Pub Date : 2023-10-10DOI: 10.21516/2072-0076-2023-16-3-54-59
V. V. Neroev, E. K. Eliseeva, G. I. Krichevskaya, G. A. Davydova, M. N. Zakharova
Purpose : to study the prevalence of various chronic infections, the frequency of their reactivation and characteristic associations of microorganisms in patients with optic neuritis of various etiologies. Material and methods . 13 patients with optic neuritis (ON) and 12 patients with ON and multiple sclerosis were tested for a broad range of infectious agents in their blood serum. Results . All patients were shown to have mixed infections; 64 % of them had an association of 4 or more infectious agents. The patients of both groups were infected with Epstein-Barr virus (100 %), Cytomegalovirus (92 %) and Herpex simplex viruses (92 %) types 1 and/or 2 with serological signs of their reactivation. The combination of Herpes virus reactivation, Toxoplasma and urogenital infection was more often detected in patients with demyelinating ON. In patients with multiple sclerosis, a mutual correlation was detected: the higher the degree of infection (combination of 5 or more pathogens), the lower the visual acuity at the onset of the disease (p < 0.05) and the less favourable the vision prognosis. Conclusion . Possibly, mixed infection may play an important role in the pathogenesis of ON, including that of demyelinating etiology, as a trigger or an aggravating factor.
{"title":"The infectious status of patients with optic neuritis of inflammatory and demyelinating etiologies","authors":"V. V. Neroev, E. K. Eliseeva, G. I. Krichevskaya, G. A. Davydova, M. N. Zakharova","doi":"10.21516/2072-0076-2023-16-3-54-59","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-54-59","url":null,"abstract":"Purpose : to study the prevalence of various chronic infections, the frequency of their reactivation and characteristic associations of microorganisms in patients with optic neuritis of various etiologies. Material and methods . 13 patients with optic neuritis (ON) and 12 patients with ON and multiple sclerosis were tested for a broad range of infectious agents in their blood serum. Results . All patients were shown to have mixed infections; 64 % of them had an association of 4 or more infectious agents. The patients of both groups were infected with Epstein-Barr virus (100 %), Cytomegalovirus (92 %) and Herpex simplex viruses (92 %) types 1 and/or 2 with serological signs of their reactivation. The combination of Herpes virus reactivation, Toxoplasma and urogenital infection was more often detected in patients with demyelinating ON. In patients with multiple sclerosis, a mutual correlation was detected: the higher the degree of infection (combination of 5 or more pathogens), the lower the visual acuity at the onset of the disease (p < 0.05) and the less favourable the vision prognosis. Conclusion . Possibly, mixed infection may play an important role in the pathogenesis of ON, including that of demyelinating etiology, as a trigger or an aggravating factor.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-26-32
I. E. Ioshin, A. I. Tolchinskaya, A. V. Rakova, I. V. Maksimov, E. A. Beresenko
Purpose : to evaluate the effectiveness of transscleral micropulse cyclophotocoagulation (mCPC) in patients with end-stage glaucoma. Material and methods . 38 patients aged 76.6 ± 7.1 years with end-stage refractory glaucoma were examined, revealing subjective complaints, uncompensated IOP at the maximum hypotensive mode, prior multiple surgical interventions. Indications for mCPC to be performed on a SUPRA 810 device (Quantel Medical, France) according to a modified protocol, in which the laser energy flux is 121.8 J/cm2, were determined. In order to prevent postoperative inflammation after mCPC, a combined drug Floas-T® (glucocorticosteroid fluorometholone + tobramycin) was used. Results . A week after mCPC, the hypotensive effect was achieved in all 38 cases. IOP showed a 30.8 % decrease from the baseline. Considering an additional mCPC given to 14 patients, the entire group showed an IOP 22.8 % decrease (from 34.7 to 26.8 ± 2.9 mm Hg, p < 0.05) achieved after an 18 months’ follow-up. The combined drug Floas-T® was found to contribute to a subjective and clinical improvement, revealing no signs of an increased IOP. Conclusion . The use of mCPC in the treatment of patients with repeatedly operated refractory end-stage glaucoma who receive a maximum hypotensive mode should be estimated as a positive measure. The combined drug based on fluoroquinolone and tobramycin has demonstrated high effectiveness of anti-inflammatory prevention. A survey showed a subjective improvement in the patients’ quality of life. The mCPC method can be recommended as one of the components of a comprehensive rehabilitation program for patients with end-stage glaucoma.
目的:评价经巩膜微脉冲光凝治疗终末期青光眼的疗效。材料和方法。38例终末期难治性青光眼患者，年龄76.6±7.1岁，主观主观性、最大低血压模式下无代偿IOP、既往多次手术干预。在SUPRA 810设备(Quantel Medical, France)上根据修改后的方案确定mCPC的适应症，其中激光能量通量为121.8 J/cm2。为了预防mCPC术后炎症，我们使用了Floas-T®(糖皮质激素氟美洛酮+妥布霉素)联合用药。结果。术后1周，38例患者均达到降压效果。IOP较基线下降30.8%。考虑到额外给予14例mCPC，整个组IOP下降22.8%(从34.7降至26.8±2.9 mm Hg, p <0.05)，随访18个月。发现联合用药Floas-T®有助于主观和临床改善，没有显示IOP增加的迹象。结论。使用mCPC治疗接受最大降压模式的反复手术难治性终末期青光眼患者应被视为一种积极措施。以氟喹诺酮和妥布霉素为基础的联合用药具有较高的抗炎预防效果。一项调查显示病人的生活质量有了主观的改善。mCPC方法可推荐作为终末期青光眼患者综合康复方案的组成部分之一。
{"title":"Micropulse cyclophotocoagulation based on a modified protocol of energy parameters in the treatment of patients with end-stage glaucoma","authors":"I. E. Ioshin, A. I. Tolchinskaya, A. V. Rakova, I. V. Maksimov, E. A. Beresenko","doi":"10.21516/2072-0076-2023-16-3-26-32","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-26-32","url":null,"abstract":"Purpose : to evaluate the effectiveness of transscleral micropulse cyclophotocoagulation (mCPC) in patients with end-stage glaucoma. Material and methods . 38 patients aged 76.6 ± 7.1 years with end-stage refractory glaucoma were examined, revealing subjective complaints, uncompensated IOP at the maximum hypotensive mode, prior multiple surgical interventions. Indications for mCPC to be performed on a SUPRA 810 device (Quantel Medical, France) according to a modified protocol, in which the laser energy flux is 121.8 J/cm2, were determined. In order to prevent postoperative inflammation after mCPC, a combined drug Floas-T® (glucocorticosteroid fluorometholone + tobramycin) was used. Results . A week after mCPC, the hypotensive effect was achieved in all 38 cases. IOP showed a 30.8 % decrease from the baseline. Considering an additional mCPC given to 14 patients, the entire group showed an IOP 22.8 % decrease (from 34.7 to 26.8 ± 2.9 mm Hg, p < 0.05) achieved after an 18 months’ follow-up. The combined drug Floas-T® was found to contribute to a subjective and clinical improvement, revealing no signs of an increased IOP. Conclusion . The use of mCPC in the treatment of patients with repeatedly operated refractory end-stage glaucoma who receive a maximum hypotensive mode should be estimated as a positive measure. The combined drug based on fluoroquinolone and tobramycin has demonstrated high effectiveness of anti-inflammatory prevention. A survey showed a subjective improvement in the patients’ quality of life. The mCPC method can be recommended as one of the components of a comprehensive rehabilitation program for patients with end-stage glaucoma.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-33-38
L. A. Katargina, N. N. Arestova, E. N. Demchenko, A. Yu. Panova, A. A. Sorokin
Purpose : to analyze morphometric, clinical and functional manifestations of glaucomatous optical neuropathy in congenital childhood glaucoma (CG). Material and methods . We examined 103 children (163 eyes) with (CG), including 54 children (86 eyes) with primary congenital glaucoma (PCG) aged 1 month to 17 years. In addition to the regular ophthalmological examination, we performed optical coherence tomography of the optic nerve head (ONH), flash visual evoked potentials, total and rhythmic electroretinogram, oscillatory potentials (OP), echobiometry of the eye axial length. Results . The thickness of the retinal nerve fiber layer peripapillary (pRNFL) ranged from 32 to 120 μm, averaging 71.67 ± 18.2 μm. The thinning was detected in 83.0% of cases, primarily in the temporal sectors (90.6%). As the condition progressed, a tendency to progressive thinning of the RNFL was detected. The minimum rim width (BMO-MRW) ranged from 87 to 336 μm and was reduced in most children (14 out of 16, 87.5%). A strong inverse correlation of the neuroretinal rim with the depth (r = -0.69) and the width (r = -0.93) of the excavation was detected. Also, a strong direct correlation was established between the minimum neuroretinal rim width reduction and the thickness of the BMO-MRW and pRNFL (r = 0.79), as well as the upper and lower temporal sectors (r = 0.81 and r = 0.88, respectively). The thickness of the ganglion cell (GC) layer varied from 8 to 23 μm and averaged 14.64 ± 4.89 μm, with a reduction recorded in most cases (64.7%). All patients showed a decrease in oscillatory potentials (OP) by 40% or more (6.31 ± 2.33) as compared to the control group (20.24 ± 6.28). Thinning of the RNFL was registered in these eyes in 90.6% of cases averagely (p < 0.05) and in the upper and the lower temporal sectors (p < 0.05). Conclusion . RNFL thickness, the minimal width of the BMO-MRW and the OP are the most sensitive criteria to assess the degree of glaucomatous optic neuropathy in children with PСG. The study of the GC layer thickness can serve as an additional diagnostic criterion of assessing the state of the ONH.
{"title":"Optical coherence tomography in the diagnosis of glaucomatous optical neuropathy in children with primary congenital glaucoma","authors":"L. A. Katargina, N. N. Arestova, E. N. Demchenko, A. Yu. Panova, A. A. Sorokin","doi":"10.21516/2072-0076-2023-16-3-33-38","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-33-38","url":null,"abstract":"Purpose : to analyze morphometric, clinical and functional manifestations of glaucomatous optical neuropathy in congenital childhood glaucoma (CG). Material and methods . We examined 103 children (163 eyes) with (CG), including 54 children (86 eyes) with primary congenital glaucoma (PCG) aged 1 month to 17 years. In addition to the regular ophthalmological examination, we performed optical coherence tomography of the optic nerve head (ONH), flash visual evoked potentials, total and rhythmic electroretinogram, oscillatory potentials (OP), echobiometry of the eye axial length. Results . The thickness of the retinal nerve fiber layer peripapillary (pRNFL) ranged from 32 to 120 μm, averaging 71.67 ± 18.2 μm. The thinning was detected in 83.0% of cases, primarily in the temporal sectors (90.6%). As the condition progressed, a tendency to progressive thinning of the RNFL was detected. The minimum rim width (BMO-MRW) ranged from 87 to 336 μm and was reduced in most children (14 out of 16, 87.5%). A strong inverse correlation of the neuroretinal rim with the depth (r = -0.69) and the width (r = -0.93) of the excavation was detected. Also, a strong direct correlation was established between the minimum neuroretinal rim width reduction and the thickness of the BMO-MRW and pRNFL (r = 0.79), as well as the upper and lower temporal sectors (r = 0.81 and r = 0.88, respectively). The thickness of the ganglion cell (GC) layer varied from 8 to 23 μm and averaged 14.64 ± 4.89 μm, with a reduction recorded in most cases (64.7%). All patients showed a decrease in oscillatory potentials (OP) by 40% or more (6.31 ± 2.33) as compared to the control group (20.24 ± 6.28). Thinning of the RNFL was registered in these eyes in 90.6% of cases averagely (p < 0.05) and in the upper and the lower temporal sectors (p < 0.05). Conclusion . RNFL thickness, the minimal width of the BMO-MRW and the OP are the most sensitive criteria to assess the degree of glaucomatous optic neuropathy in children with PСG. The study of the GC layer thickness can serve as an additional diagnostic criterion of assessing the state of the ONH.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-39-46
N. L. Leparskaya
Purpose . To evaluate the possibility of predicting the anatomical and functional results of surgical treatment of traumatic retinal detachment (RD) in trauma of various geneses, taking into account the clinical picture and the severity of the proliferative syndrome based on large clinical data. Materials and methods . A comprehensive analysis of the clinical picture (using 22 features) and long-term results of surgical treatment of 427 patients with traction traumatic RD (TRD) after open and closed eye injury was carried out. The patients were divided into 7 groups depending on the mechanism of injury. The observation period was 5 years. Results . The most severe proliferative syndrome was observed in TRD after an open injury: OEI A (contusions with scleral rupture), OEI D (double puncture wound) and OEI E (explosive trauma with scleral rupture), when both the process of mooring and PVR are present, as well as with CEI A (contusion) in the event that after the first operation PVR continued to progress. We found a direct dependence of PVR activity in TRD on the area of the detached retina and the presence of a traumatic cataract, and the inverse dependence on the presence of intraocular foreign body (IFB), its size and the ability of IFB to cause metallosis. A direct dependence of long-term functional results of treatment on the PVR stage, the area of detached retina and the diagnosed retinal rupture during the first vitreoretinal surgical intervention was established. Conclusion . In order to make the surgical treatment of TRD more effective, it is worth using antiproliferative drugs intravitreally during vitreoretinal surgery, especially in OEI A, OEI D and OGI E, when the proliferative syndrome is caused both by PVR and mooring, as well as in CEI A in the case of a pronounced PVR stage.
{"title":"Prediction of late results of surgical treatment of traumatic retina detachment in eye injury of multiple origin","authors":"N. L. Leparskaya","doi":"10.21516/2072-0076-2023-16-3-39-46","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-39-46","url":null,"abstract":"Purpose . To evaluate the possibility of predicting the anatomical and functional results of surgical treatment of traumatic retinal detachment (RD) in trauma of various geneses, taking into account the clinical picture and the severity of the proliferative syndrome based on large clinical data. Materials and methods . A comprehensive analysis of the clinical picture (using 22 features) and long-term results of surgical treatment of 427 patients with traction traumatic RD (TRD) after open and closed eye injury was carried out. The patients were divided into 7 groups depending on the mechanism of injury. The observation period was 5 years. Results . The most severe proliferative syndrome was observed in TRD after an open injury: OEI A (contusions with scleral rupture), OEI D (double puncture wound) and OEI E (explosive trauma with scleral rupture), when both the process of mooring and PVR are present, as well as with CEI A (contusion) in the event that after the first operation PVR continued to progress. We found a direct dependence of PVR activity in TRD on the area of the detached retina and the presence of a traumatic cataract, and the inverse dependence on the presence of intraocular foreign body (IFB), its size and the ability of IFB to cause metallosis. A direct dependence of long-term functional results of treatment on the PVR stage, the area of detached retina and the diagnosed retinal rupture during the first vitreoretinal surgical intervention was established. Conclusion . In order to make the surgical treatment of TRD more effective, it is worth using antiproliferative drugs intravitreally during vitreoretinal surgery, especially in OEI A, OEI D and OGI E, when the proliferative syndrome is caused both by PVR and mooring, as well as in CEI A in the case of a pronounced PVR stage.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-19-25
E. V. Denisova, E. A. Geras’kina, L. A. Katargina
Familial exudative vitreoretinopathy (FEVR) is a hereditary disease characterized by abnormal angiogenesis and avascular zones (AZ) on the retinal periphery. The leading method of treatment of its early stages (1–3) is laser coagulation (LC) of AZ and pathological retinal vessels. Purpose . To study the efficiency of retinal laser coagulation in children with various stages of FEVR. Material and methods . 65 children with FEVR (82 eyes) were observed after retinal LC for 6 months to 10 years (on average, 3 years). The efficiency of laser treatment was evaluated after 2–3 months. We regarded the result as stabilization if no progression of the disease could be observed over the entire follow-up period (at least 12 months), either with or without an additional LC. Results . The efficiency of a single LC in children with FEVR in stage 1 was 100 %, in stage 2, 50 to 56 %, in stage 3, 10 to 50 %, in stage 4, 20 to 33 %. The proportion of cases with long-term (over 12 months) stabilization after additional LC sessions was diminishing according to the initial severity of clinical manifestations: from 75–100 % in stages 1–2 to 41–60 % in stage 3 and to 17–20 % in stage 4. Conclusion . LC efficiency of AZ and pathological retinal vessels in children with FEVR is inversely proportional to the stage of the disease. In more than half of the cases, repeated sessions of LC are required to achieve stabilization. The persistence of vascular activity after LC or the appearance of new vascular malformations are prognostic signs of further FEVR progression. The results obtained indicate the need for an early detection of the disease and an LC procedure to prevent the development of extensive retinal detachment, as well as regular dynamic observation of the patients and further study of the pathogenetic mechanisms of FEVR progression.
{"title":"The efficiency of laser treatment of familial exudative vitreoretinopathy in children","authors":"E. V. Denisova, E. A. Geras’kina, L. A. Katargina","doi":"10.21516/2072-0076-2023-16-3-19-25","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-19-25","url":null,"abstract":"Familial exudative vitreoretinopathy (FEVR) is a hereditary disease characterized by abnormal angiogenesis and avascular zones (AZ) on the retinal periphery. The leading method of treatment of its early stages (1–3) is laser coagulation (LC) of AZ and pathological retinal vessels. Purpose . To study the efficiency of retinal laser coagulation in children with various stages of FEVR. Material and methods . 65 children with FEVR (82 eyes) were observed after retinal LC for 6 months to 10 years (on average, 3 years). The efficiency of laser treatment was evaluated after 2–3 months. We regarded the result as stabilization if no progression of the disease could be observed over the entire follow-up period (at least 12 months), either with or without an additional LC. Results . The efficiency of a single LC in children with FEVR in stage 1 was 100 %, in stage 2, 50 to 56 %, in stage 3, 10 to 50 %, in stage 4, 20 to 33 %. The proportion of cases with long-term (over 12 months) stabilization after additional LC sessions was diminishing according to the initial severity of clinical manifestations: from 75–100 % in stages 1–2 to 41–60 % in stage 3 and to 17–20 % in stage 4. Conclusion . LC efficiency of AZ and pathological retinal vessels in children with FEVR is inversely proportional to the stage of the disease. In more than half of the cases, repeated sessions of LC are required to achieve stabilization. The persistence of vascular activity after LC or the appearance of new vascular malformations are prognostic signs of further FEVR progression. The results obtained indicate the need for an early detection of the disease and an LC procedure to prevent the development of extensive retinal detachment, as well as regular dynamic observation of the patients and further study of the pathogenetic mechanisms of FEVR progression.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-12-18
V. V. Gar’kavenko, P. M. Balashova
Purpose . To study how filtration blebs change in the postoperative period after applying the innovative patented suture during sinus trabeculectomy (STE). Material and methods . 105 patients (105 eyes) with primary open-angle glaucoma were randomized into 2 gender and age matched groups. In group 1, the conjunctival wound was sutured with separate continuous sutures on the conjunctiva and the Tenon's capsule. In group 2, the wound was sealed according to an innovative method. Before surgery, patients underwent a comprehensive examination, including visometry, tonometry, perimetry, and retinal tomography. In the postoperative period (1 day, 1, 2 weeks, 1, 3, 6 and 12 months after the STE), the changes of filtration blebs characteristics were assessed using the Würzburg bleb classification score (WBCS). Results . In group 2, one day after the surgery, IOP showed a decrease 0.8 mm Hg greater than in group 1. One month after surgery, the decrease was 1.5 mm Hg greater. The difference in IOP levels between the study groups persisted for up to 1 year (with a significant difference of 3.6 mm Hg after 3 months, and 3.8 mm Hg after 1 year, p = 0.001). The development of intraoperative and early postoperative complications was generally comparable. In group 1, an additional suture sealing was required in 11 8 % of cases due to external filtration. In group 2, no additional sutures were required (p = 0.01). The two groups revealed differences in the degree of vascularization of the conjunctiva and in the presence of conjunctival microcysts, as well as in the degree of encapsulation (p < 0.001) Group 2 treated by the innovative suturing technique showed better results. Conclusion . The innovative method of applying a sealing suture after STE quickens the normalization of the main characteristics of filtration blebs in comparison with the control group within 1 year after the intervention.
目的。目的研究窦小梁切除术(STE)中应用创新专利缝合后滤过泡在术后期间的变化。材料和方法。105例原发性开角型青光眼患者(105只眼)随机分为性别、年龄相匹配的2组。1组结膜创面缝合，分别在结膜和Tenon’s被膜上连续缝合。第二组创面采用创新方法封闭创面。手术前，患者接受了全面的检查，包括粘度计、眼压计、视距计和视网膜断层扫描。术后(STE术后1天、1、2周、1、3、6、12个月)采用w rzburg水泡分类评分(WBCS)评价滤过泡特征的变化。结果。2组术后1天IOP较1组下降0.8 mm Hg。术后1个月，血压下降1.5毫米汞柱。研究组之间IOP水平的差异持续了长达1年(3个月后显著差异为3.6 mm Hg, 1年后显著差异为3.8 mm Hg, p = 0.001)。术中和术后早期并发症的发展大致相当。在第1组中，11.8%的病例由于外部滤过而需要额外缝合。2组患者无需再缝线(p = 0.01)。两组在结膜血管化程度、结膜微囊存在程度以及包封程度上存在差异(p <0.001)采用创新缝合技术治疗的第二组疗效较好。结论。与对照组相比，STE术后应用密封缝线的创新方法在干预后1年内加速了滤过泡主要特征的正常化。
{"title":"The impact of technique of conjunctive wound suturing during sinus trabeculectomy on the formation of the filter bleb and the hypotensive efficiency of the operation","authors":"V. V. Gar’kavenko, P. M. Balashova","doi":"10.21516/2072-0076-2023-16-3-12-18","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-12-18","url":null,"abstract":"Purpose . To study how filtration blebs change in the postoperative period after applying the innovative patented suture during sinus trabeculectomy (STE). Material and methods . 105 patients (105 eyes) with primary open-angle glaucoma were randomized into 2 gender and age matched groups. In group 1, the conjunctival wound was sutured with separate continuous sutures on the conjunctiva and the Tenon's capsule. In group 2, the wound was sealed according to an innovative method. Before surgery, patients underwent a comprehensive examination, including visometry, tonometry, perimetry, and retinal tomography. In the postoperative period (1 day, 1, 2 weeks, 1, 3, 6 and 12 months after the STE), the changes of filtration blebs characteristics were assessed using the Würzburg bleb classification score (WBCS). Results . In group 2, one day after the surgery, IOP showed a decrease 0.8 mm Hg greater than in group 1. One month after surgery, the decrease was 1.5 mm Hg greater. The difference in IOP levels between the study groups persisted for up to 1 year (with a significant difference of 3.6 mm Hg after 3 months, and 3.8 mm Hg after 1 year, p = 0.001). The development of intraoperative and early postoperative complications was generally comparable. In group 1, an additional suture sealing was required in 11 8 % of cases due to external filtration. In group 2, no additional sutures were required (p = 0.01). The two groups revealed differences in the degree of vascularization of the conjunctiva and in the presence of conjunctival microcysts, as well as in the degree of encapsulation (p < 0.001) Group 2 treated by the innovative suturing technique showed better results. Conclusion . The innovative method of applying a sealing suture after STE quickens the normalization of the main characteristics of filtration blebs in comparison with the control group within 1 year after the intervention.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.21516/2072-0076-2023-16-3-7-11
V. V. Neroev, O. V. Zaitseva, L. A. Mikhailova
In Russia, a complex approach to diabetes mellitus and diabetic retinopathy (DR) treatment is adopted, yet certain issues remain in the system of medical care for DR patients. The statistical data are important to assess the availability and quality of medical care in each region of the Russian Federation, to plan resource distribution, and determine the volume of medicinal and technical support. The article presents an analysis of the territorial differences of DR prevalence and of dispensary follow-up of DR patients. In order to eliminate certain territorial defects in the organization of medical care for such patients, an improvement of outpatient medical aid organization and a more effective interaction between ophthalmological and endocrinal health services is required.
{"title":"Diabetic retinopathy prevalence in the Russian Federation according to all-Russia statistics","authors":"V. V. Neroev, O. V. Zaitseva, L. A. Mikhailova","doi":"10.21516/2072-0076-2023-16-3-7-11","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-3-7-11","url":null,"abstract":"In Russia, a complex approach to diabetes mellitus and diabetic retinopathy (DR) treatment is adopted, yet certain issues remain in the system of medical care for DR patients. The statistical data are important to assess the availability and quality of medical care in each region of the Russian Federation, to plan resource distribution, and determine the volume of medicinal and technical support. The article presents an analysis of the territorial differences of DR prevalence and of dispensary follow-up of DR patients. In order to eliminate certain territorial defects in the organization of medical care for such patients, an improvement of outpatient medical aid organization and a more effective interaction between ophthalmological and endocrinal health services is required.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135148473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-02DOI: 10.21516/2072-0076-2023-16-2-177-182
O. I. Markelova, S. Petrov, T. D. Okhotsimskaya
The challenge of the coronavirus pandemic, and the research into the mechanism of development of the symptom complex that appears in patients who had COVID-19 (post-COVID syndrome), is a topical issue of modern medicine. Obviously, as the incidence of COVID increases, the number of patients suffering from the post-COVID syndrome increases, too. According to recent estimates, 10 to 20 % of patients who have experienced an acute symptomatic phase of SARS-CoV-2 suffer from the effects of the disease over 12 weeks from the primary diagnosis. COVID-19 has been shown to have a variety of long-term effects on virtually all body systems, including the eye. The ocular surface can serve as a gateway for the virus to enter the body, so that patients experience nonspecific changes in the conjunctiva, cornea, retina, and eye vessels. Thus, the issues of diagnosis and treatment of the COVID-19 infection itself and, notably, its complications and conditions that have arisen and continue after the disease, are of essential research and clinical interest. SARS-CoV-2 has a negative impact on the state of the vascular wall and contributes to the development of hypercoagulable conditions, which increases the risk of thrombosis and possible complications in the cardiovascular system. The review summarizes the analyses of eye vessels blood flow in patients who have undergone COVID-19.
{"title":"The impact of the new coronavirus infection COVID-19 on the microcirculation of the eye","authors":"O. I. Markelova, S. Petrov, T. D. Okhotsimskaya","doi":"10.21516/2072-0076-2023-16-2-177-182","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-2-177-182","url":null,"abstract":"The challenge of the coronavirus pandemic, and the research into the mechanism of development of the symptom complex that appears in patients who had COVID-19 (post-COVID syndrome), is a topical issue of modern medicine. Obviously, as the incidence of COVID increases, the number of patients suffering from the post-COVID syndrome increases, too. According to recent estimates, 10 to 20 % of patients who have experienced an acute symptomatic phase of SARS-CoV-2 suffer from the effects of the disease over 12 weeks from the primary diagnosis. COVID-19 has been shown to have a variety of long-term effects on virtually all body systems, including the eye. The ocular surface can serve as a gateway for the virus to enter the body, so that patients experience nonspecific changes in the conjunctiva, cornea, retina, and eye vessels. Thus, the issues of diagnosis and treatment of the COVID-19 infection itself and, notably, its complications and conditions that have arisen and continue after the disease, are of essential research and clinical interest. SARS-CoV-2 has a negative impact on the state of the vascular wall and contributes to the development of hypercoagulable conditions, which increases the risk of thrombosis and possible complications in the cardiovascular system. The review summarizes the analyses of eye vessels blood flow in patients who have undergone COVID-19.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48390043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-02DOI: 10.21516/2072-0076-2023-16-2-135-139
I. Ioshin, D. A. Merkushenkova
The main symptoms of solar maculopathy are central visual acuity decrease, the onset of central scotoma, photophobia, metamorphopsia and dyschromatopsia. In the acute period, the ophthalmoscopic picture of the disease requires a differential diagnosis with hereditary cone retinal dystrophies. An objective differentiation of these diseases is possible by fluorescein angiography, electrooculography, and optical coherence tomography of the retina. The paper presents a clinical case of solar maculopathy with an analysis of differential diagnostics used.
{"title":"Differential diagnosis of solar maculopathy and congenital cone dystrophy: a clinical case","authors":"I. Ioshin, D. A. Merkushenkova","doi":"10.21516/2072-0076-2023-16-2-135-139","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-2-135-139","url":null,"abstract":"The main symptoms of solar maculopathy are central visual acuity decrease, the onset of central scotoma, photophobia, metamorphopsia and dyschromatopsia. In the acute period, the ophthalmoscopic picture of the disease requires a differential diagnosis with hereditary cone retinal dystrophies. An objective differentiation of these diseases is possible by fluorescein angiography, electrooculography, and optical coherence tomography of the retina. The paper presents a clinical case of solar maculopathy with an analysis of differential diagnostics used.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49392840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-02DOI: 10.21516/2072-0076-2023-16-2-146-152
A. Shamanova, D. D. Voropaev
Pleomorphic sarcomas (PS) are a heterogeneous group of poorly differentiated malignant neoplasms of mesenchymal origin affecting various organs and tissues, which account for 5–7% of all malignant soft tissue tumors. PS most often affects the soft tissues of the extremities, while being extremely rare in the orbital region and the eyeball. The final diagnosis is given after a histological and immunohistochemical (IHC) test of PS supplemented by a cytogenetic test in some cases. The differential diagnosis is based on histogenetic types determined. It should be noted that clinical, instrumental or morphological differential diagnosis between PS of the eye and melanoma is sometimes extremely difficult. The paper presents a case of eyeball PS with an invasion into the orbit, providing a detailed description of the clinical signs of disease, the results of macroscopic, histological and IHC tests of the surgical material, and a review of the literature discussing this pathology. Given the rarity of PS of the eye, the description of the clinical case may be of interest to ophthalmologists and oncomorphologists.
{"title":"Pleomorphic sarcoma of the eye: a brief literature review and a clinical case","authors":"A. Shamanova, D. D. Voropaev","doi":"10.21516/2072-0076-2023-16-2-146-152","DOIUrl":"https://doi.org/10.21516/2072-0076-2023-16-2-146-152","url":null,"abstract":"Pleomorphic sarcomas (PS) are a heterogeneous group of poorly differentiated malignant neoplasms of mesenchymal origin affecting various organs and tissues, which account for 5–7% of all malignant soft tissue tumors. PS most often affects the soft tissues of the extremities, while being extremely rare in the orbital region and the eyeball. The final diagnosis is given after a histological and immunohistochemical (IHC) test of PS supplemented by a cytogenetic test in some cases. The differential diagnosis is based on histogenetic types determined. It should be noted that clinical, instrumental or morphological differential diagnosis between PS of the eye and melanoma is sometimes extremely difficult. The paper presents a case of eyeball PS with an invasion into the orbit, providing a detailed description of the clinical signs of disease, the results of macroscopic, histological and IHC tests of the surgical material, and a review of the literature discussing this pathology. Given the rarity of PS of the eye, the description of the clinical case may be of interest to ophthalmologists and oncomorphologists.","PeriodicalId":36080,"journal":{"name":"Rossiiskii Oftal''mologicheskii Zhurnal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47485378","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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