Pub Date : 2022-06-17DOI: 10.25276/0235-4160-2022-2-78-83
S. Izmailova, E. Markova, A. Z. Ciganov, L. Arutyunyan
Introduction. The review presents the current data on the methods of surgical treatment of the initial stages of keratoconus in children, the possible manifestation of keratoconus as one of the symptoms of undifferentiated connective tissue dysplasia, as well as possible methods of prevention of the disease progression. Purpose. To present current literature data regarding surgical treatment of the initial stages of progressive keratoconus in children. Material and methods. For the review the literature sources were searched through the abstract databases PubMed and Scopus for the period up to and including 2022 using the following key words: ICRS, corneal collagen crosslinking, Keratoconus, connective tissue dysplasia. A total of 51 articles relevant to the review topic were selected. Results. Numerous studies have confirmed the effectiveness of timely surgery for the initial stages of keratoconus in improving the anatomical and functional outcomes of treatment of various diseases. However, even timely and perfectly performed surgery for progressive keratoconus may have different consequences depending on the degree of connective tissue dysplasia. Conclusion. The performed analysis of the literature allows to claim that keratoconus in children should be considered as a pathology related to the disturbance of structures and organization of collagen matrix of the whole body. It is also necessary to note that treatment tactics should be determined individually and be based on the age and values of comprehensive special examination of each particular child. Key words: keratoconus, keratoconus in children, corneal collagen cross-linking, intrastromal keratoplasty, corneal segments, connective tissue, undifferentiated connective tissue dysplasia, cornea, collagen
{"title":"Surgical treatment of the initial stages of progressive keratoconus in children","authors":"S. Izmailova, E. Markova, A. Z. Ciganov, L. Arutyunyan","doi":"10.25276/0235-4160-2022-2-78-83","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-78-83","url":null,"abstract":"Introduction. The review presents the current data on the methods of surgical treatment of the initial stages of keratoconus in children, the possible manifestation of keratoconus as one of the symptoms of undifferentiated connective tissue dysplasia, as well as possible methods of prevention of the disease progression. Purpose. To present current literature data regarding surgical treatment of the initial stages of progressive keratoconus in children. Material and methods. For the review the literature sources were searched through the abstract databases PubMed and Scopus for the period up to and including 2022 using the following key words: ICRS, corneal collagen crosslinking, Keratoconus, connective tissue dysplasia. A total of 51 articles relevant to the review topic were selected. Results. Numerous studies have confirmed the effectiveness of timely surgery for the initial stages of keratoconus in improving the anatomical and functional outcomes of treatment of various diseases. However, even timely and perfectly performed surgery for progressive keratoconus may have different consequences depending on the degree of connective tissue dysplasia. Conclusion. The performed analysis of the literature allows to claim that keratoconus in children should be considered as a pathology related to the disturbance of structures and organization of collagen matrix of the whole body. It is also necessary to note that treatment tactics should be determined individually and be based on the age and values of comprehensive special examination of each particular child. Key words: keratoconus, keratoconus in children, corneal collagen cross-linking, intrastromal keratoplasty, corneal segments, connective tissue, undifferentiated connective tissue dysplasia, cornea, collagen","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115184862","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-60-66
T.N. Yur'ieva, O. Pisarevskaya
Purpose. To present clinical cases of keratorefractive surgery in patients with iridocorneal endothelial syndrome. Material and methods. The examination and symptomatic treatment of two patients who underwent laser keratorefractive surgery for myopia correction was carried out. In the postoperative period, one of the operated eyes had low visual acuity, diffuse corneal edema, decompensation of IOP of unclear genesis. Results. The consistent use of standard (biomicroscopy, ophthalmoscopy, gonioscopy) and highly informative methods of examination (OCT of the anterior segment of the eye, UBM, endothelial microscopy) made it possible to diagnose iridocorneal endothelial syndrome in both cases. Drug hypotensive therapy in one case and trabeculectomy in the other allowed to restore the transparency of the cornea and improve visual acuity. Conclusion. Manifest changes in the anterior segment of the eye in many syndromes accompanied by the formation of glaucoma make it possible to identify hydrodynamic disorders at the earliest stages and prevent the destructive effect of increased IOP. The complex application of modern imaging methods provides an objective assessment of pathological changes in the eye, and allows you to determine indications and contraindications to refractive surgery. Key words: keratorefractive surgery, complications, iridocorneal endothelial syndrome
{"title":"Non-refractive complications of refractive surgery in patients with iridocorneal endothelial syndrome","authors":"T.N. Yur'ieva, O. Pisarevskaya","doi":"10.25276/0235-4160-2022-2-60-66","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-60-66","url":null,"abstract":"Purpose. To present clinical cases of keratorefractive surgery in patients with iridocorneal endothelial syndrome. Material and methods. The examination and symptomatic treatment of two patients who underwent laser keratorefractive surgery for myopia correction was carried out. In the postoperative period, one of the operated eyes had low visual acuity, diffuse corneal edema, decompensation of IOP of unclear genesis. Results. The consistent use of standard (biomicroscopy, ophthalmoscopy, gonioscopy) and highly informative methods of examination (OCT of the anterior segment of the eye, UBM, endothelial microscopy) made it possible to diagnose iridocorneal endothelial syndrome in both cases. Drug hypotensive therapy in one case and trabeculectomy in the other allowed to restore the transparency of the cornea and improve visual acuity. Conclusion. Manifest changes in the anterior segment of the eye in many syndromes accompanied by the formation of glaucoma make it possible to identify hydrodynamic disorders at the earliest stages and prevent the destructive effect of increased IOP. The complex application of modern imaging methods provides an objective assessment of pathological changes in the eye, and allows you to determine indications and contraindications to refractive surgery. Key words: keratorefractive surgery, complications, iridocorneal endothelial syndrome","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124697308","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-38-44
A. A. Fil, O. V. Kolenko, E. L. Sorokin
Purpose. To study the relationship between choroidal and retinal hemodynamics of the eyes in retinal vein occlusion (RVO) in young women to determine the features of their clinical course. Material and methods. The main group included 15 women (15 eyes), whose age ranged from 35 to 45 years, averaging 39.7±4.0 years. 20 somatically healthy women of comparable age were included in the control group. In addition to standard examination methods, all women underwent a comprehensive study of chorioretinal hemodynamics. The linear velocity of blood flow (LVBF) in the posterior short ciliary arteries (PSCA) was evaluated using a multifunctional ultrasound diagnostic device Logiq e (General Electric, USA). Macular blood flow features were studied using an optical coherence tomograph in angiography mode RTVue-100 (Optovue, Inc., USA). A comparative analysis of the studied indicators between the groups was carried out. Results. The results of the study revealed the presence of an interrelated statistically significant decrease in choroidal and retinal hemodynamics in young women with RVO relative to the group of healthy women (p<0.001). Conclusion. Taking into account the revealed direct relationship between choroidal and retinal hemodynamics in women with acute respiratory infections, we consider it appropriate and necessary to perform a simultaneous comprehensive study of various components of the hemodynamics of the posterior segment of the eye in the presence of this pathology: LVBF in the PSCA by color Doppler mapping and macular blood flow by OCT in angiography mode. These data can significantly expand the diagnostic capabilities of identifying the severity of the clinical course of acute respiratory infections and help predict the possible formation of neovascularization. Key words: retinal vein occlusions, young women, chorioretinal hemodynamics, color Doppler mapping, optical coherence tomography in angiography mode
{"title":"Comprehensive study of the state and relationship of choroidal and regional hemodynamics in retinal vein occlusion in young women","authors":"A. A. Fil, O. V. Kolenko, E. L. Sorokin","doi":"10.25276/0235-4160-2022-2-38-44","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-38-44","url":null,"abstract":"Purpose. To study the relationship between choroidal and retinal hemodynamics of the eyes in retinal vein occlusion (RVO) in young women to determine the features of their clinical course. Material and methods. The main group included 15 women (15 eyes), whose age ranged from 35 to 45 years, averaging 39.7±4.0 years. 20 somatically healthy women of comparable age were included in the control group. In addition to standard examination methods, all women underwent a comprehensive study of chorioretinal hemodynamics. The linear velocity of blood flow (LVBF) in the posterior short ciliary arteries (PSCA) was evaluated using a multifunctional ultrasound diagnostic device Logiq e (General Electric, USA). Macular blood flow features were studied using an optical coherence tomograph in angiography mode RTVue-100 (Optovue, Inc., USA). A comparative analysis of the studied indicators between the groups was carried out. Results. The results of the study revealed the presence of an interrelated statistically significant decrease in choroidal and retinal hemodynamics in young women with RVO relative to the group of healthy women (p<0.001). Conclusion. Taking into account the revealed direct relationship between choroidal and retinal hemodynamics in women with acute respiratory infections, we consider it appropriate and necessary to perform a simultaneous comprehensive study of various components of the hemodynamics of the posterior segment of the eye in the presence of this pathology: LVBF in the PSCA by color Doppler mapping and macular blood flow by OCT in angiography mode. These data can significantly expand the diagnostic capabilities of identifying the severity of the clinical course of acute respiratory infections and help predict the possible formation of neovascularization. Key words: retinal vein occlusions, young women, chorioretinal hemodynamics, color Doppler mapping, optical coherence tomography in angiography mode","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126715651","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-26-30
Shpak A.A., M. N.A., Korobkova M.V.
Purpose. To investigate the influence of the axial length of the eyes with hypermetropia on the average ganglion cell-inner plexiform layer (GCIPL) thickness and to develop methods for correcting this effect. Material and methods. The study involved 183 patients (183 eyes) over the age of 40 years, 48 patients (48 eyes) with hypermetropia (axial length <22 mm) and 139 healthy subjects (139 eyes) of the same sex and age with axial length 22.5–24.5 mm (control group). Part of the control group (80 people) was examined earlier. Optical coherence tomography was performed on a Cirrus HD-OCT device (Carl Zeiss Meditec). Results. The average GCIPL thickness in the main group was 83.42±6.50 (from 71 to 99) µм and was higher than in the control group, where it was 80.39±5.91 (from 68 to 98) µm (p=0.004). In the control group normative data for the average GCIPL thickness were determined. For eyes with the axial length 20–22 mm corrections for calculating the equivalent average GCIPL thickness in emmetropic eyes have been developed, allowing comparison with the normative data. Conclusion. An original technique for assessing the average GCIPL thickness in patients with hypermetropia with axial length 20–22 mm, adapted to the Cirrus HD-OCT device, was developed. For this device, the normative database of healthy persons with emmetropia at the age of 41–80 years has been supplemented. Key words: optical coherence tomography, hypermetropia, ganglion cell layer, inner plexiform layer, normative data
{"title":"Assessment of the retinal ganglion cell layer in patients with axial hypermetropia","authors":"Shpak A.A., M. N.A., Korobkova M.V.","doi":"10.25276/0235-4160-2022-2-26-30","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-26-30","url":null,"abstract":"Purpose. To investigate the influence of the axial length of the eyes with hypermetropia on the average ganglion cell-inner plexiform layer (GCIPL) thickness and to develop methods for correcting this effect. Material and methods. The study involved 183 patients (183 eyes) over the age of 40 years, 48 patients (48 eyes) with hypermetropia (axial length <22 mm) and 139 healthy subjects (139 eyes) of the same sex and age with axial length 22.5–24.5 mm (control group). Part of the control group (80 people) was examined earlier. Optical coherence tomography was performed on a Cirrus HD-OCT device (Carl Zeiss Meditec). Results. The average GCIPL thickness in the main group was 83.42±6.50 (from 71 to 99) µм and was higher than in the control group, where it was 80.39±5.91 (from 68 to 98) µm (p=0.004). In the control group normative data for the average GCIPL thickness were determined. For eyes with the axial length 20–22 mm corrections for calculating the equivalent average GCIPL thickness in emmetropic eyes have been developed, allowing comparison with the normative data. Conclusion. An original technique for assessing the average GCIPL thickness in patients with hypermetropia with axial length 20–22 mm, adapted to the Cirrus HD-OCT device, was developed. For this device, the normative database of healthy persons with emmetropia at the age of 41–80 years has been supplemented. Key words: optical coherence tomography, hypermetropia, ganglion cell layer, inner plexiform layer, normative data","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124965930","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-54-59
S. Borzenok, M. Gerasimov, Y. A. Komakh, M. Khubetsova, H. Tonaeva, L. Máliková, P.I. Plaksa
Purpose. To analyze an algorithm for infectious screening of cadaver corneal donors during corneal processing at the Eye Tissue Bank (ETB) of The Fyodorov Eye Microsurgery Federal State Institution and compare it with the European Eye Bank Association (EEBA) data from 2011 through 2015. Material and methods. Data analysis were done using the ETB in-house donor data registry and EEBA annual directory forms. The extracted data included the number of received eye globes, rates of inconclusive and serological tests for human immunodeficiency virus (type 1 and 2), Hepatitis B and C viruses, and Syphilis. Results. During the analyzed period 3479 eye globes were delivered in the ETB for the processing. Hemolysis caused exclusion for 13.9% (n=486) of corneas in the ETB. In opposite, the EEBA data demonstrated far lower rates of inconclusive tests. The positive serology tests lead to canceling 19.4% (n=676) of the incoming corneas in the ETB. Overall, the rates of positive tests were far higher in comparison with EEBA data. At the ETB, positive serological tests for HIV (type 1 and 2) and Syphilis had low variability annually, while the rates of Hepatitis B increased in 2015. Predomination of Hepatitis C was also noted. Often enough, the blood samples were multiply-infected. Conclusion. Overall, the positive serology and hemolysis were the major contraindications and led to exclusion 33.4% (n=1162) of incoming corneas in the ETB. Serological tests rates for indicated infections were higher in the ETB with predomination of Hepatitis C. An algorithm for infectious screening at the Eye Tissue Bank (ETB) of The S. Fyodorov Eye Microsurgery Federal State Institution was effective in selection of postmortem donors for cornea processing in clinical use. Key words: cornea transplantation, eye bank, serological tests, human immunodeficiency virus, hepatitis B viruses, hepatitis C virus, syphilis
{"title":"An algorithm for infectious screening of corneal donors in eye tissue bank of the Fyodorov Eye Microsurgery Federal State Institution","authors":"S. Borzenok, M. Gerasimov, Y. A. Komakh, M. Khubetsova, H. Tonaeva, L. Máliková, P.I. Plaksa","doi":"10.25276/0235-4160-2022-2-54-59","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-54-59","url":null,"abstract":"Purpose. To analyze an algorithm for infectious screening of cadaver corneal donors during corneal processing at the Eye Tissue Bank (ETB) of The Fyodorov Eye Microsurgery Federal State Institution and compare it with the European Eye Bank Association (EEBA) data from 2011 through 2015. Material and methods. Data analysis were done using the ETB in-house donor data registry and EEBA annual directory forms. The extracted data included the number of received eye globes, rates of inconclusive and serological tests for human immunodeficiency virus (type 1 and 2), Hepatitis B and C viruses, and Syphilis. Results. During the analyzed period 3479 eye globes were delivered in the ETB for the processing. Hemolysis caused exclusion for 13.9% (n=486) of corneas in the ETB. In opposite, the EEBA data demonstrated far lower rates of inconclusive tests. The positive serology tests lead to canceling 19.4% (n=676) of the incoming corneas in the ETB. Overall, the rates of positive tests were far higher in comparison with EEBA data. At the ETB, positive serological tests for HIV (type 1 and 2) and Syphilis had low variability annually, while the rates of Hepatitis B increased in 2015. Predomination of Hepatitis C was also noted. Often enough, the blood samples were multiply-infected. Conclusion. Overall, the positive serology and hemolysis were the major contraindications and led to exclusion 33.4% (n=1162) of incoming corneas in the ETB. Serological tests rates for indicated infections were higher in the ETB with predomination of Hepatitis C. An algorithm for infectious screening at the Eye Tissue Bank (ETB) of The S. Fyodorov Eye Microsurgery Federal State Institution was effective in selection of postmortem donors for cornea processing in clinical use. Key words: cornea transplantation, eye bank, serological tests, human immunodeficiency virus, hepatitis B viruses, hepatitis C virus, syphilis","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134012736","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-15-19
A. Yarovoy, I. Gorshkov, Y. Gorodetskaya, R. A. Loginov
Purpose. To analyze the effectiveness of Ru106 brachytherapy in the treatment of the vasoproliferative tumor (VPT) – a neoplasm of the retina with a pronounced vascular component. Material and methods. The observation group consisted of 17 patients (17 eyes), the average lesion height according to B-scan data was 3.34 mm. Results. After treatment, the average visual acuity was 0.2, in most cases there was a decrease in the height of the VPT focus, on average by 1.4 mm. Conclusion. Brachytherapy Ru106 has shown its effectiveness as a method of treating VPT. Key words: vasoproliferative retinal tumor, brachytherapy, retinal detachment, uveitis, epiretinal fibrosis
{"title":"Brachytherapy as a treatment of a vasoproliferative retinal tumor","authors":"A. Yarovoy, I. Gorshkov, Y. Gorodetskaya, R. A. Loginov","doi":"10.25276/0235-4160-2022-2-15-19","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-15-19","url":null,"abstract":"Purpose. To analyze the effectiveness of Ru106 brachytherapy in the treatment of the vasoproliferative tumor (VPT) – a neoplasm of the retina with a pronounced vascular component. Material and methods. The observation group consisted of 17 patients (17 eyes), the average lesion height according to B-scan data was 3.34 mm. Results. After treatment, the average visual acuity was 0.2, in most cases there was a decrease in the height of the VPT focus, on average by 1.4 mm. Conclusion. Brachytherapy Ru106 has shown its effectiveness as a method of treating VPT. Key words: vasoproliferative retinal tumor, brachytherapy, retinal detachment, uveitis, epiretinal fibrosis","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128426919","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-31-37
A. Shchuko, S. I. Zhukova, M. Akulenko
Purpose. To evaluate the volume of therapeutic measures necessary for the relief of macular edema in patients with Branch Retinal Vein Occlusion (BRVO) depending on the initial macular ischemia. Material and methods. 142 patients with macular edema on the background of BRVO were included in the study. All patients received intravitreal injection of ranibizumab in 1+PRN regimen, laser coagulation if necessary. All patients underwent examination, including visometry, electroretinography, optical coherence tomography (OCT) and OCT angiography. The number of injections and laser manipulations over the entire follow up period was taken into account. The comparative analysis of the obtained results was carried out in 3 groups formed depending on the area of the initial macular ischemia. The significance level was p<0.0125. Results. It was found that in group 1 patients with an initial area of macular ischemia from 0.3 to 1.5 mm² , 1.5±0.7 injections of ranibizumab were required to resorb macular edema and increase visual acuity by more than 2 times. In group 2 patients with an area of macular ischemia from 1.5 to 1.8 mm² , an average of 7.2±2.2 injections of ranibizumab were required to relieve macular edema, in 62% of cases, sectoral laser coagulation, in 15% – panretinal laser coagulation of the retina, while visual acuity improved unreliably (p>0.05). In group 3 patients with an initial area of macular ischemia more than 1.8 mm² , despite an average of 3.6±1.4 injections of ranibizumab and in 58% of cases of panretinal laser coagulation, visual acuity did not significantly change (p>0.05), and the area of capillary nonperfusion increased in the perifoveal zone and on the periphery of the retina. Conclusion. The volume of therapeutic measures in patients with macular edema on the background of BRVO and the possibility of improving visual functions depends not only on the degree of ischemia of the peripheral retina, but also on the initial area of ischemia of the macular zone according to OCT angiography, the amplitude of the b-wave ERG and oscillatory potentials, which can be considered as markers that allow predicting the effectiveness of combined therapy of post-occlusive retinal changes. Key words: central retinal vein branch occlusion, retinal ischemia, macular ischemia, anti-VEGF therapy, OCT, OCT angiography.
{"title":"Evaluation of the effectiveness of combination therapy for post-occlusive retinal changes","authors":"A. Shchuko, S. I. Zhukova, M. Akulenko","doi":"10.25276/0235-4160-2022-2-31-37","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-31-37","url":null,"abstract":"Purpose. To evaluate the volume of therapeutic measures necessary for the relief of macular edema in patients with Branch Retinal Vein Occlusion (BRVO) depending on the initial macular ischemia. Material and methods. 142 patients with macular edema on the background of BRVO were included in the study. All patients received intravitreal injection of ranibizumab in 1+PRN regimen, laser coagulation if necessary. All patients underwent examination, including visometry, electroretinography, optical coherence tomography (OCT) and OCT angiography. The number of injections and laser manipulations over the entire follow up period was taken into account. The comparative analysis of the obtained results was carried out in 3 groups formed depending on the area of the initial macular ischemia. The significance level was p<0.0125. Results. It was found that in group 1 patients with an initial area of macular ischemia from 0.3 to 1.5 mm² , 1.5±0.7 injections of ranibizumab were required to resorb macular edema and increase visual acuity by more than 2 times. In group 2 patients with an area of macular ischemia from 1.5 to 1.8 mm² , an average of 7.2±2.2 injections of ranibizumab were required to relieve macular edema, in 62% of cases, sectoral laser coagulation, in 15% – panretinal laser coagulation of the retina, while visual acuity improved unreliably (p>0.05). In group 3 patients with an initial area of macular ischemia more than 1.8 mm² , despite an average of 3.6±1.4 injections of ranibizumab and in 58% of cases of panretinal laser coagulation, visual acuity did not significantly change (p>0.05), and the area of capillary nonperfusion increased in the perifoveal zone and on the periphery of the retina. Conclusion. The volume of therapeutic measures in patients with macular edema on the background of BRVO and the possibility of improving visual functions depends not only on the degree of ischemia of the peripheral retina, but also on the initial area of ischemia of the macular zone according to OCT angiography, the amplitude of the b-wave ERG and oscillatory potentials, which can be considered as markers that allow predicting the effectiveness of combined therapy of post-occlusive retinal changes. Key words: central retinal vein branch occlusion, retinal ischemia, macular ischemia, anti-VEGF therapy, OCT, OCT angiography.","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130576852","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-84-90
A.V. Shelankova, M. V. Budzinskaya, I. V. Andreeva
Material and methods. When writing a literature review, data was searched on the PubMed and Scopus platforms for the period up to 2021 inclusive. The search was carried out using the following keywords: diabetic macular edema, Ozurdex, dexamethasone implant, antiVEGF, meta-analysis. A total of 33 articles were selected that are relevant to the topic of this literature review. Results. DME is one of the most common causes of vision loss in the world, especially in patients of working age. However, the choice of the treatment for DME is still controversial among vitreoretinal specialists. The pathophysiological process of DME development includes several mechanisms associated with chronic hyperglycemia. It has been proven that the level of vascular endothelial growth factor (VEGF) in the eye is not only elevated in DME, but is also proportional to the severity of edema. The use of anti-VEGF drugs for intravitreal administration for the treatment of DME has improved the prognosis of visual functions. The efficacy and safety of anti-VEGF drugs has been confirmed in many clinical studies. However, more and more data appear in the literature on the fairly common resistance to anti-VEGF therapy. Based on the foregoing, the experts concluded that it is necessary to revise the DME treatment strategy and conduct additional studies in order to identify other approaches in therapy to improve visual acuity. In patients with diabetes mellitus, high concentrations of pro-inflammatory cytokines were found. Corticosteroids have an anti-inflammatory effect, including reducing the permeability of the vascular walls, thereby giving an angiostatic effect in the treatment of DME. Thus, the dexamethasone implant may be a better alternative in the treatment of DME. Conclusion. Based on these studies, it can be concluded that the use of Ozurdex in the treatment of DME can be used both as the main treatment for DME and as an alternative treatment for patients who «poorly respond» to multiple injections of anti-VEGF drugs or in cases of resistance. Dexamethasone has the highest clinical efficacy among all corticosteroids used in ophthalmic practice, the drug demonstrates its multifaceted effects due to its influence on various links in the pathogenesis of DME. Dexamethasone implant reduces the concentration of both inflammatory cytokines in the eye and VEGF. Key words: diabetic macular edema, Ozurdex, dexamethasone implant, anti-VEGF
{"title":"Современный взгляд на лечение диабетического макулярного отека","authors":"A.V. Shelankova, M. V. Budzinskaya, I. V. Andreeva","doi":"10.25276/0235-4160-2022-2-84-90","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-84-90","url":null,"abstract":"Material and methods. When writing a literature review, data was searched on the PubMed and Scopus platforms for the period up to 2021 inclusive. The search was carried out using the following keywords: diabetic macular edema, Ozurdex, dexamethasone implant, antiVEGF, meta-analysis. A total of 33 articles were selected that are relevant to the topic of this literature review. Results. DME is one of the most common causes of vision loss in the world, especially in patients of working age. However, the choice of the treatment for DME is still controversial among vitreoretinal specialists. The pathophysiological process of DME development includes several mechanisms associated with chronic hyperglycemia. It has been proven that the level of vascular endothelial growth factor (VEGF) in the eye is not only elevated in DME, but is also proportional to the severity of edema. The use of anti-VEGF drugs for intravitreal administration for the treatment of DME has improved the prognosis of visual functions. The efficacy and safety of anti-VEGF drugs has been confirmed in many clinical studies. However, more and more data appear in the literature on the fairly common resistance to anti-VEGF therapy. Based on the foregoing, the experts concluded that it is necessary to revise the DME treatment strategy and conduct additional studies in order to identify other approaches in therapy to improve visual acuity. In patients with diabetes mellitus, high concentrations of pro-inflammatory cytokines were found. Corticosteroids have an anti-inflammatory effect, including reducing the permeability of the vascular walls, thereby giving an angiostatic effect in the treatment of DME. Thus, the dexamethasone implant may be a better alternative in the treatment of DME. Conclusion. Based on these studies, it can be concluded that the use of Ozurdex in the treatment of DME can be used both as the main treatment for DME and as an alternative treatment for patients who «poorly respond» to multiple injections of anti-VEGF drugs or in cases of resistance. Dexamethasone has the highest clinical efficacy among all corticosteroids used in ophthalmic practice, the drug demonstrates its multifaceted effects due to its influence on various links in the pathogenesis of DME. Dexamethasone implant reduces the concentration of both inflammatory cytokines in the eye and VEGF. Key words: diabetic macular edema, Ozurdex, dexamethasone implant, anti-VEGF","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131302417","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-45-53
G. Semak, T. Letkovskaya, V. Zakharava, I. Zherko
Purpose. To determine the expression pattern of occludin, tight junction protein 1, connective tissue growth factor, lumikan, in corneal explants of patients with corneal graft rejection, as well as analyze changes in the expression of these proteins after application of 1% low molecular weight sodium hyaluronate. Material and methods. The prospective study included 11 patients with corneal graft rejection after penetrating keratoplasty for inflammatory diseases, endothelial-epithelial dystrophy, congenital corneal dystrophies. One group (6 patients) period underwent a course of injections of 1% low molecular weight sodium hyaluronate in the preoperative, and the second (5 patients) did not receive additional treatment. The control group consisted of explants of 3 normal donor corneas. Immunohistochemical evaluation of explants was performed using primary monoclonal antibodies to lumikan, connective tissue growth factor, occludin, tight junction protein 1, superoxide dismutase 1. Results. After preoperative use of 1% low molecular weight sodium hyaluronate, the expression coefficient of occludin and tight junction protein 1 increased, approaching normal values. An increase in the expression coefficient and the intensity index of lumican expression was revealed during therapy. During treatment with an injectable form of 1% low molecular weight sodium hyaluronate, normalization of the expression coefficient of lumican and connective tissue growth factor in the corneal stroma was noted. Conclusion. The use of 1% low molecular weight sodium hyaluronate in transplant rejection activates the regeneration processes in the corneal tissues, reduces the activity of fibrosis in the stroma and helps to restore the anatomical and functional integrity of the corneal epithelium. Key words: sodium hyaluronate, keratoplasty, graft rejection, immunohistochemistry
{"title":"The expression of lumican, tight junction protein 1, connective tissue growth factor, superoxide dismutase 1 in corneal tissues in graft disease","authors":"G. Semak, T. Letkovskaya, V. Zakharava, I. Zherko","doi":"10.25276/0235-4160-2022-2-45-53","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-45-53","url":null,"abstract":"Purpose. To determine the expression pattern of occludin, tight junction protein 1, connective tissue growth factor, lumikan, in corneal explants of patients with corneal graft rejection, as well as analyze changes in the expression of these proteins after application of 1% low molecular weight sodium hyaluronate. Material and methods. The prospective study included 11 patients with corneal graft rejection after penetrating keratoplasty for inflammatory diseases, endothelial-epithelial dystrophy, congenital corneal dystrophies. One group (6 patients) period underwent a course of injections of 1% low molecular weight sodium hyaluronate in the preoperative, and the second (5 patients) did not receive additional treatment. The control group consisted of explants of 3 normal donor corneas. Immunohistochemical evaluation of explants was performed using primary monoclonal antibodies to lumikan, connective tissue growth factor, occludin, tight junction protein 1, superoxide dismutase 1. Results. After preoperative use of 1% low molecular weight sodium hyaluronate, the expression coefficient of occludin and tight junction protein 1 increased, approaching normal values. An increase in the expression coefficient and the intensity index of lumican expression was revealed during therapy. During treatment with an injectable form of 1% low molecular weight sodium hyaluronate, normalization of the expression coefficient of lumican and connective tissue growth factor in the corneal stroma was noted. Conclusion. The use of 1% low molecular weight sodium hyaluronate in transplant rejection activates the regeneration processes in the corneal tissues, reduces the activity of fibrosis in the stroma and helps to restore the anatomical and functional integrity of the corneal epithelium. Key words: sodium hyaluronate, keratoplasty, graft rejection, immunohistochemistry","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114574971","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 : 2022-06-17DOI: 10.25276/0235-4160-2022-2-20-25
V. B. Pushchina, I. Plisov, N. Antsiferova, G. Gladysheva
Purpose. To perform a comparative assessment of the results of strabismological examination of patients with primary inferior oblique muscle overaction according to the generally accepted and proposed methods. To analyze the change in the surgical procedure protocol depending on the results obtained. Material and methods. The research included 123 patients with a bilateral symmetric primary inferior oblique muscle overaction. The generally accepted method consisted in measuring the heterotropia magnitude when moving the gaze while turning the head left right and in measuring the magnitude of when moving the gaze following the ophthalmoscope beam when it is horizontally displaced upwards by 25° and downwards by 35° from 33 cm (assessment of V-pattern and its severity). The proposed method consisted in measuring the hypertropia magnitude of the adducted eye with the maximum fixing movement of the abducted eye gaze and in measuring the heterotropia magnitude with the maximum gaze movement upwards and downwards. Results. After the strabismological examination was carried out according to the proposed method, the average magnitude of hypertropia in adduction and V-pattern in the study group was statistically significantly (p<0.05) changed in the diagnostic protocols. A more prominent magnitude of hypertropia was revealed in 110 patients (89.43%). A more prominent V-pattern was diagnosed in 117 patients (95.12%). Studying the specifics of the oculomotor system disorders in patients resulted in optimization of the surgical procedure protocol in 83 patients according to the proposed method (67.48%). Conclusion. The average under-diagnosis of hypertropia and V-pattern during the examination according to the generally accepted method is 3.98±2.39° and 3.72±2°, respectively. Clarification of the oculomotor imbalance characteristics after the examination according to the proposed method requires a change in the surgical procedure protocol in more than 67% of cases. Key words: primary inferior oblique muscle overaction, V-pattern, gaze position, Botox, partial marginal myotomy, myectomy
{"title":"Optimization of the strabismological examination of patients when planning surgical treatment of primary inferior oblique muscle overaction.","authors":"V. B. Pushchina, I. Plisov, N. Antsiferova, G. Gladysheva","doi":"10.25276/0235-4160-2022-2-20-25","DOIUrl":"https://doi.org/10.25276/0235-4160-2022-2-20-25","url":null,"abstract":"Purpose. To perform a comparative assessment of the results of strabismological examination of patients with primary inferior oblique muscle overaction according to the generally accepted and proposed methods. To analyze the change in the surgical procedure protocol depending on the results obtained. Material and methods. The research included 123 patients with a bilateral symmetric primary inferior oblique muscle overaction. The generally accepted method consisted in measuring the heterotropia magnitude when moving the gaze while turning the head left right and in measuring the magnitude of when moving the gaze following the ophthalmoscope beam when it is horizontally displaced upwards by 25° and downwards by 35° from 33 cm (assessment of V-pattern and its severity). The proposed method consisted in measuring the hypertropia magnitude of the adducted eye with the maximum fixing movement of the abducted eye gaze and in measuring the heterotropia magnitude with the maximum gaze movement upwards and downwards. Results. After the strabismological examination was carried out according to the proposed method, the average magnitude of hypertropia in adduction and V-pattern in the study group was statistically significantly (p<0.05) changed in the diagnostic protocols. A more prominent magnitude of hypertropia was revealed in 110 patients (89.43%). A more prominent V-pattern was diagnosed in 117 patients (95.12%). Studying the specifics of the oculomotor system disorders in patients resulted in optimization of the surgical procedure protocol in 83 patients according to the proposed method (67.48%). Conclusion. The average under-diagnosis of hypertropia and V-pattern during the examination according to the generally accepted method is 3.98±2.39° and 3.72±2°, respectively. Clarification of the oculomotor imbalance characteristics after the examination according to the proposed method requires a change in the surgical procedure protocol in more than 67% of cases. Key words: primary inferior oblique muscle overaction, V-pattern, gaze position, Botox, partial marginal myotomy, myectomy","PeriodicalId":424200,"journal":{"name":"Fyodorov journal of ophthalmic surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116131405","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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