Ophthalmology Reports

BACKGROUND: Data on the effect of changes in retinal perfusion on retinal functional recovery at surgical treatment of full-thickness macular holes are limited.

AIM: To investigate the effect of changes in retinal perfusion on postoperative recovery of fovea function in full-thickness macular holes.

MATERIALS AND METHODS: A prospective study included data of 93 patients (93 eyes) with full-thickness macular holes. Optical coherence tomography-angiography (OCT-A), visual acuity testing, microperimetry, and multifocal electroretinography were performed before surgical treatment, after 1 and 6 months. We studied the relationship between changes in foveal avascular zone area, vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) with changes in best corrected visual acuity (BCVA), retinal sensitivity (RS) at the fixation point and P1 amplitude in the fovea at different periods after treatment.

RESULTS: After surgical hole closure, a significant decrease in foveal avascular zone area, increase in vascular density in SCP and DCP was found within 1 month after treatment (p < 0.001). Significant increase in BCVA, RS and P1 amplitude was observed 1 and 6 months after hole closure (p < 0.001). The most pronounced correlation was found in the long-term postoperative period between the change in vessel density in the SCP and the change in BCVA, RS and P1 amplitude (r = 0.42, r = 0.26 and r = 0.3, p < 0.05), as well as between the change in vessel density in the DCP and the change in BCVA, RS and P1 amplitude (r = 0.41, r = 0.34 and r = 0.43, p < 0.05).

CONCLUSIONS: In the treatment of patients with full-thickness macular holes, there is a significant relationship between changes in retinal perfusion and the recovery of visual acuity, retinal sensitivity and bioelectrical activity in the foveal area, and it is more pronounced in the period from 1 to 6 months after macular hole closure. The obtained results suggest a possible prognostic role of OCTA results in the surgical treatment of full-thickness macular holes.

BACKGROUND: Glaucoma remains one of the leading causes of irreversible vision loss worldwide, due to the steadily increasing incidence with age. In recent years, minimally invasive glaucoma surgery combined with cataract extraction has gained significant popularity as an alternative to traditional filtering surgeries. Among the methods of hypotensive action included in the minimally invasive glaucoma surgery concept, endoscopic laser cyclodestruction plays a special role, allowing for effective reduction of aqueous humor production.

AIM: The aim of this study is to determine the optimal conditions for achieving maximum efficiency and safety of endoscopic laser cyclodestruction.

MATERIALS AND METHODS: The present study analyzed the results of 110 combined procedures (phacoemulsification and endoscopic laser cyclodestruction) performed in our clinic. The study included 110 patients (56 men and 54 women) aged from 56 to 89 years (mean age 73.7 years) diagnosed with stage I–IV glaucoma and initial complicated cataract. All patients underwent anterior endoscopic laser cyclodestruction using the E2 videoendoscopic laser ophthalmic device (Endo Optiks Inc., USA) after phacoemulsification and intraocular lens implantation. Dynamic follow-up included visual acuity testing, perimetry, tonometry, instillation regimen assessment, anterior segment OCT, and registration of complications over 60 months.

RESULTS: The data analysis showed no hemorrhagic complications and significant inflammatory reactions in the vast majority of patients. The average dynamics of intraocular pressure reduction over 60 months was 24.6%, indicating the high efficacy of endoscopic laser cyclodestruction in intraocular pressure lowering and in stabilizing the condition in glaucoma patients.

CONCLUSIONS: Endoscopic laser cyclodestruction demonstrates high efficacy and safety, with virtually no contraindications, except in cases of technical difficulties. The optimal efficiency of the procedure is achieved by destructing the ciliary body processes over 180–200°, significantly reducing intraocular pressure and decreasing dependence on hypotensive therapy.

BACKGROUND: One of the leading causes of central vision loss in patients with diabetic retinopathy is ischemic maculopathy, the incidence of which in diabetic retinopathy varies depending on the stage of the disease from 20 to 77% according to fluorescein angiography results. More accurate diagnosis of ischemic maculopathy is possible using the technique of optical coherence tomography angiography (OCTA).

AIM: To study the prevalence and severity of ischemic maculopathy in patients with diabetes mellitus type 1 and 2 with preproliferative stage of diabetic retinopathy using OCTA.

MATERIALS AND METHODS: 43 patients (72 eyes) of diabetic retinopathy levels 47 and 53, according to ETDRS criterions, were included in the study. The exclusion criterion was the presence of diabetic macular edema with involvement of the center of the macula. Patients were divided into 3 groups according to the ETDRS classification of ischemic maculopathy grade. Each of them was subject to standard ophthalmologic examination, OCT with determination with determination of central retinal thickness in macula zone and OCTA to evaluate the status of the foveolar avascular zone.

RESULTS: Ischemic maculopathy level 1 was detected in 23 patients — group 1 (33 eyes), level 2 was detected in 23 patients (27 eyes) — group 2, and level 3 — in 8 patients (12 eyes) — group 3. A statistically significant difference using “IBM SPSS Statistics” version 27 was found between the foveolar avascular zone area scores of groups 1 and 2 — 0.18 mm² versus 0.32 mm² (p < 0.001) and between groups 1 and 3 — 0.18 mm² versus 0.98 mm² (p < 0.001), and between groups 2 and 3 — 0.32 mm² versus 0.98 mm² (p < 0.008). In group 3, negative correlations were found between best-corrected visual acuity and foveolar avascular zone circumference length (r = –0.906, p = 0.02), foveolar avascular zone (r = –0.748, p = 0.033) and circularity index (r = –0.569, p = 0.141), while no such statistically significant difference was found in the other groups.

CONCLUSIONS: In patients with diabetic retinopathy levels 47 and 53, ischemic maculopathy is revealed in 100% of cases. In 83.4% of cases, level 2 of the ischemic maculopathy is detected, and in 16.6% — level 3. Ischemic maculopathy of levels 1 and 2 has no significant effect on best-corrected visual acuity. Level 3 is clinically significant, as the change of parameters characterizing foveolar avascular zone, and first of all the increase of foveolar avascular zone circumference length above 500 µm, is associated with a decrease in best-corrected visual acuity.

The article presents a description of a modified method of transplantation of the endothelium on descemet membrane and of a method of femtosecond laser-assisted posterior lamellar keratoplasty in patients with corneal endothelial dysfunction combined with severe defects of the iris-lens diaphragm integrity. During surgery, in both cases, a banded stromal flap was used. There were no complications in the early postoperative period. The air resorption in the anterior chamber in both cases lasted no more than 2 days. After air resorption, the stromal flap occupied an intermediate position between the iridolens diaphragm remnants and the endothelial graft. On day 3, the bandage stromal flap was removed in the operating room. It was shown that the use of a bandage stromal flap during surgical procedures for extensive defects of the iris-lens diaphragm allows minimizing the risk of dislocation of the endothelial graft into the vitreal cavity. Proposed technique is an universal solution for DMEK and Fs-DSAEK in patients with an abnormality of the iris-lens diaphragm. The preliminary insertion of banded stromal flap into the anterior chamber makes it possible to block the defects of the iris-lens diaphragm and provides conditions for prolonged air tamponade of the anterior chamber and primary graft adhesion.

Silicone tamponade is one of the prevailing methods used in the surgical treatment of retinal detachments. However, one of the significant disadvantages of using silicones is their emulsification and the risk of developing associated ophthalmic conditions. In this regard, the question of ways to prevent silicone emulsification remains relevant. Emulsification does not occur in all cases of tamponade, and this indicates that there are factors that could interfere with the development of this process. It is known that emulsification of silicone oil has a multifactorial etiology, and in vitro experimental models are being developed to study these mechanisms in more detail. It is the variety of factors that determine the tendency to emulsify ophthalmic silicone that formed the basis for the creation of these models. Such factors include physicochemical and mechanical effects, saccadic eye movements, adhesion of silicone oil to eye tissues, absorption of biological substances from intraocular fluids and tissues. The development of a variety of in vitro models allows, on the one hand, to obtain new fundamental knowledge, while, on the other hand, it allows us to solve practical issues related to the prevention of silicone emulsification and may provide insight into future strategies for improved intraocular tamponade.

Congenital ptosis is one of the most common eyelid abnormalities in the field of pediatric ophthalmology. This condition is characterized by drooping of the upper eyelid and can lead to functional and aesthetic problems in children in the absence of timely treatment. Various surgical methods aimed at correcting blepharoptosis are described in the literature, including levator resection, frontalis sling and tarsomullerectomy. Levator resection is the most common technique that significantly improves the position of the upper eyelid and provides lasting functional results. Frontalis sling is usually used for severe ptosis or in cases where levator resection is impractical. Tarzomullerectomy surgery is also frequently used, especially in patients with sufficient levator function. An important aspect of surgical treatment is the need for preoperative diagnosis of the degree of ptosis, levator function, and the presence of concomitant abnormalities such as amblyopia and strabismus. The results of surgical procedure show a high degree of patient satisfaction, however, they require constant monitoring to identify possible complications and the need for repeated intervention. Thus, the choice of surgical treatment method should take into account the individual anatomical and physiological characteristics of the patient.

The editorial board regret that un the published version “YAG-laser treatment of secondary cataract with silicone tamponade of the vitreous cavity” by Polina S. Ratanova, Andrei Yu. Kleimenov, Oleg A. Zykov, Nataliya S. Shuman, Anastasiya D. Arapova, Nikolai V. Strenev (Ophthalmology Reports, 2024;17(4):21–28. doi: 10.17816/OV516561) Institution (place of work) of the authors S. Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg, Russia was indicated incorrectly.

The authors’ institution is: Eye Microsurgery Yekaterinburg Center, Yekaterinburg, Russia.

The editorial board is confident that the error could not significantly affect the perception of the work and the interpretation of information by readers. The error has been corrected online, the file of the article and the issue have been updated.