Vol 8, No 4 (2015)

Articles
The choice of treatment for macular edema following retinal vein occlusion
Moshetova L.K., Tsikhonchuk T.V., Turkina K.I., Ignat'ev S.A.

Abstract

A clinical efficacy assessment was performed for the therapy of post-occlusive cystoid macular edema using intravitreal anti-VEGF-ranibizumab injections at short and remote terms from the disease onset. It has been shown that ranibizumab intravitreal injections in retinal vein occlusion allow to increase visual acuity and to reduce retinal edema, and thus rehabilitate patients in maximally short terms. Intravitreal injections of vascular endothelial growth factor inhibitors at short terms from the disease onset allow achieving stabilization of the pathological process with preservation or improvement of visual functions, while reducing the number of repeated intravitreal injections.
Ophthalmology journal. 2015;8(4):5-15
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Modified method of ostium intubation after endonasal endoscopic dacryocystorhinostomy
At’kova E.L., Krakhovetskiy V.D., Yartsev N.N.

Abstract

Introduction. The use of bicanalicular lacrimal implants designed to prevent ostium scarring after endonasal endoscopic dacryocystorhinostomy (EEDCR) may cause a number of complications. The use of Monoka monocanalicular implants (FCI, France) after EEDCR is not covered in the Russian scientific literature at all. Methods. 61 EEDCRs were performed in 56 patients with lacrimal pathway (LP) obstruction at the level of lacrimal sac cervix. In 29 cases, a new method of ostium intubation with two Monoka monocanalicular lacrimal implants (FCI, France) (that was proposed by the authors) was applied (group 1). In the remaining 32 cases, Bika bicanalicular implants (FCI, France) were used (group 2). Besides routine dacryological assessment, all patients underwent multislice computed tomography (MSCT), in which was LP were contrast-enhanced according to an original technique. Before being enrolled in either group, patients were standardized according to proposed criteria, which were based on the MSCT ones. LP extubation was performed 3 months after surgery. The follow-up period was 12 months. The following parameters were evaluated: subjective epiphora (Munk’s scale), dye test results, LP patency (irrigation test), and the shape of the ostium (nasal endoscopy). Results. Judging from the results of a comprehensive examination; favorable outcomes were achieved in 89.7% (26 cases) of patients from group 1, and in 90.6% (29 cases) of patients from group 2. In group 2, a number of complications were observed: lacrimal implant dislocation (3 cases, 9.4%), corneal epitheliopathy (2 cases, 6.2%), toxic allergic conjunctivitis (2 cases, 6.2%), lacrimal canaliculi dissection (1 case, 3.1%), lacrimal point ectopy (1 case, 3.1%), granulations within lacrimal canaliculi (1 case, 3.1%), and pterygium progression (1 case, 3.1%). In group 1, neither of the above mentioned complications occurred. Conclusion. For ostium intubation after EEDCR, with two Monoka monocanalicular lacrimal implants (FCI, France) passed through both the upper and lower lacrimal canaliculi is preferable in comparison with bicanalicular intubation using «Bika» (FCI, France).
Ophthalmology journal. 2015;8(4):16-23
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Results of intraocular foreign body removal from the posterior segment by direct approach
Nikolaenko V.P., Kataeva M.V.

Abstract

Objective: to evaluate early and remote complication of intraocular foreign body (FB) removal by direct approach, and to determine indications for splinter removal through the wound. Material and methods. Case history analysis was performed in 31 patients with missile eye injuries. In all patients, FB was removed by direct approach at initial surgical debridement. Results. Foreign body penetration was accompanied with injuries of different eye segments, which were manifested by vitreous hemorrhage, hyphema, subretinal hemorrhage, retinal detachment, traumatic cataract. In 12 patients, there was a need in additional surgical treatment consisting in retinal laser barrage, vitrectomy, cataract extraction. As a result of treatment, visual acuity increased in 58.06% of injured. At the remote post-op period, retinal detachment developed in 16.13% cases, and vitreoretinal procedures were performed. Conclusions. Intraocular foreign body removal from the posterior eye segment using direct approach is appropriate if the FB is in the wound or in its immediate proximity. Most serious complications of missile injury are proliferative vitreoretinopathy and retinal detachment, demanding vitreoretinal surgery.
Ophthalmology journal. 2015;8(4):24-29
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The role of genetically determined factors in age-related macular degeneration pathogenesis
Belekhova S.G., Astakhov Y.S.

Abstract

The article presents a review of studies dedicated to the role of genetic factors in age-related macular degeneration (AMD) pathogenesis. The polymorphisms of Y402H gene of the complement factor Н, HTRA1, ARMS2/LOC387715, and PLEKHA1 increase the risk of AMD development. More detailed description is done also for other genes, involved into this disease, which were identified so far. Possible schemes of influence of mutations in these genes on AMD development and progression
Ophthalmology journal. 2015;8(4):30-39
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Neurovascular conflict in oculomotor imbalance
Totolyan N.A., Kechek G.A., Totolyan A.A., Rubtsova I.V.

Abstract

This article, based on the data of Russian and foreign literature, considers modern approaches to the understanding of neurovascular conflict (NVC) term, different causes of its development and realization mechanisms; statistical data are presented on its occurrence in different medical specialties; modern approaches to early diagnosis of neurovascular conflicts are covered. Special attention is drawn to oculomotor imbalances being one of neurovascular conflict manifestations. Based on global experience, approaches to most exact and early diagnosis are described, differences in notion terminology of neurovascular contact and neurovascular conflict are shown. As most effective method for NVC diagnosis, the use of neurovisualization method, that is high-resolution magnetic resonance imaging (MRI) (high field MRI), is positioned.
Ophthalmology journal. 2015;8(4):40-47
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Vitrum Vision Forte therapy effect in patients with accommodative asthenopia
Astakhov Y.S., Lisochkina A.B., Nechiporenko P.A., Titarenko A.I.

Abstract

The article presents the results of observational study of Vitrum Vision Forte efficacy in patients with accommodative asthenopia. The changes in asthenopic complaints, Mesotest and computer accomodography data were measured. A decrease in asthenopic complaints’ incidence and severity, a statistically significant increase in mesopic vision and glare sensitivity, a statistically significant reduction in ciliary muscle microfluctuations and accommodative response stability increase were observed.
Ophthalmology journal. 2015;8(4):48-53
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The role of antimicrobial drops Okomistin® in combined chronic blepharoconjunctivitis treatment
Makarov I.A.

Abstract

Purpose. The evaluation of antimicrobial drops Okomistin® efficacy in combined treatment of chronic blepharoconjunctivitis. Material and methods. 80 patients (160 eyes) with chronic blepharoconjunctivitis were monitored. Demodex acne was found in eyelids of 72 eyes, the growth of saprophytic microflora in 28 cases. The complex of treatment and prevention measures consisted of daily compresses of Сalendula aqueous solution, instillations of Okomistin® eye drops, artificial tears. In the research group, the ultrasound eyelid margin micromassage was performed, and eyelid D’Arsonval therapy in demodex acne cases. Results. More rapid acute illness relief was observed in the eyes of patients in whom physiotherapy treatment was performed. Okomistin® instillations allow achieving sterile conjunctival culture in 3-5 days. Combined therapy helps to restore meibomian gland function, to achieve long-term disease remission. Conclusions. Combined use of the Okomistin®, physiotherapy, hygiene procedures, artificial tears is an effective and safe treatment method for chronic blepharoconjunctivitis combined treatment.
Ophthalmology journal. 2015;8(4):55-60
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Central retinal vein occlusion in a patient with HIV-associated thrombocytopenia
Tultseva S.N., Astakhov Y.S., Nechiporenko P.A., Titarenko A.I.

Abstract

This article describes the case of a rare HIV complication of the central retinal vein occlusion (RVO), which occurred on the background of HIV-associated thrombocytopenia. Therapy of post-RVO macular edema in this case included intravitreal injections of Ozurdex combined with general antiretroviral drugs and systemic corticosteroid use. Significant visual function improvement and stabilization of the process were achieved in 15 months in spite of the delayed treatment start (three months after the disease onset) and patient’s resistance to previous therapy. Three intravitreal injections of Ozurdex were performed, intervals between injections being from 5 to 6 months.
Ophthalmology journal. 2015;8(4):61-69
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A case of cosmetic rehabilitation after eyeball destruction (case report)
Pysin A.Y., Kulikov A.N., Sosnovskiy S.V., Shamrey D.V.

Abstract

This case report describes a successful cosmetic rehabilitation of a patient after very severe open globe injury (received by an oscillating saw). At primary surgical procedure (PSP), an eyeball destruction was diagnosed, and therefore, PSP has been completed with evisceration. To optimal cosmetic rehabilitation of patient, silicone oil-filled (silicon oil viscosity - 1300 cSt) mobile stump was created. No postoperative infectious complications were observed. Successful cosmetic rehabilitation (aesthetic factor was 82.6 %) was achieved after the selection of individual thin-walled ocular prosthesis. Evisceration followed by creation of silicon-filled stump at PSP provides successful cosmetic rehabilitation indices after eyeball destruction.
Ophthalmology journal. 2015;8(4):70-74
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Two aspects of one problem (results of questionnaire analysis in glaucoma patients)
Podyninogina V.V., Bagaev V.I., Chuprov A.D.

Abstract

The purpose of the study was to investigate the compliance of ophthalmologists and glaucoma patients using questionnaires for patients. Materials and methods: Questionnaires were applied to 72 glaucoma patients. The age range was between 47 and 76 years. All the patients were asked to answer anonymously a number of questions about their disease and treatment. Results and discussion: Problems of interaction and mutual understanding of ophthalmologists and glaucoma patients were revealed. On the one hand, ophthalmologists do not clearly and precisely explain to patients the importance of monitoring and treatment for glaucoma being a chronic disease. On the other hand, patients demonstrate carelessness regarding their health. Conclusion: Our goal was to help glaucoma patients to completely realize their problems, to incline them for treatment and to persuade them that they can cope with their problems only by cooperation of ophthalmologists and patients.
Ophthalmology journal. 2015;8(4):76-80
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