Vestnik oftalmologii最新文献

{"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":"[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":"[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}

{"title":"[Outcomes of extended depth of focus intraocular lenses implantation].","authors":"K B Pershin, N F Pashinova, A Yu Tsygankov, E A Antonov, I V Kosova, E A Korneeva","doi":"10.17116/oftalma202414002140","DOIUrl":"10.17116/oftalma202414002140","url":null,"abstract":"<p><p>Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of which (Tecnis Symfony and Acrysof IQ Vivity) are implanted in our clinic. Comparative studies devoted to the results of implantation of the new EDOF IOLs are rare in the available literature.</p><p><strong>Purpose: </strong>This article compares the outcomes of implantation of two EDOF IOLs in patients with presbyopia and/or cataract.</p><p><strong>Material and methods: </strong>The prospective study included 60 patients (81 eyes) after implantation of EDOF IOL Tecnis Symfony (32 patients, 45 eyes; group 1) or EDOF IOL AcrySof IQ Vivity (28 patients, 36 eyes; group 2). The mean follow-up period was 3.9±1.3 months.</p><p><strong>Results: </strong>All groups showed a significant (<i>p</i><0.05) increase in uncorrected near visual acuity (UCNVA), intermediate visual acuity (UCIVA), and distance visual acuity (UCDVA) at the maximum follow-up time compared to preoperative values. In group 1, the best corrected near visual acuity (BCNVA) increased from 0.61±0.10 to 0.82±0.16 at the maximum follow-up time, and in group 2 - from 0.58±0.08 to 0.67±0.12 (<i>p</i>>0.05). Both groups showed a significant increase in best corrected intermediate and distance visual acuity (BCIVA and BCDVA) at the maximum follow-up time. The increase in the indicator compared to the preoperative period was not significant in both groups (<i>p</i>>0.05). The frequency of side optical phenomena was low in both groups. No significant differences were found between the groups (<i>p</i>>0.05).</p><p><strong>Conclusion: </strong>This study presents a comparative analysis of the results of implantation of two different EDOF IOLs. Both lenses were comparable in most of the studied parameters, including providing good distance and intermediate vision, functional near vision, as well as a low frequency of side optical phenomena. In all cases the patients were satisfied with the results of the surgical intervention.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 2","pages":"40-46"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916081","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":"[Laser Doppler flowmetry in the diagnosis of chronic mixed blepharitis].","authors":"T N Safonova, N P Kintyukhina, E I Timoshenkova","doi":"10.17116/oftalma202414002268","DOIUrl":"https://doi.org/10.17116/oftalma202414002268","url":null,"abstract":"<p><p>Chronic mixed blepharitis accounts for 51.7% of all ophthalmic diseases. The use of laser Doppler flowmetry (LDF) in the diagnosis of this disease can help establish the initial manifestations of the inflammatory process in the eyelids, which is important for the prevention of possible complications - dry eye disease.</p><p><strong>Purpose: </strong>This study was conducted to determine the sensitivity and specificity of the LDF method in the diagnosis of chronic mixed blepharitis based on the study of microcirculatory changes in the eyelid skin.</p><p><strong>Material and methods: </strong>The study included 23 patients with chronic mixed blepharitis (mean age 67±5.8 years) and 18 healthy volunteers (mean age 63±1.1 years). LDF was performed using the LAZMA MC-1 device. ROC analysis was used to determine sensitivity and specificity.</p><p><strong>Results: </strong>A typical disturbance of the eyelid skin microcirculation was revealed in chronic mixed blepharitis - ischemia - with inhibition of the intensity of the functioning of blood flow regulatory systems and moderate activation of the lymph flow. The sensitivity and specificity of the coefficient of variation (reflecting the vasomotor activity of microvessels) of blood flow was 71.43 and 71.43%, lymph flow - 65.71 and 80.00%; myogenic rhythms of blood flow - 83.33 and 85.71%, lymph flow - 66.67 and 71.43%; neurogenic rhythms of blood flow - 75.00 and 78.57%, lymph flow - 91.67 and 78.57%, respectively.</p><p><strong>Conclusion: </strong>Laser Doppler flowmetry of the eyelid skin in combination with clinical, functional and instrumental research methods helped reveal with high sensitivity and specificity the eyelid damage in chronic mixed blepharitis. This method allows assessment of the condition of the eyelids in individuals without diseases of the anterior segment of the eye.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 2. Vyp. 2","pages":"68-72"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912861","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":"[Methods for assessing the microbiological diversity of the ocular surface].","authors":"E S Rodina, E I Fettser, I A Novikov","doi":"10.17116/oftalma202414003196","DOIUrl":"10.17116/oftalma202414003196","url":null,"abstract":"<p><p>This review compares data from scientific studies on the microbial community of the ocular surface (OS) in conditionally healthy individuals using cultural methods (including culture-dependent diagnostic tests), microscopic and molecular genetic methods, and assesses the influence of research methods and sample preparation on the results. Concordance and discordance of the sets of identified microorganisms were analyzed using overlapping and non-overlapping methods of studying the microbial community of a healthy OS. The article presents tables showing the names of microorganisms that were identified in different sources. Cross-verification in taxa of different ranks helped confirm the following most frequently found microorganisms on healthy OS: coccomorphic microorganisms of the genera <i>Staphylococcus</i>, <i>Micrococcus</i>, <i>Kocuria</i>, <i>Streptococcus</i>, <i>Enterococcus</i>; gram-positive spore-forming bacilli of the genera <i>Bacillus</i> and <i>Paenibacillus</i>; gram-positive non-spore-forming rod-shaped bacteria, including <i>Corynebacterium</i>, but excluding <i>Propionibacterium</i> and <i>Microbacterium</i>; gram-negative non-spore-forming rod-shaped microorganisms of the genera <i>Moraxella</i> and <i>Serratia</i>. The study also assessed the effect of wearing soft contact lenses on the composition of the microbial community of the OS.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 3","pages":"96-108"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499120","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":"[Changes in the precorneal tear film at various stages of keratoconus].","authors":"V V Averich, I A Bubnova","doi":"10.17116/oftalma202414003143","DOIUrl":"https://doi.org/10.17116/oftalma202414003143","url":null,"abstract":"<p><p>The combination of keratoconus (KC) with signs of dry eye disease (DES) has been described in numerous scientific publications. At the same time, there is a relationship between KC stage and an increase in the severity of DES symptoms, however, there is still no common understanding of the severity of xerotic process depending on the clinical course of keratectasia.</p><p><strong>Purpose: </strong>This study assesses the changes in the state of the precorneal tear film in KC relative to the stages of the disease.</p><p><strong>Material and methods: </strong>The study included 50 patients (100 eyes) with bilateral non-operated KC from subclinical to stage IV. The following methods were used for a comprehensive assessment of the condition of the tear film: biomicroscopy of the anterior segment of the eye using vital dyes, functional tests (Norn, Schirmer, Jones tests), tearscopy of the lipid layer of the tear film with software processing of the results, OCT-meniscometry, as well as filling out the OSDI questionnaire by patients.</p><p><strong>Results: </strong>The following significant changes were revealed as the KC stage progressed: an increase in the area of staining of the ocular surface with vital dyes, a decrease in the results of the Norn functional test and OCT-meniscometry, an increase in the areas of smaller thickness of lipids and areas of their complete absence according to tearscopy, as well as an increase in scores of the OSDI questionnaire.</p><p><strong>Conclusion: </strong>A comprehensive assessment of the condition of the tear film in KC indicates the relationship and the strengthening of the signs of DES as keratectasia progresses, and can be considered as justification for the need to prescribe tear replacement and reparative therapy that improves the condition of the ocular surface and stabilizes the precorneal tear film.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 3","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499069","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}