Vestnik oftalmologii最新文献

{"title":"[Dacryocystorhinostomy with a counteropening in the treatment of secondary nasolacrimal duct obstruction after radioiodine therapy].","authors":"V D Yartsev, E L Atkova, D V Lipatov","doi":"10.17116/oftalma202414002260","DOIUrl":"https://doi.org/10.17116/oftalma202414002260","url":null,"abstract":"<p><p>Among secondary forms of nasolacrimal duct obstruction caused by radioactive iodine therapy, its distal forms localized in the area of the Hasner's valve are predominant. In this regard, during dacryocystorhinostomy (DCR) there is a high probability of developing the sump syndrome, for which the anatomical prerequisite is that the lower edge of the DCR ostium is above the level of obstruction. In such cases, we propose to supplement DCR with a counteropening in the area of the Hasner's valve.</p><p><strong>Purpose: </strong>This study analyzes the clinical effectiveness of dacryocystorinostomy with a counteropening.</p><p><strong>Material and methods: </strong>The outcomes of 49 surgeries (49 patients) with secondary acquired nasolacrimal duct obstruction due to radioactive iodine therapy were analyzed, including 34 DCR and 15 DCR with a counteropening. The clinical outcomes were analyzed over the longest possible period after surgery. The analysis included the severity of tearing on the Munk scale, the characteristic of the formed ostium on the M. Ali scale and the height of the tear meniscus. Differences were considered significant at a confidence level of 95% (<i>p</i>≤0.05).</p><p><strong>Results: </strong>Analysis of the results of the performed surgeries showed that DCR was clinically effective in 30 (88%) cases, DCR with a counteropening - in 15 (100%) cases. The differences were not statistically significant in the total sample, but were statistically significant when comparing the results of surgeries in patients with distal obliteration.</p><p><strong>Conclusion: </strong>The developed and clinically tested method of DCR with a counteropening in the area of the Hasner's valve was completely effective in 15 patients with secondary nasolacrimal duct obstruction caused by radioiodine therapy.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 2. Vyp. 2","pages":"60-67"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912823","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":"[Objective structural and functional monitoring of polypeptide retinal neuroprotective therapy in diabetic retinopathy].","authors":"A I Malakhova, V V Strakhov, Yu A Malakhova","doi":"10.17116/oftalma202414005197","DOIUrl":"https://doi.org/10.17116/oftalma202414005197","url":null,"abstract":"<p><p>In recent years, there has been a growing interest in the contribution of neuroretinal degeneration to the pathogenesis of diabetic retinopathy (DR), preceding the classic vascular changes associated with DR.</p><p><strong>Purpose: </strong>This study evaluated the impact of the polypeptide drug Retinalamin on the structural and functional condition of the retina in patients with DR using optical coherence tomography (OCT) (Topcon OCT 2000 FA, Japan) and the Diopsys Nova vision testing system for electrophysiological studies of the visual organ.</p><p><strong>Material and methods: </strong>The clinical study included 56 patients (112 eyes) with type 1 and type 2 diabetes and DR without macular edema. Of these, 28 patients (56 eyes) comprised the main group receiving intramuscular Retinalamin. The control group consisted of 28 patients (56 eyes) who did not receive Retinalamin treatment. The thickness of the ganglion cell complex was analyzed by OCT imaging performed on the Topcon OCT 2000 FA. Electrophysiological studies of the visual organ were conducted using the Diopsys Nova vision testing system, following the Diopsys PERG24 (pattern ERG) and Diopsys ffERG/Multi-Luminance Flicker (full-field ERG, or flash ERG) protocols.</p><p><strong>Results: </strong>The study demonstrated convincing objective evidence of positive changes in the main observation group.</p><p><strong>Conclusion: </strong>The emergence of two pathogenetically oriented neurodegenerative vectors of DR, involving both the inner and outer retina, significantly expands our understanding of this diabetic complication. This includes the potential for retinal neuroprotective treatment with peptide bioregulators in clinical practice, especially in the early stages of DR.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 5","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682980","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":"[Approaches for improvement of ocular surface condition in primary open-angle glaucoma].","authors":"S V Yanchenko, S N Sakhnov, A V Malyshev, Sh Zh Teshaev, S S Davlatov, Z O Sapharov, E A Haribova, B G Hamroev","doi":"10.17116/oftalma20241400517","DOIUrl":"10.17116/oftalma20241400517","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares the effectiveness of various approaches to improvement of ocular surface condition in primary open-angle glaucoma (POAG) patients with dry eye syndrome (DES) and meibomian gland dysfunction (MGD).</p><p><strong>Material and methods: </strong>The study included 48 patients with stage II POAG, compensated with a fixed-combinations of dorzolamide and timolol (FC-DT) containing benzalkonium chloride (BAC), in the presence of DES and MGD. After randomization, patients in group 1 (<i>n</i>=24) received FC-DT without BAC along with eyelid hygiene (\"Blepharogel cleansing\", \"Blepharolotion\", \"Blepharogel-1\"), while patients in group 2 received only FC-DT without BAC. The control points (CP) were: 1 - at baseline, 2 - after 4 weeks of therapy. Changes in OSDI score, tear break-up time (TBUT), Bijsterveld's xerosis index (XI), MGD severity, and intraocular pressure (IOP) were assessed at each CP.</p><p><strong>Results: </strong>By the second CP, in group 1 significant improvements were observed in OSDI, TBUT, XI, and MGD severity by the 2nd CP, while in group 2 - in OSDI and TBUT. The improvements in OSDI and TBUT were significantly more pronounced in group 1, likely due to the reduction in MGD severity. The changes in IOP in both groups were insignificant.</p><p><strong>Conclusion: </strong>In patients with POAG, DES, and MGD who are undergoing therapy with BAC-containing medications, an approach involving switching to BAC-free eye drops combined with eyelid hygiene (using \"Blepharogel cleansing\", \"Blepharolotion\", and \"Blepharogel-1\") proved to be more effective than the approach of switching to BAC-free medications without additional eyelid hygiene.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 5","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682956","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":"[Contribution of Sergey Selivanovich Golovin to the development of ophthalmology].","authors":"A S Sarkisov","doi":"10.17116/oftalma2024140061159","DOIUrl":"10.17116/oftalma2024140061159","url":null,"abstract":"<p><p>This article presents a creative biography of Sergey Selivanovich Golovin, the prominent Russian ophthalmologist of the first quarter of the 20th century. The work is based on archival research and analysis of published materials, and characterizes the career of S.S. Golovin as department head and organizer of educational process. The article highlights the key aspect of his scientific aspirations - attention to socially significant issues in medicine and healthcare, and notes the international recognition of the Russian scholar's scientific achievements. Additionally, this work identifies the primary reason for the discontinuation of the first specialized journal in Russia, <i>Vestnik Oftalmologii</i>, and draws attention to the fact that the causes and consequences of the division within the Moscow Ophthalmological Society in 1924 require further investigation. His speech at the All-Russian Congress of Eye Physicians in 1928 is proposed to be considered as S.S. Golovin's scientific legacy.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 6","pages":"159-163"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898577","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":"[Dual inhibition of VEGF-A and angiopoietin-2 in the treatment of neovascular age-related macular degeneration and diabetic macular edema].","authors":"A V Zolotarev, E V Karlova, E V Balandina, E Yu Zubkova, E E Grishina, E A Zamytskiy, N V Balalayeva","doi":"10.17116/oftalma2024140061100","DOIUrl":"https://doi.org/10.17116/oftalma2024140061100","url":null,"abstract":"<p><p>The introduction of faricimab, a drug targeting both vascular endothelial growth factor-A (VEGF-A) and angiopoietin-2, has enabled the implementation of the highly effective dual inhibition strategy in real clinical practice for patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME), both previously treated with intravitreal injections and newly diagnosed. This article presents a series of 11 clinical cases involving patients with nAMD and DME who received loading doses of faricimab and continued ophthalmological observation. Among them, three patients with nAMD and two with DME were treatment-naïve, while the others were switched from alternative therapies to faricimab. The duration of follow-up after the loading phase ranged from 4 to 24 weeks at the time of this writing. All patients showed a pronounced anatomical improvement, and seven of the 11 experienced an increase in visual acuity. All reported subjective vision improvement, and no adverse events. These results confirm the high efficacy and safety of faricimab for nAMD and DME, both in treatment-naïve patients and those switched from other therapies.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 6","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898202","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":"[Optical coherence tomography angiography in the differential diagnosis of iris melanoma and progressive iris nevus].","authors":"S V Saakyan, I V Svirina, E B Myakoshina, T N Kiseleva, K V Lugovkina","doi":"10.17116/oftalma202414006155","DOIUrl":"https://doi.org/10.17116/oftalma202414006155","url":null,"abstract":"<p><p>Considering the similarity in clinical presentations of iris neoplasms of various origins, questions of their noninvasive diagnosis remain relevant. Optical coherence tomography angiography (OCT-A) is one of the imaging method that enables visualization of tumor vessels.</p><p><strong>Purpose: </strong>This article examines the features of angioarchitecture, vascular network density, and perfusion density of iris melanoma and progressive iris nevus using OCT-A.</p><p><strong>Material and methods: </strong>A total of 67 patients with iris neoplasms were examined between 2021 and 2023. Group 1 included 29 patients with progressive nevus, while group 2 included 38 patients with iris melanoma, which was further divided into two subgroups (A - 32 patients with planar growth, B - six patients with nodular growth). All patients underwent OCT-A with analysis of qualitative and quantitative characteristics. Diagnoses were morphologically verified in all cases.</p><p><strong>Results: </strong>In one-third of cases, OCT-A of pigmented melanomas and progressive iris nevi revealed single hyperreflective vessels, while signal blocking was noted in other cases. In hypopigmented forms of progressive nevus, single hyperreflective vessels were observed, with a mean vascular network density of 5.1±2.9 mm^-¹ and perfusion density of 11.7±3.2%. Hypopigmented forms of iris melanoma showed multiple, chaotically arranged hyperreflective vessels, with a mean density of 11.1±2.6 mm^-¹ (<i>p</i><0.05) and perfusion density of 34.3±7.6% (<i>p</i>=0.01), significantly exceeding these values in progressive nevi.</p><p><strong>Conclusion: </strong>OCT-A enables detection of tumor vessels primarily in hypopigmented forms of iris melanoma and progressive nevus. Increased vascular network density and perfusion, along with the presence of multiple chaotically arranged hyperreflective vessels, allows for differential diagnosis between melanoma and progressive iris nevus and facilitates appropriate organ-preserving treatment.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 6","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898387","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":"[Potential of ultrasonography in determination of orbital inflammation activity in granulomatosis with polyangiitis].","authors":"D S Ismailova, O V Eksarenko, P I Novikov","doi":"10.17116/oftalma202414006132","DOIUrl":"https://doi.org/10.17116/oftalma202414006132","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the capabilities of ultrasonography (US) in determing the stage of orbital inflammation in patients with granulomatosis with polyangiitis (GPA).</p><p><strong>Material and methods: </strong>The study included 24 patients (8 men and 16 women) with diffuse orbital tissue involvement in GPA. Group 1 (active stage) included nine patients, while group 2 (inactive stage) consisted of 18 patients. Three patients were in both groups. In four patients (16.7%), the inflammation was bilateral, while the remaining 20 (83.3%) had unilateral orbital involvement. A total of 13 US examinations were conducted in group 1, and 22 in group 2. All patients underwent orbital US, including duplex scanning of ocular and orbital vessels, along with multiplanar combined spatial analysis of the orbital inflammatory mass.</p><p><strong>Results: </strong>The ultrasound characteristics in orbital GPA, specifically acoustic density, presence of pathological blood flow within and around the inflammatory mass, and flow intensity varied according to the stage of the inflammatory process.</p><p><strong>Conclusion: </strong>Ultrasound is a non-invasive and accessible method for assessing inflammation activity in orbital GPA.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 6","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898410","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 clinical and immunomorphological analysis in chronic post-traumatic uveitis].","authors":"I A Filatova, N V Balatskaya, I G Kulikova, S A Shemetov, V O Denisyuk","doi":"10.17116/oftalma202414006139","DOIUrl":"https://doi.org/10.17116/oftalma202414006139","url":null,"abstract":"<p><strong>Purpose: </strong>This study was conducted to identify the group at highest risk for autoimmune inflammation through a comparative analysis among patients with chronic post-traumatic uveitis (CPTU).</p><p><strong>Material and methods: </strong>The clinical group included 50 patients (aged 18 to 87 years, mean age 41±2.6 years) with CPTU resulting from penetrating injury, contusion, or intraocular surgery. All patients underwent comprehensive clinical and diagnostic evaluation, including immunological assessments: leukocyte migration inhibition test (LMIT), analysis of lymphocyte subpopulation composition, and cytokine profile analysis in both blood serum (BS) and aqueous humor (AH).</p><p><p>All patients underwent removal of the blind, non-functional eye with formation of a support-motor stump, followed by morphological examination.</p><p><p>Patients were divided into four groups based on the presence of immune inflammation, confirmed by morphological analysis, as well as organ-specific sensitization to ocular tissue antigens. Group 1 - histology+, LMIT+ (<i>n</i>=36); group 2 - histology+, LMIT- (<i>n</i>=50); group 3 - histology-, LMIT+ (<i>n</i>=12); group 4 - histology-, LMIT- (<i>n</i>=52). The control group consisted of 30 individuals without ocular pathology, matched by sex and age to the main patient groups.</p><p><strong>Results: </strong>In long-term CPTU, statistically significant alterations in major regulatory subpopulations were observed in group 1, with immune inflammation and a positive LMIT. The findings were confirmed in comparisons with both the control group and across study groups.</p><p><strong>Conclusion: </strong>The clinical and immunomorphological analysis identified an association between decreased levels of transforming growth factor β1 (TGF-β1) in AH and its increased levels in BS, with the risk of autoimmune inflammation in CPTU. The observed changes in the local and systemic cytokine status - reduction of TGF-β1 in AH and increase in BS - may serve as early predictors of autoimmune inflammation, which is important in clinical practice for preventing sympathetic ophthalmia.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 6","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898414","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":"[Prevalence of diabetic retinopathy assessed using two-field mydriatic fundus photography].","authors":"T A Avanesova, J G Oganezova, V V Anisimova, A B Baeva, D Kh Miaev","doi":"10.17116/oftalma202414004160","DOIUrl":"https://doi.org/10.17116/oftalma202414004160","url":null,"abstract":"<p><p>Early detection of diabetic retinopathy (DR) is an urgent ophthalmological problem in Russia and globally.</p><p><strong>Purpose: </strong>This study assesses the prevalence of asymptomatic retinopathy and attempts to identify risk groups for its development in patients with type 1 and 2 diabetes mellitus (T1DM and T2DM).</p><p><strong>Material and methods: </strong>The study involved clinics from 5 cities in the Russian Federation and it included 367 patients with DM, 34.88% men and 65.12% women, aged 50.88±20.55 years. 34.88% of patients suffered from T1DM, 65.12% suffered from T2DM, the average duration of the disease was 9.02±7.22 years. 58.31% of patients had a history of arterial hypertension, 13.08% had a history of smoking. The primary endpoint was the frequency of detection of diabetic changes in the eye fundus of patients with T1DM and T2DM in general; the secondary endpoint - same but separately, and for T2DM patients depending on the duration of the disease. The exploratory endpoint was the assessment of the influence of various factors on the development of DR. The patients underwent visometry (modified ETDRS table), biomicroscopy, mydriatic fundus photography according to the «2 fields» protocol.</p><p><strong>Results: </strong>The average detection rate of DR was 12.26%, primarily observed in patients with T2DM (13.81%), women (9.26%), in both eyes (8.17%). Among patients with DR, 26 (19.55%) had glycated hemoglobin (HbA1c) level exceeding 7.5% (<i>p</i>=0.002), indicating a direct relationship between this indicator and the incidence of DR. Logistic regression analysis showed that the duration of diabetes of more than 10 years has a statistically significant effect on the development of DR. In the modified model for odds estimation, the likelihood of developing DR is increased by the duration of DM for more than 10 years; increased blood pressure; HbA1c level >7.5%.</p><p><strong>Conclusion: </strong>The obtained results, some of which will be presented in subsequent publications, highlight the effectiveness of using two-field mydriatic fundus photography as a screening for DR.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 4","pages":"60-67"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296635","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":"[Minoxidil-induced ophthalmic hypertension (case report)].","authors":"V P Erichev, V S Zinina, D M Safonova","doi":"10.17116/oftalma202414002290","DOIUrl":"10.17116/oftalma202414002290","url":null,"abstract":"<p><p>This article presents a case of a 31-year-old male patient who presented to the outpatient department of the Krasnov Research Institute of Eye Diseases with complaints of diplopia and increased intraocular pressure (IOP) up to 30 mm Hg. The patient had been using minoxidil topically for androgenic alopecia for 8 years. On examination, mild swelling of the bulbar conjunctiva in the upper fornix was revealed; optical coherence tomography showed thinning of the ganglion cell layer, most likely due to moderate myopia. The patient responded well to discontinuation of minoxidil and topical therapy with prostaglandin analogues. After 4 months, an attempt was made to replace topical hypotensive therapy with carbonic anhydrase inhibitors, but the previous hypotensive regimen had to be resumed due to an increase in IOP. During 10 months of observation, no signs of progression were detected according to optical coherence tomography and static perimetry.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 2. Vyp. 2","pages":"90-93"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912863","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}