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Medical Support of Adaptation to Refractive Errors with Age 随年龄增长适应屈光不正的医学支持
Q4 Medicine Pub Date : 2023-10-03 DOI: 10.18008/1816-5095-2023-3-549-556
M. A. Kovalevskaya, V. B. Antonyan, V. I. Starykh, A. V. Podoprigora, M. I. Sergeeva
Aim: to evaluate the effectiveness of treatment with Optinol on the condition of the ocular surface in people over 35 years of age with refractive error. Patients and methods. The study was carried out in two clinical and in the control group. The first group included 74 patients (148 eyes) with moderate (group 1a) and high (group 1b) myopia, mean age 38.3 ± 0.4 years. The second group consisted of 49 patients (98 eyes) with moderate (group 2a) and high (group 2b) hypermetropia, mean age 42.3 ± 0.5 years. The control group included 25 healthy individuals (50 eyes), mean age 38.2 ± 1.4 years. The anamnesis of patients, complaints and concomitant diseases were assessed by the questionnaire method. Conclusion. The results of the study proved the influence of moderate and high hypermetropia on the likelihood of dry eye syndrome (DES).
目的:评价Optinol治疗35岁以上屈光不正患者眼表状况的疗效。患者和方法。该研究在两个临床组和对照组中进行。第一组患者74例(148眼),中度(1a组)和高度(1b组)近视,平均年龄38.3±0.4岁。第二组49例(98眼),中度远视(2a组)和高度远视(2b组),平均年龄42.3±0.5岁。对照组健康个体25例(50只眼),平均年龄38.2±1.4岁。采用问卷调查法对患者的记忆、主诉及伴发疾病进行评估。结论。研究结果证实了中度和高度远视对干眼综合征(DES)发生可能性的影响。
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引用次数: 0
Tactics of Managing Patients with Bacterial Corneal Ulcers in a Multidisciplinary Hospital (Series of Clinical Cases) 多学科医院细菌性角膜溃疡患者的处理策略(附临床病例)
Q4 Medicine Pub Date : 2023-10-03 DOI: 10.18008/1816-5095-2023-3-572-579
G. S. Arzhimatova, G. M. Chernakova, E. V. Shirshova, M. Yu. Shemyakin, E. B. Emelyanova, A. O. Ugolnikova
Bacterial corneal ulcers in patients with comorbid pathology are a complex clinical situation with a high risk of complications — corneal perforation. The article presents four clinical cases of bacterial corneal ulcers in patients with chronic latent sinusitis. The publication discusses the issues of diagnostic tactics, provides an analysis of the results of instrumental and laboratory tests in each case. The results of corneal ulcer therapy are presented taking into account antibioticograms.
细菌性角膜溃疡患者的病理合并症是一种复杂的临床情况,并发症-角膜穿孔的风险很高。本文报道慢性潜伏性鼻窦炎并发细菌性角膜溃疡的4例临床病例。该出版物讨论了诊断策略的问题,对每种情况下的仪器和实验室测试结果进行了分析。角膜溃疡治疗的结果是考虑到抗生素图。
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引用次数: 0
An Integrated Stepwise Approach to the Treatment of Graft Disease in a Patient with an Implanted Iris Lens Diaphragm and Concomitant Postkeratoplastic Ametropia (Clinical Case) 综合分步治疗虹膜晶状体横膈膜植入伴角膜变形后屈光不正一例
Q4 Medicine Pub Date : 2023-10-03 DOI: 10.18008/1816-5095-2023-3-563-571
M. V. Sinitsyn, N. A. Pozdeyeva, A. E. Terent’eva
The purpose : to analyze the clinical and functional results of the complex staged treatment of graft disease in patient with an implanted iris lens diaphragm and concomitant postkeratoplastic ametropia using descemet’s stripping endothelial keratoplasty using a femtosecond laser (FS-DSEK) and MyoRing implantation into a corneal graft using a femtosecond laser on the example of a clinical case. Methods . Patient M., 51 years old, was admitted with a diagnosis of the left eye: corneal transplant disease, condition after penetrating keratoplasty, iridoartifakia, avitria, optic nerve subatrophy, high myopia. To treat the graft disease, the patient underwent FS-DSEK using a FemtoVisum 1 MHz (Troitsk, Russia). Twelve months after FS-DSEK to correct irregular postkeratoplastic astigmatism and concomitant high-grade myopia detected after restoration of the transparency of the penetrating corneal graft, the MyoRing was implanted into the penetrating corneal graft using a femtosecond laser. Results . After performing FS-DSEK, the transparency of the penetrating corneal graft was completely restored, visometry, refractokeratometry, and keratopachymetric data were stabilized by 6 months after the operation. 12 months after FS-DSEK, uncorrected visual acuity (UCVA) increased from 1.6 to 1.2 LogMAR, best corrected visual acuity (BCVA) increased from 1.6 to 0.8 LogMAR. Loss of endothelial cell density of the posterior layered graft was 27.4 %. MyoRing implantation into a penetrating corneal graft made it possible to significantly increase the UCVA from 1.3 to 0.3 LogMAR and the BCVA from 0.8 to 0.2 LogMAR. The spherical component of refraction decreased from -6.25 to -0.75 D, the cylindrical component of refraction — from -9.25 to -1.25 D, the regularity, sphericity of the corneal graft and its biomechanical properties increased (corneal resistance factor increased from 8.2 to 9.4 mm Hg, corneal hysteresis — from 7.9 to 9.1 mm Hg). Conclusion . A complex staged technique of descemet’s stripping endothelial keratoplasty using a femtosecond laser followed by MyoRing implantation into the corneal graft using a femtosecond laser is an effective and safe method for treating graft disease in a patient with an implanted iris lens diaphragm and concomitant postkeratoplastic ametropia.
目的:以1例临床病例为例,分析飞秒激光descemet剥脱内皮角膜移植术(FS-DSEK)和飞秒激光MyoRing角膜移植物植入术复合分阶段治疗虹膜晶状体膈植入伴角膜变形后屈光不正患者的临床和功能效果。方法。患者M, 51岁,因左眼诊断:角膜移植疾病,穿透性角膜移植术后状况,虹膜假体,视网膜,视神经亚萎缩,高度近视入院。为了治疗移植物疾病,患者使用FemtoVisum 1 MHz (Troitsk, Russia)进行了FS-DSEK。采用FS-DSEK矫正角膜移植透明后发现的不规则散光和高度近视12个月后,使用飞秒激光将MyoRing植入穿透性角膜移植物。结果。经FS-DSEK手术后,穿透性角膜移植物透明度完全恢复,术后6个月粘度、屈光角膜测量、角膜透浊测量数据稳定。FS-DSEK治疗12个月后,未矫正视力(UCVA)由1.6 LogMAR提高到1.2 LogMAR,最佳矫正视力(BCVA)由1.6 LogMAR提高到0.8 LogMAR。后层状移植物内皮细胞密度损失为27.4%。在穿透性角膜移植物中植入MyoRing可以使UCVA从1.3 LogMAR显著提高到0.3 LogMAR, BCVA从0.8 LogMAR显著提高到0.2 LogMAR。球形屈光分量由-6.25 D降低到-0.75 D,圆柱形屈光分量由-9.25 D降低到-1.25 D,角膜移植物的规整性、球形性和生物力学性能均有所提高(角膜阻力因子由8.2 mm Hg增加到9.4 mm Hg,角膜迟滞从7.9 mm Hg增加到9.1 mm Hg)。结论。一种复杂的分阶段技术,采用飞秒激光进行descemet剥离内皮角膜移植术,然后使用飞秒激光将MyoRing植入角膜移植物中,这是治疗植入虹膜晶状体膈并合并角膜变形后屈光不正患者移植物疾病的一种有效且安全的方法。
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引用次数: 0
A Clinical Case of Successful Penetrating Keratoplasty after Corneal Perforation that Occurred against the Background of Dacryoadenitis 泪腺炎背景下角膜穿孔后穿透性角膜移植术成功一例
Q4 Medicine Pub Date : 2023-10-03 DOI: 10.18008/1816-5095-2023-3-557-562
G. Sh. Arzhimatova, Yu. B. Slonimskij, E. A. Salikhov, M. Yu. Shemyakin, A. I. Ibraimov
The article presents a clinical case of penetrating keratoplasty performed in a patient after corneal perforation against the background of dacryoadenitis. The importance of the condition of the precorneal tear film for the normal functioning of the cornea and how dry eye syndrome affects the condition of the cornea before and after surgery are discussed. Relevant and open, in the article, remains the issue of the development of such complications as a corneal ulcer with perforation, against the background of dry eye syndrome that developed more than 10 years after the keratorefractive operation. Data on the state of the penetrating corneal graft after 6 months of dynamic follow-up are presented.
本文介绍了一个临床病例穿透性角膜移植术在患者角膜穿孔后对泪腺炎的背景。本文讨论了角膜前泪膜状况对角膜正常功能的重要性,以及干眼综合征对术前术后角膜状况的影响。在角膜屈光手术后10多年出现干眼综合征的背景下,角膜溃疡伴穿孔等并发症的发展仍然是相关且开放的问题。通过6个月的动态随访,介绍了穿透性角膜移植的情况。
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引用次数: 0
Additive Therapy for Advanced Stages of Glaucoma 晚期青光眼的附加治疗
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-523-527
I. R. Gazizova, V. E. Korelina, E. P. Goncharuk
Purpose of the study: to evaluate the efficacy and feasibility of using brimonidine 0.2 % in the additive therapy of patients with advanced stages of glaucoma. Materials and methods . There were 59 patients (77 eyes) with advanced stages of primary open-angle, glaucoma (POAG) aged 68 to 83 years in the study. Patients were randomized into 2 groups depending on the received antihypertensive therapy. The first group (I) included 32 people (41 eyes) who used a fixed combination of a prostaglandin analogue (APG) or a carbonic anhydrase inhibitor (CAI) with a beta-blocker (BB) for the treatment of POAG. The second group (II) consisted of 27 patients (36 eyes) who had the α2-adrenergic agonist brimonidine — S3 added to the previously available combination of APG or ICA with BB. The observation period was 6 months. Results . Application of brimonidine — SZ in the additive therapy of advanced stages of glaucoma led to an additional hypotensive effect. By the end of the observation period in the group of patients treated with brimonidine, intraocular pressure decreased by an additional 10 % from the initial level. A good hypotensive effect contributed to an increase in functional parameters. Analysis of the results of static automatic perimetry showed a positive trend in the mean deviation (MD) and standard deviation pattern (PSD), which may indicate a neuroprotective effect of the drug. All patients noted good tolerability of treatment. Throughout the observation period, patients maintained a high level of adherence and performance.
目的:评价0.2%溴莫尼定加药治疗晚期青光眼的疗效和可行性。材料和方法。研究对象为59例(77只眼)晚期原发性开角型青光眼(POAG),年龄68 ~ 83岁。根据患者接受降压治疗的情况将患者随机分为两组。第一组(I)包括32人(41只眼睛),他们使用前列腺素类似物(APG)或碳酸酐酶抑制剂(CAI)与β受体阻滞剂(BB)的固定组合治疗POAG。第二组(II)包括27例(36只眼)患者,他们在先前可用的APG或ICA联合BB的基础上添加α2-肾上腺素能激动剂溴硝定- S3。观察期6个月。结果。应用溴胺定- SZ加药治疗晚期青光眼可获得额外的降压效果。在观察结束时,用溴莫尼定治疗的患者眼压比初始水平又下降了10%。良好的降压效果有助于提高功能参数。静态自动视野测量结果分析显示,平均偏差(MD)和标准差模式(PSD)呈阳性趋势,可能提示该药具有神经保护作用。所有患者均表现出良好的治疗耐受性。在整个观察期间,患者保持了高水平的依从性和表现。
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引用次数: 0
Comprehensive Classification of the Severity of Bulbar and Tarsal Hyperemia in Conjunctivitis 结膜炎球、跗骨充血严重程度的综合分类
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-471-478
V. N. Trubilin, E. G. Polunina, A. A. Kozhukhov, D. V. Andzhelova, A. V. Trubilin, K. V. Chinenova, N. V. Moreva
Diagnosis of conjunctivitis is an urgent problem in ophthalmic practice, since conjunctivitis is one of the most common reasons for patients to visit a doctor. An important aspect in diagnosing of the conjunctivа’s inflammation is to determine the intensity of the inflammatory process in each case, in which hyperemia is given priority, as the most demonstrative sign of inflammation. Currently, there are many subjective and non-invasive instrumental methods for assessing conjunctival hyperemia. Taking into account the fact that most of the instrumental methods are aimed to assess the state of the bulbar conjunctiva and there are practically no methods that allow assessing the severity of tarsal hyperemia, it is necessary to develop a methodology that allows to evaluate both these indicators in combination. In this regard, it is great interest to determine the degree of hyperemia during a biomicroscopic examination in combination with visualization and fixation of hyperemia indicators using the software of the MediWorks Dixion S 350 slit lamp (weak, medium, significant, severe) depending on the index of hyperemia obtained by fixing the image on the slit lamp. Standardization of the severity indicators of conjunctival hyperemia allows to obtaine objective data on the state of the tarsal and bulbar conjunctiva at all stages of observation. In addition, based on the above indicators in clinical practice, the ophthalmologist can prescribe an adequate amount of drug therapy, this will increase the level of safety and effectiveness of the therapy, which is especially important at the stage of primary outpatient admission, when treatment is usually prescribed empirically
结膜炎的诊断是眼科实践中的一个紧迫问题,因为结膜炎是患者就诊的最常见原因之一。结膜炎症诊断的一个重要方面是确定每个病例炎症过程的强度,其中充血是优先考虑的,因为充血是炎症的最明显迹象。目前,有许多主观和非侵入性的仪器方法来评估结膜充血。考虑到大多数仪器方法的目的是评估球结膜的状态,实际上没有方法可以评估跗骨充血的严重程度,有必要开发一种方法,允许评估这两个指标的组合。在这方面,根据将图像固定在裂隙灯上获得的充血指数,利用MediWorks Dixion S 350裂隙灯软件,结合充血指标的可视化和固定,在生物显微镜检查中确定充血程度(弱、中、显著、严重)是非常有趣的。结膜充血严重程度指标的标准化可以在观察的各个阶段获得关于跗骨和球结膜状态的客观数据。此外,在临床实践中,根据上述指标,眼科医生可以开出足够的药物治疗,这将提高治疗的安全性和有效性水平,这在初级门诊入院阶段尤其重要,因为该阶段通常是根据经验进行治疗
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引用次数: 0
Experience in the Treatment of Dry Eye Syndrome in Students with Myopic Refraction 近视屈光学生干眼综合征的治疗体会
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-536-541
T. V. Gavrilova, D. D. Kozitsyna, O. A. Misheneva
Objective : to study the effectiveness of the hypromellose-based medicine Artificial Tears®, eye drops, in the treatment of dry eye syndrome in students with myopic refraction. Patients and methods . A total of 147 students of Academician E.A. Wagner Perm State Medical University with different types of clinical refraction were examined. Among them 63 students with myopic refraction of various degrees in 110 eyes were included in the study (mean age — 22.6 ± 0.16 years, 49 (78 %) women, 14 (22 %) men). Dry eye syndrome was detected in 49 (78 %) participants in 82 eyes (74.5 %). According to the myopia correction method, 3 groups were formed: Group 1 — students with eyeglasses; Group 2 — students constantly using soft contact lenses; Group 3 — students who had excimer laser correction by LASIK method. The remaining students (n = 14) had no dry eye syndrome. The study was conducted in two stages: at baseline and then repeated after 4 weeks in students with dry eye syndrome who used daily the medicine Artificial Tears®. Subjective assessment was based on the Ocular Surface Disease Index (OSDI) questionnaire. Оbjective assessment included function tests, characterizing the precorneal tear film stability and total tear production level. Results . In the process of treatment a good tolerance of the given medicine was reported. Analysis of the overall results showed that the mean OSDI score decreased statistically significantly from 26.92 to 20.29 seconds (p ≤ 0.0001). The mean tear film break-up time increased from 7.95 to 11.25 (p ≤ 0.0001). The mean Schirmer’s test score was slightly changed: from 13.98 to 14.07 mm due to the presence of increased tear production in some students, which is characteristic of the dry eye syndrome initial manifestations. Conclusion . The medicine Artificial Tears® in the form of eye drops is well tolerated and is sufficiently effective in eliminating the dry eye syndrome manifestations after only 4 weeks of use. The treatment with the medicine Artificial Tears® showed a statistically significant reduction in the disease severity (according to the OSDI questionnaire data) and an increase in the tear film break-up time. The received results allow us to recommend the medicine Artificial Tears® for medical use in patients with various degrees of myopic refraction, regardless of the myopia correction method used.
目的:探讨以羟甲羟纤维素为基础的药物人工泪液®滴眼液治疗近视屈光学生干眼综合征的疗效。患者和方法。对美国彼尔姆州立医科大学的147名不同类型的学生进行了临床屈光检查。共纳入110只眼不同程度近视屈光的学生63例(平均年龄- 22.6±0.16岁),其中女性49例(78%),男性14例(22%)。49名(78%)参与者在82只眼睛(74.5%)中检测到干眼综合征。根据近视矫正方法分为三组:第一组:配戴眼镜的学生;第二组-经常使用软性隐形眼镜的学生;第三组:准分子激光LASIK矫正组。其余14名学生无干眼综合征。该研究分为两个阶段:在基线时进行,然后在4周后对每天使用人工泪液®药物的干眼综合征学生进行重复。主观评价基于眼表疾病指数(OSDI)问卷。Оbjective评估包括功能测试,表征角膜前泪膜稳定性和总泪液产生水平。结果。在治疗过程中,报告了对所给药物的良好耐受性。综合分析结果显示,平均OSDI评分由26.92秒降至20.29秒,差异有统计学意义(p≤0.0001)。平均泪膜破裂时间由7.95增加到11.25 (p≤0.0001)。由于一些学生泪液分泌增加,这是干眼综合征的典型初始表现,因此平均Schirmer测试分数略有变化:从13.98到14.07 mm。结论。以滴眼液形式出现的人工泪液具有良好的耐受性,并且在使用4周后就足以有效地消除干眼综合征的症状。使用人工泪液®药物治疗后,疾病严重程度(根据OSDI问卷数据)有统计学显著降低,泪膜破裂时间增加。收到的结果允许我们推荐药物人工泪液®用于不同程度的近视屈光患者,无论使用何种近视矫正方法。
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引用次数: 0
Dynamics of Accommodative Asthenopia in Patients with Visually Intense Work after LASIK with Different Degrees of Myopia 不同程度近视眼LASIK术后高强度工作患者的适应性弱视动态
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-479-484
E. I. Belikova, D. V. Gatilov, I. G. Ovechkin, E. N. Eskina
Purpose — to study the dynamics of accommodative asthenopia (AA) in patients with visually stressful labor (VLT) after laser keratomileusis in situ (LASIK) with different degrees of myopia. Patients and methods . There were 300 patients with VLT under supervision, divided into three groups of equal age and gender, corresponding to weak (up to 3.0 diopters, 100 patients, 200 eyes), medium (3.25–6.0 diopters, 100 patients, 200 eyes) and high (6.25–8.0 diopters, 100 patients, 200 eyes) degrees of myopia. All patients underwent objective accommodation using the Righton Speedy-I device (Japan) with further calculation of the coefficient of microfluctuations of the ciliary muscle of the eye (CMF). Diagnosis of the type of AA was carried out according to the following indicators: with CMF less than 53.0 rel. un. — asthenic form of accommodative asthenopia (AFAA); at CMF from 53.0 to 58.0 rel. un. — NORM; at CMF more than 58.0 rel. un. — habitual excess tension of accommodation (PINA). The survey was carried out before and three months after the operation. Statistical analysis of the results of the study was performed on the basis of the rate of occurrence (in % of the total number of eyes) of different dynamics (before-after surgery) AA (NORM-NORM; PINA-PINA; AFAA-AFAA; NORM-AFAA; NORM; PINA-AFAA; AFAA-NORM; AFAA-PINA). Results . The change in the form of AA varied from 2 % (APAA-PINA) to 18 % (PINANORM), averaged 15 % and was not statistically significant. The results obtained naturally reflect the state of AA as an adequate physiological response of the accommodative system of the eye to long-term, intense visual work with a fairly high level of responsibility for the result. Based on the above situation and the patient’s desire to maintain (in some cases even increase) the volume of daily visual load after the operation, it is unlikely to expect a significant improvement in the state of accommodation. Conclusion . LASIK with different degrees of myopia in patients with VLT has practically no effect on the dynamics of AA and requires a complex of therapeutic and restorative measures based on the development of methodological principles from the standpoint of a differentiated approach to the form of AA and the basic provisions of medical rehabilitaton.
目的:研究不同程度近视的LASIK术后视压力性分娩(VLT)患者适应性弱视(AA)的动态变化。患者和方法。观察300例VLT患者,按年龄、性别分为三组,分别为弱(屈光度3.0以下,100例,200眼)、中(屈光度3.25-6.0,100例,200眼)、高(屈光度6.25-8.0,100例,200眼)近视。所有患者均使用Righton Speedy-I装置(日本)进行客观调节,并进一步计算眼睫肌微波动系数(CMF)。根据以下指标诊断AA型:CMF < 53.0 rel. un;-适应性弱视(AFAA)的衰弱形式;在CMF从53.0到58.0雷尔。——规范;在CMF超过58.0英里。-习惯性调节过度紧张(PINA)。这项调查是在手术前后三个月进行的。对研究结果进行统计分析,依据不同动态(术前-术后)AA (NORM-NORM;PINA-PINA;AFAA-AFAA;NORM-AFAA;标准;PINA-AFAA;AFAA-NORM;AFAA-PINA)。结果。AA形式的变化从2% (APAA-PINA)到18% (PINANORM)不等,平均为15%,无统计学意义。获得的结果自然地反映了AA状态是眼睛调节系统对长期、高强度视觉工作的适当生理反应,对结果负有相当高的责任。基于上述情况和患者希望术后维持(在某些情况下甚至增加)每日视觉负荷的愿望,不太可能期望适应状态有显着改善。结论。VLT患者不同度数的LASIK对AA的动态几乎没有影响,从区分AA的形态和医学康复的基本规定出发,基于方法学原则的发展,需要综合采取治疗和恢复措施。
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引用次数: 0
A New Diagnostic Method for Ptosis of the Upper Eyelid 一种诊断上睑下垂的新方法
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-502-507
I. A. Filatova, Yu. P. Kondratieva, S. A. Shemetov, M. S. Trefilova
Currently, surgical treatment of ptosis of the upper eyelid does not always lead to a good anatomical and physiological result — the frequency of dissatisfaction with the results of treatment is 8–26 %, and repeated operations on the muscle that lifts the upper eyelid are performed in 8.7–18 % cases. An important aspect of the successful treatment of upper eyelid ptosis is the preoperative examination of the patient; however, standard diagnostic methods do not provide complete information about the functional features of the upper eyelid levator. The purpose of the study is to improve the algorithm for preoperative examination of the upper eyelid in ptosis with the study of the contractility and fatigue of the upper eyelid levator. On the basis of the Helmholtz National Medical Research Center of Eye Diseases in the period from 2021 to 2022, 63 patients (67 eyes) aged from 5 to 78 years with different types of blepharoptosis admitted for surgical treatment were examined. We have developed a comprehensive dynamometric preoperative assessment of the upper eyelid levator with a study of the contractility and fatigue of this muscle using weights. For comparison and determination of normal parameters, the study was also carried out on paired intact eyes (59 eyes) and in 40 healthy people. Indicators of contractility and fatigue of the levator of the upper eyelid were obtained in normal conditions and with ptosis of the upper eyelid, and differences in these indicators were revealed in congenital and acquired blepharoptosis. With congenital ptosis of the upper eyelid, the contractility and fatigue of the levator of the upper eyelid is low, while with acquired ptosis (senile), the contractility is medium, and fatigue is medium or high. A gradation of the values of contractility and fatigue of the upper eyelid levator in blepharoptosis was developed, on the basis of it an algorithm for choosing a method for surgical correction of upper eyelid ptosis was proposed. The developed method of dynamometric preoperative study of the anatomical and functional features of the upper eyelid levator using weights is a simple and affordable method for objectively assessing the state of contractility and fatigue of the levator, which can improve the efficiency of surgical correction of upper eyelid ptosis.
目前,上睑下垂的手术治疗并不总是能取得良好的解剖和生理效果——对治疗结果不满意的频率为8 - 26%,8.7 - 18%的病例对上睑提肌进行重复手术。成功治疗上睑下垂的一个重要方面是患者的术前检查;然而,标准的诊断方法并不能提供关于上睑提肌功能特征的完整信息。本研究的目的是通过对上睑提肌的收缩和疲劳的研究,改进上睑下垂的术前检查算法。以Helmholtz国家眼病医学研究中心为基础,对2021 - 2022年收治的5 - 78岁不同类型上睑下垂患者63例(67只眼)进行手术治疗。我们已经开发了一个全面的动态术前评估的上睑提肌的收缩性和疲劳的研究使用重量。为了比较和确定正常参数,该研究还对成对的完整眼睛(59只眼睛)和40名健康人进行了研究。在正常情况下和上睑下垂时获得上睑提肌收缩和疲劳的指标,并揭示先天性上睑下垂和获得性上睑下垂在这些指标上的差异。先天性上睑下垂时,上睑提上肌的收缩性和疲劳度较低,而后天性上睑下垂(老年性)时,上睑提上肌的收缩性中等,疲劳度中等或较高。对上睑下垂患者上睑提上肌的收缩力和疲劳度进行了分级,并在此基础上提出了上睑下垂手术矫正方法的选择算法。采用重量法对上睑提上肌的解剖和功能特征进行术前动态研究,是一种简单、经济、客观评估上睑提上肌收缩和疲劳状态的方法,可提高上睑下垂手术矫治的效率。
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引用次数: 0
Clinical Manifestations and Mechanisms of Development of Eye Damage in Hemoblastosis 造血细胞病眼损伤的临床表现及发生机制
Q4 Medicine Pub Date : 2023-10-02 DOI: 10.18008/1816-5095-2023-3-528-535
N. Yu. Yusef, E. N. Misyurina, D. V. Andzhelova, E. E. Kazaryan, M. V. Vorobyeva
In the article various ophthalmic manifestations of hemoblastoses will be discussed. Detailed descriptions of the most common variants of damage to the organ of vision in the oncohematological process are presented. Here we also present the clinical symptoms and development mechanisms associated with both direct leukocyte infiltration of various structures of the eye, occurring against the background of the underlying disease, and concomitant conditions, such as violation of the hemostasis system, anemia and thrombocytopenia resulting from the progression of blood cancer. It is also considered the cases of ophthalmic manifestations of hemoblastoses developing against the background of an immunity decrease associated oncohematological disorder, or as a result of the toxic effect of chemotherapy drugs, radiotherapy and bone marrow transplantation, as well as targeted therapy.
本文将讨论成血细胞病的各种眼部表现。详细描述了在血液肿瘤过程中视觉器官损伤的最常见变异。在这里,我们还介绍了与眼部各种结构的直接白细胞浸润相关的临床症状和发展机制,发生在潜在疾病的背景下,以及伴随的条件,如止血系统的破坏,血癌进展导致的贫血和血小板减少症。还考虑了在与血液肿瘤疾病相关的免疫功能下降的背景下,或由于化疗药物、放射治疗和骨髓移植以及靶向治疗的毒性作用而出现的造血细胞病的眼部表现。
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Oftalmologiya
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