Vol 12, No 2 (2019)

Original researches

On functional results of treatment of recurrent rhegmatogenous retinal detachment after multiple endovitreal interventions

Shchukin A.D.


The present report is an extension of the study, in which on a large clinical material, the ratio of procedures used at this time for retinal detachment was shown, and the frequency of relapses after extrascleral and endovitreal surgeries was analyzed.

The purpose of the study is to determine the terms of relapse occurrence, and to estimate visual function after multiple endovitreal procedures.

Materials and methods. The study was carried out in the Ophthalmological Center of the City Hospital No. 2 of St. Petersburg. The data of 116 case histories of 23 patients (28 eyes) repeatedly admitted to the department of vitreoretinal surgery of the center and operated (2 to 7 times) for recurrent rhematogenous retinal detachment in 2015-2016 were analyzed.

Results. Multistage endovitreal surgery in patients with recurrent retinal detachment in most cases (78.6%) leads to significant decrease of visual functions; in incomplete retinal adherence in the lower segments after extrascleral surgery, additional scleral buckling or barrier laser retinal photocoagulation can be used.

Ophthalmology Reports. 2019;12(2):5-10
pages 5-10 views

Expansion of trinucleotide CTG repeats in the TCF4 gene as a marker of fuchs’ endothelial corneal dystrophy

Papanyan S.S., Astakhov S.Y., Nazarov V.D., Lapin S.V., Novikov S.A., Riks I.A., Anikina L.K., Dovydenko K.S.


Fuchs’ endothelial corneal dystrophy (FECD) is an inherited severe and progressive disease, characte­rized by endothelial cell density decrease and increasing corneal edema. FECD development may be linked to expanded trinucleotide repeat, CTG, in the third intron of the TCF4 gene. The study focuses on estimating the prevalence of expanded CTG repeat in TCF4 gene in the Russian population, in patients with normal cornea and in patients with FECD (by applying triplet repeat PCR technique and capillary electrophoresis). 51 patients with FECD and 38 patients with normal cornea were examined. The estimation of the number of CTG triplet repeats in TCF4 gene determination is the veracious laboratory marker of FECD.

Ophthalmology Reports. 2019;12(2):11-18
pages 11-18 views

“Anti-glaucoma implant A3”: surgical technique and the long term follow-up results

Grineva M.K., Astakhov S.Y.


The goal of our work was to study the safety profile and effectiveness of a domestically manufactured shunting device for the treatment of advanced stage primary open-angle glaucoma. This article describes the surgical technique of “Anti-Glaucoma Implant A3” implantation, as well as long term follow-up results obtained from 19 patients (20 eyes).

Materials and methods. The devices were implanted in 19 patients (20 eyes) with advanced stage primary open-angle glaucoma. The diagnosis was made based on collected medical history, results of objective and instrumental test findings. All patients included in the study underwent a standard ophthalmologic examination, including: automatic refractometry, best-corrected visual acuity (BCVA) assessment, automated static perimetry, biomicroscopy of the anterior segment, indirect ophthalmoscopy with an aspheric lens, gonioscopy. Optical coherence tomography (OCT) was used to assess retinal nerve fiber layer (RNFL) thickness.

Conclusion. Intraocular pressure (IOP) lowering surgical procedures using an anti-glaucoma shunting device are non-inferior by their effectiveness to trabeculectomy, and have lower complication rate.

Ophthalmology Reports. 2019;12(2):19-24
pages 19-24 views

Clinical efficacy of cryodestruction in benign ocular adnexa tumors

Steblyuk A.N., Gunter V.E., Bodnya V.N., Molokova O.A., Marchenko E.S., Tserkovnaya A.A.


The aim – to evaluate the functional state of ocular adnexa and of the eyeball after cryodestruction of benign eyelid and conjunctiva tumors using modern cryosurgical equipment.

Materials and methods. Into the study, 87 patients (87 eyes) were included with eyelid and conjunctiva benign tumors after cryosurgical treatment of atheroma, cyst, papilloma, nevus, granuloma, xanthelasma using an autonomous cryoapplicator of porous permeable titanium nickelide.

Results and conclusions. The study showed a high efficacy of cryogenic treatment method using an autonomous cryoapplicator of porous permeable titanium nickelide. Depending on dimensions of the lesion, exposure duration, and the number of repeated applications at the session, the recovery occurred within 1–2 months without functional defect and healthy tissue injury.

Ophthalmology Reports. 2019;12(2):25-32
pages 25-32 views

Optical coherence tomogrpaphy in differential diagnosis of retinal arteriolar macroaneurysms

Kulikov A.N., Maltsev D.S., Burnasheva M.A., Kazak A.A.


Aim. To study the prevalence and topographical distribution of retinal exudation in eyes with retinal arteriolar macroaneurysms (RAM) and in those with macular branch retinal vein occlusions (mBRVO).

Methods. The prevalence of optical coherence tomography (OCT) signs (different types of retinal hemorrhages and accumulation of fluid as well as hard and soft exudates) was evaluated in 28 eyes with RAM (22 males, 6 females, mean age 66.0 ± 9.9 years) versus 17 eyes with mBRVO (9 males, 7 females, mean age 56.9 ± 10.5 years). Topographical distribution of retinal exudation on OCT retinal maps was evaluated in 7 RAM eyes (6 males, 1 female, mean age 66.0 ± 11.7 years) and 8 mBRVO eyes (5 males, 3 females, mean age 60.1 ± 19.2 years). The measures were 1) position of the point of the maximum retinal thickness in relation to the macular center and RAM, 2) difference between maximum retinal thickness in the macular center and that at the site of RAM localization (surrogate control point in mBRVO eyes).

Results. Soft exudates and intraretinal fluid accumulation were mostly associated with mBRVO (p = 0.007 and p < 0.001, respectively), while hard exudates were found almost exclusively in RAM eyes (p < 0.001). Central retinal thickness in RAM eyes was lower than that of mBRVO eyes, 453.1 ± 148.6 μm and 797.5 ± 179.6 μm, respectively (p = 0.001). The point of maximum retinal thickness was found at the site of RAM localization in 8 out of 9 RAM cases (88.9%), and within the central subfield in 8 out of 8 mBRVO cases (100%). The difference between maximum retinal thickness in the macular center and at the site of RAM localization (surrogate control point in mBRVO eyes) was –77.9 ± 174.1 μm and 148.3 ± 100.4 μm for RAM and mBRVO eyes, respectively (p < 0.001).

Conclusions. Evaluation of exudative signs and their topographic distribution based on OCT data may be used for differential diagnosis and laser treatment planning in RAM.

Ophthalmology Reports. 2019;12(2):33-40
pages 33-40 views

The role of self-dependent tonometry in improving diagnostics and treatment of patients with open angle glaucoma

Astakhov S.Y., Farikova E.E., Konoplianik K.A.


Monitoring intraocular pressure in patients with open-angle glaucoma at different stages of the deve­lopment of the disease using self-measurement by a portable Icare® HOME tonometer. In study, patients were divided into 3 groups depending on the treatment prescribed. With the help of near-day monitoring, hidden IOP elevations that are not recorded during a single IOP measurement on an outpatient appointment with a doctor were detected. Perspective possibilities of prescribing drugs and regulating the mode of instillation on the basis of individual time periods of increasing intraocular pressure on the example of one of the patient. Assessment of the convenience of the method from the personal experience of using the device by patients.

Ophthalmology Reports. 2019;12(2):41-46
pages 41-46 views


Dosing regimens of angiogenesis inhibitors in the treatment of neovascular age-related macular degeneration patients

Astakhov Y.S., Nechiporenko P.A.


The literature review compares the data on different dosing regimens of angiogenesis inhibitors in the treatment of neovascular age-related macular degeneration patients. Clinical approaches to the repeated intravitreal angiogenesis inhibitors dosing are described, the results of key clinical trials on the effectiveness of various drugs used in different dosing regimens are presented, positive and negative aspects of each of discussed treatment regimens are specified.

Ophthalmology Reports. 2019;12(2):47-56
pages 47-56 views

Ophthalmic manifestations of cytomegalovirus infection in HIV (literature review)

Zumbulidze N.G., Sizova T.D., Khokkanen V.M.


Cytomegalovirus (CMV) contamination is very common: in several countries, the number of seropositive people reaches 90% among the adult population. It is a latent infection able to affect any human organs and tissues that assumes special importance in severe immunosuppression cases. Cytomegalovirus retinitis is a disabling disease, and often leads to blindness. The article deals with some issues of epidemiology, clinical course, clinical presentation characteristics of cytomegalovirus eye disease in the context of HIV-infection. A special attention is given to detection methods, problems of diagnosis against the background of immune reconstruction syndrome, treatment approaches in clinical practice, and existing recommendations.

Ophthalmology Reports. 2019;12(2):57-64
pages 57-64 views

Case reports

Astrocytoma of the optic nerve head

Goltsman E.V., Potyomkin V.V., Astakhov Y.S., Marchenko O.A., Antonov V.A., Kel’ina A.E.


In this article, a clinical case of astrocytoma of optic nerve head in patient with neurofibromatosis type 1 is presented. The main feature of this clinical case is a difficulty in differential diagnosis with amelanotic choroidal melanoma.

Ophthalmology Reports. 2019;12(2):73-79
pages 73-79 views

New opportunities for the use of miniscleral contact lenses

Fedotova K., Grabovetsky V.R., Novikov S.A., Akopov E.L.


This case report demonstrates a new possibility of using rigid gas permeable miniscleral contact lenses as a device for performing Nd:YAG laser capsulotomy in patients with corneal irregularity. A correctly formed optical surface with a lens on the eye eliminates optical errors of the distorted cornea, and can be a useful tool for the optimization of aiming laser beam directing and focusing.

Ophthalmology Reports. 2019;12(2):81-84
pages 81-84 views

Scleral IOL fixation using limbal mini-pockets: description of the method and clinical cases

Potemkin V.V., Goltsman E.V., Yarovoy D.A., Van S.Y.


The search for new techniques of fixation intraocular lenses (IOL) cases of its dislocation or inadequate capsular support continues to be an actual problem. The most physiological is the IOL position in the posterior chamber. In this article, a new method for scleral IOL fixation using limbal mini-pockets proposed by the authors will be presented.

Ophthalmology Reports. 2019;12(2):85-90
pages 85-90 views


Vitrocap efficacy in patients with the vitreous body destruction

Varganova T.S., Veryasova A.G., Erysheva E.D.


The vitreous body destruction (VBD) is one of the most common conditions bringing patients to visit an ophthalmologist. The absence of the effective treatment of VBD today worries both doctors themselves and their patients. Since 2014, “Vitrocap” (Ebiga-VISION, Germany) has been registered in the Russian Federation, its components of which prevent the biochemical and anatomical vitreous body structure changes by a natural way.

Objective: to evaluate the clinical efficacy of Vitrocap in patients with VBD, as well as to analyze the psychological characteristics of individuals complaining of “floaters”.

Material and methods. The study included 32 patients in total, 16 of which (5 men and 11 women aged from 37 to 57 years) comprised the main group of individuals complaining of “floa­ters”. The patients in this group received active treatment using Vitrocap according to the licensed posology. The control group included patients with the vitreous body floaters confirmed by B-scan, but without active complaints. All patients underwent standard echography (A-, B-scan) using the Tomey UD-8000 device with a 15 MHZ frequency sensor before and after treatment. In addition, voluntary anonymous survey was performed in both groups using “Minnesota Multiphase Personality Test” (MMPI).

The results of the study showed that after the Vitrocap course patients reported a reduction or absence of “floaters” complaints in 76% of cases, and according to A-scan characteristics (the number and height of echogenicity peaks) there were quantitative and qualitative improvements in 32% and 80% of cases, correspondingly. According to MMPI test results, the patients in the main group had an increased need for the doctor’s emotional involvement in the process of eliminating visual discomfort. In such cases, the very fact of prescribing therapy caused a beneficial effect on the patient’s emotional state. Thus, we have found Vitrocap treatment to improve both subjective and objective status in patients with VBD.

Ophthalmology Reports. 2019;12(2):67-72
pages 67-72 views

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