Saratov JOURNAL of Medical and Scientific Research

2020, volume 16

Effectiveness of neurofeedback therapy for acute nonspecific vertebrogenic pain in individuals with an increased level of anxiety

Year: 2020, volume 16 Issue: №1 Pages: 333-336
Heading: Neurology Article type: Original article
Authors: Bykovskiy P.V., Sherman M.A.
Organization: Kirov State Medical University
Summary:

Objective: to determine the effectiveness of therapy for acute nonspecific vertebrogenic pain and anxiety, as related conditions, using a non-invasive method of biological feedback, in particular neurofeedback technique. Material and Methods. The study included 60 patients with nonspecific vertebrogenic pain in the acute phase and with easily increased anxiety. Patients were divided into two equal groups (30 people in each group) by random sampling depending on the treatment protocol. The neurofeedback technique and basic therapy was applied for patients of the main group while 30 patients of the control group had only basic therapy applied to them. The effectiveness of treatment was evaluated by reducing the assessment of pain on a Visual Analogue Score (VAS), by reducing the anxiety on a Simptom Chek List-90-Revised (SCL-90-R) and to increase the alpha rhythm index. Results. In the main group, there was a greater regression of pain syndrome (p<0.05) and a significant increase in the power of alpha vibrations, recorded in the bioelectric activity of the brain. All investigated factors (anxiety level, severity of acute nonspecific pain and alpha rhythm index) are moderately related. Conclusion. It is advisable to use the non-invasive neuromodulating method of biological feedback (neurofeedback) to reduce anxiety and correct acute moderate vertebrogenic pain.

Keywords: acute nonspecific pain, anxiety, low back pain, neck pain, neurofeedback

Retina and optic nerve characteristics in fellow eyes of patients with epiretinal fibrosis after retinal detachment

Year: 2020, volume 16 Issue: №1 Pages: 318-321
Heading: Ophtalmology Article type: Original article
Authors: Yablokov M.M., Nenasheva Yu.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study was to examine the relation between the state of macular area and optic disc in fellow eyes of patients after rhegmatogenous retinal detachment (RRD) and the development of epiretinal fibrosis in association with silicone tamponade. Material and Methods. The study included 18 patients operated on for RRD using vitreous cavity tamponade by silicone oil. The examination was performed by means of optical coherence tomography-angiography for fellow eyes of patients. Results. Analysis of retinal thickness and volume revealed that the indices were lower in the group with epiretinal fibrosis. When assessing relative vascular density, area and perimeter of foveal avascular zone (FAZ) the indices were prevailed in the group with epiretinal fibrosis. Conclusion. The study revealed a significant decrease in retinal thickness in the fovea of fellow eyes in patients with epiretinal macular fibrosis. A statistically significant decrease in the thickness of the reticular membranes is revealed in patients with epiretinal macular fibrosis. A statistically significant enlargement of the area and an increase in the perimeter of FAZ, an increase in the relative vascular density in the foveal and deep plexuses in the fellow eyes of patients with epiretinal macular fibrosis were revealed as well.

Keywords: epiretinal macular fibrosis, rhegmatogenous retinal detachment, vitrectomy

The effectiveness of subtotal vitrectomy with retinotomy in surgical treatment of severe forms of proliferative diabetic retinopathy with retinal detachment

Year: 2020, volume 16 Issue: №1 Pages: 315-317
Heading: Ophtalmology Article type: Original article
Authors: Chuprov A.D., Gorbunov A.A., Kazennov A.N., Kuvaitseva Yu.S.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to increase the efficacy of surgical treatment of severe stages of proliferative diabetic retinopathy in combination with circular retinotomy. Material and Methods. The operations performed in 2016-2018 on patients with proliferative diabetic retinopathy in combination with traction retinal detachment (17 eyes). The patients' age ranged from 24 to 69 years. Tractional retinal detachment was diagnosed alongside with PDR3-4 in all eyes. In 10 (58.8%) previously operated eyes we diagnosed the relapse of retinal detachment. In 14 eyes (82.3%), vitrectomy was performed in combination with phacoemulsification, 3 eyes (17.6%) were already pseudophakic. Results. We obtained complete anatomical attachment of the retina in all 17 cases (100%). All patients we kept on 5700 cSt silicone tampon-ade. Circular retinotomy was performed on 10 (58.8%) eyes with a relapse. The period of keeping silicone oil 5700 cSt in the vitreous cavity after a circular retinotomy varied (from 1 to 3 years), emulsification of silicone oil occurred in none of the cases. Secondary glaucoma developed in 3 eyes. Conclusion. Circular retinotomy in combination with prolonged tamponade of the vitreous cavity with silicone oil provides stable anatomical effect.

Keywords: relapse of retinal detachmentent, retinotomy, silicone tamponade

Experience of FOTEK application in surgical treatment of strabismus

Year: 2020, volume 16 Issue: №1 Pages: 313-315
Heading: Ophtalmology Article type: Original article
Authors: Fokin V.P., Gorbenko V.M., Zakharova I.A.
Organization: Medical center «Sokol», Rostov-on-Don, S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose is to analyse the safety of radio-wave strabismus surgery using the FOTEK device. Material and Methods. The results of surgical treatment of strabismus were analysed in 283 patients. Results. The duration of the procedure using the FOTEK device was 12±0.5 minutes for operations on 1 muscle and 18±0.3 minutes for operations on 2 muscles involved, М±ст In the control group the duration of the operation was 16±0.4 and 25±0.5 minutes, M±a Intraoperative bleeding was recorded in the control group, which worsened the visibility of the surgical field and required additional time to stop the bleeding. Conclusion. The FOTEK device reduces the probability of hemorrhagic complications during surgical treatment of strabismus and shortens the duration of the operation.

Keywords: radio-wave surgery, surgical treatment of strabismus

Assess of treatment effectiveness of chronic ocular ischemic syndrome due to internal carotid artery stenosis of varying degrees

Year: 2020, volume 16 Issue: №1 Pages: 308-312
Heading: Ophtalmology Article type: Original article
Authors: Tuzlaev V.V., Egorov V.V., Kravchenko I.Z., Smoliakova G.P.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Postgraduate Institute for Public Health Workers
Summary:

The purpose of the study is to investigate treatment effectiveness for patients with chronic ocular ischemic syndrome (COIS) due to internal carotid artery (ICA) stenosis of varying degrees. Material and Methods. The study involved 15 patients with stage 3 COIS. They were divided into 2 groups according to treatment type: the 1 st group consisted with 7 patients with COIS and hemodynamically significant ICA stenosis, carotid endarterectomy (CE) was performed; the 2nd group consisted of 6 people with COIS and hemodynamically insignificant ICA stenosis, panretinal photocoagulation (PRP) was performed. Results. Monitoring of groups of patients for 1 year after COIS treatment allowed us to determine differentiated approach to treatment of patients depending on the degree of ICA stenosis. Reconstructive surgery at hemodynamically significant ICA stenosis caused positive dynamics in the improvement of blood flow in the ophthalmic artery (OA) by 63.8% relative to initial maximum systolic blood flow velocity, and decreased in the arterial resistivity index by 12.2%. PRP, due to improvement of microcirculation, which led to stabilization or improvement of best corrected visual acuity and COIS stabilization. Conclusion. The study has shown the appropriateness of differentiated approach to treatment of patients with severe degree COIS due to changes of ICA hemodynamics. Using stage-by-stage PRP and CE at COIS, depending on the degree of ICA stenosis, allows stabilization of ischemic process in the retina and delays the pathological metabolism processes aggravated in the ocular metabolism system.

Keywords: panretinal photocoagulation, ocular ischemic syndrome, internal carotid artery, chronic ocular ischemic syndrome, carotid endar-terectomy

Possibilities of color duplex scanning in assessing the state of ocular blood flow in patients with active retinopathy of prematurity

Year: 2020, volume 16 Issue: №1 Pages: 303-308
Heading: Ophtalmology Article type: Original article
Authors: Trifanenkova I.G., Tereshchenko A.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is to analyze the possibilities of color duplex scanning in assessing the state of ocular blood flow at various stages and forms of active retinopathy of prematurity (ROP). Material and Methods. A study of blood flow in the vessels of the eye and orbit was performed in 16 children (30 eyes) with various stages of active ROP at 6-10 weeks of life (post-conceptual age 36-38 weeks). A study of the blood flow in the vessels of the eye and orbit was performed by using the duplex scanning method in the modes of color Doppler mapping and pulsed Doppler ultrasound. The control group consisted of 9 premature infants without signs of ROP. Blood flow was evaluated in the ocular artery (OA), central retinal artery (CRA), central retinal vein (CRV), medial and lateral posterior short ciliated arteries (PSCA). The Doppler frequency shift spectrum (DFSS) was recorded and quantitative blood flow parameters were determined in these vessels, i. e. the maximum systolic rate (V ), the final diastolic rate (Vdiast), and the index of resistance or peripheral resistance (Rl). Results. The first and second stages of ROP were characterized by decreasing V in the orbital artery. A significant increasing V was detected in children with the third stage of ROP. Values of V in the orbital artery at all stages of ROP were significantly reduced if compared with the control group. The decrease of blood flow velocity index in the central retinal artery was detected in children with ROP. At the same time, a dependence of a greater extent on the type of pathological process than on the stage was found. We observed a significant increase in the Vsyst during the fourth stage. Analysis of blood flow in the posterior short ciliary arteries revealed the decreasing V during the first, second and third stages of ROP. The increase of the resistance index was revealed in all vessels under study. Conclusion. Presence of varying severity of hemodynamic disturbances of ROP was established. Color duplex scanning has significant diagnostic potential in assessing the hemodynamic parameters of the eyeball and orbit vessels, it is highly reproducible and objective.

Keywords: color duplex scanning, ocular blood flow, retinopathy of prematurity

Minimally invasive methods of keratoconus surgical treatment (review)

Year: 2020, volume 16 Issue: №1 Pages: 298-302
Heading: Ophtalmology Article type: Review
Authors: Tereshchenko A.V., Trifanenkova I.G., Vishnyakova E.N., Demyanchenko S.K., Timofeev M.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The review is devoted to minimally invasive methods of surgical treatment of keratoconus. Typical clinical manifestations of keratoconus are patients' young age and progressive course of the disease. Therefore, the problem of increasing keratoconus treatment effectiveness, especially at the early stages using minimally invasive techniques, does not lose its relevance, that determines the variety of the proposed methods and technologies and their modifications. Scientific literature review showed high activity of researchers aimed at developing new and improving the existing minimally invasive methods for surgical treatment of keratoconus. A significant number of publications is devoted to intrastromal keratoplasty (ISKP) with implantation of corneal segments. The ongoing studies touch upon both ways of forming the intrastromal tunnel, and the design of new models of the corneal segments, as well as the comprehensive analysis of their clinical application results. Special attention should be paid to the precision of performing ISKP to achieve high functional results and patient satisfaction with the quality of vision. In our opinion, this direction of research is especially promising and requires further development.

Keywords: corneal collagen crosslinking, intrastromal corneal segment, intrastromal keratoplasty, keratoconus

Keratoconus (review)

Year: 2020, volume 16 Issue: №1 Pages: 293-297
Heading: Ophtalmology Article type: Review
Authors: Tereshchenko A.V., Demyanchenko S.K., Timofeev M.A.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The article covers the main aspects regarding prevalence, pathogenesis, diagnosis and treatment of progressive, degenerative, non-inflammatory corneal disease, i. e. keratoconus. Characteristic features of this pathology affect people of a young and working age, and cause high rates of visual disability. Keratoconus is a multifactorial disease that requires individual approach in each clinical case. Existing methods of diagnosis and treatment allow to achieve stabilization of the ectatic process at an early stage and increase the visual functions of the patient. New methods of this disease treatment are alternative and high-tech methods that allow to expand the arsenal of corneal surgery without donor material use.

Keywords: corneal pathology, keratoconus

Femtolaser intrastromal implantation of segments using a digital marking device in surgical treatment of keratoconus

Year: 2020, volume 16 Issue: №1 Pages: 287-293
Heading: Ophtalmology Article type: Original article
Authors: Tereshchenko A.V., Demyanchenko S.K., Vishnyakova E.N.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose of the study is the clinical-functional evaluation and development of intrastromal keratoplasty using a digital marking device in patients with keratoconus. Material and Methods. 60 patients (60 eyes) diagnosed with second degree keratoconus were included in the study. The patients were from 19 to 35 years old. 30 patients (30 eyes) were included in the main group and underwent femtolaser intrastromal keratoplasty controlled by the Verion Digital Marker digital marking device (Alcon, USA). 30 patients (30 eyes) were included in the control group and underwent standard femtolaser intrastromal keratoplasty. Results. By the end of the observation period we recorded an increase in uncor-rected visual acuity from an average of 0.25 to 0.6, as well as corrected visual acuity from an average of 0.5 to 0.7 in the main group. Visual acuity was lower in control group, which was probably due to the fact that cyclotorsia was not taken into consideration during surgery. In the course of dynamic observation, we recorded a decrease in keratometry indices in the main group in the course of 3 months, next, in the following 12 months their stabilization was observed. In the course of dynamic observations in the main group, we recorded a decrease in keratometry indices in the course of 3 months, next, in the following 12 months their stabilization was observed. Conclusion. Application of Verion navigation system during intrastromal keratoplasty using a femtosecond laser with consideration of eye cyclotorsia has shown high efficiency in achieving precise positioning of the corneal segments.

Keywords: corneal segments, intrastromal keratoplasty, keratoconus, navigation system

Heidelberg edge perimetry and retinal tomography in diagnosis of initial open-angle glaucoma

Year: 2020, volume 16 Issue: №1 Pages: 280-287
Heading: Ophtalmology Article type: Original article
Authors: Sukhorukova A.V., Fabrikantov O.L., Tovmach L.N.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose of the study is to develop an algorithm that increases the accuracy of diagnosing initial open-angle glaucoma using Heidelberg edge perimetry and retinal tomography. Material and Methods. The study involved 624 patients (624 eyes): 236 males and 388 females. The mean age was 63.4±9.3 years old. All patients underwent routine ophthalmic examination, Heidelberg edge perimetry (HEP), and Heidelberg retinal tomography (HRT) depending on the results achieved. Results. The study revealed both direct and inverse relationships between the disease and particular HRT parameters. We established quantitative characteristics of the optic disc parameters, where pathological alterations were revealed receiver operating curve (ROC-analysis) mathematical method. We analyzed the data from the positions of attribution of a patient's individual parameters to the risk factor according to the received cut-off point limit values. Seven main parameters, which received the best evaluation of diagnostic informativity according to ROC-analysis, were assessed. Then we compared the number of risk factors and the real value of the sick/healthy characteristic. Conclusion. We have developed a new algorithm to diagnose the initial open-angle glaucoma. According to this algorithm, the most applicable diagnostic practice is to set the diagnosis in the presence of five risk factors in the individual optic disc values with 95% specificity.

Keywords: edge perimetry, retinal tomography