Anna A. Pavlova, Stella S. Nastenko, Aziza A. Bolatkhanova, Valeriya Yu. Marchenko, Darya V. Lukyanova, Maria D. Burnasheva, Zagid Z. Zarbaliev, Ilya A. Bespalov, Pavel N. Kalyuzhnyi, Diana R. Kanina, Andrey E. Shlychkov, Sonya G. Tarasova
Until recently, the assessment of individual retinal cells was possible only with the help of histological examination, since such retinal imaging methods as scanning laser ophthalmoscopy and optical coherence tomography had low resolution to obtain images of structures at the cellular level, which was mainly due to aberrations caused by the optics of the eye. Adaptive Optics (AO) technology has improved the performance of optical systems by correcting optical wavefront aberrations. AO allows noninvasively visualizing the retina at the microscopic level in vivo, providing the opportunity to analyze individual structures such as photoreceptors, blood vessels, nerve fibers, ganglion cells and a lattice plate. AO imaging in patients with diabetic retinopathy (DR) makes it possible to accurately determine the spatial distribution of cones, a decrease in which is associated with the presence of diabetic retinopathy and an increase in the severity of the disease. The detection of differences in cone distribution density between the control group and patients with diabetes mellitus without clinical signs of DR may contribute to its early diagnosis, as well as a deeper understanding of the consequences of changes in the photoreceptor apparatus. AO imaging methods are able to identify disorders of photoreceptor cells and assess the degree of progression of age-related macular degeneration (AMD), which definitely expands diagnostic capabilities at the early stages of its detection. Assessment of the condition of nerve fiber bundles through the use of AO helps to identify changes associated with glaucoma, and also provides the ability to visualize details that cannot be evaluated using optical coherence tomography (OCT). AO imaging allows you to directly measure the wall of retinal vessels and the diameter of their lumen. The ratio of wall thickness to vessel lumen and the cross-sectional area of the vessel wall directly reflect the remodeling process and can be used for the purpose of early diagnosis and monitoring of hypertension.
直到最近，由于扫描激光眼底镜和光学相干断层扫描等视网膜成像方法的分辨率较低，无法获得细胞层面的结构图像，因此只能借助组织学检查对单个视网膜细胞进行评估。自适应光学（AO）技术通过校正光学波前像差提高了光学系统的性能。自适应光学技术可在显微镜下对视网膜进行非侵入性的活体观察，为分析光感受器、血管、神经纤维、神经节细胞和晶格板等单个结构提供了机会。对糖尿病视网膜病变（DR）患者进行 AO 成像可以准确确定视锥的空间分布，视锥的减少与糖尿病视网膜病变的存在和病情严重程度的增加有关。检测对照组与无糖尿病视网膜病变临床表现的糖尿病患者之间视锥分布密度的差异，有助于早期诊断糖尿病视网膜病变，并加深对感光器变化后果的理解。AO 成像方法能够识别感光细胞的病变，并评估老年性黄斑变性（AMD）的进展程度，这无疑扩大了早期发现阶段的诊断能力。使用 AO 评估神经纤维束的状况有助于识别与青光眼有关的变化，还能观察到光学相干断层扫描 (OCT) 无法评估的细节。AO 成像可以直接测量视网膜血管壁及其管腔直径。血管壁厚度与血管腔的比率以及血管壁的横截面积直接反映了血管的重塑过程，可用于早期诊断和监测高血压。
{"title":"THE POSSIBILITIES OF USING ADAPTIVE OPTICS IN MODERN OPHTHALMOLOGY","authors":"Anna A. Pavlova, Stella S. Nastenko, Aziza A. Bolatkhanova, Valeriya Yu. Marchenko, Darya V. Lukyanova, Maria D. Burnasheva, Zagid Z. Zarbaliev, Ilya A. Bespalov, Pavel N. Kalyuzhnyi, Diana R. Kanina, Andrey E. Shlychkov, Sonya G. Tarasova","doi":"10.17816/ov628866","DOIUrl":"https://doi.org/10.17816/ov628866","url":null,"abstract":"Until recently, the assessment of individual retinal cells was possible only with the help of histological examination, since such retinal imaging methods as scanning laser ophthalmoscopy and optical coherence tomography had low resolution to obtain images of structures at the cellular level, which was mainly due to aberrations caused by the optics of the eye. Adaptive Optics (AO) technology has improved the performance of optical systems by correcting optical wavefront aberrations. AO allows noninvasively visualizing the retina at the microscopic level in vivo, providing the opportunity to analyze individual structures such as photoreceptors, blood vessels, nerve fibers, ganglion cells and a lattice plate. AO imaging in patients with diabetic retinopathy (DR) makes it possible to accurately determine the spatial distribution of cones, a decrease in which is associated with the presence of diabetic retinopathy and an increase in the severity of the disease. The detection of differences in cone distribution density between the control group and patients with diabetes mellitus without clinical signs of DR may contribute to its early diagnosis, as well as a deeper understanding of the consequences of changes in the photoreceptor apparatus. AO imaging methods are able to identify disorders of photoreceptor cells and assess the degree of progression of age-related macular degeneration (AMD), which definitely expands diagnostic capabilities at the early stages of its detection. Assessment of the condition of nerve fiber bundles through the use of AO helps to identify changes associated with glaucoma, and also provides the ability to visualize details that cannot be evaluated using optical coherence tomography (OCT). AO imaging allows you to directly measure the wall of retinal vessels and the diameter of their lumen. The ratio of wall thickness to vessel lumen and the cross-sectional area of the vessel wall directly reflect the remodeling process and can be used for the purpose of early diagnosis and monitoring of hypertension.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"75 1‐2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834702","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}
D. Belov, V. Nikolaenko, Dmitrii A. Shuvaev, V. V. Potemkin, Kirill V. Khripun, Irina V. Terekhova
BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.
{"title":"The uveitis–glaucoma–hyphema syndrome. Part 1. Pathogenesis, clinical features, diagnosis","authors":"D. Belov, V. Nikolaenko, Dmitrii A. Shuvaev, V. V. Potemkin, Kirill V. Khripun, Irina V. Terekhova","doi":"10.17816/ov626405","DOIUrl":"https://doi.org/10.17816/ov626405","url":null,"abstract":"BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. \u0000AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. \u0000MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). \u0000RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. \u0000CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"46 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141664816","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}
A.N. Kulikov, Andrey N. Belskikh, A. A. Volozhev, Aleksandr V. Podshivalov, Vera E. Sitnikova, D. S. Maltsev, S. E. Bednova
BACKGROUND: One of the socially significant ophthalmic diseases is the dry form of the age-related macular degeneration, the key feature of which consists in a slowly progressing damage to the pigment epithelium and the formation of drusen. However, the basic mechanisms of pathogenesis are still not completely clear nowadays. AIM: The aim is, using the data of OCT, OCT-angiography and visometry, to study the dynamics of structural and functional parameters of the macular area, as well as the dynamics of rheological and biochemical blood parameters in patients with an intermediate stage of the dry form of age-related macular degeneration before and after the use of serum cascade filtration. MATERIALS AND METHODS: The study included 63 patients (94 eyes) with an intermediate stage of the dry form of age-related macular degeneration. Patients were randomly separated into two groups. The first (main) group consisted of 34 patients (52 eyes), in whom serum cascade filtration was performed; the second group (control) group included 29 patients (42 eyes) who did not receive any specific treatment. In patients of the main group, before and after the serum cascade filtration course (1 month after the start of follow-up), in 6 and 12 months, in addition to standard ophthalmological examination, as an indicator of the efficacy of performed serum cascade filtration, the ultrasound triplex scanning in color Doppler mapping mode with an assessment of blood flow velocity in the posterior short ciliary arteries, Fourier IR spectroscopy, and the testing of the serum and blood viscosity were performed. Patients in the control group also underwent a similar examination at 1, 6, 12 months after the start of follow-up. RESULTS: According to optical coherence tomography, optical coherence tomography-angiography and visometry data, we found a positive dynamics of structural and functional parameters of the macular retina and an improvement in blood rheological parameters with an increase in microcirculation indices against the background of the serum cascade filtration use in treatment of patients with an intermediate stage of the dry form of age-related macular degeneration. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, being an evidence of the stabilization of the pathological process. CONCLUSIONS: This study showed that after the serum cascade filtration in patients with an intermediate stage of the dry form of age-related macular degeneration, against the background of an improvement in blood rheological and biochemical parameters, there was an improvement in structural and functional parameters of the macular area, which consisted in a decrease of the volume of the drusenoid retinal pigment epithelium detachment and in a visual acuity amelioration.
{"title":"Dynamics of rheological and biochemical blood parameters of patients with an intermediate stage of the dry form of age-related macular degeneration before and after serum cascade filtration","authors":"A.N. Kulikov, Andrey N. Belskikh, A. A. Volozhev, Aleksandr V. Podshivalov, Vera E. Sitnikova, D. S. Maltsev, S. E. Bednova","doi":"10.17816/ov626316","DOIUrl":"https://doi.org/10.17816/ov626316","url":null,"abstract":"BACKGROUND: One of the socially significant ophthalmic diseases is the dry form of the age-related macular degeneration, the key feature of which consists in a slowly progressing damage to the pigment epithelium and the formation of drusen. However, the basic mechanisms of pathogenesis are still not completely clear nowadays. \u0000AIM: The aim is, using the data of OCT, OCT-angiography and visometry, to study the dynamics of structural and functional parameters of the macular area, as well as the dynamics of rheological and biochemical blood parameters in patients with an intermediate stage of the dry form of age-related macular degeneration before and after the use of serum cascade filtration. \u0000MATERIALS AND METHODS: The study included 63 patients (94 eyes) with an intermediate stage of the dry form of age-related macular degeneration. Patients were randomly separated into two groups. The first (main) group consisted of 34 patients (52 eyes), in whom serum cascade filtration was performed; the second group (control) group included 29 patients (42 eyes) who did not receive any specific treatment. In patients of the main group, before and after the serum cascade filtration course (1 month after the start of follow-up), in 6 and 12 months, in addition to standard ophthalmological examination, as an indicator of the efficacy of performed serum cascade filtration, the ultrasound triplex scanning in color Doppler mapping mode with an assessment of blood flow velocity in the posterior short ciliary arteries, Fourier IR spectroscopy, and the testing of the serum and blood viscosity were performed. Patients in the control group also underwent a similar examination at 1, 6, 12 months after the start of follow-up. \u0000RESULTS: According to optical coherence tomography, optical coherence tomography-angiography and visometry data, we found a positive dynamics of structural and functional parameters of the macular retina and an improvement in blood rheological parameters with an increase in microcirculation indices against the background of the serum cascade filtration use in treatment of patients with an intermediate stage of the dry form of age-related macular degeneration. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, being an evidence of the stabilization of the pathological process. \u0000CONCLUSIONS: This study showed that after the serum cascade filtration in patients with an intermediate stage of the dry form of age-related macular degeneration, against the background of an improvement in blood rheological and biochemical parameters, there was an improvement in structural and functional parameters of the macular area, which consisted in a decrease of the volume of the drusenoid retinal pigment epithelium detachment and in a visual acuity amelioration.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The new coronavirus infection (COVID-19) gained the pandemic status in 2020, and despite the fact that since then the virus has become less pathogenic, its virulence has increased by 2023. Well-vascularized organs and tissues, including the retina, represent the target for coronavirus. The etiopathogenesis of COVID-associated retinopathy, first described in 2021, still remains poorly understood, and its forms and occurrence frequency during different periods of the infectious process vary greatly. AIM: To identify the main characteristics of the COVID-associated retinopathy in patients with moderate and severe COVID-19 course during the acute period of the disease. MATERIALS AND METHODS: The study, conducted in 2021 (group 1) and 2023 (group 2), included patients with confirmed COVID-19 of moderate to severe course during the first 7 days from the onset of symptoms. Group 1 included 46 people, mean age 65.5 years, and group 2 included 55 people, mean age 69.3 years. The ophthalmologic examination was carried out in the “red zone” and intensive care unit, and included examination of the anterior segment of the eye, indirect ophthalmoscopy, and fundus photography using a portable hand-held digital fundus camera (Smartscope M5, Optomed, Finland). Hypertension, diabetes mellitus, volume of lung damage, invasive mechanical ventilation, and anticoagulant therapy were considered as conditions affecting retinal microcirculation. RESULTS: The observation groups were homogeneous in terms of gender, age, and concomitant diseases. The incidence of ophthalmoscopic findings in group 1 was 17.3%, and in group 2 — 12.7%. Most often, during the first 7 days of the disease, signs of angiopathy were observed: dilatation of blood vessels, irregularity of their diameter and tortuosity. Among focal changes, there were multiple retinal hemorrhages (6.5% and 3.6%) and cotton wool spots (4.3% and 5.4%). In patients with fundus changes, diabetes mellitus was significantly less common (in group 1, 25% vs. 39%, p 0.001; in group 2, 28% vs. 44%, p 0.001), as well as arterial hypertension (in group 1, 55% vs. 66%, p = 0.003; in group 2 28% vs. 83%, p 0.001). In group 1, there was a higher proportion of patients treated in intensive care unit, as in group 2 (37% vs. 17%, p 0.001), but in group 2, patients with identified retinal changes were more likely to receive therapeutic doses of anticoagulants (33% vs. 12%, p 0.001). CONCLUSION: The main characteristics of COVID-associated retinopathy in patients with moderate to severe COVID-19 during the acute period of the disease are dilatation and pathological tortuosity of the retinal arteries and veins, intraretinal hemorrhages and cotton wool spots. The connection between COVID-associated retinopathy and concomitant to the infectious process cardiovascular conditions has not been established. Retinopathy associated with coronavirus infection, with absolute similarity of clinical manifestations, was significantly m
{"title":"Ophthalmic assessment of an intensive care ward patients in the first and last wave of the COVID-19. Do they have a difference?","authors":"V. A. Turgel, S. N. Tultseva","doi":"10.17816/ov627137","DOIUrl":"https://doi.org/10.17816/ov627137","url":null,"abstract":"BACKGROUND: The new coronavirus infection (COVID-19) gained the pandemic status in 2020, and despite the fact that since then the virus has become less pathogenic, its virulence has increased by 2023. Well-vascularized organs and tissues, including the retina, represent the target for coronavirus. The etiopathogenesis of COVID-associated retinopathy, first described in 2021, still remains poorly understood, and its forms and occurrence frequency during different periods of the infectious process vary greatly. \u0000AIM: To identify the main characteristics of the COVID-associated retinopathy in patients with moderate and severe COVID-19 course during the acute period of the disease. \u0000MATERIALS AND METHODS: The study, conducted in 2021 (group 1) and 2023 (group 2), included patients with confirmed COVID-19 of moderate to severe course during the first 7 days from the onset of symptoms. Group 1 included 46 people, mean age 65.5 years, and group 2 included 55 people, mean age 69.3 years. The ophthalmologic examination was carried out in the “red zone” and intensive care unit, and included examination of the anterior segment of the eye, indirect ophthalmoscopy, and fundus photography using a portable hand-held digital fundus camera (Smartscope M5, Optomed, Finland). Hypertension, diabetes mellitus, volume of lung damage, invasive mechanical ventilation, and anticoagulant therapy were considered as conditions affecting retinal microcirculation. \u0000RESULTS: The observation groups were homogeneous in terms of gender, age, and concomitant diseases. The incidence of ophthalmoscopic findings in group 1 was 17.3%, and in group 2 — 12.7%. Most often, during the first 7 days of the disease, signs of angiopathy were observed: dilatation of blood vessels, irregularity of their diameter and tortuosity. Among focal changes, there were multiple retinal hemorrhages (6.5% and 3.6%) and cotton wool spots (4.3% and 5.4%). In patients with fundus changes, diabetes mellitus was significantly less common (in group 1, 25% vs. 39%, p 0.001; in group 2, 28% vs. 44%, p 0.001), as well as arterial hypertension (in group 1, 55% vs. 66%, p = 0.003; in group 2 28% vs. 83%, p 0.001). In group 1, there was a higher proportion of patients treated in intensive care unit, as in group 2 (37% vs. 17%, p 0.001), but in group 2, patients with identified retinal changes were more likely to receive therapeutic doses of anticoagulants (33% vs. 12%, p 0.001). \u0000CONCLUSION: The main characteristics of COVID-associated retinopathy in patients with moderate to severe COVID-19 during the acute period of the disease are dilatation and pathological tortuosity of the retinal arteries and veins, intraretinal hemorrhages and cotton wool spots. The connection between COVID-associated retinopathy and concomitant to the infectious process cardiovascular conditions has not been established. Retinopathy associated with coronavirus infection, with absolute similarity of clinical manifestations, was significantly m","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"66 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663346","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}
Aleksei A. Kol'bin, A.N. Kulikov, N. N. Zybina, M. Y. Frolova, R. L. Troyanovsky, V. Chirskiy
BACKGROUND: An increase was noted in the number of gunshot eyeball injuries, which are accompanied by low functional outcomes. Reproduction and experimental study of this type of eye injury would help improving the functional and cosmetic treatment results in patients. AIM: The aim of the study is to investigate gunshot open globe injury type B (penetrating wound without intraocular foreign body) on a standardized experimental model. MATERIALS AND METHODS: A complete investigation of the standardized model of gunshot open globe injury type B (penetrating wound without intraocular foreign body) simulated on the ballistic test facility was carried out. The experiment was accomplished at the ophthalmology chair on 36 rabbits (71 eyes). The injury was inflicted in the projection of the ciliary body — zone II (Birmingham Eye Trauma Terminology). The examination in the control period included ophthalmologic (ophthalmoscopy, full field electroretinography, optical coherence tomography), biochemical (testing of vitreous fibronectin level), histological and radiological (magnetic resonance imaging, ultrasound examination) methods. Statistical non-parametric methods of data analysis were used. RESULTS: The analysis of gunshot open globe injury type B model demonstrated the rate and multiple foci of abnormalities practically of all eyeball structures. CONCLUSIONS: For the first time ever, the characteristics of gunshot open globe injury type B model were studied using a new complex of methods, their high reproducibility (91.5–100%) was demonstrated. Based on recorded abnormalities in all ocular structures, including proliferative vitreoretinopathy, the multifocal character of damage in this type of injury is validated.
背景：枪弹击中眼球造成眼球损伤的案例越来越多，但其功能性结果却很低。对这类眼球损伤进行再现和实验研究将有助于改善患者的功能和外观治疗效果。目的：本研究旨在通过标准化的实验模型研究枪弹造成的 B 型开球伤（无眼内异物的穿透伤）。材料与方法：对弹道测试设备上模拟的 B 型枪弹开球伤（无眼内异物的穿透伤）标准化模型进行了全面调查。实验是在眼科手术椅上对 36 只兔子（71 只眼睛）进行的。受伤部位为睫状体投影--II 区（伯明翰眼外伤术语）。对照期的检查包括眼科（眼底镜、全场视网膜电图、光学相干断层扫描）、生化（玻璃体纤维连接蛋白水平检测）、组织学和放射学（磁共振成像、超声波检查）方法。数据分析采用非参数统计方法。结果：对B型枪弹致眼球开放性损伤模型的分析表明，几乎所有眼球结构都存在异常率和多个异常灶。结论：首次使用新的复合方法研究了枪弹致眼球开放性损伤 B 型模型的特征，结果表明其具有很高的重现性（91.5%-100%）。根据记录的所有眼部结构异常（包括增殖性玻璃体视网膜病变），验证了该类型损伤的多灶性特征。
{"title":"Multifocal character of lesions in gunshot open globe injury type B in experiment","authors":"Aleksei A. Kol'bin, A.N. Kulikov, N. N. Zybina, M. Y. Frolova, R. L. Troyanovsky, V. Chirskiy","doi":"10.17816/ov627078","DOIUrl":"https://doi.org/10.17816/ov627078","url":null,"abstract":"BACKGROUND: An increase was noted in the number of gunshot eyeball injuries, which are accompanied by low functional outcomes. Reproduction and experimental study of this type of eye injury would help improving the functional and cosmetic treatment results in patients. \u0000AIM: The aim of the study is to investigate gunshot open globe injury type B (penetrating wound without intraocular foreign body) on a standardized experimental model. \u0000MATERIALS AND METHODS: A complete investigation of the standardized model of gunshot open globe injury type B (penetrating wound without intraocular foreign body) simulated on the ballistic test facility was carried out. The experiment was accomplished at the ophthalmology chair on 36 rabbits (71 eyes). The injury was inflicted in the projection of the ciliary body — zone II (Birmingham Eye Trauma Terminology). The examination in the control period included ophthalmologic (ophthalmoscopy, full field electroretinography, optical coherence tomography), biochemical (testing of vitreous fibronectin level), histological and radiological (magnetic resonance imaging, ultrasound examination) methods. Statistical non-parametric methods of data analysis were used. \u0000RESULTS: The analysis of gunshot open globe injury type B model demonstrated the rate and multiple foci of abnormalities practically of all eyeball structures. \u0000CONCLUSIONS: For the first time ever, the characteristics of gunshot open globe injury type B model were studied using a new complex of methods, their high reproducibility (91.5–100%) was demonstrated. Based on recorded abnormalities in all ocular structures, including proliferative vitreoretinopathy, the multifocal character of damage in this type of injury is validated.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"103 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666369","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}
V. Chasnyk, A.V. Kononov, V. Brzheskiy, E. Gaidar, O. Kalashnikova, M. Dubko, M. Kostik, V. Masalova, L. Snegireva, T. Nikitina, N. Kononova
BACKGROUND: Juvenile idiopathic arthritis is the most common rheumatic disease in children, and uveitis is its most destructive extra-articular manifestation. Despite the existence of Federal clinical guidelines for the management of these patients, their treatment is largely based on the experience of doctors and varies greatly even within the same country. AIM: The aim of the study is to find factors for predicting the course of uveitis and optimizing therapy. MATERIALS AND METHODS: The case histories of 150 children aged 1.5 to 17 years with active uveitis in the structure of juvenile arthritis were analyzed using multifactorial modeling (construction of classification trees). RESULTS: The fact of a significant influence of the time elapsed from the onset of rheumatic disease and uveitis until the start of therapy by genetically engineered medications (tumor necrosis factor alpha inhibitors) in treatment programs has been established. CONCLUSIONS: Thus, the inclusion of this factor into the group of controlling ones makes it possible to achieve inactive uveitis status after 1, 3, and 6 months in a higher percentage of cases. However, the obtained data still require additional clinical confirmation.
{"title":"Predicting the course of uveitis against the background of juvenile idiophatic arthritis when using topical therapy regimens. The results of mathematical modeling","authors":"V. Chasnyk, A.V. Kononov, V. Brzheskiy, E. Gaidar, O. Kalashnikova, M. Dubko, M. Kostik, V. Masalova, L. Snegireva, T. Nikitina, N. Kononova","doi":"10.17816/ov628282","DOIUrl":"https://doi.org/10.17816/ov628282","url":null,"abstract":"BACKGROUND: Juvenile idiopathic arthritis is the most common rheumatic disease in children, and uveitis is its most destructive extra-articular manifestation. Despite the existence of Federal clinical guidelines for the management of these patients, their treatment is largely based on the experience of doctors and varies greatly even within the same country. \u0000AIM: The aim of the study is to find factors for predicting the course of uveitis and optimizing therapy. \u0000MATERIALS AND METHODS: The case histories of 150 children aged 1.5 to 17 years with active uveitis in the structure of juvenile arthritis were analyzed using multifactorial modeling (construction of classification trees). \u0000RESULTS: The fact of a significant influence of the time elapsed from the onset of rheumatic disease and uveitis until the start of therapy by genetically engineered medications (tumor necrosis factor alpha inhibitors) in treatment programs has been established. \u0000CONCLUSIONS: Thus, the inclusion of this factor into the group of controlling ones makes it possible to achieve inactive uveitis status after 1, 3, and 6 months in a higher percentage of cases. However, the obtained data still require additional clinical confirmation.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"39 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665082","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}
I. Gndoyan, A. V. Petraevsky, Viktoriya V. Chubarikova
Inflammatory diseases of the uvea demonstrate a high incidence and a significant prevalence among people of working age. Uveitis complications often lead to blindness and low vision in patients of various age groups. Diagnostics and monitoring the efficacy of uveitis therapy requires the use of quantitative criteria to assess the degree of inflammatory reaction. The aim of this review is to analyze the informative value and accuracy of various clinical methods for subjective and objective assessment of the inflammatory reaction in the anterior and posterior segments of the eye in uveitis. To assess the inflammatory reaction in uveitis in everyday clinical practice, biomicroscopy is most often used, which is characterized by subjectivity associated with the level of qualification of the ophthalmologist. Other clinical methods, such as fluorescein angiography, optical coherence tomography-angiography, have high sensitivity and informative value along with independence from the subjective impression of the examiner. However, the first of them is invasive, and the second is still not available to a wide range of practicing ophthalmologists today, especially in the “angio” mode. Laser flare photometry is of special importance in the diagnosis of uveitis. It is both a non-invasive and sensitive method that makes it possible to obtain quantitative indicators characterizing the activity of uveal inflammation. The prospects for the application and development of this method are important both for clinical practice and for research purposes.
{"title":"Assessment of the degree of inflammatory reaction in uveitis: diagnostic capabilities of clinical methods","authors":"I. Gndoyan, A. V. Petraevsky, Viktoriya V. Chubarikova","doi":"10.17816/ov625354","DOIUrl":"https://doi.org/10.17816/ov625354","url":null,"abstract":"Inflammatory diseases of the uvea demonstrate a high incidence and a significant prevalence among people of working age. Uveitis complications often lead to blindness and low vision in patients of various age groups. Diagnostics and monitoring the efficacy of uveitis therapy requires the use of quantitative criteria to assess the degree of inflammatory reaction. The aim of this review is to analyze the informative value and accuracy of various clinical methods for subjective and objective assessment of the inflammatory reaction in the anterior and posterior segments of the eye in uveitis. To assess the inflammatory reaction in uveitis in everyday clinical practice, biomicroscopy is most often used, which is characterized by subjectivity associated with the level of qualification of the ophthalmologist. Other clinical methods, such as fluorescein angiography, optical coherence tomography-angiography, have high sensitivity and informative value along with independence from the subjective impression of the examiner. However, the first of them is invasive, and the second is still not available to a wide range of practicing ophthalmologists today, especially in the “angio” mode. Laser flare photometry is of special importance in the diagnosis of uveitis. It is both a non-invasive and sensitive method that makes it possible to obtain quantitative indicators characterizing the activity of uveal inflammation. The prospects for the application and development of this method are important both for clinical practice and for research purposes.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"109 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665871","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}
G. Osipyan, Vardan R. Mamikonyan, N. P. Shakhbazyan, Khusam Khraistin
The so-called “triple procedure,” including penetrating keratoplasty in combination with cataract removal and posterior chamber IOL implantation, is the preferred treatment method for patients with combined pathology of the cornea and lens. Methods to reduce intraoperative complications and ensure rapid visual rehabilitation in patients with concomitant conditions are of particular importance when planning such surgeries. In this article, we describe a clinical case of a triple procedure, which involves a lamellar dissection of the damaged cornea of the recipient followed by exposure of the residual corneal stroma to a 40% glucose solution in combination with a viscoelastic, which allowed for optical clearing of the stroma and improved visualization of the anterior chamber structures for phacoemulsification with posterior chamber IOL implantation. This approach represents a safer alternative to the “cataract stage” of surgery, performed under “open sky” conditions.
{"title":"Improving the quality of visualization in phacoemulsification in the “triple procedure”","authors":"G. Osipyan, Vardan R. Mamikonyan, N. P. Shakhbazyan, Khusam Khraistin","doi":"10.17816/ov624311","DOIUrl":"https://doi.org/10.17816/ov624311","url":null,"abstract":"The so-called “triple procedure,” including penetrating keratoplasty in combination with cataract removal and posterior chamber IOL implantation, is the preferred treatment method for patients with combined pathology of the cornea and lens. Methods to reduce intraoperative complications and ensure rapid visual rehabilitation in patients with concomitant conditions are of particular importance when planning such surgeries. In this article, we describe a clinical case of a triple procedure, which involves a lamellar dissection of the damaged cornea of the recipient followed by exposure of the residual corneal stroma to a 40% glucose solution in combination with a viscoelastic, which allowed for optical clearing of the stroma and improved visualization of the anterior chamber structures for phacoemulsification with posterior chamber IOL implantation. This approach represents a safer alternative to the “cataract stage” of surgery, performed under “open sky” conditions.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"122 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666328","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}
Dmitry V. Davydov, Nataliya S. Serova, Olga A. Kakorina, Olga Yu. Pavlova
BACKGROUND: It is believed that accurate reconstruction of the correct anatomy of the orbital bony walls, restoration of symmetry and volume are necessary for a favorable functional prognosis and elimination of an aesthetic defect. The main problem when estimating orbital volume is its complex anatomy. Scientists use various methods to determine orbital volume, and in reviews comparing various methods for calculating orbital volumes, there is no data on which orbital volumetric method is the most accurate, since each of them has both advantages and disadvantages. AIM: The aim of this study is the analysis and the comparison of orbital volumes according to multispiral computed tomography data of healthy patients without bone-traumatic changes of orbital walls. MATERIALS AND METHODS: To measure the volume of orbits, 50 random patients were selected who were examined in the radiology department No. 2 of the University Clinical Hospital No. 1 of the Sechenov University from 2023 to 2024 and who underwent multispiral computed tomography of the facial skeleton for indications unrelated to orbital conditions. Computed tomography data from 25 women and 25 men of different ages (from 18 to 85 years old) were analyzed. A total of 8 groups were formed depending on gender and age: group 1 — women 18–25 years old, group 2 — men 18–25 years old, group 3 — women 26–35 years old, group 4 — men 26–35 years old, group 5 — women 36–50 years old, group 6 — men 36–50 years old, group 7 — women 51 and older, group 8 — men 51 and older. Multispiral computed tomography of the facial skeleton was performed using the Aquilion One 640 CT scanner (Japan) with 0.5 slice thickness in bone and soft tissue windows, to be able to calculate orbital volumes at the workstation, all bone contours of the orbits were marked on each axial slice, starting from the upper wall to the bottom of the orbit with a representation of the orbital volumes in ml. RESULTS: The difference in the volumes of the right and left orbits of 0.5 ml or more was detected in 5 women out of 25 cases, among men the difference was present in 12 cases out of 25; a difference in volumes of more than 1 ml was noted in 1 woman and 2 men; a difference of more than 1.5 ml was not observed in any study group. The orbital asymmetry coefficient in women ranged from 0 ml to 1.21 ml, in men — from 0.08 ml to 1.19 ml, in women, the average volume of both orbits is less than in men. It was also detected that the volume of orbits increases with age, both in men and women. CONCLUSIONS: Considering that the majority of patients had differences in orbital volumes of up to 1.0 ml, we agree with studies that indicate the possibility of using a healthy contralateral orbit as a guideline when planning reconstructive surgery. However, for planning surgical treatment, it is recommended to use manual contouring, as this allows the most accurate reproducibility of the bone boundaries of the orbit, although it requires more time than
{"title":"Comparative study of orbital volumes according to multispiral computed tomography data","authors":"Dmitry V. Davydov, Nataliya S. Serova, Olga A. Kakorina, Olga Yu. Pavlova","doi":"10.17816/ov630330","DOIUrl":"https://doi.org/10.17816/ov630330","url":null,"abstract":"BACKGROUND: It is believed that accurate reconstruction of the correct anatomy of the orbital bony walls, restoration of symmetry and volume are necessary for a favorable functional prognosis and elimination of an aesthetic defect. The main problem when estimating orbital volume is its complex anatomy. Scientists use various methods to determine orbital volume, and in reviews comparing various methods for calculating orbital volumes, there is no data on which orbital volumetric method is the most accurate, since each of them has both advantages and disadvantages. \u0000AIM: The aim of this study is the analysis and the comparison of orbital volumes according to multispiral computed tomography data of healthy patients without bone-traumatic changes of orbital walls. \u0000MATERIALS AND METHODS: To measure the volume of orbits, 50 random patients were selected who were examined in the radiology department No. 2 of the University Clinical Hospital No. 1 of the Sechenov University from 2023 to 2024 and who underwent multispiral computed tomography of the facial skeleton for indications unrelated to orbital conditions. Computed tomography data from 25 women and 25 men of different ages (from 18 to 85 years old) were analyzed. A total of 8 groups were formed depending on gender and age: group 1 — women 18–25 years old, group 2 — men 18–25 years old, group 3 — women 26–35 years old, group 4 — men 26–35 years old, group 5 — women 36–50 years old, group 6 — men 36–50 years old, group 7 — women 51 and older, group 8 — men 51 and older. Multispiral computed tomography of the facial skeleton was performed using the Aquilion One 640 CT scanner (Japan) with 0.5 slice thickness in bone and soft tissue windows, to be able to calculate orbital volumes at the workstation, all bone contours of the orbits were marked on each axial slice, starting from the upper wall to the bottom of the orbit with a representation of the orbital volumes in ml. \u0000RESULTS: The difference in the volumes of the right and left orbits of 0.5 ml or more was detected in 5 women out of 25 cases, among men the difference was present in 12 cases out of 25; a difference in volumes of more than 1 ml was noted in 1 woman and 2 men; a difference of more than 1.5 ml was not observed in any study group. The orbital asymmetry coefficient in women ranged from 0 ml to 1.21 ml, in men — from 0.08 ml to 1.19 ml, in women, the average volume of both orbits is less than in men. It was also detected that the volume of orbits increases with age, both in men and women. \u0000CONCLUSIONS: Considering that the majority of patients had differences in orbital volumes of up to 1.0 ml, we agree with studies that indicate the possibility of using a healthy contralateral orbit as a guideline when planning reconstructive surgery. However, for planning surgical treatment, it is recommended to use manual contouring, as this allows the most accurate reproducibility of the bone boundaries of the orbit, although it requires more time than","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"125 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665237","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}
Anton A. Sharma, N. G. Zumbulidze, E.V. Boyko, A.V. Kononov
The prognosis for the life of patients with genetic pathology depends on the interaction between specialists from different areas of medicine for timely detection and selection of treatment tactics. Pseudoxanthoma elasticum (Grenblad–Strandberg syndrome) is a hereditary disease in which elastic fibers of the skin, the cardiovascular system and the retina are affected. Clinical manifestations: skin changes in Grenblad–Strandberg syndrome are represented by flat xanthomatous nodules of yellowish color. Cardiovascular manifestations of pseudoxanthoma elasticum are angina pectoris, decreased pulse amplitude, cardiomyopathy, sudden heart failure, often leading to death. Eye disorders occur in stages. For the early stages, the appearance of angioid streaks is typical, which appear as a result of calcification of elastic fibers of capillaries. The progression of the process leads to neovascularization and hemorrhages from the choriocapillaries, the formation of a subretinal neovascular membrane of foveolar localization, causing a decrease in vision. The late stages are characterized by scarring. Therapy depends on the stage and rate of progression of the disease and is effective at stages I–II (according to Vivaldi). Own clinical observation: Male patient, 71 years old, referred for cataract surgery with the diagnosis “Both eyes: Senile cataract, open-angle glaucoma, (stage I a, under beta-blocker therapy), Grenblad–Strandberg syndrome”. Attention is drawn to the long observation period — 34 years, with documented data from the first examinations in 1989 and all subsequent ones. Of particular interest is the availability of preserved patient documentation for all years of follow-up, including diagnosis and treatment.
{"title":"Analysis of long-term (34 years) observation of a patient with ophthalmological manifestations of Grenblad–Strandberg syndrome","authors":"Anton A. Sharma, N. G. Zumbulidze, E.V. Boyko, A.V. Kononov","doi":"10.17816/ov623597","DOIUrl":"https://doi.org/10.17816/ov623597","url":null,"abstract":"The prognosis for the life of patients with genetic pathology depends on the interaction between specialists from different areas of medicine for timely detection and selection of treatment tactics. Pseudoxanthoma elasticum (Grenblad–Strandberg syndrome) is a hereditary disease in which elastic fibers of the skin, the cardiovascular system and the retina are affected. Clinical manifestations: skin changes in Grenblad–Strandberg syndrome are represented by flat xanthomatous nodules of yellowish color. Cardiovascular manifestations of pseudoxanthoma elasticum are angina pectoris, decreased pulse amplitude, cardiomyopathy, sudden heart failure, often leading to death. Eye disorders occur in stages. For the early stages, the appearance of angioid streaks is typical, which appear as a result of calcification of elastic fibers of capillaries. The progression of the process leads to neovascularization and hemorrhages from the choriocapillaries, the formation of a subretinal neovascular membrane of foveolar localization, causing a decrease in vision. The late stages are characterized by scarring. Therapy depends on the stage and rate of progression of the disease and is effective at stages I–II (according to Vivaldi). Own clinical observation: Male patient, 71 years old, referred for cataract surgery with the diagnosis “Both eyes: Senile cataract, open-angle glaucoma, (stage I a, under beta-blocker therapy), Grenblad–Strandberg syndrome”. Attention is drawn to the long observation period — 34 years, with documented data from the first examinations in 1989 and all subsequent ones. Of particular interest is the availability of preserved patient documentation for all years of follow-up, including diagnosis and treatment.","PeriodicalId":518354,"journal":{"name":"Ophthalmology Reports","volume":"09 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141664128","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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