[Micropulse laser treatment of complicated forms of sclerogenic macular degeneration]. / Mikroimpul'snoe lazernoe lechenie oslozhnennykh form sklerogennoi makulyarnoi degeneratsii.

Focal dome-shaped prominence of the macular profile due to thickening of the scleral layers leads to the development of sclerogenic macular degeneration (SMD), which causes a decrease in vision when it evolves into complicated forms. PURPOSE: To evaluate the effectiveness of subthreshold micropulse laser (SML) coagulation in patients with SMD complicated by detachment of neuroepithelium. MATERIAL AND METHODS: The study included 14 patients (13 women and 1 man), aged 28 to 63 years, median age 55.5 (50; 62) years. All patients underwent standard ophthalmologic examination, optical coherence tomography, as well as fluorescence and/or indocyanine-green angiography. Subthreshold micropulse laser treatment was performed using a diode laser with a wavelength of 810 nm, and consisted of 2-3 sessions of 10% micropulse duty cycle in subthreshold mode with an interval of 2-4 months. Patient data were recorded at 5 time points, each subsequent data point was compared with the baseline. Treatment was carried out according to the dense "lattice" technique with an additional effect on the dye leakage zones. The follow-up period lasted 6-12 months. RESULTS: Complete regression of subretinal fluid after all SML sessions was observed in 42.9% of cases. In other cases, persistent positive dynamics in terms of edema decrease was noted. The average values of best corrected visual acuity did not significantly change over the course of the follow-up. According to the OCT data, choroidal thickness in fovea significantly decreased at the 1st, 3rd and 4th time points, while the retinal thickness did not significantly change during the observation period. CONCLUSION: Subthreshold micropulse laser treatment accelerates the resorption of subretinal fluid in SMD, but this effect cannot be considered satisfactory due to the very slow rate of resorption of subretinal fluid and the absence of a significant effect on visual acuity of patients. The effectiveness of this technique must be compared with other treatment techniques and the natural course of the disease.

[Protocol of intravitreal drug delivery. Consensus of the Expert Counsil of Retina and Optic Nerve Diseases of the All-Russian Public Organasation «Association of Ophthalmologists¼]. / Protokol vypolneniya intravitreal'nogo vvedeniya lekarstvennykh preparatov. Konsensus Ekspertnogo soveta po zabolevaniyam setchatki i zritel'nogo nerva Obshcherossiiskoi obshchestvennoi organizatsii «Assotsiatsiya vrachei-oftal'mologov¼.

Intravitreal drug administration is a procedure that has become widespread in modern ophthalmology. However, there is no global consensus on certain aspects of this manipulation, and practitioners feel the need for guidelines. In the Russian Federation, until now, such a document was not available. The expert council on diseases of the retina and optic nerve of All-Russian public organization «Association of Ophthalmologists¼, with participation of invited specialists, has studied and analyzed the existing foreign guidelines for performing intravitreal injections, as well as the regulatory framework in Russia. As a result, this Protocol was developed and approved for use in the healthcare system of the Russian Federation. The document regulates the requirements for specialists and organizations, the conditions for performing the procedure and the necessary material resources and presents an algorithm for performing intravitreal drug administration, a patient examination check-list for various conditions of the procedure, as well as parameters for evaluating and monitoring the quality of the procedure.

[Dome-shaped macula: features of differential diagnostics with clinical examples]. / Fenomen kupoloobraznoi makuly: osobennosti differentsial'noi diagnostiki (klinicheskie nabliudeniia).

The phenomenon of dome-shaped macula (DSM) constitutes protrusion of membranes of the posterior pole of the eye toward the vitreous body due to local thickening of sclera layers. The phenomenon was detected using enhanced depth imaging optical coherence tomography (EDI-OCT). In uncomplicated forms of DSM, all layers of the retina are contiguous, but the setting of DSM can involve a number of pathological conditions causing decrease in vision. One of the most often described concurrent conditions in DSM is serous retinal detachment (SRD). Such complicated forms of DSM are often masked as a non-pigmented neoplasm of the choroid, in particular hemangioma (HC). PURPOSE: To demonstrate the possibilities of differential diagnostics of DSM with HC using modern instrumental diagnostic methods. MATERIAL AND METHODS: The study involved two clinical cases of patients with DSM and HC, who underwent comprehensive ophthalmological examination including EDI-OCT and OCT angiography, fluorescent angiography (FA), indocyanine-green angiography (ICG) and magnetic resonance imaging of brain and orbits (MRI). RESULTS: The most simple and highly informative method for differential diagnostic of DSM with HC is currently EDI-OCT. In difficult differential diagnostic cases, it is recommended to use FA and MRI. Additionally, for identification of the cause of SRD in DSM, OCT-angiography and ICG-angiography can be used. Thus, diagnostics of DSM is difficult today primarily because of the low awareness of ophthalmologists about the presence of such macula pathology. Detection of this anatomical feature by means of ophthalmoscopy alone can be difficult and requires special skills and experience. The use of EDI-OCT, as well as FA and MRI in difficult differential diagnostic cases, and correct interpretation of the obtained data can help avoid diagnostic errors.

[The use of the helium-neon laser in the treatment of amblyopia in children]. / Ob ispol'zovanii gelii-neonovogo lazera v lechenii ambliopii u detei.

The authors analyze the efficacy of He-Ne laser therapy of amblyopia of various origins in 48 children (81 eyes). Group 1 children were not treated at all in order to assess the visual function background fluctuations (absolute controls). Along with He-Ne laser, used in Group 2, a 'placebo', slit lamp with blinking light, was used in Group 3. Vision acuity was assessed with the use of Sivtsev-Golovin's and Orlova's tables and by visocontrastometry in a blind test. Common visometry has shown a reliable and approximately similar improvement of the vision acuity in Groups 2 and 3 patients, whereas visocontrastometry has not detected any changes of visual function in all the 3 groups. These results cast doubt on the true efficacy of He-Ne laser stimulation of visual function, at least in children, and once again demonstrate that such investigations may be carried out only with a reliable ('blind') control and placebo.