Saratov JOURNAL of Medical and Scientific Research

Khodzhaev N.S.

S. Fedorov Eye Microsurgery Federal State Institution, Deputy General Head for Organizational Work and Innovative Development, Professor, DSc

Comparative characteristics of melatonin content in lacrimal fluid and blood serum depending on the stage of senile cataract with age-related macular degeneration

Year: 2020, volume 16 Issue: №2 Pages: 673-678
Heading: Ophtalmology Article type: Original article
Authors: Khodzhaev N.S., Chuprov A.D., Smolyagin A.I., Kim S.M., Filippova Yu.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to evaluate factors affecting concentration of melatonin in the tear and blood serum in patients with a non-exudative form of age-related macular degeneration (AMD). Material and Methods. 140 patients (140 eyes) were examined, of which 52% were women, 48% were men. The following groups of patients were formed: 1) patients with non-exudative AMD and senile cataract who took melatonin; 2) patients with non-exudative AMD and senile cataract who did not take melatonin; 3) without AMD and cataract; 4) patients with non-exudative AMD, not requiring surgical treatment of cataract; 5) patients with neovascular (exudative) form of AMD (nAMD). The melatonin content was determined using immunosorbent assay. Results. The content of melatonin in all examined patients' serum ranged from 0.001 to 0.161 ng/ml, the highest median of melatonin values was observed in healthy individuals (0.125 ng/ml), and the lowest in patients with nAMD (0.021 ng/ml). The level of melatonin in the tear varies from 0.067 to 0.477 ng/ml, while its highest median was found in group 1 patients: 0.324 ng/ml. In group 2 and reference groups (without cataract with AMD and with nAMD), the melatonin content in the tear was significantly reduced (p <0.05) compared with the level in the group of healthy individuals. Conclusion. The content of melatonin in the blood serum and lacrimal fluid depends on the following factors: age, arterial hypertension, body mass index (BMI), insomnia, smoking, hair and eye color, night shifts. Using melatonin in the treatment of patients with AMD helps to increase the concentration of melatonin in tear.

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Modern complex rehabilitation of a patient after removal of tumor of iridociliary zone (clinical case)

Year: 2020, volume 16 Issue: №2 Pages: 671-673
Heading: Ophtalmology Article type: Case report
Authors: Khodzhaev N.S., Sobolev N.P., Shkandina Yu.V., Soboleva M.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

A clinical case of optical reconstructive treatment of a patient after removal of an iridociliary zone tumor (ICZ) is presented. 1 year after blockexcision of the right eye, patient A., 63 years old, treated to the S. Fyodorov Eye Microsurgery Federal State Institute with the aim of correcting visual functions, where him was scheduled for optical reconstructive surgery (ORS): phacoemulsification of cataract with implantation of an intraocular lens, capsular ring and iris-lens diaphragm. 1 year after the ORS, there was no recurrence of the tumor process, and the obtained clinical and functional results remained stable, a patient did not complain. The proposed deadlines and technical features of ORS in a patient with a history of ICZ tumor removing create the necessary conditions for improving of functional results and the quality of life after organ-preserving operations.

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Drainage surgery for refractory glaucoma combined with micropulse cyclophotocoagulation

Year: 2020, volume 16 Issue: №1 Pages: 273-276
Heading: Ophtalmology Article type: Original article
Authors: Sidorova A.V., Khodzhaev N.S., Eliseeva M.A., Starostina A.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to evaluate the possibility of using Micropulse technology in combined treatment of refractory glaucoma, including implantation of an Ex-PRESS micro shunt and one-stage micropulse sectoral cyclophotocoagulation (mCPC). Material and Methods. The study included 25 patients with advanced stages of previously operated primary open-angle glaucoma. IOP before surgery averaged 35.3±4.4 mmHg. Surgical treatment was carried out using combined method, including implantation of an Ex-PRESS micro shunt and one-stage sectoral mCPC. Results. In 2 cases in the early postoperative period, according to the B-scan, a detachment of the choroid was diagnosed, which was treated with medication. The IOP level on the first day after surgery averaged 8.3±1.4 mmHg, after 12 months of observation 19.9±4.1 mmHg, while hypotensive drops were re-appointed in 2 cases. Before surgery all patients underwent ultrasound biomicroscopy with measurement of the ciliary body (CB) thickness, which was an average of 0.69±0.04 mm before surgery. After 12 months of follow-up, no cases of postoperative atrophy of CB were diagnosed, the CB thickness was 0.67±0.03 mm on average. Conclusion. Combined treatment of refractory glaucoma, including implantation of the Ex-PRESS micro shunt and one-stage mCPC, is an effective and safe method for IOP reduction.

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Clinical effectiveness of prophylactic treatment of women at risk for the formation of vascular retinal pathology after preeclampsia

Year: 2020, volume 16 Issue: №1 Pages: 220-223
Heading: Ophtalmology Article type: Original article
Authors: Kolenko O.V., Sorokin E.L., Fil A.A., Khodzhaev N.S., Chizhova G.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, Postgraduate Institute for Public Health Workers, Far Eastern Federal University
Summary:

The purpose of the study is to investigate the clinical effectiveness of prophylactic treatment of women who have previously undergone preeclampsia and are a part of the risk group for the formation of vascular retinal pathology. Material and Methods. The main group consisted of 40 women aged 24 to 43. The selection criterion was presence of a risk of vascular retinal pathology formation. Women of the main group were prescribed periodic courses of preventive treatment for a period of time of 3-4.5 years. The comparison group consisted of 51 women, who underwent preeclampsia, and also had a risk of forming vascular retinal pathology and did not receive preventive treatment. Results. Systematic conduct of preventive treatment courses with antiplatelet agents and antioxidants to women who have undergone preeclampsia and are at risk of vascular retinal pathology formation have been effective. Conclusion. Frequency of vascular retinal pathology formation in the main group decreased to 15% against 34% in the comparison group (p<0.05).

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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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The vascular- platelet and coagulation hemostasis in preeclampsia and gestational arterial hypertension in the third trimester of pregnancy

Year: 2019, volume 15 Issue: №2 Pages: 501-506
Heading: Ophtalmology Article type: Original article
Authors: Kolenko O.V., Chizhova G.V., Sorokin E.L., Fil A.A., Khodzhaev N.S., Pomytkina N.V.
Organization: Postgraduate Institute for Public Health Workers, The Khabarovsk branch of the S. Fedorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to conduct a retrospective analysis of the initial state of the indicators of systemic hemostasis in women during a complicated pregnancy, to determine its likely relationship with the formation of vascular retinal pathology in the long-term period after childbirth. Material and Methods. The 1st main group consisted of 47 women whose pregnancy proceeded against the background of gestational hypertension. The 2nd main group is represented by 48 women, whose pregnancy was complicated by pre-eclampsia. The control group was formed by 50 women with normal ongoing pregnancy. In women of all groups, the initial state of hemostasis was assessed in the third trimester of pregnancy, according to medical records. Results. It turned out that in women with hypertensive disorders in the third

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