Vestnik oftalmologii最新文献

{"title":"[Comparative evaluation of tonometry methods in keratoconus].","authors":"S E Avetisov, V V Averich, A V Volzhanin, A A Antonov, T E Borisenko, D V Kosova, A A Vitkov, E A Budnikova","doi":"10.17116/oftalma20251410617","DOIUrl":"https://doi.org/10.17116/oftalma20251410617","url":null,"abstract":"<p><p>The chronic course of keratoconus (KC) and the associated structural and functional changes in the cornea complicate the interpretation of intraocular pressure (IOP) measurements. A promising approach is to analyze tonometric data with consideration of the variability of corneal biomechanical (viscoelastic) properties and thickness rather than disease stage. This is supported by clinical observations showing a wide variation in IOP values even within the same stage of KC.</p><p><strong>Purpose: </strong>This study aimed to comparatively evaluate tonometric readings obtained by different devices in KC based on corneal biomechanical characteristics and thickness.</p><p><strong>Material and methods: </strong>A total of 167 patients (334 eyes) with bilateral KC (mean age 31.0±8.8 years) were examined. Three subgroups were formed according to data from bidirectional pneumotonometry (Ocular Response Analyzer, ORA) and non-contact tonometry (Corvis ST with Scheimpflug imaging), taking into account corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT). IOP was measured by pneumotonometry, bidirectional pneumotonometry (ORA), rebound tonometry (RT), dynamic contour tonometry (DCT), and Maklakov tonometry.</p><p><p>The analysis assumed that, excluding structural changes in the cornea in young subjects, differences in IOP values between subgroups would be minimal. Thus, the observed deviations were attributed mainly to biomechanical changes in KC, where lower tonometric readings reflected greater dependence of IOP on the degree of corneal deformation.</p><p><strong>Results: </strong>Statistically significant differences (<i>p</i><0.05) in tonometry readings between subgroups confirmed the substantial impact of corneal biomechanical parameters and thickness on IOP measurements in KC. The greatest variability (39-50%) was observed with pneumotonometry and bidirectional pneumotonometry (Goldmann-correlated IOP, IOPg, by ORA). In these cases, lower IOP values correlated with poorer biomechanical status of the cornea and lower CCT. For other methods (corneal-compensated IOP (IOPcc) by ORA, RT, DCT, and Maklakov tonometry), the variability was less pronounced and did not exceed 26%.</p><p><strong>Conclusion: </strong>Regardless of the method used to assess intraocular pressure, alterations in corneal biomechanics in KC result in underestimation of IOP values.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811315","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}

{"title":"[Results of corneal confocal microscopy in cavitation-related complications of femtosecond LASIK].","authors":"Yu Yusef, Z V Surnina, V M Sheludchenko, S V Ermakova, N V Sheludchenko","doi":"10.17116/oftalma202514106163","DOIUrl":"https://doi.org/10.17116/oftalma202514106163","url":null,"abstract":"<p><p>Keratorefractive surgical procedures have become widely used in recent years. However, during femtosecond LASIK, a number of intraoperative cavitation-related complications may occur, one of which is the formation of an opaque bubble layer (OBL). This necessitates careful postoperative monitoring of corneal status. One of the most effective diagnostic methods in such clinical situations is corneal confocal microscopy (CCM), which has proven to be a reliable tool for visualizing all corneal layers, including in keratorefractive surgery. However, the characteristics of OBL revealed using this technique have not yet been adequately studied.</p><p><strong>Purpose: </strong>This study aimed to evaluate the potential of CCM using an original algorithm for confocal image analysis in patients with and without OBL in randomized groups.</p><p><strong>Material and methods: </strong>The study included 45 patients (90 eyes) with myopia (mean -5.0 D). Participants were divided into two groups: the study group consisting of individuals with OPL, and the comparison group (patients without this complication). In all cases, visual acuity assessment, refractometry, and CCM were performed with acquisition of images of various corneal layers before femto-LASIK and at 1, 4, 12, and 24 weeks postoperatively. Liner Calculate, a proprietary software program, was used to analyze the dimensions of the OPL zone.</p><p><strong>Results: </strong>Destructive changes in keratocytes were more pronounced in patients with OBL compared to those in the femtosecond LASIK group without the complication. The depth of stromal damage was also increased; blurred cell boundaries and increased size and reflectivity of keratocyte nuclei were observed in all study participants. At 6 months postoperatively, complete restoration of the corneal stromal layers was not achieved in either group. Morphological and structural keratocyte abnormalities persisted by the end of this period, and were more pronounced in patients with OBL.</p><p><strong>Conclusion: </strong>The formation of OBL after femtosecond LASIK is associated with more extensive destructive keratocyte changes, which prolongs the corneal stromal recovery period.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811349","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}

{"title":"[Biomarkers in tear fluid in uveitis].","authors":"N B Chesnokova, L A Katargina, T A Pavlenko, O V Beznos","doi":"10.17116/oftalma202514104188","DOIUrl":"https://doi.org/10.17116/oftalma202514104188","url":null,"abstract":"<p><p>The etiology of uveitis, choroid inflammation, is diverse, the disease is often recurrent, difficult to treat, and frequently results in disability at a young age. Studies investigating the tear fluid composition in uveitis have revealed promising biomarkers relevant for prognosis and treatment optimization. This review presents literature data on changes in the tear fluid content of proteins involved in local immune responses, intercellular interactions, proteolytic and free radical processes, nitric oxide metabolism, and other metabolic pathways in different forms of uveitis. The paper also demonstrates the significance of assessing these changes for prognosis and for a pathogenetically based, personalized treatment approach, and identifies specific alterations associated with different uveitis etiologies, offering insight into the mechanisms underlying this pathology.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 4","pages":"88-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016243","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}

{"title":"[Modern approaches to combined surgery for cataract and primary open-angle glaucoma].","authors":"A R Nurmeeva, A Panas, N S Zenkin, N D Fokina, A S Vvedenskiy, M N Ivanov","doi":"10.17116/oftalma202514103192","DOIUrl":"https://doi.org/10.17116/oftalma202514103192","url":null,"abstract":"<p><p>The problem of combined surgical treatment for cataract in patients with primary open-angle glaucoma remains highly relevant due to the large number of comorbid patients. Ultrasound phacoemulsification has become the modern standard of cataract phaco surgery, including in combination with other procedures. However, the choice of the antiglaucoma component in simultaneous surgical interventions remains largely unresolved. This review outlines the main current techniques - in particular, pathogenetically oriented - for performing the antiglaucoma component of combined surgery in patients with cataract and primary open-angle glaucoma.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"92-99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545014","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}

{"title":"[Ultrasound evaluation of eyelid weight placement results].","authors":"Y O Grusha, E I Fettser, K V Presnyakova, O V Eksarenko, E A Chizhonkova","doi":"10.17116/oftalma202514103120","DOIUrl":"https://doi.org/10.17116/oftalma202514103120","url":null,"abstract":"<p><p>Placement of gold eyelid weights (GWs) is an effective minimally invasive method for protecting the cornea in paralytic lagophthalmos (PL). Potential complications of this surgery include nonspecific inflammatory response (NIR), implant dislocation and eruption, and others. Timely detection, monitoring, and management of these complications require assessment of eyelid tissues, GW capsule and GW position using ultrasonography.</p><p><strong>Purpose: </strong>Sonographic evaluation of the results of GW placement in patients with PL.</p><p><strong>Material and methods: </strong>The study included 20 patients (20 eyelids) with chronic facial palsy (CFP) and PL who underwent ultrasound examination (high-resolution gray-scale B-scan, color Doppler mapping (CDM), three-dimensional color Doppler, echodensitometry, ultrasound biomicroscopy (UBM) of the upper eyelid) in the long-term (2 to 13 years) after the placement of a multi-segment gold eyelid weight made of 999-purity gold (99.99% pure metal).</p><p><strong>Results: </strong>This study characterizes ultrasound diagnostic features that allow determining the GW size and echodensity, GW capsule, anterior lamella, as well as the vascularization of surrounding tissues. The study also describes the imaging features of upper eyelid tissue with proper GW placement in the primary fixation site, and in cases of its dislocation and exposure.</p><p><strong>Conclusion: </strong>Ultrasound imaging methods provide reliable visualization of the GW and upper eyelid tissues in both uncomplicated and complicated cases involving implant disclocation or tendency to exposure. These methods show promise for identifying risk factors for implantation-related complications and require further investigation.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 3","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545029","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}

{"title":"[A modern perspective on the pathogenesis of proliferative diabetic retinopathy].","authors":"R R Fayzrakhmanov, M M Shishkin, S N Saraeva","doi":"10.17116/oftalma202514101192","DOIUrl":"10.17116/oftalma202514101192","url":null,"abstract":"<p><p>This article reviews the pathogenic mechanisms underlying proliferative diabetic retinopathy (DR), focusing on the development of angio-fibrotic switch, neurodegeneration, pro-inflammatory and pro-angiogenic biomarkers, emphasizes the modern perspectives on the role of the vitreous body and mechanical traction in DR progression. Understanding of these pathogenic mechanisms will provide new opportunities for improvement and development of treatments for DR at earlier stages, before significant and persistent functional impairment occurs.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 1","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568151","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}

{"title":"[Neuroprotective therapy in advanced primary open-angle glaucoma].","authors":"D A Dorofeev, I V Kozlova, A I Vereshchagina","doi":"10.17116/oftalma202514106175","DOIUrl":"10.17116/oftalma202514106175","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the changes in structural and functional characteristics of the visual analyzer in patients with advanced primary open-angle glaucoma (POAG) in the course of long-term regular use of Retinalamin (Geropharm, Russia).</p><p><strong>Material and methods: </strong>The study was conducted from 2022 to 2024 at two clinical centers: the M.M. Krasnov Research Institute of Eye Diseases and the Chelyabinsk Glaucoma Center. This multicenter cohort prospective study examined the structural and functional parameters of the visual analyzer in patients with advanced POAG during long-term regular use of Retinalamin.</p><p><p>The study included a total of 56 patients (98 eyes) divided into two groups. The observation group comprised patients with advanced glaucoma who regularly received 10 intramuscular injections of Retinalamin 5 mg (Geropharm, Russia) diluted in 1.0 mL of 0.9% sodium chloride solution in outpatient setting once every three months over a two-year period. The control group consisted of patients with advanced glaucoma who did not receive neuroprotective therapy.</p><p><strong>Results: </strong>At baseline, all patients in both groups had achieved target intraocular pressure (IOP) through surgical and/or medical treatment, which remained stable throughout the follow-up period.</p><p><p>The mean deviation (MD) decreased by 0.98 (0.78; 1.76) dB/year in the observation group and by 1.65 (0.59; 1.79) dB/year in the control group. The pattern standard deviation (PSD) increased by 0.02 (-0.3; 1.2) dB/year in the observation group and by 0.3 (0.7; 1.3) dB/year in the control group. Mean retinal nerve fiber layer (RNFL) thickness showed a similar trend. Following repeated courses of Retinalamin therapy, the observation group demonstrated stable, minimal decrease in RNFL thickness amounting to 1.5 (-0.25; 5.0) μm/year. The control group exhibited more pronounced decrease in RNFL thickness averaging 3.0 (0.75; 10.2) μm/year.</p><p><strong>Conclusion: </strong>Long-term neuroretinoprotective therapy with Retinalamin (Geropharm, Russia) in patients with advanced POAG is justified when administered regularly and the intraocular pressure is stable and well controlled.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811381","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}

{"title":"[Prognostic role of early changes in choroidal thickness during optical therapy with HAL lenses in children with progressive myopia].","authors":"E P Tarutta, S E Kondratova, S V Milash","doi":"10.17116/oftalma202514106169","DOIUrl":"https://doi.org/10.17116/oftalma202514106169","url":null,"abstract":"<p><p>Early changes in choroidal thickness (CT) following the initiation of optical or pharmacological therapy may serve as a predictor of the subsequent rate of axial length (AL) increase and progression of myopia, as well as a biomarker of individual sensitivity to the treatment.</p><p><strong>Purpose: </strong>This study aimed to investigate the relationship between the dynamics of myopia progression in children wearing newly prescribed spectacles with highly aspherical lenslets (HAL) and the early choroidal response to this optical correction.</p><p><strong>Material and methods: </strong>The study included 36 children (72 eyes) aged 7-13 years (mean age 10.41±1.14 years) with myopia of 3.74±0.64 D who wore HAL spectacle lenses for 12 months. Based on the choroidal response after the first month of optical correction, patients were divided into two groups: group 1 included 24 children (48 eyes) with an increase in CT of ≥5 µm, and group 2 consisted of 12 children (24 eyes) in which CT either did not change or decreased. Changes in AL and refractive error were assessed after one year.</p><p><strong>Results: </strong>In group 1 (CT increase), refractive progression was 0.03±0.3 D and axial elongation was 0.04±0.16 mm after one year; in group 2, these values were 0.12±0.2 D and 0.18±0.2 mm, respectively (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>Early increase in CT was associated with greater stability of refractive error and AL during one year of follow-up. The early response of the choroid may serve as a predictor of further treatment effectiveness and a criterion for selecting myopia control strategies.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811326","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}

{"title":"[Modern spacers for the correction of lower eyelid retraction].","authors":"V A Sheptulin, Y O Grusha","doi":"10.17116/oftalma2025141061127","DOIUrl":"https://doi.org/10.17116/oftalma2025141061127","url":null,"abstract":"<p><p>Functional and anatomical problems associated with lower eyelid retraction (LER) can significantly affect the patient's vision and quality of life. Numerous methods have been proposed for correcting the position and contour of the lower eyelid; however, surgical management is often challenging and insufficiently effective. One of the widely used approaches is the release of lower eyelid retractors with the use of a spacer graft. This article reviews literature on available spacers for correcting lower eyelid position.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"127-134"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811333","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}

{"title":"[Influence of the functional status of the autonomic nervous system on the development and course of habitual excessive accommodation].","authors":"A Zh Fursova, M K Artykova, V V Zelenskaya","doi":"10.17116/oftalma202514106144","DOIUrl":"https://doi.org/10.17116/oftalma202514106144","url":null,"abstract":"<p><p>Habitual excessive accommodation (HEA) in children is often accompanied by signs of autonomic imbalance, which substantiates the need for a comprehensive study of autonomic regulation in this condition.</p><p><strong>Purpose: </strong>This study aimed to investigate the features of autonomic regulation in children with habitual excessive accommodation (HEA).</p><p><strong>Material and methods: </strong>A total of 104 children aged 6-17 years were examined: the main group comprised 54 patients with HEA and the control group included 50 children without this disorder. Mean manifest spherical equivalent was -1.75±0.60 D in the main group and -0.85±0.50 D in the control group (<i>p</i><0.001); cycloplegic spherical equivalent was -0.72±0.52 D and -0.45±0.46 D, respectively (<i>p</i><0.01). Ophthalmological examination included assessment of accommodative functions, pupil diameter, and cardiointervalography (CIG).</p><p><strong>Results: </strong>Children with HEA had lower accommodative amplitude (8.6±1.9 vs. 11.2±2.1 D), reserve (1.4±0.6 vs. 2.6±0.7 D), and facility (5.3±1.8 vs. 9.1±2.0 cycles/min; <i>p</i><0.01), as well as lower (<i>p</i><0.001) parasympathetic heart rate variability (HRV) indices - standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), percentage of NN intervals >50 ms (pNN50), and high-frequency power (HF), while sympathetic markers - low-frequency power (LF), sympathovagal index (LF/HF), and stress index (SI) - were higher (<i>p</i><0.001). Pupil diameter was smaller (3.96±0.75 vs. 5.04±0.49 mm; <i>p</i><0.001). The amplitude of accommodative miosis (Δ_accom) correlated positively with LF/HF (<i>r</i>=0.34) and negatively with SDNN and HF (<i>r</i>≈-0.34; <i>p</i><0.05). Autonomic imbalance was most pronounced at ages 14-17 and in grade 3 HEA (LF/HF=2.67±0.3; SI=200±35).</p><p><strong>Conclusion: </strong>HEA is associated with reduced parasympathetic and increased sympathetic activity. Cardiointervalography and pupillometry are informative for early detection of autonomic maladaptation.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 6","pages":"44-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811375","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}