Saratov JOURNAL of Medical and Scientific Research

2018, volume 14

Disruption of the microcirculation of the retinal macular zone in a patient who had hemorrhagic fever with renal syndrome according to OCT-angiography of the macula

Year: 2018, volume 14 Issue: №4 Pages: 880-882
Heading: Ophtalmology Article type: Case report
Authors: Aznabaev ВМ, Batyrshin RA, Aleksandrov АА, Idrisova LR, Khakimova NP.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

The article presents the results of a standard diagnostic examination and a description of the impaired microcirculation of the macular retinal area according to optical coherence tomography angiography (ОСТ angiography) in a patient who had hemorrhagic fever with renal syndrome. The survey revealed a violation of the microcirculation of the macula in the form of a decrease in perfusion of the inner layers of the retina. This diagnostic method allows objectively, quickly and without contact to assess the state of the microcirculation of the macula in persons who have had hemorrhagic fever with renal syndrome, and can be recommended for assessing the effects of the disease and preventing complications from the organ of vision.

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Results of treatment of optic neuritis

Year: 2018, volume 14 Issue: №4 Pages: 875-879
Heading: Ophtalmology Article type: Original article
Authors: Latypova Е.А.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: to investigate the epidemiological and clinical features of optic neuritis, evaluate the effectiveness of treatment and underlying diseases. Material and Methods. 58 patients (60 eyes) with optic neuritis (ON) were observed. Among them, 54 adults (26 men, 28 women) aged 19-67 years (mean age 36±11.8 years) and 4 children (1 boy, 3 girls) 14-16 years. Along with the standard ophthalmologic examination, electrophysiological studies, visual evoked potentials and magnetic resonance imaging of the brain and orbit, and a consultation with a neurologist were conducted. The patients were divided into two groups. In the main group of 32 patients (34 eyes), the complex treatment is carried out according to the developed method, which includes daily administration of 1 % nicotinic acid solution in the age dose (from 1 ml to 6 ml per day) with pentoxifylline on the background of basic ON therapy. In the control group of 26 patients (26 eyes), along with basic therapy of 1% nicotinic acid, 1 ml intramuscularly is prescribed a course of 10-15 days. Results. The number of children of young working age (65.5%), including children (6.9%). In the overwhelming number of cases, intrabulbar neuritis was diagnosed (84.5%). In 8 of 9 patients, the precursor of retrobulbar neuritis (PN) was multiple sclerosis (MS). Among other etiological causes of ON viral infection prevailed (37.9%). In patients prolonged by the proposed method, an improvement in visual functions (increased visual acuity, expansion of the general boundaries of the visual field) was achieved in 91% of cases, including high vision (0.5-1.0) in 65% of cases; in patients of the control group, these indicators correspond to 54% and 23%. Conclusion. The use of nicotinic acid intravenously in age dosage with pentoxifyllone in complexes with basic therapy allows the use of methods of treatment of optical neuritis using etiology and can be recommended for widespread use in practical ophthalmology.

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Central retinal vein thrombosis in a patient with newly diagnosed congenital thrombophilia

Year: 2018, volume 14 Issue: №4 Pages: 872-875
Heading: Ophtalmology Article type: Case report
Authors: Latypova E.A., Zagidullina A.Sh., Yamlikhanov A.G., Arslanova A.l., Nugmanova A.R.
Organization: Bashkir State Medical University of the Russian Health Care, City clinical hospital 10 Ufa
Summary:

To date the etiology and pathogenesis of retinal vein thrombosis have not been fully studied despite a large body of scientific research. The article describes a rare clinical case of central retinal vein thrombosis in a 52-year-old man with newly diagnosed congenital thrombophilia.

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Surgical treatment of rhegmatogenous retinal detachment with inferior breaks using gas tamponade of the vitreal cavity

Year: 2018, volume 14 Issue: №4 Pages: 870-872
Heading: Ophtalmology Article type: Short message
Authors: Shkvorchenko D.O., Gorshkov I.M., Yukhananova A.V, Khurdaeva A.G.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to evaluate the efficacy of tamponade of a vitreous cavity with gas-air mixture in patients with rhegmatogenous retinal detachment (RRD) in the lower hemisphere. Materials and Methods. We examined and operated on 52 patients with RRD with the localization of the discontinuities in the lower hemisphere: 30 patients with RRD with involvement of macula and 22 patients with RRD without macular involvement. All patients underwent general and special ophthalmological examination. Standard surgical treatment of retinal detachment finalized with injection of gas-air mixture into the vitreal cavity was performed. Results. In all cases, patients with RRD without involvement of macula and in 27 cases of RRD with involvement of macula there was a full adherence of the retina. In 3 cases patients with RRD involving the macula underwent repeat surgery with tamponade of the vitreous cavity with silicone, after which the retina adherence was finally observed. Close relationship between the improvement of visual acuity in patients 6 months after the operation and reduction in retinal thickness. Conclusion. The obtained results demonstrate the possibility of using gas tamponade of the vitreous cavity in RRD surgery with localization of rupture in the lower hemisphere.

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Surgical treatment of regmatogenous retinal detachment complicated by macular hole using platelet-rich blood plasma and local staining

Year: 2018, volume 14 Issue: №4 Pages: 867-870
Heading: Ophtalmology Article type: Original article
Authors: Zaharov V.D., Shkvorchenko D.O., Krupina E.A., Kakunina S.A., Norman K.S., Khurdaeva A.G., Yukhananova A.V.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to study the effectiveness of surgical treatment of regmatogenous retinal detachment (ROS) complicated by macular hole (MH) using platelet-rich blood plasma (PRP). Material and Methods. The study included 27 patients (27 eyes) with a diagnosis of ROS complicated by MH. In each case, the technique was used, namely, that after performing vitrectomy, a perfluororganic compound (PFOS) was injected into the hole area with a diameter of 2-3 diameter of the disk, to prevent penetration of dye under the retina, stained and removed internal limiting membrane (ILM). After serial PFOS/air replacement at the gap introduced PRP. The operation was completed with the introduction of silicone oil (CM). CM was removed from the vitreous cavity after 2 months. The follow-up period is 12 months. Results. In all cases, it was possible to achieve the adhesion of the retina and block Mr. During the observation period visual acuity increased to 0.1-0.9. Conclusion. According to the evaluation of the results, surgical treatment of regmatogenous retinal detachment complicated by MH using PRP is an effective method of treatment.

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Surgical treatment of regmatogenous retinal detachment complicated by macular hole using platelet-rich blood plasma and local staining

Year: 2018, volume 14 Issue: №4 Pages: 867-870
Heading: Ophtalmology Article type: Original article
Authors: Zaharov V.D., Shkvorchenko D.O., Krupina E.A., Kakunina S.A., Norman K.S., Khurdaeva A.G., Yukhananova A.V.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to study the effectiveness of surgical treatment of regmatogenous retinal detachment (ROS) complicated by macular hole (MH) using platelet-rich blood plasma (PRP). Material and Methods. The study included 27 patients (27 eyes) with a diagnosis of ROS complicated by MH. In each case, the technique was used, namely, that after performing vitrectomy, a perfluororganic compound (PFOS) was injected into the hole area with a diameter of 2-3 diameter of the disk, to prevent penetration of dye under the retina, stained and removed internal limiting membrane (ILM). After serial PFOS/air replacement at the gap introduced PRP. The operation was completed with the introduction of silicone oil (CM). CM was removed from the vitreous cavity after 2 months. The follow-up period is 12 months. Results. In all cases, it was possible to achieve the adhesion of the retina and block Mr. During the observation period visual acuity increased to 0.1-0.9. Conclusion. According to the evaluation of the results, surgical treatment of regmatogenous retinal detachment complicated by MH using PRP is an effective method of treatment.

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Evidence of the safe period intravitreal tamponade by perfluorodecalin in clinical practice

Year: 2018, volume 14 Issue: №4 Pages: 862-866
Heading: Ophtalmology Article type: Original article
Authors: Arslanov G.M., Aznabaev В.М., Mukhamadeev T.R., Dibaev T.I.
Organization: Saratov State Medical University, The Eye Clinic «Zrenie» (Saint Petersburg)
Summary:

 Purpose: to perform clinical testing of perfluorocarbon liquid on the basis of perfluorodecalin with the possibility of intravitreal postoperative tamponade in patients with vitreoretinal pathology and explain the effectiveness of this practice. Material and Methods. Were evaluated anatomical and clinical results of vitrectomy with PFCL intravitreal tamponade in 105 (113 eyes) patients with severe vitreoretinal pathology. Three observation groups were distinguished: group I (in-traoperative and postoperative intravitreal tamponade by perfluorodecalin, national sample); group II (only intraopera-tive use of perfluorodecalin, foreign sample); group III (only intraoperative use of perfluoro-1.3- dimethylcyclohexane). Results. Retinal attachment in the group of patients with postoperative intravitreal tamponade was 97.1% (visual acuity increased in 71.5% cases). All cases of failure or redetachment, postoperative complications and cataract progression did not have a statistically significant association with postoperative intravitreal tamponade as risk factor (x2=0,316; X2=0,068; x2=0.061; x2=0.403, p>0.05). Conclusion. Clinical testing of perfluorocarbon liquid intravitreal tamponade on the basis of perfluorodecalin in patients with vitreoretinal pathology showed high anatomical and clinical results with a high probability of retinal attachment.

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The analysis of microcirculation parameters of the macular area after ultrasonic vitrectomy using optical coherence tomography-angiography

Year: 2018, volume 14 Issue: №4 Pages: 856-862
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Ismagilov T.I..
Organization: Saratov State Medical University, ZAO Optimedservis
Summary:

Purpose: to analyze the parameters of the microcirculation of the macular area in patients operated on by the method of ultrasound vitrectomy 25G for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF). Material and Methods. ОСТ angiograms of 35 patients operated on by ultrasound vitrectomy for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF) before and for 3 months after surgery were analyzed. The following parameters of microcirculation of the retina were investigated: the area of the foveal avascularzone (FAZ), the density of the foveal vessels in the ring 300 urn around the FAZ, the density of the vessels in the superficial and deep capillary networks of the retina. Results. The FAZ area with IMO decreased within 3 months, while with ERF an increase in this parameter was recorded (p<0.05). In the superficial capillary network in both pathologies there was a decrease in the density of the vascular pattern (p<0.05), in IMH there was a tendency to recovery to the pre-op values. The deep capillary network was characterized by decrease of vascular pattern density to 1 month with following increase to 3 month (p<0.05). Conclusion. Features of the dynamics of the parameters of the microcirculation of the macular area in different periods of the postoperative period largely depend on the nature of the pathology, the stress response of the tissue to the operative traumaand the degree of recovery of the vascular pattern of the retinal neuroepithelium in the superficial and deep capillar networks.

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Intraoperative OCT-assisted vitreoretinal surgery

Year: 2018, volume 14 Issue: №4 Pages: 849-855
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Husniyarova A.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: comparative analysis of clinical and functional results of surgery of vitreomacular interface and rheg-matogenous retinal detachment with the use of intraoperative optical coherence tomography. Material and Methods. Clinical and morphofunctional data were analyzed in 102 patients with epiretinal fibrosis (ERF), idiopathic macular hole (IMH), and rhegmatogenous retinal detachment (RRD), who were divided into 2 groups. In the main group (n=52), the surgery was performed using intraoperative ОСТ control, in the control group without it. In the main group intraoperative control was performed at 4 stages of the surgery: before vitrectomy, after vitrectomy, during the main stage of the surgery and after completion of endotamponade of the vitreous cavity. During surgery for macular disorders intraoperative complications were assessed, in RRD the intraoperative screening for the detection of undiagnosed pathological changes was performed. In the postoperative period, clinical and functional results were assessed in up to 6 months. Results. The use of intraoperative ОСТ control allowed to reduce the frequency of intraoperative complications, such as capillary retinal bleeding (19.2% in the control group, 11.5% in the main group) and pinching of the inner retinal layers (not observed in the main group, in the control group its incidence was 23.1%) in macular surgery. Intraoperative ОСТ made it possible to better identify concomitant retinal pathology (secondary epiretinal membranes in the main group were found during the surgery in 11.5% of cases, in the control group in 4.2%, while in the postoperative period in 12.5%). In complicated cases of RDD, tomographic control allows to identify microstructural features of the posterior pole of the eye, which are important in achieving stability of the anatomical result, such as retinal defects over staphyloma of the posterior pole in high myopia cases. Conclusion. Intraoperative OCT-assisted vitreoretinal surgery reduces the rate of intraoperative complications during macular surgery and gives valuable diagnostic information in complicated retinal detachment cases.

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Microinvasive non-surgical treatment of vitreomacular traction

Year: 2018, volume 14 Issue: №4 Pages: 846-849
Heading: Ophtalmology Article type: Original article
Authors: Lyskin P.V., Zakharov V.D., Shpak А.А., Zgoba M.l.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: evaluation of the effectiveness of treatment for vitreomacular traction below 500 urn in length uncomplicated by epiretinal fibrosis and macular holes. Material and Methods. Enzymatic vitreolysis was used to treat 23 patients (23 eyes) with uncomplicated vitreomacular traction up to 500 urn in length. Results. Elimination of vitreomacular traction was achieved in 17 cases (74%). The goal of intervention was not achieved in 5 cases (21 %), in 1 case (5%) a macular hole was formed. Conclusion. The results have shown that enzymatic vitreolysis can be a method of choice for treatment of vitreomacular traction up to 500 urn uncomplicated by epiretinal fibrosis and macular holes.

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