Oftalmologiya最新文献

{"title":"Medical Support of Adaptation to Refractive Errors with Age","authors":"M. A. Kovalevskaya, V. B. Antonyan, V. I. Starykh, A. V. Podoprigora, M. I. Sergeeva","doi":"10.18008/1816-5095-2023-3-549-556","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-549-556","url":null,"abstract":"Aim: to evaluate the effectiveness of treatment with Optinol on the condition of the ocular surface in people over 35 years of age with refractive error. Patients and methods. The study was carried out in two clinical and in the control group. The first group included 74 patients (148 eyes) with moderate (group 1a) and high (group 1b) myopia, mean age 38.3 ± 0.4 years. The second group consisted of 49 patients (98 eyes) with moderate (group 2a) and high (group 2b) hypermetropia, mean age 42.3 ± 0.5 years. The control group included 25 healthy individuals (50 eyes), mean age 38.2 ± 1.4 years. The anamnesis of patients, complaints and concomitant diseases were assessed by the questionnaire method. Conclusion. The results of the study proved the influence of moderate and high hypermetropia on the likelihood of dry eye syndrome (DES).","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"252 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135745223","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":"Tactics of Managing Patients with Bacterial Corneal Ulcers in a Multidisciplinary Hospital (Series of Clinical Cases)","authors":"G. S. Arzhimatova, G. M. Chernakova, E. V. Shirshova, M. Yu. Shemyakin, E. B. Emelyanova, A. O. Ugolnikova","doi":"10.18008/1816-5095-2023-3-572-579","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-572-579","url":null,"abstract":"Bacterial corneal ulcers in patients with comorbid pathology are a complex clinical situation with a high risk of complications — corneal perforation. The article presents four clinical cases of bacterial corneal ulcers in patients with chronic latent sinusitis. The publication discusses the issues of diagnostic tactics, provides an analysis of the results of instrumental and laboratory tests in each case. The results of corneal ulcer therapy are presented taking into account antibioticograms.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135745224","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":"An Integrated Stepwise Approach to the Treatment of Graft Disease in a Patient with an Implanted Iris Lens Diaphragm and Concomitant Postkeratoplastic Ametropia (Clinical Case)","authors":"M. V. Sinitsyn, N. A. Pozdeyeva, A. E. Terent’eva","doi":"10.18008/1816-5095-2023-3-563-571","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-563-571","url":null,"abstract":"The purpose : to analyze the clinical and functional results of the complex staged treatment of graft disease in patient with an implanted iris lens diaphragm and concomitant postkeratoplastic ametropia using descemet’s stripping endothelial keratoplasty using a femtosecond laser (FS-DSEK) and MyoRing implantation into a corneal graft using a femtosecond laser on the example of a clinical case. Methods . Patient M., 51 years old, was admitted with a diagnosis of the left eye: corneal transplant disease, condition after penetrating keratoplasty, iridoartifakia, avitria, optic nerve subatrophy, high myopia. To treat the graft disease, the patient underwent FS-DSEK using a FemtoVisum 1 MHz (Troitsk, Russia). Twelve months after FS-DSEK to correct irregular postkeratoplastic astigmatism and concomitant high-grade myopia detected after restoration of the transparency of the penetrating corneal graft, the MyoRing was implanted into the penetrating corneal graft using a femtosecond laser. Results . After performing FS-DSEK, the transparency of the penetrating corneal graft was completely restored, visometry, refractokeratometry, and keratopachymetric data were stabilized by 6 months after the operation. 12 months after FS-DSEK, uncorrected visual acuity (UCVA) increased from 1.6 to 1.2 LogMAR, best corrected visual acuity (BCVA) increased from 1.6 to 0.8 LogMAR. Loss of endothelial cell density of the posterior layered graft was 27.4 %. MyoRing implantation into a penetrating corneal graft made it possible to significantly increase the UCVA from 1.3 to 0.3 LogMAR and the BCVA from 0.8 to 0.2 LogMAR. The spherical component of refraction decreased from -6.25 to -0.75 D, the cylindrical component of refraction — from -9.25 to -1.25 D, the regularity, sphericity of the corneal graft and its biomechanical properties increased (corneal resistance factor increased from 8.2 to 9.4 mm Hg, corneal hysteresis — from 7.9 to 9.1 mm Hg). Conclusion . A complex staged technique of descemet’s stripping endothelial keratoplasty using a femtosecond laser followed by MyoRing implantation into the corneal graft using a femtosecond laser is an effective and safe method for treating graft disease in a patient with an implanted iris lens diaphragm and concomitant postkeratoplastic ametropia.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135745111","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 Clinical Case of Successful Penetrating Keratoplasty after Corneal Perforation that Occurred against the Background of Dacryoadenitis","authors":"G. Sh. Arzhimatova, Yu. B. Slonimskij, E. A. Salikhov, M. Yu. Shemyakin, A. I. Ibraimov","doi":"10.18008/1816-5095-2023-3-557-562","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-557-562","url":null,"abstract":"The article presents a clinical case of penetrating keratoplasty performed in a patient after corneal perforation against the background of dacryoadenitis. The importance of the condition of the precorneal tear film for the normal functioning of the cornea and how dry eye syndrome affects the condition of the cornea before and after surgery are discussed. Relevant and open, in the article, remains the issue of the development of such complications as a corneal ulcer with perforation, against the background of dry eye syndrome that developed more than 10 years after the keratorefractive operation. Data on the state of the penetrating corneal graft after 6 months of dynamic follow-up are presented.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135745109","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":"Additive Therapy for Advanced Stages of Glaucoma","authors":"I. R. Gazizova, V. E. Korelina, E. P. Goncharuk","doi":"10.18008/1816-5095-2023-3-523-527","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-523-527","url":null,"abstract":"Purpose of the study: to evaluate the efficacy and feasibility of using brimonidine 0.2 % in the additive therapy of patients with advanced stages of glaucoma. Materials and methods . There were 59 patients (77 eyes) with advanced stages of primary open-angle, glaucoma (POAG) aged 68 to 83 years in the study. Patients were randomized into 2 groups depending on the received antihypertensive therapy. The first group (I) included 32 people (41 eyes) who used a fixed combination of a prostaglandin analogue (APG) or a carbonic anhydrase inhibitor (CAI) with a beta-blocker (BB) for the treatment of POAG. The second group (II) consisted of 27 patients (36 eyes) who had the α2-adrenergic agonist brimonidine — S3 added to the previously available combination of APG or ICA with BB. The observation period was 6 months. Results . Application of brimonidine — SZ in the additive therapy of advanced stages of glaucoma led to an additional hypotensive effect. By the end of the observation period in the group of patients treated with brimonidine, intraocular pressure decreased by an additional 10 % from the initial level. A good hypotensive effect contributed to an increase in functional parameters. Analysis of the results of static automatic perimetry showed a positive trend in the mean deviation (MD) and standard deviation pattern (PSD), which may indicate a neuroprotective effect of the drug. All patients noted good tolerability of treatment. Throughout the observation period, patients maintained a high level of adherence and performance.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900677","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":"Comprehensive Classification of the Severity of Bulbar and Tarsal Hyperemia in Conjunctivitis","authors":"V. N. Trubilin, E. G. Polunina, A. A. Kozhukhov, D. V. Andzhelova, A. V. Trubilin, K. V. Chinenova, N. V. Moreva","doi":"10.18008/1816-5095-2023-3-471-478","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-471-478","url":null,"abstract":"Diagnosis of conjunctivitis is an urgent problem in ophthalmic practice, since conjunctivitis is one of the most common reasons for patients to visit a doctor. An important aspect in diagnosing of the conjunctivа’s inflammation is to determine the intensity of the inflammatory process in each case, in which hyperemia is given priority, as the most demonstrative sign of inflammation. Currently, there are many subjective and non-invasive instrumental methods for assessing conjunctival hyperemia. Taking into account the fact that most of the instrumental methods are aimed to assess the state of the bulbar conjunctiva and there are practically no methods that allow assessing the severity of tarsal hyperemia, it is necessary to develop a methodology that allows to evaluate both these indicators in combination. In this regard, it is great interest to determine the degree of hyperemia during a biomicroscopic examination in combination with visualization and fixation of hyperemia indicators using the software of the MediWorks Dixion S 350 slit lamp (weak, medium, significant, severe) depending on the index of hyperemia obtained by fixing the image on the slit lamp. Standardization of the severity indicators of conjunctival hyperemia allows to obtaine objective data on the state of the tarsal and bulbar conjunctiva at all stages of observation. In addition, based on the above indicators in clinical practice, the ophthalmologist can prescribe an adequate amount of drug therapy, this will increase the level of safety and effectiveness of the therapy, which is especially important at the stage of primary outpatient admission, when treatment is usually prescribed empirically","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135901022","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":"Experience in the Treatment of Dry Eye Syndrome in Students with Myopic Refraction","authors":"T. V. Gavrilova, D. D. Kozitsyna, O. A. Misheneva","doi":"10.18008/1816-5095-2023-3-536-541","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-536-541","url":null,"abstract":"Objective : to study the effectiveness of the hypromellose-based medicine Artificial Tears®, eye drops, in the treatment of dry eye syndrome in students with myopic refraction. Patients and methods . A total of 147 students of Academician E.A. Wagner Perm State Medical University with different types of clinical refraction were examined. Among them 63 students with myopic refraction of various degrees in 110 eyes were included in the study (mean age — 22.6 ± 0.16 years, 49 (78 %) women, 14 (22 %) men). Dry eye syndrome was detected in 49 (78 %) participants in 82 eyes (74.5 %). According to the myopia correction method, 3 groups were formed: Group 1 — students with eyeglasses; Group 2 — students constantly using soft contact lenses; Group 3 — students who had excimer laser correction by LASIK method. The remaining students (n = 14) had no dry eye syndrome. The study was conducted in two stages: at baseline and then repeated after 4 weeks in students with dry eye syndrome who used daily the medicine Artificial Tears®. Subjective assessment was based on the Ocular Surface Disease Index (OSDI) questionnaire. Оbjective assessment included function tests, characterizing the precorneal tear film stability and total tear production level. Results . In the process of treatment a good tolerance of the given medicine was reported. Analysis of the overall results showed that the mean OSDI score decreased statistically significantly from 26.92 to 20.29 seconds (p ≤ 0.0001). The mean tear film break-up time increased from 7.95 to 11.25 (p ≤ 0.0001). The mean Schirmer’s test score was slightly changed: from 13.98 to 14.07 mm due to the presence of increased tear production in some students, which is characteristic of the dry eye syndrome initial manifestations. Conclusion . The medicine Artificial Tears® in the form of eye drops is well tolerated and is sufficiently effective in eliminating the dry eye syndrome manifestations after only 4 weeks of use. The treatment with the medicine Artificial Tears® showed a statistically significant reduction in the disease severity (according to the OSDI questionnaire data) and an increase in the tear film break-up time. The received results allow us to recommend the medicine Artificial Tears® for medical use in patients with various degrees of myopic refraction, regardless of the myopia correction method used.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900810","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":"Dynamics of Accommodative Asthenopia in Patients with Visually Intense Work after LASIK with Different Degrees of Myopia","authors":"E. I. Belikova, D. V. Gatilov, I. G. Ovechkin, E. N. Eskina","doi":"10.18008/1816-5095-2023-3-479-484","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-479-484","url":null,"abstract":"Purpose — to study the dynamics of accommodative asthenopia (AA) in patients with visually stressful labor (VLT) after laser keratomileusis in situ (LASIK) with different degrees of myopia. Patients and methods . There were 300 patients with VLT under supervision, divided into three groups of equal age and gender, corresponding to weak (up to 3.0 diopters, 100 patients, 200 eyes), medium (3.25–6.0 diopters, 100 patients, 200 eyes) and high (6.25–8.0 diopters, 100 patients, 200 eyes) degrees of myopia. All patients underwent objective accommodation using the Righton Speedy-I device (Japan) with further calculation of the coefficient of microfluctuations of the ciliary muscle of the eye (CMF). Diagnosis of the type of AA was carried out according to the following indicators: with CMF less than 53.0 rel. un. — asthenic form of accommodative asthenopia (AFAA); at CMF from 53.0 to 58.0 rel. un. — NORM; at CMF more than 58.0 rel. un. — habitual excess tension of accommodation (PINA). The survey was carried out before and three months after the operation. Statistical analysis of the results of the study was performed on the basis of the rate of occurrence (in % of the total number of eyes) of different dynamics (before-after surgery) AA (NORM-NORM; PINA-PINA; AFAA-AFAA; NORM-AFAA; NORM; PINA-AFAA; AFAA-NORM; AFAA-PINA). Results . The change in the form of AA varied from 2 % (APAA-PINA) to 18 % (PINANORM), averaged 15 % and was not statistically significant. The results obtained naturally reflect the state of AA as an adequate physiological response of the accommodative system of the eye to long-term, intense visual work with a fairly high level of responsibility for the result. Based on the above situation and the patient’s desire to maintain (in some cases even increase) the volume of daily visual load after the operation, it is unlikely to expect a significant improvement in the state of accommodation. Conclusion . LASIK with different degrees of myopia in patients with VLT has practically no effect on the dynamics of AA and requires a complex of therapeutic and restorative measures based on the development of methodological principles from the standpoint of a differentiated approach to the form of AA and the basic provisions of medical rehabilitaton.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900821","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 New Diagnostic Method for Ptosis of the Upper Eyelid","authors":"I. A. Filatova, Yu. P. Kondratieva, S. A. Shemetov, M. S. Trefilova","doi":"10.18008/1816-5095-2023-3-502-507","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-502-507","url":null,"abstract":"Currently, surgical treatment of ptosis of the upper eyelid does not always lead to a good anatomical and physiological result — the frequency of dissatisfaction with the results of treatment is 8–26 %, and repeated operations on the muscle that lifts the upper eyelid are performed in 8.7–18 % cases. An important aspect of the successful treatment of upper eyelid ptosis is the preoperative examination of the patient; however, standard diagnostic methods do not provide complete information about the functional features of the upper eyelid levator. The purpose of the study is to improve the algorithm for preoperative examination of the upper eyelid in ptosis with the study of the contractility and fatigue of the upper eyelid levator. On the basis of the Helmholtz National Medical Research Center of Eye Diseases in the period from 2021 to 2022, 63 patients (67 eyes) aged from 5 to 78 years with different types of blepharoptosis admitted for surgical treatment were examined. We have developed a comprehensive dynamometric preoperative assessment of the upper eyelid levator with a study of the contractility and fatigue of this muscle using weights. For comparison and determination of normal parameters, the study was also carried out on paired intact eyes (59 eyes) and in 40 healthy people. Indicators of contractility and fatigue of the levator of the upper eyelid were obtained in normal conditions and with ptosis of the upper eyelid, and differences in these indicators were revealed in congenital and acquired blepharoptosis. With congenital ptosis of the upper eyelid, the contractility and fatigue of the levator of the upper eyelid is low, while with acquired ptosis (senile), the contractility is medium, and fatigue is medium or high. A gradation of the values of contractility and fatigue of the upper eyelid levator in blepharoptosis was developed, on the basis of it an algorithm for choosing a method for surgical correction of upper eyelid ptosis was proposed. The developed method of dynamometric preoperative study of the anatomical and functional features of the upper eyelid levator using weights is a simple and affordable method for objectively assessing the state of contractility and fatigue of the levator, which can improve the efficiency of surgical correction of upper eyelid ptosis.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135901024","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":"Clinical Manifestations and Mechanisms of Development of Eye Damage in Hemoblastosis","authors":"N. Yu. Yusef, E. N. Misyurina, D. V. Andzhelova, E. E. Kazaryan, M. V. Vorobyeva","doi":"10.18008/1816-5095-2023-3-528-535","DOIUrl":"https://doi.org/10.18008/1816-5095-2023-3-528-535","url":null,"abstract":"In the article various ophthalmic manifestations of hemoblastoses will be discussed. Detailed descriptions of the most common variants of damage to the organ of vision in the oncohematological process are presented. Here we also present the clinical symptoms and development mechanisms associated with both direct leukocyte infiltration of various structures of the eye, occurring against the background of the underlying disease, and concomitant conditions, such as violation of the hemostasis system, anemia and thrombocytopenia resulting from the progression of blood cancer. It is also considered the cases of ophthalmic manifestations of hemoblastoses developing against the background of an immunity decrease associated oncohematological disorder, or as a result of the toxic effect of chemotherapy drugs, radiotherapy and bone marrow transplantation, as well as targeted therapy.","PeriodicalId":37645,"journal":{"name":"Oftalmologiya","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900678","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}