Vol 8, No 2 (2015)

Articles
Some aspects of the comparative characteristics of different computerized perimetry methods
Simakova I.L., Serdyukova S.A.
Abstract
Purpose - to compare the ease of use, the comfort for persons to be tested, the examination rate, as well as the variability of repeated results obtained using four methods of computerized perimetry. Materials and methods. This clinical study included three groups of patients with open-angle glaucoma (OAG). The 1st group included patients with OAG stage I, the 2nd group - with OAG stage II, the 3rd group - with OAG stage III. The control group included healthy individuals. All tested persons underwent examinations by 4 computerized methods (HFA II, Tomey AP-1000, Pericom, and the FDT-perimetry modification developed at the Ophthalmology Department of the Military Medical Academy). Results. FDT-perimetry appeared to be the shortest, easiest test and most comfortable for tested persons. Perimetry using Tomey AP-1000, Pericom and HFA II was more time-consuming and more difficult to perform. Repeated results of all four methods were better than the first one due to the “learning curve” effect, and showed different variability. Conclusion. To obtain reliable computerized perimetry results, taking into account the possible “learning curve” effect, we recommend repeating the perimetric test at least 2-3 times at same conditions. It is important for the selected perimetric test to be easy to perform, comfortable for persons to be tested, and quite fast to perform.
Ophthalmology journal. 2015;8(2):5-9
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Ranibizumab and retinal photocoagulation in the treatment of ischemic retinal vein occlusion
Tultseva S.N., Astakhov Y.S., Nechiporenko P.A., Ovnanyan A.Y., Khatina V.A.
Abstract
Introduction. This investigation was focused on the post-RVO (retinal vein occlusion) macular edema treatment in cases with peripheral retinal ischemia, and on methods to estimate the ischemic area. Aim. To develop an examination and treatment algorithm for patients with chronic macular edema due to ischemic RVO. Material and methods. A prospective non-randomized study included 250 patients with RVO, the mean follow-up was 24.5 ± 6.5 months. Results. The drop-out of retinal capillary perfusion was detected in 175 patients (70 %). Peripheral ischemia was found in 125 cases, that is in 50% of all RVO patients and 71.4 % of all patients with ischemia. The mean number of ranibizumab injections performed after retinal photocoagulation was 2.9 ± 1.4. Patients treated with ranibizumab monotherapy for 24 months received 10.6 ± 2.5 intravitreal injections. Conclusions. The combination of ranibizumab intravitreal injections with retinal photocoagulation in the capillary non-perfusion areas can significantly reduce the number of injections and reduce the amount of neovascular complications.
Ophthalmology journal. 2015;8(2):11-27
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Сomputed tomography anatomy of the orbital apex
Yatsenko O.Y.
Abstract
The apex of the bony orbit and its soft tissues are most difficult to investigate. Meanwhile just pathological processes in this area cause several serious conditions which could lead to blindness and in many cases to disability. Purpose: to study linear and volume indices of the bony orbital apex and its soft content in normal conditions. Material and methods: 210 patients (266 orbits) are examined. Both orbits were investigated in 56 patients (112 orbits) with no orbital pathology. In patients with unilateral orbital involvement, the normal orbit was investigated (154 orbits). Among examined patients, 86 were men and 124 women. Mean age was 41.2 ± 10.4 years. The CT scan according to the standard technique obtaining axial and frontal sections was carried out in all patients (section thickness was 1.0 mm; interval - 1.0 mm). Results and discussions: The average horizontal size of the external part of an orbit in men was 22.2 ± 0.41 mm (range 17-28 mm). The same size in women was 21.4 ± 0.23 mm (17-26 mm). The vertical size of the external part of the orbit in men is equal to 23.12 ± 0.38 mm, in average and at women - 23.4 ± 0.31 mm. Orbital apex length is 16-24 mm (average 20.1 ± 0.47 mm) in men, in women it is 15-23 mm (average 19,2 ± 0,35 mm). In the article, normal volume of the orbital apex, of the optic nerve, extraocular muscles and orbital fat are presented. Ratios of volume characteristics of studied structures of the orbital apex are displayed. Conclusions: Volume characteristics of the orbital apex and its soft content could be useful to understand the pathogenesis of pathological processes in this area. They could be also used to carry out the differential diagnosis between true and false proptosis, and for surgery planning.
Ophthalmology journal. 2015;8(2):28-34
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First results of balloon dacryoplasty in dacryostenosis
At’kova E.L., Yartsev V.D., Krakhovetskiy N.N., Root A.O., Reznikova L.V.
Abstract
Background. Outpatient care is not widely spread in modern dacryology. At the same time, its necessity increases. There are no evidences of balloon dacryoplasty (BDP) application in Russian periodical literature. Material and methods. 50 surgical procedures in 30 patients with partial nasolacrimal duct obliteration were performed, among them 30 BDP without lacrimal pathways intubation (group 1) and 20 with bicanalicular Ritleng intubation of lacrimal pathways (group 2). Lacrimal scintigraphy, single photon emission computed tomography, combined with X-ray computed tomography, subjective tearing estimation in points, and health depending quality of life evaluation wre performed in all cases. Same tests were repeated in 3 months after surgery. Results. A positive outcome rate was 90 % in both groups. There were no complications in group 1. A single case of stent dislocation was recorded in group 2. Conclusion. BDP is an effective procedure in dacryostenosis of the lacrimal pathways vertical part obliteration. This procedure helps to avoid complications associated with long stent retention. It is possible to get good functional results even at short term after BDP surgery, and there is a possibility for this procedure to be carried out in an outpatient setting.
Ophthalmology journal. 2015;8(2):35-40
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Femtosecond laser effect on the self-sealing properties of the corneal incision of various lengths and profile (experimental trial)
Nizametdinova Y.S., Takhtaev Y.V., Nikolaenko V.P.
Abstract
An experimental investigation was carried out to study self-sealing properties of corneal incisions of different profile and length carried out with femtosecond laser Victus (Technolas Perfect Vision/Bausch&Lomb). Using femtosecond laser for this purpose allows creating corneal incisions of high precision and predictability. Reproducibility and standardization of the incision profile and length are an advantage of this technology. Obtained results showed that single-profile incisions are less stable and safe when compared to multi-profile ones. It was noted that incision length increase promotes its self-sealing properties.
Ophthalmology journal. 2015;8(2):41-46
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Primary glaucoma etiology: current theories and researches
Petrov S.Y., Fokina N.D., Sherstneva L.V., Vostruhin S.V., Safonova D.M.
Abstract
The article presents a review of latest researches related to various aspects of primary glaucoma and optic neuropathy etiology. The effect of somatic factors on glaucoma progression is described. Arguments in favor of the interrelation of glaucoma and neurodegenerative processes are presented. The genetic basis for the development of glaucoma and a variety of its conjoined syndromes is considered. Immunological mechanisms that initiate the programmed cell death are analyzed. The processes that influence the increase of trabecular meshwork retention are also described as well as its role in the glaucoma pathogenesis.
Ophthalmology journal. 2015;8(2):47-56
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Our experience of Restasis® use in patients with “dry eye” syndrome occurring against the context of graft versus host reaction after bone marrow allografting
Astakhov S.Y., Tkachenko N.V., Chistyakova N.V.
Abstract
Restasis® is the only ophthalmic medication containing cyclosporine A that is registered in the Russian Federation. According to prescribing information, it is indicated in keratoconjunctivitis sicca with decreased tear secretion. However, there are several similar conditions, in particular ophthalmic forms of graft versus host reaction, in which its use may be appropriate and of high practical interest. We observed 20 patients with ophthalmic forms of graft versus host reaction after bone marrow allografting. All patients were treated by Restasis® b.i.d., there were no side-effects. In one month of treatment tear breakup time test results improved, as well as the corneal epithelium status.
Ophthalmology journal. 2015;8(2):58-70
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Cordarone keratopathyand Fabry disease: Differential diagnosis, treatment
Astakhov S.Y., Tkachenko N.V., Papanyan S.S.
Abstract
Cordarone keratopathy corresponds to medically induced corneal changes developing with time in a majority of patients against the background of systemic cordarone (amiodarone) therapy. This condition does threaten by substantial visual function decrease and does not demand medication withdrawal. Similar intraepithelial corneal inclusions may be found in treatment by several other medications, as well as in Fabry disease. This is to be reminded when considering differential diagnosis.
Ophthalmology journal. 2015;8(2):71-78
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The role of preventive topical antibiotic treatment prior to intravitreal injection
Ageeva E.V., Grodnenskaya A.E., Popova K.A.
Abstract
Treatment of wet age-related macular degeneration (AMD) requires frequent intravitreal injections of anti-VEGF agents, sometimes on monthly basis during a long period of time. Endophthalmitis is a rare but extremely severe complication of intravitreal injections. As it has been proven before, the flora from the conjunctival surface is the main source for endophthalmitis. Using Povidone-iodine solution (Betadine10 % Povidone-iodine, EGIS PHARMACEUTICALS) is the only way to prevent endophthalmitis. The efficacy of it was proven by numerous studies. No evidence exists that topical antibiotiotics prior and after injections could be effective for prevention of endophthalmitis. Purpose: To study the advisability of topical antibiotic application before intravitreal injection. Materials and methods: Under investigation, there were 25 eyes of 25 patients with wet AMD treated by anti-VEGF intravitreal injections. All patients used topical antibiotics 3 days before injection. Conjunctival culture from injection eye was collected three times: before topical antibiotic use; after topical antibiotic use, and after Betadine 5 % application. Results: The rates of Staphylococcus epidermidis before and after topical antibiotic use were approximately equal. However there was no Staphylococcus epidermidis found after Betadine 5 % application. Conclusion: Our study showed the effectiveness of Betadine 5 % solution in conjunctival flora reduction. Use of topical antibiotics 3 days prior intravitreal injections is not effective. Key words: age-related macular degeneration; endophthalmitis; intravitreal injection; topical antibiotics; endophthalmitis prevention.
Ophthalmology journal. 2015;8(2):79-83
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Clinical case of congenital microphtalmos with cyst
Gorbachev D.S., Korovenkov R.I.
Abstract
The paper contains a detailed description of the clinical case of a rare ophthalmic congenital disease - congenital microphthalmos with cyst. Obtained information may facilitate a correct diagnosis and treatment of this condition and may be useful for practicing ophthalmologists.
Ophthalmology journal. 2015;8(2):84-89
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