Russian Journal of Clinical Ophthalmology最新文献

{"title":"Glaucoma \"landscape\" in Russia, CIS and Eastern European countries: what has changed over 15 years?","authors":"A. Brezhnev, E. Egorov, V. Erichev, A. Kuroedov, P. Zavadsky, M. Božić, N. N. Voronova, M. Dzhumova, N. V. Ivanova, T. Imshenetskaya, T. Kamenskikh, O. I. Lebedev, L. N. Marchenko, A. L. Onishchenko, N. А. Sobyanin, V. F. Ekgardt","doi":"10.32364/2311-7729-2023-23-2-73-79","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-2-73-79","url":null,"abstract":"Aim: to assess the changes in clinical and epidemiological characteristics, diagnostic and treatment options of primary open-angle glaucoma (POAG) in the Russian Federation and multiple near- and far-abroad countries over the period of 2005–2020. Patients and Methods: the final protocol of this retrospective multi-center research and clinical study included 289 patients with POAG from 7 states (Russia, Belarus, Serbia, Moldova, Kyrgyzstan, Slovakia, and Slovenia). The authors analyzed the methods used for establishing POAP diagnosis, clinical and demographic patient characteristics (gender, age and place of residence), as well as the process of glaucoma development (age of onset, disease duration and stages, intraocular pressure, ocular hypotensive medications, and the used laser and surgical procedures). All patients were divided into four groups depending on the time of making the initial diagnosis: 2004–2005, 2009–2010, 2014–2015, 2019–2020. Results: tonometry with Maklakov and Goldmann tonometers is still considered the gold standard for measuring intraocular pressure (IOP) (95% of cases). The percentage of pneumotonometry increased from 40% in 2005 to 60% in 2020. Approximately a third of clinics are still using electronic tonography as a supplementary method. Static automated perimetry is a basic tool for diagnosis and follow-up of patients with POAG (more than 95% of cases). Manual kinetic perimetry (Foerster's perimetry) is used in less than 10% of cases. Ophthalmoscopy (direct and binocular) was involved in the diagnostic process in all clinics and in all cases. The range of instrumental visualization technologies includes optical coherence tomography (OCT), Heidelberg Retina Tomography (HRT), and scanning laser polarimetry. Currently, OCT is utilized in 90% of clinics. It was found out that in 2005 the standard of initial POAG diagnosis encompassed a set of Maklakov/Goldmann tonometry, ophthalmoscopy and kinetic perimetry. In 2020, this list includes Maklakov/ Goldmann tonometry, pneumotonometry as a supplemental tool, static automated perimetry, ophthalmoscopy and OCT. The percentage of newly diagnosed POAG at the early stage has increased twofold over the past 15 years (from 20% in 2005 to 38% in 2020). The mean age of patients at the time of initial POAG diagnosis in 2005 was 62 (52; 67) years, in 2020 — 65 (50; 70) years, respectively (р=0.694). The proportion of prostaglandins in medication therapy increased by 20% over the past 15 years, while the proportion of beta-blockers reduced by the same percentage. The use of cholinomimetic drugs was almost discontinued. The total number of glaucoma laser surgeries has grown, and in the last decade the top priority has been given to selective laser trabeculoplasty, while the share of argon laser trabeculoplasty has decreased by 10%. The rate of primary glaucoma surgeries (trabeculectomy) keeps going down. Conclusion: a gradual and consistent implementation of high-tech diagnostic methods (","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80773770","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":"Combined surgery for large macular hole in complicated cataract: case report","authors":"M. Bikbov, O. I. Orenburkina, A. A. Zinnatullin, A. L. Yarmukhametova, M. R. Kalanov, A. Babushkin","doi":"10.32364/2311-7729-2023-23-3-7","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-7","url":null,"abstract":"The only effective treatment for macular holes (MH) is surgery. Published data demonstrate that surgery (vitrectomy, internal limiting membrane/ILM peeling, and vitreous tamponade) of small and medium MHs is usually highly effective. Meanwhile, good outcomes and a high recurrence rate of large MHs postoperatively remain challenges. The authors propose a surgical technique for MHs in complicated cataracts (patent of the RF No. 2731794 dated 09/08/2020) that involves vitrectomy, posterior hyaloid removal, ILM staining, ILM peeling, formation of a flap from the anterior lens capsule to close MH, and air tamponade. This paper describes a woman who underwent combined surgery for cataract and MH as described. The technique provided a complete and stable anatomical outcome. After 1 month (i.e., after complete resorption of air), the best-corrected visual acuity of the right eye increased to 20/40. IOP was 19.0 mm Hg. KEYWORDS: vision, idiopathic macular hole, retina, anterior les capsule, surgery, postoperative follow-up. FOR CITATION: Bikbov M.M., Orenburkina O.I., Zinnatullin A.A., Yarmukhametova A.L., Babushkin A.E., Kalanov M.R. Combined surgery for large macular hole in complicated cataract: case report. Russian Journal of Clinical Ophthalmology. 2023;23(3):152–156 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-7.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74752316","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":"On the optimal selection of nonsteroidal anti-inflammatory drugs in the management scheme of cataract patients","authors":"T. Morozova","doi":"10.32364/2311-7729-2023-23-1-54-59","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-1-54-59","url":null,"abstract":"This article aims to review the up-to-date approaches to the control of a non-specific inflammatory response following cataract phacoemulsification with intraocular lens implantation. The authors highlight the key objectives of using nonsteroidal anti-inflammatory agents after cataract surgery during the entire postoperative period, primarily to control inflammatory response and pain and to reduce the risk of cystoid macular edema. The article presents a wide range of data on the outcomes of using various nonsteroidal anti-inflammatory drugs (NSAIDs) in postoperative patients. Over the past years, classical approaches to the selection of patient management schemes have been revised taking into consideration findings of the numerous multicenter trials constructed on the principles of evidence-based medicine. The authors provide rationale for the selection of an optimal anti-inflammatory drug underpinned by the clinical trial results, pharmacodynamic and pharmacokinetic parameters of NSAIDs of a new generation. The emphasis is made on the use of bromfenac in patients with cataract. In addition, the risk factors and the major strategies of prevention and treatment of macular edema following surgical procedures are reviewed, including those in patients with diabetes mellitus. Keywords: cataract surgery, cystoid macular edema, NSAID, bromfenac, diabetes mellitus, perioperative period. For citation: Morozova T.A. On the optimal selection of nonsteroidal anti-inflammatory drugs in the management scheme of cataract patients. Russian Journal of Clinical Ophthalmology. 2023;23(1):54–59 (in Russ.). DOI: 10.32364/2311-7729-2023-23-1-54-59.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85499118","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":"Anti-VEGF-therapy for pseudoxanthoma elasticum (case reports)","authors":"A. Chuprov, S.M. Kim, E. A. Pidodniy, A. Iserkepova","doi":"10.32364/2311-7729-2023-23-3-8","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-8","url":null,"abstract":"Pseudoxanthoma elasticum (PXE), also known as Gröenblad-Strandberg syndrome, is a rare autosomal recessive disease affecting the skin, eyes, gastrointestinal tract, and cardiovascular system. The disease is caused by a defect in ABCC 6 (adenosine triphosphate-binding cassette, subfamily C, member 6) transporter involved in the homeostasis of serum pyrophosphate, the key inhibitor of ectopic calcification. Dysfunction or lack of ABCC 6 leads to a decrease in serum pyrophosphate levels and, as a result, ectopic calcification of soft connective tissue. Skin lesions in PXE are flat yellowish xanthomatous nodules of various shapes and sizes. The leading signs of eye disorder are angioid streaks and choroidal neovascularization (CNV). Progressive destruction of Bruch's membrane favors CNV, whereas macular neovascularization is the key reason for a reduction in central vision in PXE. Intravitreal injection of anti-VEGF medications is a promising treatment for CNV due to angioid bands. Ranibizumab is approved for CNV of various origins, including CNV due to angioid streaks. This paper addresses clinical observations illustrating the efficacy of anti-VEGF therapy for pseudoxanthoma elasticum. KEYWORDS: Gröenblad-Strandberg syndrome, angioid streaks, choroidal neovascularization, pseudoxanthoma elasticum, VEGF inhibitors. FOR CITATION: Chuprov A.D., Kim S.M., Pidodniy E.A., Iserkepova A.M. Anti-VEGF-therapy for pseudoxanthoma elasticum (case reports). Russian Journal of Clinical Ophthalmology. 2023;23(3):157–163 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-8.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90472548","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":"Selected results of a post-registration observational study on the clinical efficacy and tolerability of Bimicombi Antiglau ECO and Brim Antiglau ECO in different stages of primary open-angle glaucoma in real-world clinical practice (Brim Bimicombi Antiglau Real World Ophthalmology, BRAWO)","authors":"A. Kuroyedov, M. V. Kosakovskaya, O. V. Gapon’ko, V. Gorodnichiy, D. Lovpache, I. A. Bulakh","doi":"10.32364/2311-7729-2023-23-3-4","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-4","url":null,"abstract":"Aim: to assess the clinical efficacy and tolerability of bimatoprost/timolol (Bimicombi Antiglau ECO) and brimonidine (Brim Antiglau ECO) in different stages of primary open-angle glaucoma (POAG) compared with prior therapy. Patients and Methods: data from 1036 patients were included in the final protocol of the multicenter combined scientific and clinical study. All patients were diagnosed with POAG or were glaucoma suspects (GS) with ocular hypertension (OHT). All patients underwent a complex eye examination. Treatment with the drugs studied should have lasted 2 to 4 months. Treatment choice resulted from the lack of efficacy, ineffectiveness, or intolerance of prior therapies. The control study was conducted once not less than a month after inclusion in the study. Results: POAG (any stage) was diagnosed in 982 patients (94.8%), and GS with OHT were 54 patients (5.2%). Changing treatment regimen (in a planned manner) prevented tachyphylaxis and tolerance to previously prescribed drugs, which was established by IOP measurements (a 20% reduction in IOP compared with prior data). If the regimen was changed for any reason (overall, 6 reasons were analyzed), three most common reasons were poor clinical efficacy (36.6%), discomfort (26.6%), and poor tolerability (23.9%). Prescription of preservative-free IOP-lowering medications (eye drops studied) for 1 month after the washout period significantly (by 19 times) reduced the number of these complaints. Preservative-free medications significantly increase the maximum satisfaction with prescribed treatment regimens (Likert score 4.61 of 5) and largely meet the expectations of doctors in terms of drug efficacy and tolerability (Likert score 4.67 of 5). Conclusion: preservative-free IOP-lowering medications (eye drops studied) are effective and well tolerated. KEYWORDS: glaucoma therapy, efficacy, tolerability, bimatoprost/timolol, brimonidine, primary open-angle glaucoma, real-world clinical practice, BRAWO. FOR CITATION: Kuroyedov A.V., Kosakovskaya M.V., Gapon'ko O.V., Gorodnichiy V.V., Lovpache D.N., Bulakh I.A. Selected results of a post- registration observational study on the clinical efficacy and tolerability of Bimicombi Antiglau ECO and Brim Antiglau ECO in different stages of primary open-angle glaucoma in real-world clinical practice (Brim Bimicombi Antiglau Real World Ophthalmology, BRAWO). Russian Journal of Clinical Ophthalmology. 2023;23(3):129–135 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-4.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89844587","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":"Selective micropulse individual retinal therapy in the navigation- guided treatment for central serous chorioretinopathy with parameter selection by preliminary testing","authors":"P. L. Volodin, E. V. Ivanova","doi":"10.32364/2311-7729-2023-23-3-1","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-1","url":null,"abstract":"Aim: to evaluate the outcomes of selective micropulse individual retinal therapy (SMIRT) in navigation-guided treatment for central serous chorioretinopathy (CSCR) by selecting parameters by preliminary testing. Patients and Methods: 61 patients (61 eyes) aged 36–58 with acute CSCR and transparent media were enrolled. The patients were divided into two groups. In the study group (31 eyes), CSCR treatment was performed using SMIRT technology and Laser system. Micropulse mode was applied. According to the computer simulation, this mode implies selective destruction of the retinal pigment epithelium with minimal damage to the neurosensory retina and choroid. Parameters were customized for each patient by preliminary testing and evaluation of the results by short-wavelength fundus autofluorescence (488 nm). Laser spots were applied close to each other to completely cover the leakage points revealed by fluorescein angiography. Control group patients (30 eyes) did not receive laser treatment. Follow-up examinations were performed 1, 3, 6, and 12 months after enrollment. Results: after one year, complete resorption of subretinal fluid was reported in all eyes in the study group and 10 eyes (33.3%) in the control group. In the study group, the best-corrected visual acuity (BCVA) increased from 0.85±0.02 to 0.98±0.02 (p<10-8), while central photosensitivity increased from 24.34±0.33 to 29.15±0.17 dB (p<6×10-6). In the control group, BCVA decreased from 0.84±0.02 to 0.77±0.03, while photosensitivity slightly increased from 25.09±0.32 to 25.32±0.72 dB. Conclusion: navigation-guided treatment for CSCR using the SMIRT technology with selecting parameters by preliminary testing has demonstrated high efficacy and safety. This tool can be used when leakage points are located in the fovea. KEYWORDS: selective micropulse individual retinal therapy (SMIRT), central serous chorioretinopathy, micropulse, navigation, customized approach. FOR CITATION: Volodin P.L., Ivanova E.V. Selective micropulse individual retinal therapy in the navigation-guided treatment for central serous chorioretinopathy with parameter selection by preliminary testing. Russian Journal of Clinical Ophthalmology. 2023;23(3):112–118 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-1.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83555974","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":"The assessment of the tear film lipid layer in different types of dry eye syndrome","authors":"T. Safonova, V. Averich, E. S. Medvedeva","doi":"10.32364/2311-7729-2023-23-1-9-13","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-1-9-13","url":null,"abstract":"Aim: to assess the tear film (TF) lipid layer in different types of dry eye syndrome. Patients and Methods: this study included 60 patients (120 eyes), 20–35 years old: group 1 consisted of 20 patients (40 eyes) with a verified diagnosis of burning eye syndrome (BES) and group 2 consisted of 20 patients (40 eyes) with an established diagnosis of dry eye syndrome (DES). Group 3 (control) comprised 20 individuals (40 eyes) of the same age range, who did not have any somatic or eye diseases. The results of thiascopy in the control group individuals were considered conditionally normal findings. The exclusion criterion used in the study was the presence of clinical signs of blepharitis and meibomian gland dysfunction (MGD) in patients and individuals of the control group. The evaluation of all patients included determining the number of blinking movements and the completeness of eyelid closure, conducting the Norn's test, and using an improved thiascopy method. The computed analysis of the obtained digital images was performed with \"Lacrima\" software. Results: in 70% of cases, an incomplete eyelid closure was detected in the group of patients with BES, while the multiplicity of blinking movements was within the normal range. The Norn's test measurements in the group of patients with BES were 12 seconds, in the group of patients with DES — 7 seconds, and in the control group — 15 seconds. The absence of TF sections with a lipid layer exceeding 0.5 microns (p<0.05); a 2.5-fold decrease in the zone with a lipid layer thickness of 0.13 — 0.27 μm a 3-fold decrease in the zone with a lipid layer thickness of 0.27 — 0.5 μm; and a 12% increase in the uncertainty zone were reported in the group of patients with BES compared to those in the group of patients with DES. Conclusion: changes in the tear film lipid layer were more pronounced in patients with BES. Keywords: dry eye syndrome, burning eye syndrome, tear film, Lacrima, thiascopy, cationic emulsion, lipid-containing agents. For citation: Safonova T.N., Averich V.V., Medvedeva E.S. The assessment of the tear film lipid layer in different types of dry eye syndrome. Russian Journal of Clinical Ophthalmology. 2023;23(1):9–13 (in Russ.). DOI: 10.32364/2311-7729-2023-23-1-9-13.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77717791","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":"The relationship between the individual biomechanical properties of the eye and the intraocular pressure measurements based on modern methods of ocular tonometry","authors":"M. Kats","doi":"10.32364/2311-7729-2023-23-2-86-93","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-2-86-93","url":null,"abstract":"A thorough analysis of the intraocular pressure (IOP) measurements is crucial for making diagnosis and decisions concerning the management of glaucoma patients. At the same time, there is a large inter-individual variability of ocular anatomical and physiological parameters impacting such measurements. IOP has been identified as a potential independent risk factor for the glaucoma progression. However, in clinical practice it is not always possible to achieve its accurate quantitative evaluation. Currently, multiple modern devices are available to determine IOP indicators and biomechanical properties of the eye. In addition, various clinical algorithms have been proposed for adjusting these indicators and thus to ensure an adequate interpretation of IOP measurements. However, there are still no clear guidelines on how to use the correction factors. In turn, the interpretation of measurement results with consideration of new (biomechanical) characteristics of the eye's support structure, requires a detailed analysis of the received data to establish correlations between non-standard parameters and specific characteristics of the glaucoma progression. This review presents an assessment of the latest ophthalmotonometry methods and their individual characteristics based on the available clinical experience. Keywords: ophthalmotonometry, biomechanical properties of the eye, intraocular pressure, glaucoma. For citation: Kats M.D. The relationship between the individual biomechanical properties of the eye and the intraocular pressure measurements based on modern methods of ocular tonometry. Russian Journal of Clinical Ophthalmology. 2023;23(2):86–93 (in Russ.). DOI: 10.32364/2311- 7729-2023-23-2-86-93.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85067434","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":"Advanced approach to primary microsurgical debridement of extensive scleral lacerations involving simultaneous vitrectomy and chorioretinal wound closure","authors":"S. S. Shamkin, S. N. Subbotina, A. Stepanyants, D. V. Salov","doi":"10.32364/2311-7729-2023-23-3-3","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-3","url":null,"abstract":"Background: the current strategy for managing extensive zone 3 scleral lacerations implies delayed subtotal vitrectomy. A high rate of poor treatment outcomes requires novel approaches to surgical debridement of lacerations given anatomical and pathogenic specifics. Aim: to assess the treatment results of extensive zone 3 scleral laceration surgery by simultaneous vitrectomy and chorioretinal wound debridement. Patients and Methods: 14 patients (14 eyes) diagnosed with extensive penetrating scleral/corneoscleral laceration and polymorphic intraocular lesions associated with grade 4–5 visual impairment were enrolled. All patients underwent primary microsurgical debridement using a technique that involved external debridement and suturing of scleral laceration, single-step subtotal vitrectomy, and internal debridement of the chorioretinal wound. The chorioretinal wound was filled with pure platelet-rich plasma (P-PRP). Endotamponade was performed using silicone oil (n=9) or air-gas mixture (n=5). Results: after 6 months, visual acuity (VA) was estimated to be 0.02–0.5 in 12 patients and light perception in 2 patients. During the follow- up, no phthisis bulbi was reported. The progression of proliferative vitreoretinopathy (formation of intraretinal adhesions or subretinal bands involving healthy retina) was reported in 3 patients (21.4%). Chorioretinal scars were characterized by local nonaggressive proliferation, no prominence in the vitreous cavity, or proliferation of tissue beyond the scars. Conclusion: our approach to severe eye injury management has demonstrated positive outcomes by providing a stable anatomical result, significant improvement in early and late postoperative VA. KEYWORDS: open globe injury, primary microsurgical debridement, proliferative vitreoretinopathy, scleral lacerations, vitrectomy, platelet- rich plasma. FOR CITATION: Shamkin S.S., Subbotina S.N., Stepanyants A.B., Salov D.V. Advanced approach to primary microsurgical debridement of extensive scleral lacerations involving simultaneous vitrectomy and chorioretinal wound closure. Russian Journal of Clinical Ophthalmology. 2023;23(3):124–128 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-3.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86756678","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":"Endogenous endophthalmitis associated with autoimmune hepatitis: case report","authors":"D. F. Belov, V.G. Korotkov, P. Nikitin, I. Terekhova, Y. Konenkova","doi":"10.32364/2311-7729-2023-23-3-9","DOIUrl":"https://doi.org/10.32364/2311-7729-2023-23-3-9","url":null,"abstract":"Endogenous endophthalmitis (EE) is a severe inflammatory disease resulting from hematogenous dissemination of pathogenic agents (bacteria, fungi) from the primary focus into the choroid due to impaired permeability of blood-ocular barrier. Retina, vitreous body, and anterior chamber are further involved. This paper describes a 61-year-old woman with EE associated with autoimmune hepatitis (AIH). Ocular inflammation was preceded by bacteremia. Clinical signs of EE included vitreitis, choroidal effusion, and exudative retinal detachment followed by amaurosis and phthisis bulbi. In 2008, the woman was diagnosed with AIH of unknown origin. Insulin-dependent diabetes developed secondary to treatment with prednisolone. After canceling steroids, AIH progressed to cirrhosis. Here, the development of EE was probably associated with secondary immunodeficiency in the setting of AIH. The timely diagnosis of EE is important for selecting an effective treatment strategy that involves intravitreal antibiotics and vitrectomy. Ophthalmologists should be aware of previous fever or flu-like disorder, severe ocular inflammation (hypopion, vitreitis, choroidal effusion, retinal detachment), no red reflex, and severe vision loss. KEYWORDS: endogenous endophthalmitis, autoimmune hepatitis, vitrectomy, intravitreal injections, and phthisis bulbi, hypopyon, choroid, bacteremia, cirrhosis, retinal detachment. FOR CITATION: Belov D.F., Korotkov V.G., Nikitin P.A., Terekhova I.V., Konenkova Ya.S. Endogenous endophthalmitis associated with autoimmune hepatitis: case report. Russian Journal of Clinical Ophthalmology. 2023;23(3):164–169 (in Russ.). DOI: 10.32364/2311-7729- 2023-23-3-9.","PeriodicalId":36455,"journal":{"name":"Russian Journal of Clinical Ophthalmology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86596772","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}