Ophthalmology in Russia
ISSN / EISSN : 1816-5095 / 2500-0845
Published by: PE Polunina Elizareta Gennadievna (10.18008)
Total articles ≅ 432
Latest articles in this journal
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-276-283
Purpose: study the microscopic examination and microtopography of explanted hydrophilic acrylic IOLs with opacification. Material and methods. 5 samples of soft hydrophilic acrylic IOLs produced in European countries and the USA were studied. Explanted IOLs were studied using a scanning electron microscope (EVO LS10, Karl Zeiss, Germany-UK). Results. In 4 cases changes in hydrophilic acrylic IOL had the character of surface opacification in the area of the anterior wall of the optical element of the lens with localization in the Central zone (pupil area). In one case, the opacities were located over the entire surface of a hydrophilic IOL having a hydrophobic coating. The changes were characterized by the formation of crystalline deposits on the IOL surface at different stages of evolution. In the initial stage, primary point precipitates with sizes of 3–5 microns were formed. At a later stage, the changes had the form of “adult” spherocrystals with a typical radial-concentric zonal structure, up to 50 microns in size. In one of the of IOLs, the growth of crystals under the surface of the lens — in the thickness of IOLs was determined. Conclusion. The changes characterize different stages of the same type of pathological process with sedimentation of crystal deposits on the surface of IOL with changing crystallomorphology.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-234-239
Melatonin is a hormone of the epiphysis and a regulator of circadian rhythms of living organisms, which affects a number of important physiological processes. Melatonin synthesis has also been found in other organs, in particular in various structural systems of the eyeball. A number of studies demonstrate that melatonin plays an important role in a variety of biochemical and physiological processes that ensure functioning of visual analyzer. This review provides information on the synthesis of melatonin, its secretion and metabolism, considers key information about melatonin receptors (MT1, MT2 and MT3), their localization in various eye’s structures, and their affinity to melatonin. Over the last years, researchers’ attention has been drawn to the therapeutic properties of melatonin, relevant for treatment of age-related diseases. The aggressive effects of solar radiation and environmental toxicants expose the organ of vision to oxidative attacks. A large amount of evidence has been accumulated of the participation of oxidative stress in the development of many eye diseases, resulting in an imbalance between the generation of reactive oxygen species and the expression of antioxidant enzymes. Melatonin, which has antioxidant and anti-inflammatory properties and regulates mitochondrial functions, can be a powerful tool to counter age-related changes. Globally, the number of people of all ages with visual impairment is estimated at 285 million. Cataract and age-related macular degeneration (AMD) are the leading causes of vision loss around the world. AMD and cataracts often coexist in patients, so there is a concern that age-related cataract surgery increases the risk of morbidity and progression of AMD. The pathogenesis of both cataracts and AMD is still unclear, although a number of theories have been put forward, including oxidative stress, age-related changes, inflammatory processes, etc. Analysis of modern domestic and foreign literature shows good perspectives of using melatonin as preventive and therapeutic agent in the treatment of ophthalmic diseases of various origins.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-253-259
There are quite systematic data of the ophthalmic manifestations in SARS-CoV-2, on the presence of conjunctivitis in patients with COVID-19, as well as on the detection of viruses in the lacrimal fluid and eye tissues. And, although ophthalmic manifestations are considered rather rare for COVID-19 and are not included in the list of important for diagnosis, there is not enough reliable data on the inflammatory processes of the eye’s anterior part and their connection with COVID-19, as well as those arising against the background of the treatment. Purpose. To study the development of inflammatory diseases of the anterior part of the eye in patients who have undergone the new coronavirus infection COVID-19. resu. In the Department of Infectious and Allergic Eye Diseases of the Helmholts National Medical Research Center of Eye Diseases, 88 patients with confirmed transferred new coronavirus infection COVID-19 of varying severity were observed. The main method of laboratory diagnostics is the detection of SARS-CoV-2 RNA in swabs from the nasopharynx, the patient’s sputum. Serodiagnostics of COVID-19 includes the determination of IgG-, IgM-antibodies to SARS-CoV-2 in the blood in an enzyme-linked immunosorbent assay. Results. Acute conjunctivitis associated with COVID-19 is quite rare and is an early sign of the disease. In the complex nonspecific topical therapy of viral conjunctivitis in COVID-19, along with etiopathogenetic systemic treatment, local eye medications with immunomodulatory and antiviral activity should be used. Conjunctivitis during a pandemic may be the only sign of COVID-19. The development of allergic conjunctivitis in COVID-19 is possibly associated not only with the effect of a viral agent, but also depends on the toxic effect of drugs used in the complex treatment of this disease. The increase in the number of patients with episcleritis after the postponed coronavirus infection needs further detailed study, with the analysis of laboratory data from this group of patients and the accumulation of clinical material. Conclusion. Ophthalmic manifestations in COVID-19 are very different, affecting various structures of the eye, occur at different periods — both during the course of the disease and after clinical recovery, and, of course, need further consideration, study and structuring.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-188-197
The article provides brief information on the history of microRNA studies. Today, their role in human pathology is regarded as key regulators of the expression of genes and the proteins encoded by them: miRNA molecules perform important physiological functions in cells and tissues of various organs. The specific mechanisms of their participation in the pathological process are insufficiently known. MicroRNAs were the first to be studied in patients with spinal muscular atrophy and leukemia. Publications devoted to the study of miRNAs and their role in the life of the eye appeared in 2002. Initially, miRNAs were studied in the tissues of the animals’ eyes (mice and zebras), and later the role of miRNAs of retinal pigment epithelium in inflammatory changes was studied in the experiment. The first information on the searches and isolation of microRNAs, their quantitative characterization in patients with primary open-angle glaucoma, age-related macular degeneration, autoimmune uveitis was analyzed. Encouraging results were obtained and the prospects of such studies in revealing the pathogenesis and the possibility of targeted treatment. Preliminary judgments were made about the role of miRNAs in the formation of various clinical forms of Graves’ ophthalmopathy (endocrine ophthalmopathy), which also gives hope for the emergence of targeted therapy for this disease. More publications have been devoted to the importance of miRNAs in the development of primary malignant intraocular tumors (retinoblastoma and uveal melanoma). Considerable attention is paid to retinoblastoma: the results of a study of various miRNAs as biomarkers of this tumor for early diagnosis with final access to targeted therapy, both in case of local lesion and in conditions of its metastasis, are presented. Most studies are limited to the study of miRNAs in tumor tissues. Over the past 5 years, a number of studies have been performed to highlight the spectrum of circulating miRNAs that have potential diagnostic value for early detection of metastases of uveal melanoma. The number of observations or experiments in the analyzed works is small, the studies are exploratory in nature and the publications all end almost with the phrase: “Further research is required”.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-290-295
Thermography is the method of noninvasive registration of visible image of the own infrared radiation of the human body surface by special devices. The physiological basis of its application in medical diagnostics is the amplification of infrared radiation intensity from pathologic spots that is connected with the enhancement of blood supply and metabolism. Purpose. To study the possibilities of thermography for functional bleb status assessment, for early diagnostics of bleb scarring processes and for definition of needling indications. Patients and methods. There were executed 32 thermography (32 patients and eyes) of blebs in 7 days after minimally invasive sinustrabeculectomy. Authors used thermal imaging Тesto 875-2i with SuperResolution technology and telephoto lens 9°×7°. The bleb area and temperature were studied With IRSoft and Universal Desktop Ruler programs. Intraocular pressure (corneal compensated) (IOPcc) was measured with Ocular Response Analyzer®, ORA. Conclusion. The study has shown the direct correlation dependence between bleb functional activity and its thermographic characteristics (area and temperature).
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-240-244
Introduction. Recent population studies reveal steady growth in intraocular lens (IOL) exchanges including those for refractive and other optical reasons. To lower complication risks related to IOL exchange, we introduced a modular IOL model with replaceable optical part. Purpose: preliminary analysis of modular IOL implantation clinical results. Patients and methods. From August 2018 to February 2020, five patients as part of their surgical treatment for various forms of cataract received newly designed modular IOLs. The modular IOL is composed of two separate parts — haptic and optic, manufactured from the same elastic acrylic material with hydrophobic properties. The haptic includes a closed ring and a pair of open equally distant loops in a unified design. The haptic ring with projections serves as a base for optical disk. The current study evaluated characteristics of the IOL implantation and assembly process, as well as possible development of intra- and early postoperative complications. Results. First implantations of the modular IOL accomplished using standard surgical instrumentation and disposables passed without complications. We did not observe scratches, breaks or any other mechanical damage to neither haptic, nor optical parts. During simultaneous implantation, optical disks fixated in haptic rings preserved their due positioning after transiting through slender injector channel. There were no specific, modular-IOL related complications in the early postoperative period. The optical disk maintained correct location, delimited by fixation leaflets of the haptic ring. Conclusion. Early results for clinical application of the novel modular IOL demonstrated feasibility of its safe implantation in disassembled and preassembled modes.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-228-233
Diabetes mellitus is a serious health problem in both developed and developing countries. It is expected that by 2040 the incidence of diabetes mellitus in the world will increase to 642 million people. With the increase in the incidence of diabetes mellitus, the incidence of diabetic vascular complications increases, which worsen the quality of life of patients and triple the risk of death. Diabetic retinopathy is one of the most common microvascular complications of diabetes mellitus, leading to progressive loss of visual function. Diabetic retinopathy occurs in conjunction with diabetic nephropathy. This fact is associated with the anatomical similarity of the blood-retinal barrier and the glomerular filtration barrier, as well as with the general pathogenetic mechanisms of the effect of hyperglycemia on peripheral microcirculation. On average, after 10–15 years, patients with decompensated diabetes mellitus develop end-stage renal failure, requiring renal replacement therapy, such as peritoneal dialysis, programmed hemodialysis, and kidney transplantation. This article highlights the latest data on the effect of programmed hemodialysis on the morphofunctional state of the retina in patients with diabetes mellitus.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-245-252
Background. In recent years there is a tendency to more often admission in our institution children with multiple IOL damage caused by laser treatment of secondary cataract operated at local hospitals. Purpose. To analyze the causes of laser damage to IOL in children underwent YAG laser destruction of secondary cataract and find best ways to prevent them. Patients and methods. We analyzed the frequency of acrylic IOL damage after YAG-laser destruction in 593 children with congenital, posttraumatic and postuveal cataract at age from 6 months to 17 years (one third of patients were less than 3 years old). All laser operations were performed on identical YAG-laser, by the same protocol and by one surgeon. Results. We confirmed that main reliable prevention factor of damage to IOL in children is the precise focus of laser beam. In past 10 years in our institution, we managed to decrease frequency of laser damage to IOL in children with secondary cataract in 4.5 times due to performing operations under general anesthesia (43.8 % in 2007–2008, 65.8 % in 2018). Thus, decreasing frequency from 5.9 % to 1.3 % in the same age group of patients. Conclusion. To achieve the effective prevention of laser damage to IOL in cases of YAG laser destruction of secondary cataract it is essential to use general anesthesia in following conditions: children 5 or below age, non-contact children of older age, children with nystagmus, CNS pathology, psychomotor development delay. It is unacceptable to perform this operations without general anesthesia in children that can’t fix the gaze. Furthermore it is important to use contact lenses to fix the eyes of a child, select the individual less invasive method and technique of laser operation, utilize single short impulses with minimal effective energy, thoroughly follow standard safe energy modes (impulse energy shouldn’t be more than 2.4 mJ, impulse number should be not more than 100).
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-181-187
This article presents data on clinical ophthalmological manifestations of COVID-19 described in the literature, clinical examples that we met in pandemic conditions, COVID-19 including early and late manifestations, as well as references to studies conducted decades ago and aimed to evaluate the effects of coronavirus infection on the visual organ. The purpose of the most studies was to study the effect of COVID-19 on the visual organ indicate that the most common ophthalmological manifestation of this disease is conjunctivitis, which occurs in 3–10 % of cases. Our observations showed that patients with COVID-19, when applying for an appointment with an ophthalmologist after 1–3 months, make complaints about the feeling of dryness, discomfort in the eyes, itching and redness of the eyelids. These complains arose immediately after the illness and persisted during the above terms. This phenomenon can be explained by the fact that any inflammatory process occurring on the eye surface disrupts the process of lacrimation and leads to the emergence of dry eye syndrome. It is necessary to pay close attention to complaints from the visual organ not only in patients with COVID-19 in the early stages of the disease, but also in the coming months after stopping the acute pathological process. As studies have shown, coronavirus can involve the posterior segment of the eye in the pathological process, since this virus has a retinotropic effect. This hypothesis can be confirmed by the reports of several authors who studied with optical coherence tomography (OCT) the state of the retina 11–33 days after the onset of symptoms in patients with COVID-19. OCT data indicate the presence of hyperreflexive zones at the level of the ganglion cell layer and the plexiform layer, the severity of these zones being greater in the papillomacular bundle region. In addition, cases of thromboembolic complications affecting the vascular system of the eye are described. Considering the fact that in the development of thromboembolism of the central artery and retinal vein, therapy is as effective as possible in the first hours from the beginning of this pathological process development, close attention should be paid to patients’ complaints to visual impairment occurred against the background of coronavirus infection. The data presented in this article open up a range of possibilities for conducting new scientific research that will help to preserve the vision and health of our patients as effectively as possible.
Ophthalmology in Russia, Volume 18; https://doi.org/10.18008/1816-5095-2021-2-222-227
Age-related macular degeneration (AMD) is a chronic disease of the central retina and one of the main causes of blindness in patients over 60 years of age in industrialized countries. Currently, anti-vascular endothelial growth factor therapy (anti-VEGF therapy) has become the standard of neovascular AMD treatment, leading to the prevention of progressive vision loss in more than 90 % of treated patients during a two-year follow-up period. In the modern world there are transition from quantitative assessment of “fluid” according to optical coherence tomography (OCT) — the thickness of the central retinal zone, to qualitative — the presence of IRF, SRF, fluid under RPE. The data obtained by Zinkernagel have shown that, despite good functional results (an increase in visual acuity), the administration of the drug once every 2 months leads not only to fluctuations in IRF and SRF, but also to serous PED . The existing qualitative and quantitative analysis is not perfect. Fluctuation is a new qualitative marker of the study of disease activity, it is defined as the sum of all types of fluid (IRF + SRF + fluid under RPE) in a certain time interval (with monthly measurement of the indicator). The fluctuation index was determined from the cumulative change in the thickness of the retina in the fovea over time . Thus, the fluid is considered as a key morphological criterion for the activity of nVMD and an indication for (initiation or continuation) of antiangiogenic therapy. At the same time, there is evidence that a lower level of each type of fluid (IRF, SRF, fluid under RPE) is associated with better BCVA results against the background of anti-VEGF therapy . The stability of retinal thickness during anti-VEGF therapy is no less important parameter than the statement of fluid resolution at a certain time, and it appears that better control of the central retinal thickness was associated with higher overall NEI VFQ-25 scores and individual scales reflecting important daily activities of the patient .