Saratov JOURNAL of Medical and Scientific Research

The S. Fyodorov Eye Microsurgery Federal State Institution

Realization of the «Health care» national project in the initial stages: telemedicine consultations conducted with the use of the unifed state health care information system

Year: 2019, volume 15 Issue: №2 Pages: 572-576
Heading: Ophtalmology Article type: Original article
Authors: Chukhrayov A.M., Khodzhaev N.S., Kechin E.V.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to analyze the structure of telemedicine consultations (TMС) implemented using the «Telemedicine con-sultations» component of the subsystem of the federal electronic registry of the unifed state health care information system (component of TMС FER USHIS) for the period from 01.01.2019 to 31.03.2019. Material and Methods. The study was carried out according to the reporting forms of the component of TMС FER USHIS. Results. In total, 490 TMK of the «doctor — doctor» type were carried out, of them: 306 (62.5 %) — ophthalmologist consultations; 158 (32.2 %) — rehabilitologist consultations; consultations of a phthisiatrician, endocrinologist, pediatric surgeon, pediatric oncologist, cardiologist, cardiovascular surgeon, radiotherapist in total 26 (5.3 %). Consultative medical organization was S. Fe-dorov Eye Microsurgery Federal State Institution in all conducted TMC of ophthalmology. In the Russian Federation, in 72.9 % TMC cases of an ophthalmology profle was conducted to determine treatment tactics, 10.5 % to determine the diagnosis, and 10.5 % to agree on conditions and hospitalization in a federal medical organization, the other aim of the consultation were 6.1 % in total. TMC according to the «Ophthalmology» profle was performed with 37 regions of the Russian Federation, with 48 regions were not carried out. Conclusion. The analysis of the TMC structure showed that it is necessary to carry out further work on the implementation of the TMС FER USHIS component in medical organizations of the Russian Federation regions.

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Role of melatonin in pathogenesis of age-related macular degeneration

Year: 2019, volume 15 Issue: №2 Pages: 559-563
Heading: Ophtalmology Article type: Review
Authors: Khodzhaev N.S., Chuprov A.D., Kim S.M.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in people aged 50 years and older in the advanced world. The article deals with the epidemiology and pathogenesis of the disease. Special attention is given to a new approach to the prevention and treatment of AMD with the help of melatonin; modern management options and scientifc achievements are discussed. Many researchers have shown that melatonin is able to protect retinal epithelial cells from oxidative damage. Perhaps the physiological reduction of melatonin in the elderly may be an important factor in the dysfunction of the retinal pigment epithelium, which is the cause of AMD.

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Evaluation of retinal neuroarchitectonics in presence of optic nerve head drusen

Year: 2019, volume 15 Issue: №2 Pages: 490-494
Heading: Ophtalmology Article type: Review
Authors: Kabanova EA, Ioyleva EE, Zinovyeva AV.
Organization: Moscow State Medical Stomatological University n.a. A. I. Evdokimov, The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: assessment of retinal neuroarchitectonics in presence of optic nerve head (ONH) drusen. Materials and Methods. 108 patients (216 eyes) with bilateral drusen of the optic disc aged 18–60 years were examined, and the control group consisted of 28 healthy subjects. All patients underwent optical coherence tomography (OCT) using Cirrus HD-OCT 5000–7544 device (Carl Zeiss Meditec Inc.). Results. Three types of ONH drusen localization relative to the Bruch membrane were identifed: superfcial, deep and difuse. Difuse localization of the drusen was determined in 48.6 % of cases, deep — in 40.3 %, superfcial — in 11.1 %. Deep optic disc drusen were more common in a young age (35.5±13.1 years), difuse — in medium age (42.0±13.2 years), superfcial — at an older age (51.7±12.8 years). With superfcial and difuse drusen of the optic disc, a signifcant (p<0.05) decrease in the thickness of the ganglion cell (GC) layer in all studied sectors, a decrease in the minimum and average GC thickness was found, as well as a signifcant (p<0.05) decrease in the average thickness and cubic volume of the neuroepithelium. With deep drusen opacities, the changes in GC were less pronounced and statistically insignifcant. Conclusion. analysis of the obtained data showed that deep drusen of the optic disc are the initial stage of congenital pathology, difuse drusen are a developed stage, and superfcial drusen of the optic disc characterize the development of fnal stage.

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Diagnostic criteria for optic nerve atrophy in patients with multiple sclerosis determined by next generation spectral optical coherence tomography

Summary:

Purpose: identifcation of diagnostic criteria for optic nerve atrophy by spectral optical coherent tomography in patients with multiple sclerosis (MS). Material and Methods. 81 patients with optic nerve atrophy due to MS (37 men, 44 women, mean age 35.6±3.7 years) were examined using spectral optical coherent tomography (S-OCT). Results. We obtained reliable data suggesting on the asymmetry of S-OCT parameters in patients with multiple sclerosis and optic nerve atrophy. In the process of a detailed assessment of the thickness of the GCS+IPL complex, signifcant difer-ences in the worst and paired eyes were obtained. In addition, when the total aggregating all of the results obtained by the method of binary logical regression determined the threshold for partial atrophy of the optic nerve due to MS. The average thickness of GCS+IPL complex, as determined by S-OCT, is a reliable marker of neuroaxonal degeneration in patients with optic nerve atrophy due to MS. Conclusion. S-OCT criteria for optic nerve atrophy in multiple sclerosis are a decrease in the average thickness of the retinal nerve fber layer of less than 62 microns, combined with a decrease in the average thickness of retinal ganglion cell complex and the inner plexiform layer less than 52 microns, thickness of upper segment of GCS+IPL less than 51 μm, and the lower segment of GCS+IPL less than 50 microns.

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Evaluation of the functional efect of surgical treatment of rhegmatogenous detachment in the late postoperative period

Year: 2019, volume 15 Issue: №2 Pages: 470-473
Heading: Ophtalmology Article type: Original article
Authors: Zaika V.A., Yakimov A.P., Yuryeva T.N.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to identify the key factors determining the functional outcome of surgical treatment of rhegmatogenous retinal detachment. Material and Methods. The study group included 39 patients operated for rhegmatogenous retinal detachment, which 6 months after surgery were divided into 2 groups depending on visual acuity obtained. All patients underwent standard ophthalmologic examination and color computed perimetry, electrophysiological studies, electro-retinography and registration of visual evoked potentials, optical coherent tomography, color Doppler mapping of posterior pole vessels. Results. 6 months after the surgical treatment of retinal detachment in the 1st group, best corrected monocular visual acuity increased by 4 times in comparison with the 2nd group. When analyzing color-opponent perim-etry results in patients of the frst group, a threefold improvement in medium sensitivity and reliability factor indices for both red and blue stimuli was detected in comparison with the 2nd group. Patients in the 2nd group showed an increase in the phosphene index. In patients of this group in late postoperative period there was an increase in peripheral resistance of vascular wall in both arterial and venous parts of the blood fow, which was probably one of important reasons for non- recovery of vision in patients of this group. Conclusion. Full restoration of regional blood fow and receptor channels of organ of vision, as well as restoration of local and general electrical sensitivity of retina and visual pathway conductivity, is a necessary component of successful restoration of visual functions.

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Wide-feld retinal optical coherence tomography for imaging of peripheral vitreoretinal interface and stratifcation of risk for rhegmatogenous retinal detachment recurrence

Year: 2019, volume 15 Issue: №2 Pages: 456-459
Heading: Ophtalmology Article type:
Authors: Doga A.V., Shkvorchenko D.O., Kryl L.A., Buryakov D.A., Bayzulaeva M.R.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to evaluate the peripheral vitreoretinal interface changes after combined laser-surgical treatment of local rhegmatogenous retinal detachments revealed by wide-feld OCT. Material and Methods. 21 patients (21 eyes) with local rhegmatogenous retinal detachment localized in the upper half of the fundus were enrolled in this study. All patients underwent a combined laser-surgical treatment, which included 3 steps: 1) Nd: YAG laser excision of the vitreoretinal adhesion zone, determined by wide-feld OCT; 2) pneumatic retinopexy; 3) barrier laser photocoagulation at the edge of the tear after retinal reattachment. All patients underwent OCT of the peripheral vitreoretinal interface to identify areas of pathological vitreoretinal adhesions in the post-operative period. Results. OCT analysis of 21 patients has demonstrated the complete elimination of the traction component in the treatment area. However, vitreoretinal adhesions near the tear area were found in 4 patients. These patients underwent additional barrier laser photocoagulation at zones of pathological vitreoretinal traction. Conclusion. Visualization of

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Hormonal and lipid imbalances in the formation of myopic chorioretinal neovascularization in women

Year: 2019, volume 15 Issue: №2 Pages: 447-451
Heading: Ophtalmology Article type: Original article
Authors: Grigorieva A.V., Shchuko A.G., Kursakova Yu.V., Ivanova E.l., Samsonov D.Yu.
Organization: Irkutsk State Medical University, The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to determine the role of hormonal and lipid imbalance in the formation of myopic chorioretinal neovascularization in women. Material and Methods. The frst clinical group includes the results of the study of patients with the active form of myopic chorioretinal neovascularization, the second — the results of the study of their paired eyes. The control groups were formed separately. Ophthalmologic and somatic status of all patients and people in the control groups were thoroughly examined. Results. An increase in the level of prolactin to 501.7±28.2 mlU/ml was established, in the control group to 272.9±33.4 mlU/ml, the level of follicle-stimulating hormone 13±0.1 mlU/ml, the control group 4,6±1.2 mlU/ml. The concentration of estradiol is reduced 35.2±3.1 pg/l, progesterone 2.8±0.1 nmol/l, compared to the control group 66.8±8.1 and 6.2±1.1 nmol/l respectively. An increase in the level of acute-phase proteins was revealed: fibrinogen 3.8 (14.0±0.5) and C-reactive protein 2 times (5.72±2.30) compared with the control group 3.6±0.5 and 2.5±0.7. Increased lipoprotein level (a) 50.2±1.2 g/l and ApoB/ApoA 0.6±0.1 compared with the control group 9.1±1.1 et 0.4±0.1 g/l. Conclusion. The fndings confrm the pathogenetic signifcance of systemic risk factors in the development of choroidal dysfunction and, as a

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The possibilities of optical coherence tomography in En Face mode in planning and conducting computer-assisted laser surgery for central serous chorioretinopathy

Year: 2019, volume 15 Issue: №2 Pages: 433-442
Heading: Ophtalmology Article type: Original article
Authors: Volodin P.L., Ivanova E.V., Fomin A.V., Agafonov S.G., Polyakova E.Yu.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to assess the diagnostic capabilities of optical coherence tomography (OCT) in En Face mode for planning and conducting surgical navigation using Navilas 577s laser system in patients with central serous chorioretinopa-thy (CSC). Material and Methods. 12 patients (12 eyes) with CSC underwent high-resolution OCT in En Face mode showing morphological changes in the retinal pigment epithelium (RPE). The treatment was performed on Navilas 577s laser device with an individual selection of the necessary energy parameters in the micropulse mode. The follow-up was performed at 1, 3 and 6 months. Results. According to the OCT data in the En Face mode, all patients had morphological changes in RPE, which made it possible to plan and perform computer-assisted laser surgery. 1, 3 and 6 months after treatment, positive dynamics was observed in all cases. Conclusion. The OCT method in En Face mode allows detailed study of architectonics and identifes pathological changes in RPE, which play an important role in the manifestation of CSC, as it enables planning and implementation of topographic-oriented treatment using the Navilas 577s navigation laser system in the areas of RPE detachments.

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Bacterial collagenase in the treatment of vitreoretinal pathology

Year: 2018, volume 14 Issue: №4 Pages: 953-956
Heading: Ophtalmology Article type: Review
Authors: Zgoba M.l., Lyskin P.V., Makarenko I.R.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Bacterial collagenase has been used in Russian ophthalmology for more than 40 years, its official medical use is allowed since 1983 Collagenase is used in the treatment of a broad spectrum of ophthalmopathology For the treatment of vitreoretinal pathology the drug has been used since 1996 To date, quite a lot of experience in the use of bacterial collagenase for the treatment of vitreoretinal pathology has been accumulated. The article presents the literature data on the possibilities of using the drug in various areas of vitreoretinal pathology and the prospects of expanding the indications for the use of the drug in a wider ophthalmic practice.

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Bacterial collagenase in the treatment of vitreoretinal pathology

Year: 2018, volume 14 Issue: №4 Pages: 953-956
Heading: Ophtalmology Article type: Review
Authors: Zgoba M.l., Lyskin P.V., Makarenko I.R.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Bacterial collagenase has been used in Russian ophthalmology for more than 40 years, its official medical use is allowed since 1983 Collagenase is used in the treatment of a broad spectrum of ophthalmopathology For the treatment of vitreoretinal pathology the drug has been used since 1996 To date, quite a lot of experience in the use of bacterial collagenase for the treatment of vitreoretinal pathology has been accumulated. The article presents the literature data on the possibilities of using the drug in various areas of vitreoretinal pathology and the prospects of expanding the indications for the use of the drug in a wider ophthalmic practice.

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