Vol 9, No 4 (2016)

Articles
Comparison of visual function and patient satisfaction with AcrySof ReSTORSN6AD1 multifocal intraocular compared to monofocal intraocular lenses 5
Alchinova A.S., Morina K.Y., Rakhmanov V.V., Potemkin V.V., Khripun K.V., Meshveliani E.V., Ageeva E.V.

Abstract

Aim. To compare visual function and satisfaction in patients after implantation of AcrySof ReSTOR SN6AD1 multifocal intraocular lens (IOL), AcrySof SA60AТ spherical monofocal IOL, or Akreos АО aspheric monofocal IOL during cataract surgery.

Materials. Overall, 34 patients received SN6AD1 multifocal (group 1, 48 eyes), 19 patients received Akreos АО monofocal aspheric (group 2, 30 eyes), and 13 patients received AcrySof SA60AТ monofocal spherical (group 3, 18 eyes) IOL. Patients with multifocal IOL were closely matched for age, sex, and ocular findings with patients who had monofocal IOL implantation. Six months postoperatively, uncorrected/corrected distance visual acuity (UDVA/CDVA), uncorrected intermediate (60 cm) and near (35 cm) visual acuity (UNVA), defocus curve, contrast sensitivity, and a quality-of-life questionnaire were evaluated. Furthermore, independence from glasses and presence of optical phenomena were assessed.

Results. Patients in group 2 had statistically significant increase in UDVA than that in group 1 (p = 0.037). There was no significant difference in the mean uncorrected intermediate and best corrected distance visual acuities between the groups. UNVA was better in group 1 than that in groups 2 and 3 (p < 0.0001). Photopic contrast sensitivity for high spatial frequencies was better in groups 2 and 3. Glare was reported in 5.9% of patients in group 1. Halos occurred in 32.4% of patients in group 1. No one reported undesirable visual symptoms in groups 2 and 3.

Conclusion. Multifocal IOLs provided higher spectacle independence and satisfactory functional vision over a broad range of distances but were associated with increased subjective visual symptoms and reduced photopic contrast sensitivity for high spatial frequencies and distance visual quality compared with monofocal IOLs.

 

Ophthalmology journal. 2016;9(4):5-12
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Morphological study of idiopathic epiretinal membranes and their cytokine profile
Altynbaev U.R., Lebedeva A.I.

Abstract

The article presents comparative morphological analysis and assessment of response to antigens of fibronectin, laminin, glial fibrillary acidic protein (GFAP) in idiopathic epiretinal membranes (iERM). Authors found a comparable positive iERM reaction to fibronectin and GFAP, which indicates the involvement of these cytokines in the development and progression of the posterior segment neurodegenerative process. Cellular elements in the vitreous gel responsible for iERM formation were fibroblasts, myofibroblasts, hyalocytes, and retinal radial glial cells. Retinal radial glial cells play the main role in the recurrent iERM formation.

Conclusion. Due to its hemodynamic, nootropic, neurotrophic action, the investigated bioregulatory complex increases the optic nerve tolerance to the stress effect of IOP, SBP, and DBP asynchronous fluctuations, and improves the ocular blood perfusion.

Ophthalmology journal. 2016;9(4):13-17
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Assessment of regional fibrinolytic activity of tear fluid by determining the levels of D-dimer in patients with retinal vein occlusion
Moshetova L.K., Kosyrev A.B., Tsikhonchuk T.V., Yarovaya G.A., Turkina K.I., Neshkova E.A.

Abstract

First defined level of D-dimer in the tear fluid in order to assess regional fibrinolytic activity in patients with retinal vein occlusion. It is shown that normally the level of D-dimer in tear fluid significantly higher than in blood plasma. It has been found to have elevated levels of D-dimer tear fluid in patients with CRVO and BRVO, which may indicate the activation of fibrinolysis, as a component of the inflammatory response. In appointing the anticoagulant and fibrinolytic therapy have a tendency to normalization of D-dimer in the tear fluid.
Ophthalmology journal. 2016;9(4):18-29
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Age-related desynchronosis in primary open-angle glaucoma patients: cause or consequence? Correction possibilities
Malishevskaya T.N.

Abstract

Purpose of this investigation was to study the circadian biologic rhythm dysregulation of intraocular pressure (IOP), blood pressure (BP), and heart rate (HR) in primary open-angle glaucoma (POAG) patients of different age groups. Objectives: to reveal the desynchronosis pattern of biologic rhythm parameters in POAG patients, to study the influence of peptide bioregulatory complex on the synchronization of chosen parameters, to investigate correction possibilities from the perspective of the optic nerve tolerance enhancement, ischemia decrease and ocular perfusion improvement.

Materials and methods. At the first stage, we performed a representative selection of patients with BP, HR and IOP dysregulation among POAG patients and subjects without glaucoma of corresponding age (n = 330). For mathematic justification of the desynchronosis identification, we used cosinor-analysis of circadian changes of functional indices. At the second stage, we performed a randomized study with parallel comparison groups masked for the investigator estimating the results. Patients with revealed desynchronosis (n = 56) were randomly divided into two groups for comparison. The main group consisted of 27 patients who, in addition to systemic and local pressure-lowering therapy, received 1 tablet of epifamin (Longvi-Farm, Russia) 3 times a day for 30 days; сortexin (Geropharm, Russia) 10 mg daily for 10 days; retinalamin (Geropharm, Russia) 5 mg daily as peribulbar injections for 10 days. 29 control group patients received traditional treatment (vitamins, spasmolytics, antioxydants) together with local and systemic pressure-lowering therapy. In compared groups, we calculated the tolerant pressure level, investigated the dynamics of retinal sensitivity mean deviation (MD), registrated the oscillatory potentials (OP) with the OP index calculation.

Results. In elderly patients with glaucoma, significant changes of the temporal order of physiological parameters were found (deviation of IOP daily rhythm curves, systolic blood pressure (SBP), diastolic blood pressure (DBP), and hemodynamic indices).

Conclusion. Through hemodynamic, nootropic, neurotrophic effects of the investigated bioregulatory peptide complex, the optic nerve tolerance to the stress influence of IOP, SBP and DBP asynchronous fluctuations increased, and ocular perfusion enhanced.

Ophthalmology journal. 2016;9(4):31-42
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Comparative estimation of laser coagulation efficiency in macular and microphotocoagulation of high density in diabetic maculopathy treatment
Kotsur T.V., Izmaylov A.S.

Abstract

Subthreshold microphotocoagulation leads to the development of barely visible or invisible retinal burns. It has also been shown to be effective in macular edema treatment without any side effects that are inherent to the ETDRS method (atrophy of retinal pigment epithelium and choroid and decreased retinal sensitivity). Microphotocoagulation efficacy may be increased by high-density laser applications; however, publications drawing attention to this matter are rare in modern literature.

Ophthalmology journal. 2016;9(4):43-45
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Reconstructive surgery of post-burn cicatricial ectropion of upper and lower eyelid
Nuraeva A.B.

Abstract

In the article, an outcome analysis of post-burn upper and lower eyelid ectropion repair in 27 patients (49 cases) is presented. The study group included 31 cases (15 males, 2 females, aged 16-67), the control group consisted of 18 cases (5 males, 5 females, aged 2-52). Patients from the control group underwent free skin grafting of upper and lower eyelids. Patients from the study group underwent combined surgery using two different types of Alloplant biomaterial: allogenous tendon fibres and transplant for eyelid plasty. The operation results were assessed by change in ectropion grade, lagophthalmos and interpalpebral width.
Ophthalmology journal. 2016;9(4):46-51
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Pseudoexfoliation syndrome and meibomian gland dysfunction
Potemkin V.V., Ageeva E.V.

Abstract

Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease of connective tissue. The condition of meibomian glands in patients with PEX was not evaluated yet. Aim. To evaluate the condition of meibomian glands in PEX. Methods. Overall, 132 eyes of 66 patients with PEX syndrome and 128 eyes of 64 patients without it were enrolled in this prospective study. Results. The signs of atonic changes in meibomian glands were similar in both groups. Meibomian glands dysfunction was significantly more expressed in patients with PEX (p < 0,05).

Ophthalmology journal. 2016;9(4):52-57
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Ocular neovascular-related diseases: immunological mechanisms of development and the potential of anti-angiogenic therapy
Gadzhieva B.K.

Abstract

The paper adresses three ocular diseases - “wet” type of age-related macular degeneration, diabetic macular edema and neovascular glaucoma, which have similar neovascular changes and immunological disorders. The key moment of neovascularization development is an imbalance between pro- and anti-angiogenic factors. Particular attention is paid to vascular endothelial growth factor (VEGF-A), pigment epithelial derived factor (PEDF), transforming growth factor-beta (ТGF-β). The paper discusses the “immune privilege” of the eye, ACAID phenomenon, aspects of choroidal neovascularization pathogenesis, inflammation as an important part of neovascularization and the protective response to endogenous and exogenous damage, as well as complement system’s disorders, cytokine status impairment and autoimmune mechanisms. Laser treatment is widely used for treatment of neovascular diseases, but pharmacotherapy is very important too. Anti-angiogenic therapy is extremely promising and is held to provide regression of the newly-formed vasculature and/or normalization of newly formed blood vessels structure and suppress the functional activity of a key proangiogenic factor VEGF-A. Pegaptanib, ranibizumab and bevacizumab are discussed, and results of international clinical trials MARINA, ANCHOR, FOCUS, PrONTO, IVAN, CATT, RESTORE are provided.
Ophthalmology journal. 2016;9(4):58-67
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Efficacy of retinalamin in the complex treatment of rhegmatogenous retinal detachment
Astakhov Y.S., Belova T.V., Boyko E.V., Lukovskaya N.G., Ryabtzeva A.A., Sajgina E.A., Terehova I.V., Fokina D.V.

Abstract

From 2009 to 2014, a multicenter, open-labeled, comparative controlled randomized study was conducted investigating the efficacy of peribulbar injections of retinalamin in combination with standard therapy for rhegmatogenous retinal detachment compared with that of standard therapy in the early postoperative period.
Ophthalmology journal. 2016;9(4):69-77
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Trehalose efficacy in dry eye syndrome treatment after phacoemulsification
Astakhov S.Y., Tkachenko N.V.

Abstract

Purpose to estimate the efficacy of “artificial tear” preparation on the trehalose base in dry eye syndrome treatment in cataract patients after phacoemulsification.

Materials and methods: in 40 patients with incipient cataract phacoemulsification with IOL implantation was performed. During 1 week, all patients received eye gel with dexpanthenol in addition to postoperative therapy. Then, all patients were divided into two groups (randomization using envelopes): in the main group, the gel was replaced by Thealoz®, in the control group, the gel was discontinued. Special investigation tests (OSDI score, TBUT test, conjunctival hyperemia, corneal confocal tomography) were performed before surgery, in one week and one month after it. Statistical analysis was performed using SAS 9.4 program.

Results: all investigated parameters had significant differences with time and between groups (р < 0.001). TBUT test result decreased in one week after surgery from 7.4 ± 2.1 to 4.6 ± 1.9 sec in the main group and from 7.5 ± 2.3 to 4.4 ± 2 sec in the control group. Return to baseline results in the control group was slowed down and made 6.4 ± 2.8 sec (compared with 7.9 ± 2.4 sec in the main one). In the trehalose group, OSDI score ameliorated from 35.1 ± 8.7 (in one week) to 14.2 ± 5.3 (in one month), in the control group, from 40.1 ± 11.5 to 24.8 ± 9. Conjunctival hyperemia was also less pronounced in the main group in one month after surgery: 0.45 ± 0.6 (1.6 ± 0.7 in one week), in the control group, these indices were equal to 1.7 ± 0.5 (in one week) and 1.3 ± 0.7 (in one month).

Conclusions: Thealoz® use as a part of combined postoperative therapy helps to effectively fight against dry eye syndrome main signs and enhances treatment tolerance.

Ophthalmology journal. 2016;9(4):79-89
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Morphological changes in the macular area at post-thrombotic maculopathy after intravitreal injection of a dexamethasone implant (evidence from 5 clinical cases)
Bikbov M.M., Fayzrakhmanov R.R., Gil’manshin T.R., Arslangareeva I.I.

Abstract

Purpose. To evaluate the effect of intravitreal implant with dexamethasone on the morphological changes of macular area in patients with central retinal vein occlusion.

Materials and methods. Results of optical coherence tomography of the central retinal area of 5 patients (5 eyes) with newly diagnosed central retinal vein occlusion complicated by macular edema (ME) are presented. All the patients underwent single intravitreal injection of dexamethasone implant. Maximal follow-up period – 12 months.

Results. In 1 month after dexamethasone implant injection, we observed a decrease of foveal retinal thickness from 425.36 ± 57.87 to 273.75 ± 36.65 µm. In 1 year after treatment, foveal retinal thickness increased by 1.2 times compared to results got in 1 month after dexamethasone implant injection. The transformation of the macular area under the implant action was mainly due to changes in thickness and structure in the outer and inner nuclear and plexiform retinal layers.

Conclusion. Intravitreal injection of dexamethasone implant provides a decrease in post-thrombotic macular edema in 1 month since implantation. Retinal layers transform selectively at various pathological conditions of the retina, including macular edema. Retinal thickness changes in post-thrombotic ME, including those occurring under the dexamethason implant action are mainly related to changes in the outer and inner nuclear and plexiform retinal layers. The duration of morpho-functional effect persists not less than 12 months after treatment.

Ophthalmology journal. 2016;9(4):90-97
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A clinical case of knapsack-shaped dermoid orbital cyst
Marchenko O.A., Potemkin V.V., Malakhova Y.I.

Abstract

In the present article, two clinical cases of knapsack-shaped dermoid orbital cyst are presented. Diagnosis and treatment were performed in an ophthalmological department with oncology specialization of a multi-functional hospital.
Ophthalmology journal. 2016;9(4):98-101
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Superior orbital fissure syndrome caused by an internal carotid artery aneurysm in the cavernous sinus
Astakhov Y.S., Marchenko O.A., Potemkin V.V., Titarenko A.I.

Abstract

This article describes a case of superior orbital fissure syndrome caused by an internal carotid artery aneurysm in the cavernous sinus. Etiology, clinical presentations, and diagnostic methods are discussed. Possible regression of signs and symptoms after timely endovascular treatment of an internal carotid artery aneurysm in the cavernous sinus is reported.

Ophthalmology journal. 2016;9(4):102-106
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