Vol 12, No 2 (2019)

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.

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.

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.

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.

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.

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.

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.