Pub Date : 2023-09-30DOI: 10.18008/1816-5095-2023-3-398-404
A. N. Kulikov, M. V. Zakharov, A. A. Volozhev
Age related macular degeneration is a leading cause of vision loss and an increasing problem of disability throughout the world among adults. That revue covers historical points, risk factors, pathogenesis, classification and current treatment ways of that pathology. The causes of age-related macular degeneration are not fully understood, in spite of keeping a great amount of knowledge at etiology, pathogenesis, diagnosis and modern types of treatment. The problem of age-related macular degeneration treatment has remained actual nowadays. Now, the medicine doesn’t have etiotropic treatment of AMD, because we still don’t know a definite etiologic factor of this developing disease. The main treatment for wet AMD is the injection of medications called anti-VEGF agents. Currently, treatment of dry age-related macular degeneration includes modification of risk factors (stop smoking, healthy life style and etc) and dietary supplements containing a combination of certain ingredients (vitamin C, vitamin E, zinc, copper, and lutein with zeaxanthin or beta-carotene) may be able to slow the progression of the disease. The disadvantage of current treatment methods is a narrow focus at one of the pathogenesis components or using as symptomatic therapy. The analysis of literature date has allowed noticing of using of an extracorporeal hemocorrection as perspective way at exploration of new methods of treatment of dry age-related macular degeneration.
{"title":"Treatment Methods Dry Form of Age Macular Degeneration — History and Prospects. Review","authors":"A. N. Kulikov, M. V. Zakharov, A. A. Volozhev","doi":"10.18008/1816-5095-2023-3-398-404","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-398-404","url":null,"abstract":"Age related macular degeneration is a leading cause of vision loss and an increasing problem of disability throughout the world among adults. That revue covers historical points, risk factors, pathogenesis, classification and current treatment ways of that pathology. The causes of age-related macular degeneration are not fully understood, in spite of keeping a great amount of knowledge at etiology, pathogenesis, diagnosis and modern types of treatment. The problem of age-related macular degeneration treatment has remained actual nowadays. Now, the medicine doesn’t have etiotropic treatment of AMD, because we still don’t know a definite etiologic factor of this developing disease. The main treatment for wet AMD is the injection of medications called anti-VEGF agents. Currently, treatment of dry age-related macular degeneration includes modification of risk factors (stop smoking, healthy life style and etc) and dietary supplements containing a combination of certain ingredients (vitamin C, vitamin E, zinc, copper, and lutein with zeaxanthin or beta-carotene) may be able to slow the progression of the disease. The disadvantage of current treatment methods is a narrow focus at one of the pathogenesis components or using as symptomatic therapy. The analysis of literature date has allowed noticing of using of an extracorporeal hemocorrection as perspective way at exploration of new methods of treatment of dry age-related macular degeneration.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032195","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-414-422
N. V. Pomytkina, E. L. Sorokin, O. V. Kolenko
Color Doppler imaging became widespread for study hemodynamics in patients with vascular eyes pathologies. A number of studies have shown changes in ocular blood flow velocity and Doppler indices in patients with diabetes mellitus in both the absence and presence of diabetic retinopathy. With the progression of diabetic retinopathy, an increase in parameters’ changes was revealed, variations in ocular blood flow were studied after conservative treatment, retinal laser photocoagulation, against the background of anti-VEGF therapy. Due to its non-invasiveness, color Doppler imaging is used to assess orbital blood flow in pregnant patients at any gestational age. The works of this direction concern the assessment the changes in orbital blood flow during the physiological course of pregnancy and preeclampsia. However, there is still no information on the state of ocular blood flow in pregnant women with diabetes mellitus, which can serve as a basis for further research.
{"title":"Prospects Using of Colour Doppler Imaging to Study Ocular Hemodynamics in Pregnant Women with Diabetic Retinopathy. Review","authors":"N. V. Pomytkina, E. L. Sorokin, O. V. Kolenko","doi":"10.18008/1816-5095-2023-3-414-422","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-414-422","url":null,"abstract":"Color Doppler imaging became widespread for study hemodynamics in patients with vascular eyes pathologies. A number of studies have shown changes in ocular blood flow velocity and Doppler indices in patients with diabetes mellitus in both the absence and presence of diabetic retinopathy. With the progression of diabetic retinopathy, an increase in parameters’ changes was revealed, variations in ocular blood flow were studied after conservative treatment, retinal laser photocoagulation, against the background of anti-VEGF therapy. Due to its non-invasiveness, color Doppler imaging is used to assess orbital blood flow in pregnant patients at any gestational age. The works of this direction concern the assessment the changes in orbital blood flow during the physiological course of pregnancy and preeclampsia. However, there is still no information on the state of ocular blood flow in pregnant women with diabetes mellitus, which can serve as a basis for further research.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032351","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-431-436
K. B. Pershin, N. F. Pashinova, A. Yu. Tsygankov, I. V. Kosova, O. S. Saidalieva
Purpose : to evaluate the incision width and implantation time of different IOL models using three preloaded and one manual injector. Patients and methods . 146 patients (160 eyes) including 94 females and 52 males were included in a prospective study. Group I — Isert® (28 patients, 32 eyes); Group II — Multisert® (27 patients, 30 eyes); Group III — Autonome® (45 patients, 50 eyes) and Group IV — Monarch® (46 patients, 48 eyes). mean age of patients was 71.8 ± 11.7 years, follow-up period — 3.0 ± 0.2 months. Results . There were no significant differences (p > 0.05) between the groups when comparing the incision width before IOL implantation. After lens implantation, the incision width in group I was significantly higher than in groups II (p = 0.04), III (p = 0.037) and IV (p = 0.029). There were no significant differences in incision width after IOL implantation between groups II, III, and IV (p > 0.05). The average increase in corneal incision width in group I was 0.6 mm, and for groups II, III, and IV it ranged from 0.2 to 0.3 mm. Groups II, III, and IV showed lower values of surgically induced astigmatism compared with group I (0.47 ± 0.06 D, 0.41 ± 0.06 D, and 0.44 ± 0.07 D compared with 1.12 ± 0.17 D, respectively; p < 0.05 for all groups). No significant differences were found between groups II, III, and IV. Minimum implantation time was observed for groups II and III, maximum for groups I and IV, with a mean difference of about 30 seconds. Differences when comparing the mean IOL implantation time were not statistically significant (p > 0.05). Conclusion . This paper presents the first worldwide comparative analysis of four IOL implantation systems, including Isert®, Multisert®, Autonome®, and Monarch®. The new Multisert® IOL implantation system has similar advantages to the known monofocal IOL injectors with respect to corneal incision width, surgically induced astigmatism magnitude, and time required for IOL implantation. IOL implantation time did not depend on the type of implantation (hydro- or viscous) and the type of injector.
{"title":"Comparative Analysis of Three Preloaded and One Manual Injector for Intraocular Lens Implantation","authors":"K. B. Pershin, N. F. Pashinova, A. Yu. Tsygankov, I. V. Kosova, O. S. Saidalieva","doi":"10.18008/1816-5095-2023-3-431-436","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-431-436","url":null,"abstract":"Purpose : to evaluate the incision width and implantation time of different IOL models using three preloaded and one manual injector. Patients and methods . 146 patients (160 eyes) including 94 females and 52 males were included in a prospective study. Group I — Isert® (28 patients, 32 eyes); Group II — Multisert® (27 patients, 30 eyes); Group III — Autonome® (45 patients, 50 eyes) and Group IV — Monarch® (46 patients, 48 eyes). mean age of patients was 71.8 ± 11.7 years, follow-up period — 3.0 ± 0.2 months. Results . There were no significant differences (p > 0.05) between the groups when comparing the incision width before IOL implantation. After lens implantation, the incision width in group I was significantly higher than in groups II (p = 0.04), III (p = 0.037) and IV (p = 0.029). There were no significant differences in incision width after IOL implantation between groups II, III, and IV (p > 0.05). The average increase in corneal incision width in group I was 0.6 mm, and for groups II, III, and IV it ranged from 0.2 to 0.3 mm. Groups II, III, and IV showed lower values of surgically induced astigmatism compared with group I (0.47 ± 0.06 D, 0.41 ± 0.06 D, and 0.44 ± 0.07 D compared with 1.12 ± 0.17 D, respectively; p < 0.05 for all groups). No significant differences were found between groups II, III, and IV. Minimum implantation time was observed for groups II and III, maximum for groups I and IV, with a mean difference of about 30 seconds. Differences when comparing the mean IOL implantation time were not statistically significant (p > 0.05). Conclusion . This paper presents the first worldwide comparative analysis of four IOL implantation systems, including Isert®, Multisert®, Autonome®, and Monarch®. The new Multisert® IOL implantation system has similar advantages to the known monofocal IOL injectors with respect to corneal incision width, surgically induced astigmatism magnitude, and time required for IOL implantation. IOL implantation time did not depend on the type of implantation (hydro- or viscous) and the type of injector.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032350","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-444-450
N. V. Maychuk, A. V. Tikhov, Kh. P. Takhchidi, N. Sh. Sarkhadov, I. S. Malyshev
Relevance. Modern keratorefractive surgery (CRS) is a high-tech field of ophthalmology aimed at solving various problems of correcting a wide range of ametropias. Increasing the security of the RFI is one of the priority areas Purpose. To analyze the clinical and functional results of the use of the “Olimp™-2000” solid-state laser system during CRS using the method of superficial and sublamellar laser keratoablation and formulate recommendations for the therapeutic management of patients. Materials and methods. 53 patients (106 eyes) were examined, the average age was 28.5 ± 2.4 years. The inclusion criterion was moderate myopia and the absence of contraindications to CRC. If sufficient, taking into account safety criteria, CRS was performed by sublamellar keratoablation, if insufficient, superficial keratoablation was performed. In both cases, ablation was performed using a domestic solid-state laser machine. The observation period was 3 months. Pharmacological support in all cases was standard, adopted for the management of patients in FCMMG “YourMed”. Results. An analysis of the clinical and functional results of CRS using a solid-state laser device showed full compliance with the criteria set by the Food and Drug Administration (FDA). The accuracy of hitting the target refraction in the range of ± 0.5 diopters was 99.2 %; in 3 months of observation, no regression of the obtained refractive result was observed in any case. There was no loss of lines in any case, the BCVA after the operation corresponded to or exceeded by 1–2 lines the BCVA before the operation. When performing superficial keratoablation, in two cases, the loss of line 1 of the NCVA was noted due to the development of early subepithelial fibroplasia, which required correction of the pharmacological support. Conclusion. The analysis of the clinical and functional results of the correction of moderate myopia using the “Olimp™-2000” solid-state laser device showed high efficiency in terms of efficiency, safety, and predictability, despite little experience in using solid-state ablation in clinical practice. The use of Floas Mono® did not cause side effects in all cases and contributed to the smooth course of the early postoperative period. Thus, this drug is effective in the postoperative period and can be recommended for use in patients after CRC. The generation of ultraviolet radiation by modern solid-state devices for the purpose of correcting ametropia is a promising direction in CRS.
{"title":"The First Clinical and Functional Results of Myopia Correction Using a Solid-State Laser Unit","authors":"N. V. Maychuk, A. V. Tikhov, Kh. P. Takhchidi, N. Sh. Sarkhadov, I. S. Malyshev","doi":"10.18008/1816-5095-2023-3-444-450","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-444-450","url":null,"abstract":"Relevance. Modern keratorefractive surgery (CRS) is a high-tech field of ophthalmology aimed at solving various problems of correcting a wide range of ametropias. Increasing the security of the RFI is one of the priority areas Purpose. To analyze the clinical and functional results of the use of the “Olimp™-2000” solid-state laser system during CRS using the method of superficial and sublamellar laser keratoablation and formulate recommendations for the therapeutic management of patients. Materials and methods. 53 patients (106 eyes) were examined, the average age was 28.5 ± 2.4 years. The inclusion criterion was moderate myopia and the absence of contraindications to CRC. If sufficient, taking into account safety criteria, CRS was performed by sublamellar keratoablation, if insufficient, superficial keratoablation was performed. In both cases, ablation was performed using a domestic solid-state laser machine. The observation period was 3 months. Pharmacological support in all cases was standard, adopted for the management of patients in FCMMG “YourMed”. Results. An analysis of the clinical and functional results of CRS using a solid-state laser device showed full compliance with the criteria set by the Food and Drug Administration (FDA). The accuracy of hitting the target refraction in the range of ± 0.5 diopters was 99.2 %; in 3 months of observation, no regression of the obtained refractive result was observed in any case. There was no loss of lines in any case, the BCVA after the operation corresponded to or exceeded by 1–2 lines the BCVA before the operation. When performing superficial keratoablation, in two cases, the loss of line 1 of the NCVA was noted due to the development of early subepithelial fibroplasia, which required correction of the pharmacological support. Conclusion. The analysis of the clinical and functional results of the correction of moderate myopia using the “Olimp™-2000” solid-state laser device showed high efficiency in terms of efficiency, safety, and predictability, despite little experience in using solid-state ablation in clinical practice. The use of Floas Mono® did not cause side effects in all cases and contributed to the smooth course of the early postoperative period. Thus, this drug is effective in the postoperative period and can be recommended for use in patients after CRC. The generation of ultraviolet radiation by modern solid-state devices for the purpose of correcting ametropia is a promising direction in CRS.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032347","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-437-443
H. Khraistin, G. A. Osipyan, S. I. Anisimov, A. K. Dzamikhova, M. Jourieh
Objective of the study. To analyze the effectiveness of accelerated local corneal cross linking in the treatment of keratoconus (KC). Patients and methods. Thirty-four patients (42 eyes) were included in the study: 19 people (24 eyes) with stage II keratoconus, 15 people (18 eyes) with stage III Amsler keratoconus. All patients were examined using the following methods: visometry, refractokeratometry, keratotopography, optical coherence tomography of anterior segment, endothelial cell density calculation before and after surgical treatment in 6 months, 1, 2 and 3 years. Results . Significant increase of uncorrected (UDVA) and corrected (CDVA) distance visual acuity was registered 6 months after operation in KC of the II and III stages. In KC stage II, the NCOZ and EOC were greater, from 0.39 ± 0.14 to 0.61 ± 0.18 by 0.22 ± 0.04 (p < 0.05) and from 0.60 ± 0.15 to 0.77 ± 0.12 by 0.17 ± 0.03 (p < 0.05), respectively, in stage III. — from 0.12 ± 0.03 to 0.23 ± 0.07 by 0.12 ± 0.04 (p < 0.05) and from 0.45 ± 0.10 to 0.53 ± 0.12 by 0.10 ± 0.02 (p < 0.05), due to decreased refractive indices in the central 3.0 mm zone. Refractive indexes of the central corneal zone, UVA and CVA in all patients after one, two and three years, as well as data of minimal corneal thickness and endothelial cell density did not change statistically significantly during the entire observation period.
{"title":"Results of Accelerated Local Cross-Linking in Keratoconus","authors":"H. Khraistin, G. A. Osipyan, S. I. Anisimov, A. K. Dzamikhova, M. Jourieh","doi":"10.18008/1816-5095-2023-3-437-443","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-437-443","url":null,"abstract":"Objective of the study. To analyze the effectiveness of accelerated local corneal cross linking in the treatment of keratoconus (KC). Patients and methods. Thirty-four patients (42 eyes) were included in the study: 19 people (24 eyes) with stage II keratoconus, 15 people (18 eyes) with stage III Amsler keratoconus. All patients were examined using the following methods: visometry, refractokeratometry, keratotopography, optical coherence tomography of anterior segment, endothelial cell density calculation before and after surgical treatment in 6 months, 1, 2 and 3 years. Results . Significant increase of uncorrected (UDVA) and corrected (CDVA) distance visual acuity was registered 6 months after operation in KC of the II and III stages. In KC stage II, the NCOZ and EOC were greater, from 0.39 ± 0.14 to 0.61 ± 0.18 by 0.22 ± 0.04 (p < 0.05) and from 0.60 ± 0.15 to 0.77 ± 0.12 by 0.17 ± 0.03 (p < 0.05), respectively, in stage III. — from 0.12 ± 0.03 to 0.23 ± 0.07 by 0.12 ± 0.04 (p < 0.05) and from 0.45 ± 0.10 to 0.53 ± 0.12 by 0.10 ± 0.02 (p < 0.05), due to decreased refractive indices in the central 3.0 mm zone. Refractive indexes of the central corneal zone, UVA and CVA in all patients after one, two and three years, as well as data of minimal corneal thickness and endothelial cell density did not change statistically significantly during the entire observation period.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032194","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-423-430
O. V. Shilovskikh, V. O. Ponomarev, V. L. Timofeev
Fungal keratitis (FK) is 8–30 % in the structure of infectious inflammation of the cornea. There are 2 main types of mushroom growth — mycelial and yeast. Mycelial (mold) fungi grow in the form of special branched microscopic tubes — hyphae. Yeast fungi form compact colonies of individual oval cells. Due to the peculiarities of the yeast structure, the tendency to rapid spread in the tissues is reduced, which determines the less aggressive clinical course of such keratomycosis compared to mold. Until the 50s of the 20th century, the occurrence of FK in the world was low. However, probably with the introduction of corticosteroid and antibacterial drugs into medicine, their prevalence began to grow. The highest frequency of occurrence of FK is in regions with a hot climate and high involvement of the population in agriculture. The main provoking factor for the appearance of FK is corneal injury with damage to the epithelium and adhesion to the Bowman’s membrane or stroma components. Highly adhesive fungi ( Aspergillus spp., Candida spp. ) trigger a cascade of immune inflammatory reactions, production of reactive oxygen species and matrix metalloproteases-9, which leads to the destruction of lamellae. Fungi with low adhesive ability ( Fusarium spp. ) can grow parallel to lamellae for a long time and indefinitely without inducing pronounced inflammation. Symptoms of FC are similar to those observed in other forms of infectious keratitis, but more often they develop more slowly (5–10 days) and are less acute. A defect against the background of mycelial FC is more often characterized by jagged edges, a raised slough, and a non-yellow color. Yeast FK is manifested by oval ulceration of the epithelium with expanding, more sharply demarcated, densely focal suppuration.
{"title":"Fungal Keratitis. Part 1. Etiomorphology, Historical Aspects, Epidemiology, Risk Factors, Pathogenesis and Clinical Features","authors":"O. V. Shilovskikh, V. O. Ponomarev, V. L. Timofeev","doi":"10.18008/1816-5095-2023-3-423-430","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-423-430","url":null,"abstract":"Fungal keratitis (FK) is 8–30 % in the structure of infectious inflammation of the cornea. There are 2 main types of mushroom growth — mycelial and yeast. Mycelial (mold) fungi grow in the form of special branched microscopic tubes — hyphae. Yeast fungi form compact colonies of individual oval cells. Due to the peculiarities of the yeast structure, the tendency to rapid spread in the tissues is reduced, which determines the less aggressive clinical course of such keratomycosis compared to mold. Until the 50s of the 20th century, the occurrence of FK in the world was low. However, probably with the introduction of corticosteroid and antibacterial drugs into medicine, their prevalence began to grow. The highest frequency of occurrence of FK is in regions with a hot climate and high involvement of the population in agriculture. The main provoking factor for the appearance of FK is corneal injury with damage to the epithelium and adhesion to the Bowman’s membrane or stroma components. Highly adhesive fungi ( Aspergillus spp., Candida spp. ) trigger a cascade of immune inflammatory reactions, production of reactive oxygen species and matrix metalloproteases-9, which leads to the destruction of lamellae. Fungi with low adhesive ability ( Fusarium spp. ) can grow parallel to lamellae for a long time and indefinitely without inducing pronounced inflammation. Symptoms of FC are similar to those observed in other forms of infectious keratitis, but more often they develop more slowly (5–10 days) and are less acute. A defect against the background of mycelial FC is more often characterized by jagged edges, a raised slough, and a non-yellow color. Yeast FK is manifested by oval ulceration of the epithelium with expanding, more sharply demarcated, densely focal suppuration.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032348","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-390-397
O. I. Butranova, S. K. Zyryanov
Dosage forms for topical ocular administration are the basis of patient management in ophthalmology. The eye is a structure evolutionarily protected from the effects of xenobiotics by a number of physiological and anatomical barriers. The development of dosage forms, the targeted delivery into the eye structures is carried out due to the inclusion of special excipients, is aimed at improving the efficiency of managing patients with eye diseases. The action mechanisms of the most common groups of excipients used in ophthalmology underlie their effectiveness and safety, as well as create a basis for the various dosage forms development. Cellulose derivatives, due to their physicochemical and pharmacological characteristics, are one of the preferred groups for the development of topical dosage forms used in ophthalmology. Hypromellose (hydroxypropyl methylcellulose) is one of the most studied cellulose derivatives, which is characterized by a wide range of indications for both the active substance (artificial tear component) and the excipient. The favorable pharmacological properties of hypromellose (the ability to provide long-term exposure to effective concentrations of drugs used topically in ophthalmology, the ability to increase the degree of hydration of the cornea) contribute to the active study of this substance to assess the possibilities of its use in the development of new dosage forms (nanoparticles), as well as expanding the existing list of indications. This review is devoted to the analysis of clinical and experimental studies of the efficacy and safety of hypromellose.
{"title":"Hypromellose in Ophthalmology","authors":"O. I. Butranova, S. K. Zyryanov","doi":"10.18008/1816-5095-2023-3-390-397","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-390-397","url":null,"abstract":"Dosage forms for topical ocular administration are the basis of patient management in ophthalmology. The eye is a structure evolutionarily protected from the effects of xenobiotics by a number of physiological and anatomical barriers. The development of dosage forms, the targeted delivery into the eye structures is carried out due to the inclusion of special excipients, is aimed at improving the efficiency of managing patients with eye diseases. The action mechanisms of the most common groups of excipients used in ophthalmology underlie their effectiveness and safety, as well as create a basis for the various dosage forms development. Cellulose derivatives, due to their physicochemical and pharmacological characteristics, are one of the preferred groups for the development of topical dosage forms used in ophthalmology. Hypromellose (hydroxypropyl methylcellulose) is one of the most studied cellulose derivatives, which is characterized by a wide range of indications for both the active substance (artificial tear component) and the excipient. The favorable pharmacological properties of hypromellose (the ability to provide long-term exposure to effective concentrations of drugs used topically in ophthalmology, the ability to increase the degree of hydration of the cornea) contribute to the active study of this substance to assess the possibilities of its use in the development of new dosage forms (nanoparticles), as well as expanding the existing list of indications. This review is devoted to the analysis of clinical and experimental studies of the efficacy and safety of hypromellose.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032357","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 : 2023-09-30DOI: 10.18008/1816-5095-2023-3-405-413
D. V. Petrachkov, E. N. Korobov
Currently, laser technologies are widely used in the treatment of diseases of the eye and its accessory apparatus. Basically, they are used in oculoplastic surgery during operations on the accessory apparatus of the eye, in refractive and corneal surgery, laser support for ultrasound cataract surgery, laser treatment of glaucoma, laser coagulation of the retina, thermotherapy of choroidal formations. In the 21st century, Nd: YAG laser treatment of floating opacities in the vitreous body began to be actively popularized with mixed results. In vitreoretinal surgery, which is improving every decade, laser technology remains at the level of the 20th century. In endovitreal surgery, the laser is still used only for endolaser coagulation of the retina, despite the fact that there is a huge potential for using lasers as a “laser scalpel” for removing the vitreous, precision removal of a retinal tear, epiretinal fibrosis, precision retinotomy, and choroidotomy. In this regard, it is necessary to search for the most suitable laser radiation, which will make it possible to carry out thin cuts on the retina and choroid with high accuracy, minimal damage to the surrounding tissues, and a sufficient degree of coagulation to prevent hemorrhages. This laser will allow for surgical interventions in the posterior eye segment with a lower risk of intra- and postoperative complications, as well as better anatomical and functional results. With further development, this new approach to laser ablation may become an alternative to mechanical instruments for surgical dissection and removal of pathological tissue from the surface of the retina.
{"title":"Possibilities of Using Laser Radiation in Vitreoretinal Surgery","authors":"D. V. Petrachkov, E. N. Korobov","doi":"10.18008/1816-5095-2023-3-405-413","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-405-413","url":null,"abstract":"Currently, laser technologies are widely used in the treatment of diseases of the eye and its accessory apparatus. Basically, they are used in oculoplastic surgery during operations on the accessory apparatus of the eye, in refractive and corneal surgery, laser support for ultrasound cataract surgery, laser treatment of glaucoma, laser coagulation of the retina, thermotherapy of choroidal formations. In the 21st century, Nd: YAG laser treatment of floating opacities in the vitreous body began to be actively popularized with mixed results. In vitreoretinal surgery, which is improving every decade, laser technology remains at the level of the 20th century. In endovitreal surgery, the laser is still used only for endolaser coagulation of the retina, despite the fact that there is a huge potential for using lasers as a “laser scalpel” for removing the vitreous, precision removal of a retinal tear, epiretinal fibrosis, precision retinotomy, and choroidotomy. In this regard, it is necessary to search for the most suitable laser radiation, which will make it possible to carry out thin cuts on the retina and choroid with high accuracy, minimal damage to the surrounding tissues, and a sufficient degree of coagulation to prevent hemorrhages. This laser will allow for surgical interventions in the posterior eye segment with a lower risk of intra- and postoperative complications, as well as better anatomical and functional results. With further development, this new approach to laser ablation may become an alternative to mechanical instruments for surgical dissection and removal of pathological tissue from the surface of the retina.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135031990","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 : 2023-09-29DOI: 10.18008/1816-5095-2023-3-384-389
T. N. Kiseleva, M. S. Zaitsev
Age-related cataract is the leading cause of vision loss in old people worldwide. According to the World Health Organization it accounts for 47.8 % of the total number of ocular pathologies in people over 50 years old. Despite the rapid development of cataract surgery technology, surgery remains a challenge due to its cost and the increasing number of patients. Literature review is devoted to current concepts of pathogenesis and molecular mechanisms of age-related changes in eye lens. There are the three main theories of cataractogenesis: oxidative stress; the impact of quinoid substances, which are formed due to the impairment of aromatic amino acid metabolism and the activation of aldo reductase enzyme with subsequent accumulation of sorbitol, reactive oxygen species (ROS) generation, dysfunction of Na + /K + channels and calcium deregulation causing lens epithelial cells apoptosis. Theories of pathogenesis are linked and based on the development of age-related changes in protein metabolism (the majority of nuclear α-crystallins are insoluble), glucose metabolism (non-enzymatic glycosylation of proteins), lipid metabolism, enzyme activity and the loss of membrane potential of cells ( the increase of Na + and Ca 2 + level and the decrease of K+ level). Key element of all theories of age-related changes in eye lens is the aggregation of high molecular weight proteins covalent-bonded of disulfide linkages. Based on molecular mechanisms of cataractogenesis, the development of pathogenetically oriented medical methods of correction of the age-related changes in lens is carried on. This review provides information on results of experimental and clinical studies which demonstrate the anti-cataract effect of Pirenoxine 0, 005 %.
{"title":"Current Concepts of Molecular Mechanisms of Age-Related Changes in Eye Lens","authors":"T. N. Kiseleva, M. S. Zaitsev","doi":"10.18008/1816-5095-2023-3-384-389","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-384-389","url":null,"abstract":"Age-related cataract is the leading cause of vision loss in old people worldwide. According to the World Health Organization it accounts for 47.8 % of the total number of ocular pathologies in people over 50 years old. Despite the rapid development of cataract surgery technology, surgery remains a challenge due to its cost and the increasing number of patients. Literature review is devoted to current concepts of pathogenesis and molecular mechanisms of age-related changes in eye lens. There are the three main theories of cataractogenesis: oxidative stress; the impact of quinoid substances, which are formed due to the impairment of aromatic amino acid metabolism and the activation of aldo reductase enzyme with subsequent accumulation of sorbitol, reactive oxygen species (ROS) generation, dysfunction of Na + /K + channels and calcium deregulation causing lens epithelial cells apoptosis. Theories of pathogenesis are linked and based on the development of age-related changes in protein metabolism (the majority of nuclear α-crystallins are insoluble), glucose metabolism (non-enzymatic glycosylation of proteins), lipid metabolism, enzyme activity and the loss of membrane potential of cells ( the increase of Na + and Ca 2 + level and the decrease of K+ level). Key element of all theories of age-related changes in eye lens is the aggregation of high molecular weight proteins covalent-bonded of disulfide linkages. Based on molecular mechanisms of cataractogenesis, the development of pathogenetically oriented medical methods of correction of the age-related changes in lens is carried on. This review provides information on results of experimental and clinical studies which demonstrate the anti-cataract effect of Pirenoxine 0, 005 %.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135295225","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 : 2023-09-29DOI: 10.18008/1816-5095-2023-3-377-383
N. I. Kurysheva, V. E. Kim, H. M. Plieva, V. Yu. Kim, D. M. Nurmahadzhiev
In the modern world, glaucoma is one of the main causes of irreversible vision loss. Normal tension glaucoma (NTG) constitutes the major proportion of POAG, which is common in Asian populations. NTG is a disease resulted from the interaction of multiple genetic risk factors. But other factors are also important, such as thinning of the scleral lamina cribrosa and a lesion of the transmembrane pressure gradient. Central visual field defects and disc hemorrhage are characteristics finding that is highly associated with the progression of NTG.
{"title":"Normal-Tension Glaucoma: Epidemiology, Pathogenesis, Diagnosis and Treatment. Review. Part 1","authors":"N. I. Kurysheva, V. E. Kim, H. M. Plieva, V. Yu. Kim, D. M. Nurmahadzhiev","doi":"10.18008/1816-5095-2023-3-377-383","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-377-383","url":null,"abstract":"In the modern world, glaucoma is one of the main causes of irreversible vision loss. Normal tension glaucoma (NTG) constitutes the major proportion of POAG, which is common in Asian populations. NTG is a disease resulted from the interaction of multiple genetic risk factors. But other factors are also important, such as thinning of the scleral lamina cribrosa and a lesion of the transmembrane pressure gradient. Central visual field defects and disc hemorrhage are characteristics finding that is highly associated with the progression of NTG.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135295321","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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