2017, volume 13

The aim ofthisworkwasto analyze the intensity of the laser coagulates in the treatment of diabetic macular edema conducted in navigation mode on robotic laser system Navilas. Material and Methods. Retrospective analysis of outpatient cards and photographs of the fundus 20 patients (28 eyes) had been done. The patients had type II diabetes mellitus. We performed laser treatment of diabetic macular edema. There were evaluated 4260 coagulates, of which 0 degree 2166 (50.85%), I degree —525 (12.32%), II degree —747 (15.74%), III degree—498 (11.96%), grade IV — 324 (7.6 per cent). Result. The thickness of the retina before treatment in the area of edema was made 339.72±45.3 urn, and after treatment 346±70 urn, student's t-test 0.7124, a difference of 6.5±57.4. Visual acuity before treatment 0.532±0.3, after— 0.521±0.3mm, student's t-test 0,889. Conclusion. The facts obtained in the analysis suggests that the algorithm of selection of power and the way it adjustments in the course of treatment are the weak point of this technique. Development of new methods, giving the possibility to adjust the power depending on the height of the swelling region of the retina, thereby gaining coagulates strictly necessary for the specific case of intensity, will enable to increase the efficiency and safety of laser treatment.

Prolonged hypotensive effect in the postoperative period is one of the main tasks of modern glaucoma surgery. In connection with this, the aim of our study is to develop a surgical method of prevention of scarring during the classical sinustrabeculectomy. Material and Methods. The operation was performed in 13 patients (13 eyes) with primary open angle glaucoma (POAG) ll-lll (B-C) in steps aged 50-70 years. The duration of observation up of 2 year. Results. After 9-12 months of hypotensive efficacy was 100% (13 eyes) in 20-24 months — 98% (12 of 13 eyes). The result was confirmed using standard methods of examination (visometry, tonometry, computerized perimetry, tonography et al.), in the early postoperative period was performed optical coherence tomography of the anterior segment, then — ultrasound biomicroscopy. Conclusions. Developed a new version of the surgical treatment of glaucoma a long-acting hypotensive effect.

Purpose: to analyze the results of microinvasive surgical treatment of children with post-traumatic endophthalmitis. Patients and Methods. Under our observation there were 5 children aged 9-13 years with penetrating wounds of the cornea. All children referred to the clinic with clinical manifestations of endophthalmitis. Visual acuity was reduced from 0,01 up to light perception with the correct projection. Results. Lensvitrectomy allowed to visually detect foreign bodies in vitreous and to remove them through the corneal access. Finished the operation by the intraocular introduction of antibiotics and corticosteroids. Criteria of efficiency of treatment: relief ofthe infectious process, the transparency of optical media, lack of subatrophy ofthe eyeball during the observation period of 3-5 months. Conclusion. Timely primary surgical rehabilitation of children with post-traumatic endophthalmitis appropriate, despite the severity of the injury.

The purpose of the study was to investigate the efficiency of nistagmus treatment method using videooculography in a long-term observation. Material and methods. 288 patients were examined. The nystagmogram had been record-ering at the time of the patient's admission, every day after the treatment and after the entire course of treatment. The video image had been recordering for 1 minute at the sight of the patient directly. Based on the diagnostic results, there had been determining the following parameters: the main nystagmus frequency, the amplitude of the nystagmus (maximum deviation from the central position). The treatment procedure had been carrying out for 7-10 minutes in average, depending on the degree of decrease in the amplitude of the nystagmus. It is necessary to correct the frequency of light stimulus when the main nystagmus frequency changes. Results. Suppression of nystagmus in patients after a single treatment procedure persisted for different times (from several seconds to several minutes), after which the gradual recovery of the nystagmus occurred before the values of the amplitudes less than before the start of the treatment procedure. The result of repeated procedures was a further decrease in nystagmus amplitudes and an increase in the time of preservation of the suppression effect. One course included 7-10 treatment procedures. On average, for 2 courses of treatment per year in 60% of patients the amplitude of nystagmus decreased by 40-85%, in 30% of patients the amplitude of nystagmus did not change more than 8-12%, in 10% of patients there were no significant changes. Conclusion. The developed method using videooculography is effective in the diagnosis and treatment of nystagmus, as it allows to reveal the frequency of nystagmus of each patient with further treatment by light stimulus of the patient at this frequency and the possibility of its correction.

Objective: to evaluate the effectiveness of orthokeratological correction in the treatment of progressive myopia in children. Material and methods. A retrospective study correction of myopia orthokeratology lenses of 100 patients (178 eyes) with an established diagnosis of myopia of an average degree, undergoing treatment at the Clinic of eye diseases of SSMU. Group I consisted of 50 patients who received OK-correction lenses "Emerald" by Euclid Systems Corporation (USA). The wear time is 2 years. Group II included 50 people (87 eyes), using spectacle correction during the same time. Patients underwent visual acuity testing, biomicroscopy, refractometry, determination of reserves of accommodation, ultrasonic biometry (IOL-Master, CarlZeiss) is a measurement of the size of the front-sadayoshi eyeball, survey after 2 years of using the selected correction. Results. Comparative analysis showed that the use of OK lenses for patients with myopia of an average degree resulted in a significant reduction in the rate of progression of myopia. In the background wearing OK lenses for 2 years has been the increase PZO, PZO dynamics were 0.09±0.05 mm. For the correction of progressive myopia spectacle lens changes were more significant, the dynamics of early school leaving amounted to 0,36±0,11 mm. Conclusion. The identified inhibitory effect of OK-lenses on myopia progression, confirmed by the indices of refraction and ultrasound biometry within 2 years of the study. The data allow us to recommend OK-therapy, as an effective tool for progressive myopia.

The objectives of the study are to establish the occurrence of uveitis in patients with rheumatic diseases, to assess the features of the uveitis in rheumatic disease in children and adults, and to analyze the effectiveness of theirtreatment. Materials and Methods. The study included 670 people with RH (stage I) and 35 patients who had uveitis and / or rheumatic fever who agreed to undergo additional ophthalmologic bleeding (stage II), including a standard ophthalmological examination including visiometry, biomicroscopy of the anterior segment, ophthalmoscopy of the posterior segment of the eye, refractometry, optical coherence tomography in angiomode(tomograph-angiograph CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany), dopplerography of the vessels of the eye. Results. The prevalence of uveitis in rheumatic diseases was established in 21%, which is higher than that in the general population. Uveitis in rheumatic diseases is recurrent and well-treated condition with frequent and complete improvement of visual acuity, and angiographycal features of uveitis, p <0,05 for all parameters. Conclusions. The high incidence of uveitis and relapsing their course in rheumatic diseases lead to necessity of an ophthalmologist's examination every 6 months. It is desirable to perform a comprehensive angiographic examination of uvea for the timely detection of erased and subclinical forms of uveitis.

Objective: to develop algorithms of processing of video images of optical slices of the eye retina to quantify the degree of folding of the epiretinal membranes and of the central fossa. Material and methods. The object of the study was the video image of the retina obtained by optical coherence tomography. To develop methods of determining the degree of folding epiretinal membrane was formed mathematical model of the profile consisting of a base profile (low frequency component) and folding (high frequency part). Results. There had been developed two alternative methods of estimation of folding epiretinal membrane: retinal-averaging method and the method using the wavelet transform. The algorithm of geometrical parameters of the central fossa: the height, width and line shape. These algorithms are implemented in a software system. Conclusion. The practical application of the developed system showed its adequacy, as well as an introduction into medical practice the use of quantitative estimates of some parameters of the retina condition.

Purpose: to investigate the informative value of fluorescent angiography (FA) and optical coherence tomography with fundus angiography (angio-OCT) in the diagnosis of "wet" form of age-related macular degeneration (AMD). Material and methods. The present study included 20 patients (20 eyes) diagnosed with degeneration of macula and posterior pole of the eye, the "wet" form (late stage age-related macular degeneration, AREDS category 4). The study used machines: optical coherence tomography, Spectralis HRA+OCT (Heidelberg Engeneering, Germany), optical со- herence tomography-angiography CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany). Results. When conducting the FA, in 11 patients found the ill-defined zone of small leakage of dye in 7 patients revealed a clearly defined area of hyperfluorescence in the early phase, and marked leakage of dye in the late phase, 2 patients — uncertain indices. In connection with the received data questionable PHAGE in 11 patients, all were held angio-OCT, to clarify the localization of choroidal neovascularization (CNV). When performing angio-OCT in 11 patients revealed that "wet" form of AMD with occult choroidal neovascularization. In 7 patients there had been discovered classic CNV in 2 patients combined. Conclusion. Angio-OCT gives a clearer picture about the presence of a choroidal neovascular membrane that plays a significant role in determining the course of treatment of patients with wet age-related macular degeneration.

Purpose: to evaluate the effectiveness of combined surgical treatment in patients with proliferative stage of diabetic retinopathy. Material and Methods. 52 patients with advanced stage of proliferative diabetic retinopathy who were divided into 2 groups were examined. Group 1 consisted of 30 patients with a preliminary intravitreal injection of ranibi-zumab, followed by vitrectomy In group 2, 22 patients underwent vitrectomy without anti-VEGF therapy. Visual acuity in the 1st group before treatment was 0.04±0.02, in the second 0.05±0.03. The thickness of the retina in the foveolar zone of the 1st group was 358±34 urn, in the second 378±44 urn. Height of the complex "PHM with fibro-glial proliferation — retina" 670±38 and 710±30, respectively. Results. The visual acuity after treatment increased 4.2 times (group 1), in comparison with the results of the second group by 2.5 times. In patients of the 1st group intraoperative hemor-rhagic manifestations were observed in 36.6% of cases, in the 2nd group in all patients. An increase in the height of the complex "PHM with fibro-glial proliferation — retina" was noted in 83.3% in patients of the 1st group one month after the injection. The height of the complex increased on average to 153±25 urn, which in 76.6% increased the traction effect on the retina. The neovascularization regression occurred 4-8 days after ranibizumab injection in group 1 patients. The retinal thickness of the central zone 10 months after vitrectomy decreased to 220±10 urn in the 1st group and to 273±14 urn in the 2nd group, respectively. Conclusion. The use of inhibitors of angiogenesis, in particular ranibizumab, as a preoperative preparation of patients with proliferative stage of diabetic retinopathy reduces the risk of intra- and postoperative hemorrhagic complications, which facilitates the implementation of vitrectomy, avoids additional vitreo-retinal interventions, in connection with which a positive functional result remains.

The purpose of study is to compare an effectiveness of different refractive laser surgery methods. Material and methods. 72 LASIK patients (141 eyes) and 21 TransPRK patients (39 eyes) were analyzed. Among them there were 42 women and 50 men. The age of patients at the operation moment was from 18 to 46 years. Patients were divided into 3 groups, according to myopia rate. The research method is descriptive statistics. Results. A differentiated approach to the choice of surgery gives the maximum possible and stable functional result. Confocal corneal microscopy data show a decrease in the corneal epithelium of the number of cells with large nuclei (markers of hypoxia) in operated patients, in contrast to patients using contact lenses. This confirms the advantage of laser correction in comparison with contact correction of myopia. Conclusion. High and stable recuperated vision sharpness at all patients attests eximer-laser correction efficiency and safety under any myopia rates.