Saratov JOURNAL of Medical and Scientific Research

Ophtalmology

A clinical case of fungal dacryocanaliculitis

Year: 2018, volume 14 Issue: №2 Pages: 217-219
Heading: Ophtalmology Article type: Case report
Authors: Krasyuk E.Yu., Strelnikova N.V.
Organization: Tambov Ophthalmological Clinical Hospital
Summary:

Objective: to study the clinical case of a patient with fungal dacryocanaliculitis. The patient with dacryocanaliculitis received a standard ophthalmological examination and tests with the disappearance of the dye. The contents of the lacrimal duct were examined. Only a comprehensive examination of the patient using various diagnostic methods may allow specialists to make a diagnosis and to administer the necessary treatment.

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Assessment of possibilities of transmission polarization mapping for the characterization of sclera macrostructure

Year: 2017, volume 13 Issue: №2 Pages: 435-441
Heading: Ophtalmology Article type: Original article
Authors: Shvachkina M.E., Pravdin А.В., Tikhonov D.A., Kamenskikh T.G., Yakovlev D.D., Yakovlev D.A.
Organization: Saratov state university, Saratov State Medical University
Summary:

The purpose of the study is to assess possibilities of applying the method of transmission polarization mapping for characterization of sclera structure. Material and methods. In the work, samples of rat, rabbit, porcine, and human sclera were examined. Samples of the human sclera were taken (enucleation of the eyeball) from patients with diagnoses: terminal painful glaucoma, subatrophy of the eyeball. From the enucleated eyes, sclera samples were taken from the posterior pole of the eye and from the equator. The sample transparency required for carrying out transmission polarization mapping in thick samples was achieved using immersion optical clearing, 85% and 50% aqueous glycerol solutions and 40% aqueous glucose solution being used as immersion agents. The polarization mapping system used in this work was assembled on the basis of a polarization microscope equipped with a measuring video camera. Re-sults. It is shown that the method of transmission polarization mapping can be used to measure the parameters of the orientational order of scleral collagen fibers, mapping of human sclera samples requiring conduction of the polarization measurements under optical clearing conditions. Since the disorganization of collagen structures of eye connective tissue can be considered as the initial stage of glaucoma process, the technique of transmission polarization mapping can be used as a basis for in vitro studies of the pathogenesis of primary open-angle glaucoma. Conclusion. The potential and limitations of polarization mapping in studying sclera structure in vitro have been established.

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Experience of modified procedure treatment of progressive keratoconus based on corneal collagen cross-linking with femtosecond formation of intrastromal pocket

Year: 2017, volume 13 Issue: №2 Pages: 431-434
Heading: Ophtalmology Article type: Original article
Authors: Solodkova E.G., Fokin V.P.
Organization: "Eye Microsurgery" n.a. academician S. N. Fedorov, Volgograd branch
Summary:

Aim: analysis of clinical and functional results, histomorphological changes of corneas in the application of the method of corneal collagen crosslinking with the formation of a femtosecond intrastromal pocket. Material and Methods. We studied 20 patients (20 eyes) that were operated for progressive keratoconus (1-2 stage) with a peripheral zone of maximum ectasia arrangement via corneal collagen cross-linking with femtosecond formation of intrastromal pocket for introduction of a photosensitizerand local ultraviolet radiation. Results. The result was a decrease of surgery duration and reduction of the severity of pain in the early postoperative period. Conclusion. This method allows to increase the safety of the treatment of keratoconus, reducing the risk of postoperative complications.

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Intraocular and blood pressure monitoring of the spiritual orchestra musicians

Year: 2017, volume 13 Issue: №2 Pages: 429-431
Heading: Ophtalmology Article type: Original article
Authors: Ryazantseva T.V., Ryazantsev N.S.
Organization: Saratov State Medical University
Summary:

Objective: to reveal glaucomatous changes and to analyze the intraocular and blood pressure dynamics of a spiritual orchestra musicians during playing their instruments. Material and Methods. Under supervision were 80 musicians aged from 20 to 76 years, with a professional experience from 5 to 50 years. The following examinations were carried out: visometry, kinetic perimetry, ophthalmoscopy of the fundus, Maklakov tonometry, blood pressure measurement (BP) and non-contact transpalpebral tonometry (Po). The dynamics of pressure was evaluated while playing the wind instruments. Results. In the examined group of cases, glaucoma was not identified. During the first minute of playing the IOP (Po) of all musicians was observed to rise to an average of 29.25±0.53 mm Hg with a gradual decrease in five minutes to 24.12±0.51 and full normalization to 15.57±0.53mm Hg after 15 minutes. Arterial BP rose slightly and came back to normal 5 minutes after the end of playing. Conclusion. During the first minutes of playing the wind instruments, the musicians have an increase of BP and IOP due to the activation of the sympathoadrenal system, which leads to the launch of a cascade of adaptive changes, and as a result to full normalization. Such systematic occupational loads may be a contributing factor in the development of glaucoma, which necessitates regular preventive examinations by an ophthalmologist.

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The features of general anesthesia by sevofluran in pediatric vitreoretinal surgery with different diseases and ophthalmosurgeral pathologies

Year: 2017, volume 13 Issue: №2 Pages: 426-428
Heading: Ophtalmology Article type: Original article
Authors: Pronin S.N., Yeliseyev N.Yu., Tsypyaschuk A.F.
Organization: Saratov State Medical University
Summary:

Objective: clinical studies of inhalation anesthesia with sevoflurane as the main anesthetic for various diseases in children with vitreoretinal operations. Material and Methods. There was considered the age groups of children from 3 to 16 years old. Among 76 children: 18 with non-prosperrous psycho-emotional statuses, 2 with ICP, 2 with bronchial asthma, 3 with atopic dermatitis, 5 with small anomalies of heart development, 46 were somatically healthy. All of children had different ophthalmosuregery pathology. Results. The performing of general anesthesia by sevoflurane at vitreoretinal surgeries of children with the different diseases and ophthalmological pathologies displayed appropriateness and safety during the surgeries. Conclusion. The appliance of sevoflurane is the reasonable and optimal scheme in modern ophtalmosurgery and anesthesiology.

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Modern aspects of diagnostics and monitoring of tape-toretinal degeneration

Year: 2017, volume 13 Issue: №2 Pages: 422-426
Heading: Ophtalmology Article type: Original article
Authors: Nekhorosheva А.А., Popova T.S., Batishcheva Yu.S., Kolbenev I.O.
Organization: Saratov State Medical University
Summary:

Objective: to evaluate the informativity of clinical and instrumental methods of examining patients with tapetoretinal abiotrophy (TRA). Material and Methods. 45 patients with a diagnosis ofTRA, divided into 3 groups: 1) 8 people (under 18 years); 2) 20 people (19-40 years); 3) 17 people (over 41 years). Performed: standard ophthalmological examination, computer perimetry (kinetic, static perimetry in the "Macula threashold 24-2bs" mode, OCULUS Twinfield device), fundus shots (TOPCON device), EPS* (Neuro-MEP device). Results. The average total value of the visual fields of the first group patients amounted to 394±23°, the second group has 173±26° result and the third group has 86±15° result. Mean deviation of the bacillary component of electroretinogram in the first group has reached 53.8±10.4%, 70.2±4.3% in the second group and 84.7±7.3% in the third group. As for the rhythmic component, the indicators were following: 20.3±4.3%, 41.6±5.2%, 62.3±6.4% in the first, second and the third groups respectively. The data of static perimetry showed a decrease in the average photosensitivity in the central parts with respect to the population's age. According to the data of ophthalmoscopy the bony bodies' remoteness of the location from the center of the fundus corresponds to the degree of narrowing of the field of vision. Conclusion. There is a significant relationship between the total value of the peripheral boundaries of the visual field, electroretinogram data and perimetry.

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The effectiveness of The Atlas of Ophthalmic Instruments (an application for smartphones) in optimization of the educational process of students, residents, and ophthalmologists

Year: 2017, volume 13 Issue: №2 Pages: 420-421
Heading: Ophtalmology Article type: Short message
Authors: Moiseev R.V., Kryuchkov Yu.A., Kamenskikh T.G.
Organization: Saratov State Medical University
Summary:

Objective: to determine the effectiveness of the Atlas of Ophthalmic Instruments for Smartphones (the application for smartphones) in optimization of the educational process of students, residents, and ophthalmologists. Material and methods. On the Android platform there had been created and placed in the Google Play an application "Ophthalmic Instruments" with illustrations and description of ophthalmic surgical instruments. Next, a survey had been conducted of users of the application (1005 respondents). To this was applied a specially designed questionnaire in English. Results. According to the survey, the average score among students (652 users) is 4.9; among residents (281) 4.7 and doctors (72) and 4.6. Conclusion. Obtained data allow to conclude that the use of interactive mobile applications positively influences the optimization of the educational process and can be considered as a new and effective form of tutorials.

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Development of ophthalmic training simulator for cataract surgery

Year: 2017, volume 13 Issue: №2 Pages: 417-420
Heading: Ophtalmology Article type: Original article
Authors: Kumova S.V., Lunev I.A., Gasparyan E.A., Virsta A.M., Batishcheva Yu.S., Kamenskikh T.G., Dolinina O.N.
Organization: Saratov State Medical University, Saratov state university, Yuri Gagarin State Technical University of Saratov
Summary:

Purpose: development of interactive simulator for the development of phacoemulsification. Material and Methods. Material and methods: the Software developed by the authors ophthalmic virtual simulator has several modules that can also be complemented by depending on put before the students the task. Testing the virtual simulator "Phacoemulsification" held at the Department of ophthalmology with the participation of 20 interns and 18 residents. Results. The development of residents and interns of ophthalmological profile of the theoretical foundations of cataract surgery using developed by the authors of the publication virtual interactive simulator demonstrated the effectiveness of this technique in comparison with passive viewing of video recording operations and the familiarity with the course of phacoemulsification in the operating room. Conclusion. The application of the developed simulator with the purpose of optimization of educational process of residents and interns of ophthalmic profile is a very effective tool in the world today.

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Comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy.

Year: 2017, volume 13 Issue: №2 Pages: 412-416
Heading: Ophtalmology Article type: Original article
Authors: Kozorezova O.V., Kamenskikh T.G., Kolbenev I.О., Zakharova N.B., Kozletsov A.P., Stepanova T.V.
Organization: Saratov State Medical University
Summary:

Objective: comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy. Material and methods. The study group included 137 patients with diabetic retinopathy. A control group consisted of 30 patients with myopia average. Results. The increase of indicators such as glycated hemoglobin, glucose, cholesterol, LDL cholesterol, IL-8, IL-6, TNF-alpha in patients with diabetic retinopathy compared to normal values. The content of IFN -y in both groups significantly below the normal level. Conclusion. The final peroxidation products, reactive oxygen species generate new antigens and trigger an immune response that is expressed in the form of increased concentration of IL-6 (acute phase of immune inflammation), and then TNF-alpha and IL-8; these cytokines activate angiogenic growth factors TGF 131 and VEGF. Increasing the concentration of angiogenic factors triggers neovascularization and proliferation.

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Efficiency analysis of laser magnetic stimulation of an eye drainage system in the treatment of patients with different stages of primary open angle glaucoma based on developments of functional indicators and biochemistry factors

Year: 2017, volume 13 Issue: №2 Pages: 406-411
Heading: Ophtalmology Article type: Original article
Authors: Filatova V.S., Kamenskikh T.G., Zaharova N.B.
Organization: Saratov State Medical University
Summary:

The purpose of study is to develop efficiency analysis of laser magnetic stimulation of an eye drainage system in the treatment of patients with primary open angle glaucoma (POAG). Material and Methods. The study included 197 patients with established diagnosis of POAG. The first group included 104 patients treated with drug treatment and laser magnetic stimulation of the drainage system of the eye using the «AMO-ATOS-ICL». The second group included 93 patients who received only drug therapy. Patient underwent visometry, oftalmobiomicroscopy, threshold perimetry electrophysiological study, the study of intraocular blood flow, level of VEGF and MCP-1. Results. A comparative analysis showed that the use of laser magnetic stimulation eye's drainage system in the treatment of patients with different stages of POAG to an activation of intraocular blood flow, but it was more significant in patients of the main group who were diagnosed with I and II stages of POAG. The decrease in intraocular blood flow resulted in ischemia while the level of VEGF increased. Conclusion. Analysis of clinical, electrophysiological and hemodynamic parameters in treatment of patients with POAG before and after laser magnetic stimulation improved of the state of the visual system in comparison with those in control group.

Keywords: MCP-1, VEGF
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