Vol 10, No 1 (2017)

Articles
Analysis of treatment results of endophthalmitis patients accordingto the data from the City Ophthalmology Center for 2014-2015
Astakhov S.Y., Shchukin A.D.
Abstract

Aim. To estimate development terms, visual functions upon hospital admission and discharge, and medical and surgical treatment results of different types of endophthalmitis.

Materials and methods. Data of 40 patients who received treatment for postoperative, endogenous, and posttraumatic endophthalmitis were studied. The mean age of patients was 61 years.

Results and discussion. Patients with postoperative endophthalmitis have higher baseline visual acuity, and emergency vitrectomy is a method of choice. Patients with endogenous severe endophthalmitis need enucleation more often. Intravitreal antibiotic injection does not always cause an improvement in endophthalmitis, but could be used as an adjunct to systemic therapy or as a measure in anticipation of vitrectomy.

Ophthalmology journal. 2017;10(1):5-9
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25-Hydroxyvitamin D and matrix metalloproteinases-2, -9 level in patients with primary open angle glaucoma and pseudoexfoliative glaucoma/syndrome
Beletskaya I.S., Karonova T.L., Astakhov S.Y.
Abstract

Aim. To determine serum 25(OH)D and plasma MMP-2 and MMP-9 levels in patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PEG), and pseudoexfoliation syndrome (PES) – to assess potential associations between vitamin D status and the above mentioned diseases.

Methods. We included 238 patients (105 males and 133 females) aged from 55 to 75 years. One hundred twenty two patients had PEG, 46 patients had POAG, 32 had PES. 38 subjects were healthy, and were considered as the control group. Cases with clinically significant systemic diseases and concomiatant eye diseases were excluded, if there was a confirmed pathogenic impact of vitamin D and MMP. The serum 25(OH)D level was investigated by immunochemiluminescence method, plasma MMP-2 and MMP-9 levels – by ELISA.

Results. Serum 25(OH)D level was between 4.6 and 82.25 nM/l (mean 41.7 nM/l), so most participants showed vitamin D deficiency. It was shown that mean serum 25(OH)D level in patients with PEG, POAG and PES was similar (39.3 ± 1.2, 38.8 ± 2.1 and 40.51 ± 2.4 nM/l, p > 0.05), but it was lower than those in the control group (52.7 ± 2.1 nM/l, p < 0.01). Plasma MMP-2 concentration was the same in all study groups. Plasma MMP-9 level was higher in POAG and PES patients (48.23 ± 3.26 and 54.01 ± 3.57 ng/ml) than in the control group (32.60 ± 2.34 ng/ml, p < 0.001) and in patients with PEG (40.86 ± 3.60 ng/ml, p < 0.05). We found positive correlations between MMP-2 and MMP-9 levels in patients with PEG (r = 0.48, p = 0.001) and patients with POAG (r = 0.43, p = 0.003). The correlation analysis showed also a negative relation between 25(OH)D and MMP-9 (r = –0.32, p = 0.02), as well as MMP-2 (r = –0.33, p = 0.02) in patients with POAG.

Summary. Study results confirmed a potential role of vitamin D in apoptosis regulation and tissue remodeling in patients with POAG and PES. Hence, vitamin D deficiency can be considered as a risk factor for glaucoma development.

Ophthalmology journal. 2017;10(1):10-16
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Research of Mitomycin-C saturation in dacryocystorhinostomy osteotomy site tissue
At´kova E.L., Root A.O., Krahoveckiy N.N., Yartsev V.D., Yartsev S.D.
Abstract

Introduction. Mitomycin-C is an alkylating antibiotic used to prevent excessive scar formation in the dacryostoma area after dacryocystorhinostomy. In vitro studies proved its inhibition effect on fibroblast growth in 0.2 mg/ml concentration. Up to date, clinical data on its efficacy remain contradictory.

Aim. To evaluate the concentration of Mitomycin-C in nasal cavity and lacrimal sac mucosa after topical application and to determine the clinical efficacy of this procedure.

Materials and methods. 30 patients with nasolacrimal duct obliteration underwent an endonasal endoscopic dacryocystorhinostomy. At the end of the surgery, at the osteotomy site, a sponge soaked in Mitomycin-C 0,2 mg/ml was applied for 3 minutes. Nasal mucosa biopsy was performed immediately after application, in 30 minutes, and at the 1st day after surgery. Biopsy material analysis of was performed by liquid chromatography – mass spectrometry. The surgical treatment efficacy was established according to proposed efficacy criteria.

Results. The analysis of Mitomicyn-C concentrations established them to be: 626 ± 176 ng/g tissue immediately after application, 230 ± 61 ng/g tissue in 30 minutes after application. In 24 hours after surgery, there was no Mitomycin-C in the tissue. Surgical efficacy was 86.7%, recurrences were found in 13.3% of cases.

Conclusion. Surgery clinical results coincide with those obtained by other researchers. But chemical investigation showed that Mitomycin-C tissue concentration was lower than that in previous in vitro studies.

Ophthalmology journal. 2017;10(1):17-22
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Confocal microscopy in ocular surface disease
Potemkin V.V., Varganova T.S., Ageeva E.V.
Abstract

Confocal microscopy is a modern clinical method, which provides in real-time mode a non-invasive possibi lity for in vivo imaging of the cornea, limbus, and conjunctiva. In several ocular surface disorders, this method could be applied for diagnostic purposes, as well as for disease monitoring and treatment efficacy evaluation. In present article, we discuss main changes observed by confocal microscopy in patients with dry eye, and propose our examination algorithm of ocular surface investigation in dry eye disease.

Ophthalmology journal. 2017;10(1):23-30
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Efficacy of leucosapphire drainage implant use in IOP-lowering surgery in patients with refractory glaucoma
Naumenko V.V., Pravosudova M.M., Kladko M.A.
Abstract

Aim. to evaluate the efficacy of leucosapphire explantodrainage implantation in IOP-lowering surgery in patients with refractory course of glaucoma.

Materials and methods. An analysis of surgical treatment results of 58 patients (60 eyes) with refractory glaucoma of different nature was performed. In 29 cases (29 eyes), at IOP-lowering procedure, a leucosapphire drainage was implanted. In 29 cases (31 eyes), standard deep sclerectomy was performed. We estimated immediate and long-term IOP-lowering and functional results of surgeries, as well as complication frequency and character. The follow-up of patients was from 1 to 8 years.

Results. In the first week after surgery, mean IOP after implantation of leucosapphire drainage decreased from 32.4 ± 0.7 to 14.8 ± 1.0 mm Hg (by Maklakov 10 g tonometry), and from 30.8 ± 0.9 to 16.4 ± 1.0 mm Hg after deep sclerectomy. After 12 months, mean IOP was 20.5 ± 0.9 mm Hg and 24.6 ± 1.2 mm Hg in patients who underwent leucosapphire drainage implantation and deep sclerectomy, respectively. By that time, IOP was stabilized in 89.6% of cases after leucosapphire drainage implantation (in 37.9% – without additional therapy) and in 61.3% (16.1% without additional therapy) – after deep sclerectomy. Perimetry data were ameliorated or stabilized in 69.0% of cases after implantation of leucosapphire drainage and in 48.3% – after deep sclerectomy.

Conclusion. The implantation of leucosapphire drainage device is an effective treatment method for patients with refractory glaucoma forms. It provides better IOP control in the late postoperative period in comparison with a traditional technique of glaucoma surgery. The frequency and character of complications were comparable in both groups.

Ophthalmology journal. 2017;10(1):31-39
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Prostaglandin analogues: past, present, and future
Astakhov Y.S., Nechiporenko P.A.
Abstract

This literature review is focused on the prostaglandin topical analogues and describes peculiarities of their structure, pharmacokinetics and pharmacodynamics, results of clinical trials and meta-analyzes, as well as modern trends in the topical IOP-lowering glaucoma therapy evolution.

Ophthalmology journal. 2017;10(1):40-52
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Modern surgical methods of ectropion treatment
Nuraeva A.B.
Abstract

This review is considering methods of ectropion surgical treatment, which are based on modern understanding of etiology and pathogenic mechanisms of this eyelid condition. Attention is driven both to monosurgical methods for mild ectropion correction and to combined methods in complicated cases. Special aspects of surgical approach to severe cicatricial ectropion are described.

Ophthalmology journal. 2017;10(1):53-61
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Infectious and sterile endophthalmitis after intravitreal injections: differential diagnosis, prevention, treatment
Astakhov Y.S., Belekhova S.G., Litvinova E.A.
Abstract

Endophthalmitis is a rare but extremely severe complication of different intraocular procedures. In the article, we analyze world literature data on prevalence, differential diagnosis, prevention methods, and treatment of endophthalmitis after intravitreal injections.

Ophthalmology journal. 2017;10(1):62-69
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Botulinum therapy in post-traumatic strabismus and diplopia treatment
Filippova O.A., Hat´kova S.E.
Abstract

In the article, a first-hand experience of paretic post-traumatic strabismus treatment using botulinum toxin type A is presented. Analysis of strabismus angle alteration and of diplopia severity has been performed.

Ophthalmology journal. 2017;10(1):70-76
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Comparison of cytotoxicity of fluoroquinolone antimicrobial eye drops and its effect on their bioavailability
Hintuba T.S., Takhtaev Y.V., Okolov I.N., Motyleva V.A., Shlyakman R.B.
Abstract

In addition to the breadth of activity of antibacterial medications as well as to their pharmacokinetic and pharmacodynamic properties, their safety and bioavailability represent an important aspect. Currently, there is no consensus on fluoroquinolone toxicity.

The aim of the present study was to compare the total cytotoxic effect on corneal epithelium and bioavailability of three antibacterial fluoroquinolone eye drops, registered in the Russian Federation: 1) Oftaquix™ (levofloxacin 5 mg/ml; preservative benzalkonium chloride (BAC) 0.05 mg/ml; produced by Santen Oy, Finland), hereafter “levofloxacin (original)”; 2) Signicef® (levofloxacin 5 mg/ml; preservative BAC 0.1 mg/ml; produced by Sentiss Pharma Pvt. Ltd., India), hereafter “levofloxacin (generic)”; 3) Vigamox® (moxifloxacin® 5 mg/ml; preservative-free; produced by Alcon Laboratories, Inc., USA) hereafter “moxifloxacin” - using in vivo methods and determining the possible effect of preservative presence (in different concentration) or of its absence on reaching the minimal threshold concentrations of the antibiotic in the anterior chamber fluid, using the high-yield liquid chromatography combined with mass-spectrometric detection. The study showed that tested antibacterial medications could exert a cytostatic effect on the corneal epithelium at in vivo conditions and differ in their cytotoxic potential. Benzalkonium chloride presence in Signicef in a concentration twice as high than that of the main medication (Oftaquix) causes a proven by confocal microscopy effect on the corneal epithelium, and this may influence the bioavailability of the medication.

Ophthalmology journal. 2017;10(1):77-86
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Ophthalmic comlications of functional endoscopic sinus surgery
Karpishchenko S.A., Beldovskaya N.Y., Baranskaya S.V., Karpov A.A.
Abstract

Functional endoscopic sinus surgery (FESS) is an effective and safe surgical technique, which revolutionized the surgical management of nasal cavity and paranasal sinus diseases. The intimate connection between paranasal sinuses and the orbit places the orbital content at a risk of injury during sinus surgery, especially that of ethmoid sinuses. The orbit, the optic nerve, extraocular muscles and the lacrimal drainage system could be damaged during FESS. The risk of injury correlates to anatomical variations, degree and severity of disease, previous procedure results, and surgical experience. Ophthalmic complications can vary in severity from minor ones, such as localized hematomas, to extremely dangerous, such as optic nerve injury, that could lead to complete blindness. In order to minimize the risk of such complications, it is necessary to consider probable anatomic variations of paranasal sinuses and orbit, which are to be detected by CT scan before surgery.

Ophthalmology journal. 2017;10(1):87-92
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Orbital lymphangioma
Potemkin V.V., Marchenko O.A., Ageeva E.V., Malakhova Y.I.
Abstract

In this article, clinical features, methods of diagnostic and treatment options of orbital lymphangioma are described.

Ophthalmology journal. 2017;10(1):93-96
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Retinal astrocytic hamartoma in tuberous sclerosis
Astakhov Y.S., Nechiporenko P.A., Atlasova L.K., Titarenko A.I., Monakhov K.N., Romanova O.L., Molodykh K.Y.
Abstract

The article describes a clinical case of long-term undiagnosed tuberous sclerosis with retinal astrocytic hamartoma. Etiology, pathogenesis, clinical and pathomorphological diagnostic criteria of tuberous sclerosis are also described.

Ophthalmology journal. 2017;10(1):97-101
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Ocular cicatricial pemphigoid
Vitaly V.P., Marchenko O.A., Ageeva E.V., Malakhova Y.I.
Abstract

In this article, pathogenesis, clinical features, as well as methods of diagnosis and treatment of ocular mucous membrane pemphigoid are described.

Ophthalmology journal. 2017;10(1):102-106
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