Vol 10, No 3 (2017)

Scleral capsule biophysical properties in the prognosis of the stabilizing effectiveness of orthokeratological myopia correction
Tarutta Y.P., Iomdina Y.N., Toloraya R.R., Kruzhkova G.V.

Purpose: determine the impact of biophysical properties of the scleral capsule on the stabilizing effect of orthokeratological correction in progressive myopia.

Material and methods. In 57 patients (114 eyes) aged 8-18 (average age 12.5 ± 0.6 years) with myopia from 1.0 to 7.0 D, acoustic scleral density (ASD) was tested. All patients used (during different terms) orthokeratological (OK) lenses Contex – OKE-System during the night time. To measure ASD (in conventional units) we used digital analysis of ultrasound tissue histograms obtained with a multifunctional ultrasound diagnostic device Voluson 730 Pro (Kretztechnik AG) with a linear frequency sensor of 10 to 16 mHz. ASD was measured in the posterior pole and in the superior temporal quadrant of the equatorial zone. The anteroposterior axis (APA) was measured by ultrasound biometry using an ultrasound device A/B Scan System Model 837 (Allergan Humphrey, USA). Myopia progression was found in 18 eyes of 9 patients with APA increase over 0.1 mm in 6 months, i. e. in 15.5% of cases, while the remaining 48 patients (96 eyes) showed no myopia progression over the follow-up period.

Results. APA was less in eyes with progressive myopia as compared to those with stabilized myopia, both in the equatorial and the posterior pole zones. In progressive myopia, mean APA was 213 ± 3.6 units in the posterior pole and 208 ± 2.19 units in the equatorial zone. In cases of stable myopia, APA was 2.1% higher in the posterior pole area (217 ± 1.3 units) and 1.86% higher in the equatorial area (212 ± 1.4 units). On average, APA in stable myopia was 4 ± 2.0 units higher than in progressive myopia (р < 0.05).

Conclusion. The APA parameter could serve as a prognostic criterion for the myopia course by OK-correction, and as an indicator for choosing treatment tactics.

Ophthalmology Journal. 2017;10(3):6-11
The concept of the foveola anatomical reconstruction in the surgical treatment of full-thickness macular tears using intraoperative OCT control
Bayborodov J.V.

Background. The concept of foveola anatomical reconstruction in surgical treatment of macular holes is a minimally invasive approach based on sparing principles of visualization and removal of transparent structures.

Purpose. To estimate the practical value of high-resolution intraoperative OCT control (IOСT) at surgical treatment of macular holes.

Materials and methods. The study included 95 patients (95 eyes) with macular holes from 400 to 900 microns in diameter, being during the period from September 2015 to October 2016.

Results. IOСT control increases the anatomical and functional success of macular hole surgery, allowing determining more accurately the vitreomacular interface anatomical structures during the procedure and making more precise choice of tamponade agent to the end of it.

Conclusion. The proposed foveola anatomical reconstruction in surgical treatment of full-thickness macular holes enhanced by intraoperative OCT control provides high functional and anatomic postoperative retinal indices.

Ophthalmology Journal. 2017;10(3):12-17
Objective anterior chamber angle evaluation of healthy eyes with optical coherence tomography
Arkhipova A.N., Turkina K.I.

A quantitative assessment of the anterior chamber angle in its various segments was performed using optical coherence tomography. 96 eyes of healthy volunteers were assessed, divided into groups based on gender, age, and refraction. It was shown that the anterior chamber angle width has natural variability in different segments, tends to decrease with increasing age, and depends on refractive characteristics.

Ophthalmology Journal. 2017;10(3):18-21
The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period
Berdieva N.N., Shapovalova E.V., Riks I.A.

Introduction. Until the 2000s, in diseases leading to corneal blindness, it was expediently to perform subtotal keratoplasty in order to provide an organ-sparing effect and restore visual functions. Such procedures were not widely spread due to a great number of problems; they were performed with extended depressurization of the eye, and had a high risk of intraoperative complications. Nowadays, many ophthalmologists face the remote consequences of subtotal keratoplasty.

Aim. The purpose is to evaluate the transplant after subtotal penetrating keratoplasty (SPK) and visual functions in the remote postoperative period.

Materials and methods. We have examined 14 patients (14 eyes), aged from 28 to 81 years, at 6-10 years after SPK. Visual acuity (VA) testing, autorefractometry and confocal microscopy (Confoscan 4) were performed.

Results. According to visual acuity testing results, patients were divided into 3 groups: 1st group with high VA (more than 0.2 – in 7.2% of patients), 2nd group with medium VA (from 0.2 to 0.005 – in 21.4% of patients), and 3rd – low VA (less than 0.005 – in 71.4% of patients). Before the SKP, VA was 0.004-0.7. After the SKP, the indices varied from light sensation with correct light projection to 1.0. High rate was in 21.5%, medium – in 35.7%, low in 42.8% of cases. According to autorefractometry data, the cylindrical component was in average 6.5 ± 3.0. Most often, astigmatism was revealed in the low (up to 3) and high degree (more than 6). According to confocal microscopy data, the average density of endothelial cells was 1700 ± 50 cells/mm2.

Conclusion. More than a half of patients has preserved good visual functions and a transparent transplant at 6-10 years after the SKP, and this significantly improves the quality of patients´ life.

Ophthalmology Journal. 2017;10(3):22-28
The influence of phacoemulsification on various corneal layers in patients with pseudoexfoliation syndrome assessed with confocal in vivo microscopy
Potemkin V.V., Varganova T.S., Terekhova I.V., Ageeva E.V.

Phacoemulsification (PHACO) is the basic procedure of cataract extraction.

Purpose. To assess the impact of PHACO on corneal epithelium layers in patients with pseudoexfoliation syndrome (PEX) by confocal in vivo microscopy.

Methods. 24 patients with PEX syndrome and 18 patients without it were enrolled in the prospective study. In vivo confocal microscopy was performed with assessment of cellular density in corneal epithelial layers, degree of its desquamation, degree of Bowman membrane stiffening and dendritic cells density.

Results. The epithelial cells density didn’t change significantly in groups. Confocal microscopy showed high density of dendritic cells and marked desquamation of the epithelium in patients with PEX (p < 0,05) after PHACO.

Ophthalmology Journal. 2017;10(3):29-34
Radiation methods of tear pathways pathology diagnosis
Lyubavska V., Beldovskaya N.Y., Novikov S.A., Zubareva A.A., Shavgulidze M.A.

A review of the literature is presented concerning radiological methods of lacrimal pathways’ pathology diagnosis, paying attention not only to specific features of each method, but also to characteristics of contrast agents used in lacrimal pathways’ and oto-rhyno-laryngologic diseases diagnosis.

Ophthalmology Journal. 2017;10(3):35-45
Novel clinico-morphological classification of the corneal endothelial-epithelial dystrophy
Riks I.A., Papanyan S.S., Astakhov S.Y., Novikov S.A.

The article reviews the literature on the classification of endothelial-epithelial dystrophy (EED) of the cornea. The description of endothelial structure, etiology and pathogenesis of the corneal EED are described. Based on own multiple observations and modern methods of corneal tissue imaging, a new modification of the EED classification by V.V. Volkov and M.M. Dronov was created and is presented in the article. This classification makes it possible to more accurately determine the etiopathogenesis of changes in corneal layers and to choose a most rational and effective treatment method.

Ophthalmology Journal. 2017;10(3):46-52
A new method for treatment severe forms of dry keratoconjunctivitis (preliminary results)
Safonova T.N., Gladkova O.V., Novikov I.A., Boev V.I.

The aim is to improve the treatment method of severe keratoconjunctivitis sicca (KCS) forms using designed soft contact lenses (SCL).

Material and methods. An original SCL of silicone hydrogel material with individual optical power, consisting of a non-through depot filled with 0.05% Cyclosporin A (CyA) was designed. The therapeutic CyA saturated SCL was used in 5 patients (1 male and 4 females; 7 eyes) aged from 34 to 66 years, with severe KCS, who were constantly wearing them for 7-14 days. Patients additionally instilled hyaluronic acid containing non-preserved artificial tears up to 6 times a day. Standard ophthalmic examination, Schirmer test, tear break-up-time test, tests using vital dyes (assessed using the Oxford scale), tear osmolarity measurements (TearLab System, USA), tear pH measurement by a highly sensitive litmus test, conjunctival culture, measurement of the interpalpebral fissure width were carried out, the ocular surface disease index (OSDI) was determined. Treatment results were assessed in 1 week, 1 month, and 3 months since the SCL wear start.

Results. The use of therapeutic CyA saturated SCL allows to achieve complete corneal epithelization, and helps to reduce inflammation within the time from 1 week up to 1 month, significantly reducing the treatment timeframe of severe forms of KSC in comparison to standard therapy.

Conclusion.The developed treatment method for severe forms of the KCS consists in using specifically designed therapeutic SCL which provides an even CyA 0.05% release on the ocular surface, while instilling non-preserved artificial tears. Preliminary results show a high efficacy of this method in terms of reducing corneal epithelization time up to 1 week-1 month and resolving inflammation on the ocular surface.

Ophthalmology Journal. 2017;10(3):53-59
Experience in the Cationorm® use in the treatment of dry eye syndrome in patients after adenoviral keratoconjunctivitis
Sokolov V.O., Morozova N.V., Polovinkina G.V., Borisova M.L., Zvontsova I.N., Gasymzade L.M., Kulikova Y.A., Shtupun D.R., Batynkova O.S.

The dry eye syndrome ranges among widespread and persisting ophthalmic diseases. It is also called a disease of civilization. Among the causes particularly often leading to the dry eye syndrome adenoviral infection has to be listed. Over the last years, in Saint Petersburg, an increasing incidence rate of the epidemic adenoviral keratoconjunctivitis is noted, which is proceeding in severe membranous and infiltrative forms, involving the cornea. Occurring therewith secondary dry eye syndrome demands using effective medications. In the article, the experience in Cationorm® (Santen, Japan) clinical use for secondary dry eye syndrome treatment is disclosed.

Ophthalmology Journal. 2017;10(3):61-66
Our experience in visual functions' improvement in patiens with “wet” age-related macular degeneration at switching from one anti-VEGF agent to another
Korotkikh S.A., Bobykin E.V.

Purpose. To assess mean changes in visual acuity, central retinal thickness and macular volume as well as to determine the duration of clinical choroidal neovascularization inactivity after single aflibercept injection in neovascular age-related macular degeneration (nAMD) patients switched from ranibizumab (preliminary date). Methods. Open-label prospective study. The study enrolled 23 patients with nAMD previously treated with ranibizumab.

Results. Mean age of patients was 70.5 years, 16 were women. Mean number of ranibizumab injections given prior to switching to aflibercept was 8.7. After single aflibercept inravitreal injection mean visual acuity has significantly improved from 0.40 to 0.47 Snellen chart. Mean central retinal thickness has significantly reduced from 323.1 to 246.9 μm and mean macular volume has significantly reduced from 7.71 to 6.74 mm3. Duration of choroidal neovascularization (CNV) inactivity was 2.91 months.

Conclusion. Single aflibercept intravitreal injection has resulted in significant visual gain as well as in significant central retinal thickness (CRT) and macular volume reduction. This provides evidence of aflibecept efficacy in nAMD patients previously treated with anti-VEGF. Duration of CNV inactivity provides clinical data supporting aflibercept injection every 8 weeks in nAMD patients.

Ophthalmology Journal. 2017;10(3):67-73
A case of isolated intraocular recurrence of acute lymphoblastic leukemia
Chistyakova N.V., Shadrichev F.E., Kuznetsova T.I.

The development of diagnostic and therapeutic capabilities in hematology contributed to a growth in survival rate in patients with acute leukemia and to the increase in number of different ocular conditions as rare signs of hemoblastosis recurrence and treatment’s side effects. We observed a female patient with extramedullar leukemic ocular damage in acute lymphoblastic leukemia. It is noteworthy that the process of ocular involvement into the underlying disease occurred on the background of complete confirmed hematologic remission.

Ophthalmology Journal. 2017;10(3):74-84
Combination of congenital optic never coloboma in one eye and congenital choroidal coloboma in the fellow eye
Simakova I.L., Kirillov Y.A., Sosnovskiy S.V., Tikhonovskay I.A., Kharakozov A.S., Nikolaenko E.N.

The article presents an interesting and fairly rare clinical case of congenital posterior segment anomaly of both eyes manifesting itself by coloboma of the optic nerve head in the right eye and choroidal coloboma in the left eye. For the first time, this pathology was diagnosed in our female patient at the age of 48.

Ophthalmology Journal. 2017;10(3):85-90
Professor E.E. Andresen 125th anniversary
Astakhov Y.S., Reituzov V.A., Orudzhova A.B., Angelopoulo G.V., Beldovskaya N.Y.

The article is dedicated to the 125th anniversary of Professor E.E. Andrezen’s birth. Authors describe his life’s journey, scientific and pedagogic activities.

Ophthalmology Journal. 2017;10(3):91-95

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