Ophthalmology in Russia
ISSN / EISSN : 1816-5095 / 2500-0845
Published by: PE Polunina Elizareta Gennadievna (10.18008)
Total articles ≅ 493
Latest articles in this journal
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-938-945
Currently the ophthalmologists meet with corneal-conjunctival xerosis more often in their daily practice. The objective of this research is identifying a new alternative method of treatment of the dry eye syndrome of different severity. In this work there will be a demonstration and the results of usage of BAA Delphanto® in treatment of different cases of the dry eye syndrome. The data collected from a dynamic research of groups of patients reveals the effectiveness of the comprehensive therapy with the use of BAA Delphanto®. Consequently, the research results demonstrate an improvement of the initial data from the biomicroscopy, OSDI index, Schirmer-1 test and the tear break up time. The statistically significant results were received reveal the effectiveness of the use of BAA Delphanto® with a significant improvement of the quality of life. It can be used widely by ophthalmologists for the treatment of corneal-conjunctival xerosis of different severity.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-897-907
Aim: to study genotype-phenotype correlations in patients with inherited retinal diseases with mutations in ABCA4 gene in Russian Federation.Patients and methods. 21 patients from Russian population aged from 7 to 51 years old (mean age 20 ± 11 years with best-corrected visual acuity from 0,02 to 0,6 (0,14 ± 0,11) with ABCA4-associated retinopathy, verified by molecular genetics methods. All patients besides standard ophthalmic examination and photodocumentation were performed Spectral-Domain OCT and fundus autofluorescence on Spectralis ®HRA+OCT (Heidelberg Engineering, Germany). Full-field electroretinogram (ERG), 30-Hz flicker ERG and macular chromatic ERG (MERG) to red stimulus were recorded on electroretinographic system MBN (MBN, Russia). (Russia) Molecular genetic studies were performed using Next Generation Sequencing (NGS) and Sandger direct sequencing. Results: In ABCA4-associated Stargardt disease 1 type (STGD1) genotype [p.L541P, p.A1038V] of «frequent» mutations was revealed in 9 patients, in 2 cases in was associated another “frequent” mutation p.G1961E. In 4 patients with genotype [p.L541P, p.A1038V] “severe” phenotype of Stargardt disease was found: with large defect of the ellipsoid zone and large zone of central reduced autofluorescence, severely subnormal macular ERG (MERG) to red stimulus and subnormal 30 Hz flicker and full-field maximal ERG. In one patient with these mutations in homozygous state ABCA4-associated cone-rod dystrophy (CORD3, clinically looking alike secondary retinal dystrophy is diagnosed. In 2 patients with genotype [p.L541P, p.A1038V] and mutation p.G1961E was found mild phenotype. One patient with homozygous mutation p.R653C autosomal recessive ABCA4-associated retinitis pigmentosa (RP19) was diagnosed. Clinical picture and autofluorescence were polymorphic in all patients.Conclusions. Our study with ophthalmological, molecular genetics and instrumental methods widens the spectrum of clinical signs of inherited eye diseases associated with mutations in АВСА4 gene, widens the spectrum mutations in Russian Federation and reveals clinicо-genetic genotype-phenotype correlations.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-922-925
Myopia is an actual health issue in the world. The World Health Organization estimates that 50 % of the world population may be myopic by 2050. In response to the coronavirus disease 2019 (COVID-19) outbreak, the Russian government started a nationwide school closure as an emergency measure to prevent spreading of the infection since the 23rd of March 2020. The present study was organized to investigate prevalence of myopia in school-aged children during the COVID-19 home confinement in Moscow. The studied group included school-age children: pupils of 1, 5, 11th classes. The inclusion criteria were: myopia — refraction above –0.5 D in conditions of cycloplegia. The results of survey 523 pupils from Moscow schools, the proportion of patients with myopia was 20.1 %, while the proportion of patients with myopia among 1st class pupils was only 8.3 %. In 5th class, the rate was 16 %, in the 11th grade reached 42.1 %, i.e. increased more than 5 times. The trend with an increase in the number of children with myopia in the learning process is explained by the increased visual load of the high school curriculum. Home confinement during the COVID-19 pandemic appeared to be associated with a significant myopic shift for children aged 6 to 8 years due to the visual load increase in and a decrease in time spent outdoors. Further research is needed to evaluate these results and long-term follow-up of these children.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-981-987
Introduction: to evaluate the clinical and functional results of two-stage treatment in a patient with post-infectious Central corneal opacity combined with mixed astigmatism.Patient and methods. Patient N., 19 years old with postinfectious (postherpetic) Central corneal opacity, mixed astigmatism was examined and operated using two-stage corneal laser treatment. To determine the possibility of surgical treatment of the patient, a complex of General ophthalmology was performed (checking visual acuity near and far in natural conditions and in conditions of drug-induced mydriasis, IOP measurement, autorefractometry, examination of visual fields, A- and Bscanning, ophthalmoscopy with examination of the Central and peripheral areas of the fundus), as well as special (keratopography and Scheimpflug camera examination, optical coherence tomography (OCT) of the anterior segment of the eye with analysis of the epithelial map, quantitative assessment (Schirmer test-1) and qualitative (tear film rupture time) lachrymal products, assessment of the epithelium state when stained with vital dyes and infrared meibography) research methods. To determine the activity of herpetic infection, PCR diagnostics were performed. The follow-up period was 2 years.Results and discussion. To achieve high visual-functional rehabilitation while preserving the native lens, a two-stage treatment algorithm was developed using technologies of laser corneal refractive surgery. At the first stage, in order to regularize the ocular surface and eliminate Central corneal opacity, an inverted topographically oriented PRK was performed; at the second stage, residual refractive errors were corrected using topographically oriented FemtoLASIK technology.Conclusion. According to the results of a literature search and analysis of Internet resources, there were no previously recorded and published works using a similar two-stage method. Therefore, the described clinical case justifies the relevance and novelty of the goal and has an evidence-based Foundation for the use of a two-stage laser keratorefractive treatment system in the ophthalmological practice of visual and functional rehabilitation of patients with Central corneal opacity in combination with mixed astigmatism or hypermetropic refraction. The two-year postoperative follow-up period showed stable and high visual-functional results with no recurrence of the inflammatory process.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-955-961
Purpose: to study the state and dynamics of changes in primary ocular disability in the period 2016–2018 by nosological forms. A complete retrospective study was made based on the data of the MSE (medical and social expertise) Bureau’s reporting documents. The following indicators of primary disability (per 10 thousand population) were registered from 2016 till 2018: among the adult population (18 years and older) 69,0–70,7–68,6 respectively; among the able-bodied population 42,8–44,1–41,1 respectively; among the population of retirement age — 125,1–126,4–124,6 accordingly. In the structure of primary disability of the adult population by severity for the period 2016–2018, the dynamics recorded an increase in the proportion of 1 group and 3 group with a decrease in the share of disability of 2 group. In the nosological structure of primary disability of the adult population in 2016–2017–2018, eye diseases account for 3 %, 3 % and 3.2 %, respectively, of all first recognized as disabled. There has been an increase in first-time applicants to the MSE Bureau. In the nosological structure of primary disability, the percentage of glaucoma patients over the past period is 47–33–32.5 % of the total number of primary disability for eye diseases, which determines the 1st rank. There is a progressive increase in the number of people with disabilities due to glaucoma of group 1 and group 2 throughout the study period. In the nosological structure of primary disability for 2016–2018 the percentage of patients with retinal diseases is 25–23–23.8 % of the total number of primary disability for eye diseases, which corresponds to the 2nd rank. There is a progressive increase in the number of disabled people in group 2. A low proportion of persons of working age in the structure of primary ocular disability was noted. A consistently high share of primary disability and a progressive increase in severe disability combined with an increase in persons of retirement age in the Krasnodar region forms an unfavorable forecast for an increase in the number of blind and visually impaired residents of the region.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-972-980
Purpose: to evaluate the effectiveness and safety of the plasma ablation technique of Fugo blade system to enlarge phimotic capsulotomies in the management of anterior capsule contraction syndrome.Patients and methods. Results of the enlargement of phimotic capsulotomies using the plasma ablation technique in 17 patients with anterior capsule contraction syndrome (10 men and 7 women, 18 eyes; average age — 73.8 ± 9.6 years) were retrospectively analyzed. Surgically, after pupil dilation, the anterior chamber was irrigated with a viscoelastic device (1.4 % solution of hyaluronic acid), and the tip of the Fugo blade was inserted through a 2.0–2.2 mm wide corneal incision. After slightly touching the anterior capsule, the apparatus was activated, and its tip was moved in a concentric manner, excising the required size of the fibrosed anterior capsule in a resistance-free fashion. Finally, the viscoelastic material was aspirated, and the incisions were hydrated.Results. Phimotic capsulotomies were enlarged in all cases. Except for three cases where the bimanual technique was required to ablate the anterior capsule, all other cases were managed single-handedly. The use of cohesive viscoelastic device (1.4 % solution of hyaluronic acid) made it possible to perform this procedure with minimum trauma and under visual control. No serious complications were encountered during surgery or in the early postoperative period. Patients were discharged 1–2 days after surgery. Corneal edema, which was observed in six eyes, resolved within 3–4 days. Visual acuity improved in all cases, except for 2 patients with complete glaucomatous optic atrophy. IOP remained under control in all cases. No negative effect on the hypotensive results of previous glaucoma surgeries was observed.Conclusion. The plasma-generating Fugo blade system is an effective and safe tool to enlarge phimotic capsulorhexis in a resistance-free fashion. It is easy to use, mastering of new surgical skills is not required, surgical trauma is minimal, the surgical time is reduced, and the patient’s rehabilitation period is significantly shortened.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-946-954
Purpose: to evaluate the effectiveness of plasmapheresis as a method for preventing and treating the graft rejection reaction in corneal transplantation.Patients and methods. The study involved patients with surgical pathology of the cornea, who underwent a prophylactic course of plasmapheresis procedures and underwent penetrating keratoplasty (Main group); and patients with surgical pathology of the cornea who underwent penetrating keratoplasty, but did not undergo plasmapheresis (Comparison group), whose data were analyzed retrospectively. The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group.Results. Patients with keratoplasty who received a course of therapeutic plasmapheresis in the perioperative period demonstrated a statistically significant increase in the number of cases of a decrease in the level of C-reactive protein and a statistically significant decrease in the median values of the mean stimulated cytochemical index and the mobilization coefficient. Depending on the risk group for keratoplasty, the patients showed different dynamics of the levels of the studied interleukins after the course of plasmapheresis and keratoplasty. In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24 %) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. In patients of the Comparison group (in total for two subgroups), the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. At the same time, the patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease (in both subgroups).Conclusion: the obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-962-971
The article presents expert study results about myopia control. The study was conducted by Russian eye care practitioners in 2019.Purpose. to summarize the views of eye care practitioners on the problem of myopia control in Russia.Methods. The study was conducted by mailing (sending) questionnaires to practitioners. The questionnaire contained 9 questions. Base questionnaire was developed by British Contact Lens Association (BCLA) for global study, translated into Russian and updated with items of interest to Russian practitioners.Results. 356 questionnaires were received and processed. Concern increasing frequency of pediatric myopia was highest (9.0 ± 0.08 on a 10 point scale). Orthokeratology was perceived to be the most effective method of myopia control, followed by myopia control soft contact lenses and increased time outdoors. Perceived effectiveness rated as percentage was 50.7 ± 1.6 %, 44.9 ± 1.8 % и 42.9 ± 1.7 % respectively. Perifocal spectacles correction was perceived to be the most effective method in the Southern area of Russia (56.8 ± 11.1 %), atropine — in the Northwestern Federal District (39.5 ± 7.1 %), scleroplasty — in the Far East (55.1 ± 7.6 %). Under-correction was perceived to be the least effective method in all areas (11.6 ± 1.0 %). Increased time outdoors was a priority for most practitioners (on average 94.0 ± 7.8 prescriptions per month by one practitioner). Practitioners prescribed single vision spectacles as the primary mode of correction for myopic patients (47.2 ± 3.6 prescriptions per month by one practitioner). Phenylephrine instillation was used often (49.4 ± 3.6 prescriptions per month by one practitioner). This trend was in most areas. Vision therapy was used most frequent in Siberia and the Urals and in the Far East (70.4 ± 11.5 и 20.0 ± 5.2 prescriptions per month by one practitioner respectively). The most common reasons practitioners gave for not adopting myopia control strategies were: they were felt to be uneconomical (42.1 %); they considered there to be inadequate information about the modalities (22.2 %). 45 % practitioners from the Far East called the last reason the main one. 42.9 % practitioners from Northwestern Federal District did not believe that these are any more effective methods then single vision correction.Conclusion. The active promotion and introduction into everyday clinical practice of myopia control methods that have proven to be highly effective could help reduce the frequency of progressive and degenerative myopia
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-932-937
The problem of drug therapy for bacterial eye infections in children has remained relevant for many years. The greatest interest of ophthalmologists in recent years is associated with the use of fluoroquinolones in the treatment of inflammatory eye diseases of the bacterial etiology. At the same time, new ophthalmic dosage forms of fluoroquinolones that have appeared in recent years naturally require additional research on their effectiveness.Objective: to study the clinical efficacy of the antibacterial drug Oftocypro (0.3 % cyprofloxacin in ophthalmic ointment) in the treatment of chronic blepharoconjunctivitis in children.Materials. The study involved 38 children aged 3 to 18 years (mean age 10.3 ± 2.7 years) with clinical manifestations of blepharoconjunctivitis. All patients were divided into 2 groups of equal size: 18 children (36 eyes) — with bacterial blepharoconjunctivitis and 20 (40) — with chlamydial blepharoconjunctivitis. The diagnosis was verified based on the clinical picture of blepharoconjunctivitis and laboratory data: detection of pathogenic microflora in the conjunctival cavity of patients of the first group and chlamydia antigen — in epithelial cells in scraping material from the conjunctiva by immunohistochemical analysis.Results. The analysis of the data obtained during the examination and treatment of children with blepharoconjunctivitis of bacterial etiology (group I), a reliable dynamics of controlled clinical and laboratory parameters was established. There was a significant positive dynamics of all controlled parameters of the clinical course of chronic bacterial blepharoconjunctivitis against the background of the drug Oftocipro ophthalmic ointment 0.3 % use. All children with chronic chlamydial blepharoconjunctivitis with the background of treatment with Oftocypro, ophthalmic ointment 0.3 %, showed a steady tendency towards relief of the estimated clinical signs of the disease. According to the results of laboratory studies, it was found that on the 28th day of treatment with Oftocypro chlamydia in the cells of the epithelium of the conjunctiva was re-detected in 4 out of 20 patients (20 %).Conclusion. The high efficacy of the drug Oftocypro ophthalmic ointment 0.3 %, in combination with the absence of pronounced side effects, makes it possible to recommend this drug for wider practical use.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-4-926-931
Purpose: scientific substantiation and development of methodological principles of the “quality of life” (QOL) assessment questionnaire in patients with symptoms of computer visual syndrome (CVS).Material and мethods. As part of the first stage of the study, an individual interview was carried out (according to the standard developed methodology) with 100 patients with visually strenuous labor, according to the results of which the entire spectrum of complaints arising during prolonged work with a computer was determined (44 complaints in total). As part of the second stage, a special questionnaire was developed, in which the identified complaints were transformed into questions. The study involved 96 ophthalmologists aged 32 to 62 years with an average of 17.3 ± 1.4 years. The task of an expert ophthalmologist was to assess the relevance each of the questions in terms of the influence degree on the patient’s QOL, as well as the “severity” of the complaint in terms the of occurrence frequency.Results. The development of the questionnaire was based on the sequential implementation of five stages (development of a conceptual framework; development of a preliminary version and confirmation of validity content; additional modification; scaling procedure development; psychometric properties determination). The results obtained made it possible to form the questionnaire (22 questions) the final version, which (according to the analysis) meets the requirements of meaningful and constructive validity (specificity, reflection of questions and scales of significance for the patient, the results of an expert assessment by ophthalmologists of the psychometric response scale) with the weight coefficients development, the required values correlation coefficients (according to Pearson) between the relevance assessment of the question from the points according to the symptom severity, as well as the high level of consistency according to the “Cronbach-α” indicator.Conclusion. The main direction of the assessment QOL improving of a patient with GLC is active participation in the ophthalmologist’s questionnaire development. Our results determine that the expert assessment provides a mathematically confirmed choice of the most significant (in terms on QoL impact) subjective manifestations, which (in conjunction with the development of each patient’s possible responses expert assessments, in points) provides the required level of the questionnaire meaningful and constructive validity. The developed questionnaire can be recommended for further clinical testing.