foreign (Viscoat and Amvisc Plus) viscoelastics. MATERIALS AND METHODS: 60 cataract patients (60 eyes) were included in the clinical study, which were divided into two equal groups. In the first group (30 patients, 30 eyes), Adgevisc and Kogevisc (Solofarm, Russia) were used during the procedure. The mean age of the patients was 66 11 years. In the second group (30 patients, 30 eyes), Viscoat (Alcon) and Amvisc Plus (BauschLomb) were used. The mean age of the patients was 69.03 10.44 years. All patients underwent phacoemulsification with the implantation of the AcrySof IOL (model SA60AT, Alcon) according to the standard technique. Visual acuity, IOP level, CCT, corneal endothelial cell density were assessed. All studies were performed before surgery, the next day, 7 days and 1 month after surgery. RESULTS: In patients of the second group, on the 1st (p 0.05) and 7th day (p 0.01) after surgery, a statistically significant increase in IOP was revealed compared to the first group. The central cornea thickness in the early postoperative period was higher in patients of the second group, however, it was not statistically significant. The loss of corneal endothelial cells 1 month after surgery was 8.5 7.0% (p 0.01) in the first group and 6.6 6.4% in the second group (p 0.01). The mean value of endothelial cell loss in patients of the first group was higher, however, it was not statistically significant. The best corrected visual acuity in both groups at all stages of follow-up after surgery (days 1, 7 and 30) was comparable, there was no significant difference between the groups. CONCLUSIONS: The clinical efficacy of domestic adhesive and cohesive viscoelastics Adgevisc and Kogevisc (Solofarm, Russia) in phacoemulsification using the soft-shell technique is comparable to the foreign analogues Viscoat (Alcon) and Amvisc Plus (Bausch Lomb), which is confirmed by the absence of statistically significant differences in the studied parameters of the postoperative state of ocular structures and explained by their similar composition, molecular weight and viscosity.
{"title":"Comparative evaluation of the results of phacoemulsification using domestic and foreign viscoelastics","authors":"Georgiy Z. Dzhaliashvili, E. E. Farikova","doi":"10.17816/ov109016","DOIUrl":"https://doi.org/10.17816/ov109016","url":null,"abstract":"BACKGROUND: Phacoemulsification, being the safest technique, is the golden standard of cataract surgery worldwide. However, as any surgery, it is accompanied by inevitable damage to intraocular structures. The most prevalent among them is the loss of corneal endothelial cells. In order to prevent these complications, various viscoelastics with particular features and characteristics are widely used. \u0000AIM: To compare the anatomical and functional state of ocular structures after standard phacoemulsification with monofocal posterior chamber intraocular lens (IOL) implantation using domestic (Kogevisc and Adgevisc) and foreign (Viscoat and Amvisc Plus) viscoelastics. \u0000MATERIALS AND METHODS: 60 cataract patients (60 eyes) were included in the clinical study, which were divided into two equal groups. In the first group (30 patients, 30 eyes), Adgevisc and Kogevisc (Solofarm, Russia) were used during the procedure. The mean age of the patients was 66 11 years. In the second group (30 patients, 30 eyes), Viscoat (Alcon) and Amvisc Plus (BauschLomb) were used. The mean age of the patients was 69.03 10.44 years. All patients underwent phacoemulsification with the implantation of the AcrySof IOL (model SA60AT, Alcon) according to the standard technique. Visual acuity, IOP level, CCT, corneal endothelial cell density were assessed. All studies were performed before surgery, the next day, 7 days and 1 month after surgery. \u0000RESULTS: In patients of the second group, on the 1st (p 0.05) and 7th day (p 0.01) after surgery, a statistically significant increase in IOP was revealed compared to the first group. The central cornea thickness in the early postoperative period was higher in patients of the second group, however, it was not statistically significant. The loss of corneal endothelial cells 1 month after surgery was 8.5 7.0% (p 0.01) in the first group and 6.6 6.4% in the second group (p 0.01). The mean value of endothelial cell loss in patients of the first group was higher, however, it was not statistically significant. The best corrected visual acuity in both groups at all stages of follow-up after surgery (days 1, 7 and 30) was comparable, there was no significant difference between the groups. \u0000CONCLUSIONS: The clinical efficacy of domestic adhesive and cohesive viscoelastics Adgevisc and Kogevisc (Solofarm, Russia) in phacoemulsification using the soft-shell technique is comparable to the foreign analogues Viscoat (Alcon) and Amvisc Plus (Bausch Lomb), which is confirmed by the absence of statistically significant differences in the studied parameters of the postoperative state of ocular structures and explained by their similar composition, molecular weight and viscosity.","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":"42586501","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: The cutting action of a femtosecond laser (FS-laser) on the corneal tissue is performed using a photodestructive effect. FS-laser technology is used in many different areas of corneal surgery, and studying this effect is an actual issue. AIM: To evaluate the surface of the corneal incision created by a FS-laser (experimental study). MATERIALS AND METHODS: 20 porcine eyes were divided into two groups (FS-laser and keratome). The corneal tissue surface in the area of contact between two lips of the incision was visualized by electron microscopy. RESULTS: In all cases, we received a full-thickness incisions through the cornea. Images obtained by electron microscopy showed regular surface, no signs of thermal or mechanical damage to the corneal structure. CONCLUSIONS: The FS-laser is used as a microscopic scalpel in surgery. The precision cutting process is performed by mechanical forces generated by photodestruction by expanding cavitation bubbles.
{"title":"The creation of a corneal incision with a femtosecond laser","authors":"Y. S. Nizametdinova, Y. Takhtaev","doi":"10.17816/ov109082","DOIUrl":"https://doi.org/10.17816/ov109082","url":null,"abstract":"BACKGROUND: The cutting action of a femtosecond laser (FS-laser) on the corneal tissue is performed using a photodestructive effect. FS-laser technology is used in many different areas of corneal surgery, and studying this effect is an actual issue. \u0000AIM: To evaluate the surface of the corneal incision created by a FS-laser (experimental study). \u0000MATERIALS AND METHODS: 20 porcine eyes were divided into two groups (FS-laser and keratome). The corneal tissue surface in the area of contact between two lips of the incision was visualized by electron microscopy. \u0000RESULTS: In all cases, we received a full-thickness incisions through the cornea. Images obtained by electron microscopy showed regular surface, no signs of thermal or mechanical damage to the corneal structure. \u0000CONCLUSIONS: The FS-laser is used as a microscopic scalpel in surgery. The precision cutting process is performed by mechanical forces generated by photodestruction by expanding cavitation bubbles.","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":"48285638","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}
Liliia K. Anikina, S. Astakhov, Vitaliy V. Potemkin, S. E. Babaeva, Serafima A. Kostygina
BACKGROUND: Most of the thyroid eye disease (TED) patients have dry eye syndrome. Upper eyelid retraction (UER) is the most common TED symptom and one of dry eye causes. There are two groups of UER surgical treatment methods: transconjunctival and transcutaneous, which can influence on upper eyelid contour, tear film and ocular surface. AIM: To evaluate the influence of different methods of UER surgery on upper eyelid contour and ocular surface. MATERIALS AND METHODS: 12 patients (19 eyes) were included in the study. Visual acuity test, measurements of UER and palpebral fissure height, Shirmer 1 test, LIPCOF-test and tear break-up time test, Meibomian gland dysfunction staging, corneal and conjunctival fluorescein staining and determination of the ocular surface disease index (OSDI) were performed before surgery and 1 week, 1 and 3 months after. Patients were divided into two groups. Patients of group 1 had UER less than 4 mm and they underwent an upper tarsal muscle extirpation. Patients of group 2 had UER 4 mm and more and they underwent a recession of the levator palpebrae superioris muscle apouneurosis. RESULTS: In all patients UER and the height of the palpebral fissure decreased 7 days after surgery and increased again after 3 months, and the dynamics of this change was more pronounced in group 2. There was one patient (both sides) with poor upper eyelid contour after surgery in both groups. BCVA and OSDI improved, while other parameters had a large scatter of data. CONCLUSIONS: We have found that surgical treatment of UER caused by TED improves the contour of the eyelid, increases visual acuity and leads to a subjective improvement in the condition of the ocular surface.
{"title":"Ocular surface and the upper eyelid contour after surgical treatment of upper eyelid retraction in thyroid eye disease","authors":"Liliia K. Anikina, S. Astakhov, Vitaliy V. Potemkin, S. E. Babaeva, Serafima A. Kostygina","doi":"10.17816/ov105166","DOIUrl":"https://doi.org/10.17816/ov105166","url":null,"abstract":"BACKGROUND: Most of the thyroid eye disease (TED) patients have dry eye syndrome. Upper eyelid retraction (UER) is the most common TED symptom and one of dry eye causes. There are two groups of UER surgical treatment methods: transconjunctival and transcutaneous, which can influence on upper eyelid contour, tear film and ocular surface. \u0000AIM: To evaluate the influence of different methods of UER surgery on upper eyelid contour and ocular surface. \u0000MATERIALS AND METHODS: 12 patients (19 eyes) were included in the study. Visual acuity test, measurements of UER and palpebral fissure height, Shirmer 1 test, LIPCOF-test and tear break-up time test, Meibomian gland dysfunction staging, corneal and conjunctival fluorescein staining and determination of the ocular surface disease index (OSDI) were performed before surgery and 1 week, 1 and 3 months after. Patients were divided into two groups. Patients of group 1 had UER less than 4 mm and they underwent an upper tarsal muscle extirpation. Patients of group 2 had UER 4 mm and more and they underwent a recession of the levator palpebrae superioris muscle apouneurosis. \u0000RESULTS: In all patients UER and the height of the palpebral fissure decreased 7 days after surgery and increased again after 3 months, and the dynamics of this change was more pronounced in group 2. There was one patient (both sides) with poor upper eyelid contour after surgery in both groups. BCVA and OSDI improved, while other parameters had a large scatter of data. \u0000CONCLUSIONS: We have found that surgical treatment of UER caused by TED improves the contour of the eyelid, increases visual acuity and leads to a subjective improvement in the condition of the ocular surface.","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":"46940816","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: Nowadays the problem of orbital trauma remains extremely relevant. Combined damage of several anatomical structures, globe injury, various clinical manifestations, the necessity of optimal surgical treatment require high-quality, timely diagnostics. Considering the current development of diagnostic equipment, postprocessing of CT data acquires the key role in order to obtain objective diagnostic information in patients with orbital trauma. AIM: Evaluation of the effectiveness of the developed methods for CT data assessing in patients with orbital trauma. MATERIALS AND METHODS: From 2016 to 2021 a total of 107 patients (100%) with orbital injuries were examined in Sechenov University clinics. All patients were distributed depending on the injury occurrence time: 50 patients (47%) in acute and subacute periods, 30 patients (28%) in the period of formation of post-traumatic deformities, 27 patients (25%) in the period of formed post-traumatic deformities. All patients (n = 107; 100%) underwent CT data analysis according to the developed protocol: analysis of bone and soft tissue trauma using a specialized algorithm, assessment of orbital volumes, evaluation of defects in the inferior orbital wall, examination of the globe position and of changes in the density of the orbital soft tissues. RESULTS: In the preoperative period the developed algorithm for orbital volumes measuring additionally revealed a post-traumatic increase in orbital volume in 21 patients (19%). The technique for the globe position assessing additionally revealed the risk of enophthalmos in 9 patients (8.1%), and in 1 case (0.9%) the suspicion of globe displacement was not confirmed. The defects of the inferior orbital wall were classified into small (n = 18; 17%), medium (n = 31; 29%) and large/total (n = 38; 35% and n = 20; 19%, respectively). In 88 patients (82%), the ratio of the defect to the entire inferior orbital wall was more than 6.65%, in 19 patients (18%) less than 6.65%. Changes in the density of the orbital soft tissues were as follows: soft tissue edema n = 60 (56%), soft tissue atrophy n = 28 (27%), hematoma of the orbital soft tissues n = 10 (9%), density was not changed n = 9 (8%). In the postoperative period, the developed methods for CT data processing revealed incomplete restoration of the orbital volume in 31 cases (29%), incomplete coverage of the inferior orbital wall defect in 38 cases (35%), globe displacement in 14 cases (13%), which was not determined by the standard CT data assessment without the specialized technique. In 7 cases (6%), a suspicion of an increase in the orbital volume was not confirmed by the developed methodology. CONCLUSION: The developed methods for measuring orbit volumes, assessing defects in the lower orbital wall, the globe position, and the condition of the orbital soft tissues provide statistically reliable additional diagnostic information about the patients condition and personalized approach for preoperative p
{"title":"Modern capabilities of the computed tomography in orbital traumatic injuries diagnosis","authors":"Dmitry V. Davydov, N. Serova, O. Pavlova","doi":"10.17816/ov106092","DOIUrl":"https://doi.org/10.17816/ov106092","url":null,"abstract":"BACKGROUND: Nowadays the problem of orbital trauma remains extremely relevant. Combined damage of several anatomical structures, globe injury, various clinical manifestations, the necessity of optimal surgical treatment require high-quality, timely diagnostics. Considering the current development of diagnostic equipment, postprocessing of CT data acquires the key role in order to obtain objective diagnostic information in patients with orbital trauma. \u0000AIM: Evaluation of the effectiveness of the developed methods for CT data assessing in patients with orbital trauma. \u0000MATERIALS AND METHODS: From 2016 to 2021 a total of 107 patients (100%) with orbital injuries were examined in Sechenov University clinics. All patients were distributed depending on the injury occurrence time: 50 patients (47%) in acute and subacute periods, 30 patients (28%) in the period of formation of post-traumatic deformities, 27 patients (25%) in the period of formed post-traumatic deformities. All patients (n = 107; 100%) underwent CT data analysis according to the developed protocol: analysis of bone and soft tissue trauma using a specialized algorithm, assessment of orbital volumes, evaluation of defects in the inferior orbital wall, examination of the globe position and of changes in the density of the orbital soft tissues. \u0000RESULTS: In the preoperative period the developed algorithm for orbital volumes measuring additionally revealed a post-traumatic increase in orbital volume in 21 patients (19%). The technique for the globe position assessing additionally revealed the risk of enophthalmos in 9 patients (8.1%), and in 1 case (0.9%) the suspicion of globe displacement was not confirmed. The defects of the inferior orbital wall were classified into small (n = 18; 17%), medium (n = 31; 29%) and large/total (n = 38; 35% and n = 20; 19%, respectively). In 88 patients (82%), the ratio of the defect to the entire inferior orbital wall was more than 6.65%, in 19 patients (18%) less than 6.65%. Changes in the density of the orbital soft tissues were as follows: soft tissue edema n = 60 (56%), soft tissue atrophy n = 28 (27%), hematoma of the orbital soft tissues n = 10 (9%), density was not changed n = 9 (8%). In the postoperative period, the developed methods for CT data processing revealed incomplete restoration of the orbital volume in 31 cases (29%), incomplete coverage of the inferior orbital wall defect in 38 cases (35%), globe displacement in 14 cases (13%), which was not determined by the standard CT data assessment without the specialized technique. In 7 cases (6%), a suspicion of an increase in the orbital volume was not confirmed by the developed methodology. \u0000CONCLUSION: The developed methods for measuring orbit volumes, assessing defects in the lower orbital wall, the globe position, and the condition of the orbital soft tissues provide statistically reliable additional diagnostic information about the patients condition and personalized approach for preoperative p","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46471921","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}
Natalia N. Haritonova, D. Gorbachev, Maksim S. Safonov, A. A. Kolbin, A. Kulikov, Alena A. Kolke, I. Batyrshin, E. Zinoviev
BACKGROUND: A rare severe, characterized by high mortality in some localizations (up to 70%) necrotizing periorbital fasciitis has not been described previously in the national literature. AIM: to show a multidisciplinary approach to the treatment and rehabilitation of patients with periorbital necrotizing fasciitis on the example of the clinical case. CLINICAL CASE: Patient with the acute necrotizing fasciitis of both eyelids, with the dissemination to the superficial face and neck fascies, the sepsis development is given. Monitoring of vital functions, homeostasis indicators, repeated inoculations, computed tomography, regular examination by an ophthalmologist included the control of visual functions, anterior and posterior segments, closure of the eye fissure. Conservative and surgical treatment applied by a multidisciplinary team is presented, which allowed to save the patients life, overpass the purulent-necrotic, and then the rough scar process and to achieve satisfactory anatomical and functional results. CONCLUSION: Timely multidisciplinary treatment of periorbital necrotizing fasciitis is necessary for the life preservation, prevention of severe complications from the eye. With the threat of developing lagophthalmos, it is necessary to perform permanent blepharoraphy for 36 months after the first surgery and further surgical and pharmacological correction of scarring processes.
{"title":"The acute necrotizing periorbital fasciitis. Clinical case","authors":"Natalia N. Haritonova, D. Gorbachev, Maksim S. Safonov, A. A. Kolbin, A. Kulikov, Alena A. Kolke, I. Batyrshin, E. Zinoviev","doi":"10.17816/ov100108","DOIUrl":"https://doi.org/10.17816/ov100108","url":null,"abstract":"BACKGROUND: A rare severe, characterized by high mortality in some localizations (up to 70%) necrotizing periorbital fasciitis has not been described previously in the national literature. \u0000AIM: to show a multidisciplinary approach to the treatment and rehabilitation of patients with periorbital necrotizing fasciitis on the example of the clinical case. \u0000CLINICAL CASE: Patient with the acute necrotizing fasciitis of both eyelids, with the dissemination to the superficial face and neck fascies, the sepsis development is given. Monitoring of vital functions, homeostasis indicators, repeated inoculations, computed tomography, regular examination by an ophthalmologist included the control of visual functions, anterior and posterior segments, closure of the eye fissure. Conservative and surgical treatment applied by a multidisciplinary team is presented, which allowed to save the patients life, overpass the purulent-necrotic, and then the rough scar process and to achieve satisfactory anatomical and functional results. \u0000CONCLUSION: Timely multidisciplinary treatment of periorbital necrotizing fasciitis is necessary for the life preservation, prevention of severe complications from the eye. With the threat of developing lagophthalmos, it is necessary to perform permanent blepharoraphy for 36 months after the first surgery and further surgical and pharmacological correction of scarring processes.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45968374","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. Tkachenko, Svetlana G. Belekhova, N. Zhukova, Vera S. Prokopchuk, Natalya S. Chernova
The emergence of targeted therapy has become a significant breakthrough in the management of cancer patients, but even it is not without drawbacks. The article describes a clinical case of the development choroidal neovascularization in a 42-year-old patient with stage IV skin melanoma during 15 months of therapy with MEK and BRAF inhibitors. Clinicians need to remember that such patients may have not only MEK-associated retinopathy, but also other pathological changes in the retina, in particular choroidal neovascularization, which may be associated with both the chemotherapy they receive and the paraneoplastic syndrome itself against the background of the course of the underlying disease. Timely diagnosis and adequate management tactics allow such patients to preserve visual functions.
{"title":"A clinical case of the development of choroidal neovascularization in a patient with skin melanoma on the background of therapy with MEK and BRAF inhibitors","authors":"N. Tkachenko, Svetlana G. Belekhova, N. Zhukova, Vera S. Prokopchuk, Natalya S. Chernova","doi":"10.17816/ov107047","DOIUrl":"https://doi.org/10.17816/ov107047","url":null,"abstract":"The emergence of targeted therapy has become a significant breakthrough in the management of cancer patients, but even it is not without drawbacks. The article describes a clinical case of the development choroidal neovascularization in a 42-year-old patient with stage IV skin melanoma during 15 months of therapy with MEK and BRAF inhibitors. Clinicians need to remember that such patients may have not only MEK-associated retinopathy, but also other pathological changes in the retina, in particular choroidal neovascularization, which may be associated with both the chemotherapy they receive and the paraneoplastic syndrome itself against the background of the course of the underlying disease. Timely diagnosis and adequate management tactics allow such patients to preserve visual functions.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44832755","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 review describes the current state of knowledge oт the phenomenon of disorganization of retinal inner layers. DRIL is characterized by alteration of microcirculation in retinal capillary plexuses detected with optical coherence tomography angiography, alteration of several inner layers of the retina with the inability to differentiate them on optical coherence tomography, and by an impact on the quality of vision. Disorganization of retinal inner layers occurs in a number of different vascular retinal disorders, which indicates its importance as a clinical biomarker and clinical significance. However, the literature data on disorganization of retinal inner layers are still limited, and questions about the pathogenesis of this disease warrant further investigations.
{"title":"Disorganization of retinal inner layers: diagnostic and clinical characteristics","authors":"M. Burnasheva, A. Kulikov, D. Maltsev","doi":"10.17816/ov104631","DOIUrl":"https://doi.org/10.17816/ov104631","url":null,"abstract":"This review describes the current state of knowledge oт the phenomenon of disorganization of retinal inner layers. DRIL is characterized by alteration of microcirculation in retinal capillary plexuses detected with optical coherence tomography angiography, alteration of several inner layers of the retina with the inability to differentiate them on optical coherence tomography, and by an impact on the quality of vision. Disorganization of retinal inner layers occurs in a number of different vascular retinal disorders, which indicates its importance as a clinical biomarker and clinical significance. However, the literature data on disorganization of retinal inner layers are still limited, and questions about the pathogenesis of this disease warrant further investigations.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47240571","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}
Vladimir A. Antonov, Alexey G. Rukhovets, S. Astakhov, Yulya V. Kozlova, Anton A. Sharma
BACKGROUND: Non-arteritic anterior ischemic optic neuropathy (NAION) takes the first place in the total amount of acute vascular optic neuropathy cases. There is no common understanding of pathogenetic mechanisms of disease. This is largely due to the absence of direct optic nerve head blood flow registration method in ophthalmology. AIM: The aim of this work is to evaluate ocular hemodynamics using different methods in patients with non-arteritic anterior ischemic optic neuropathy (NAION). MATERIALS AND METHODS: 73 patients were enrolled in the study. 46 patients (46 eyes) with NAION were included in the first group. Control group was composed of 27 patients (50 eyes) with systemic risk factors of NAION without any retinal and optic nerve diseases. Regional hemodynamics parameters were evaluated with ophthalmosphigmography, ophthalmoplethysmography, ophthalmoreography, OCT-angiography and EDI-OCT. RESULTS: Blood flow values in different parts of the choroid did not statistically differ between groups when using ophthalmosphigmography, ophthalmoplethysmography, ophthalmoreography methods. Radial peripapillary capillaries in optic nerve head area were evaluated, and statistically significant difference was found in all sectors. CONCLUSION: The main component of NAION pathogenesis is a decreasing perfusion pressure in paraoptic short posterior ciliary arteries. Blood flow in choroid does not play an important role in the disease pathogenesis.
{"title":"Regional hemodynamics characteristics in patients with non-arteritic anterior ischemic optic neuropathy","authors":"Vladimir A. Antonov, Alexey G. Rukhovets, S. Astakhov, Yulya V. Kozlova, Anton A. Sharma","doi":"10.17816/ov107011","DOIUrl":"https://doi.org/10.17816/ov107011","url":null,"abstract":"BACKGROUND: Non-arteritic anterior ischemic optic neuropathy (NAION) takes the first place in the total amount of acute vascular optic neuropathy cases. There is no common understanding of pathogenetic mechanisms of disease. This is largely due to the absence of direct optic nerve head blood flow registration method in ophthalmology. \u0000AIM: The aim of this work is to evaluate ocular hemodynamics using different methods in patients with non-arteritic anterior ischemic optic neuropathy (NAION). \u0000MATERIALS AND METHODS: 73 patients were enrolled in the study. 46 patients (46 eyes) with NAION were included in the first group. Control group was composed of 27 patients (50 eyes) with systemic risk factors of NAION without any retinal and optic nerve diseases. Regional hemodynamics parameters were evaluated with ophthalmosphigmography, ophthalmoplethysmography, ophthalmoreography, OCT-angiography and EDI-OCT. \u0000RESULTS: Blood flow values in different parts of the choroid did not statistically differ between groups when using ophthalmosphigmography, ophthalmoplethysmography, ophthalmoreography methods. Radial peripapillary capillaries in optic nerve head area were evaluated, and statistically significant difference was found in all sectors. \u0000CONCLUSION: The main component of NAION pathogenesis is a decreasing perfusion pressure in paraoptic short posterior ciliary arteries. Blood flow in choroid does not play an important role in the disease pathogenesis.","PeriodicalId":31539,"journal":{"name":"Ophthalmology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49100740","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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