[A case of arrhythmogenic right ventricular cardiomyo-pathy associated with myocardial inflammation].

Recent years have been marked by a number of published reports that have shown a high frequency of signs of myocardial inflammation in patients with confirmed arrhythmogenic right ventricular cardiomyopathy (ARVC). This article presents a clinical case of typical phenotypic manifestations of ARVC associated with morphometric signs of subacute myocarditis. A 66-year-old man presented to the emergency department with signs of arrhythmogenic shock caused by ventricular tachycardia. Examination detected electrocardiographic signs of (ARVC), visualized signs of right ventricular dilatation, increased trabeculation, and wall fibrosis. Endomyocardial biopsy of the right ventricular wall showed degenerative alterations of cardiomyocytes with perivascular lymphocytic infiltration and areas of granulation tissue. New facts that evidence inflammatory alterations of the myocardium will still require specifying and reconsidering positions of expert consensuses on diagnostics and treatment of ARVC.

[Analysis of intraocular lens displacement relative to the haptic plane by ultrasound biomicroscopy data]. / Analiz smeshchenii opticheskoi chasti intraokulyarnoi linzy otnositel'no ploskosti gapticheskikh elementov po dannym ul'trazvukovoi biomikroskopii.

PURPOSE: This study analyzed cases with postoperative displacement of intraocular lens (IOL) relative to the haptic plane using ultrasound biomicroscopy (UBM). MATERIAL AND METHODS: The study analyzed biometry data of 231 patients (277 eyes) aged 72.39±7.77 years, among them 43.25% were males. IOL position and refraction were analyzed at 1, 3 and 6 months after standard phacoemulsification. RESULTS AND DISCUSSION: UBM was performed to analyze the position of the IOL. Stabilization of lens position was observed by the 3rd month of observation. Among the cases with displacement of the optical part relative to the haptic plane, the forward shift was determined in 24.85%, backward - in 16.67% of cases. Eyes with opposite IOL displacements differed significantly in lens diameter, ciliary sulcus diameter and the power of implanted IOL. IOL shift towards the retina produced significant hyperopic refractive error. A discriminant function was compiled using preoperative biometry data comprising the model for predicting backward IOL displacement with high probability. However, we failed to obtain a qualitative model for forward IOL displacements. CONCLUSION: Calculation error in modern formulas could occur because of IOL displacement, including the shift of the optical part relative to the haptic plane in postoperative period. Analysis of biometry data allows calculating IOL displacement towards the retina with a high probability, which could help avoid hyperopic refraction error postoperatively.

[Ocular complications in intense pulsed light therapy (case study)]. / Glaznye oslozhneniya intensivnoi fototerapii (klinicheskoe nablyudenie).

A 24-year-old female patient with photophobia, discoria, redness and dryness in her right eye after intense pulsed light (IPL) therapy applied for posttraumatic subcutaneous hemorrhage received a comprehensive ophthalmic examination including optical coherence tomography (OCT) and OCT angiography of the anterior eye segment. Her best corrected visual acuity was 20/20 in both eyes. Medically induced mydriasis revealed discoria with paresis of pupil dilatator in the left eye (pupil size 4.2 mm and 6.6 mm in the right and left eye, respectively). Anterior segment OCT showed anterior chamber cytosis and increased iris vascularity. The patient was prescribed topical 1.0% tropicamide 2 times per day and 1.0% dexamethasone 4 times per day for two weeks. Examination performed after 3 months showed no restoration of pupil dilatator function in the left eye. The case demonstrates potential ocular complications of IPL therapy, which may include iris burn with iritis and persistent pupil dilatator dysfunction.

[Short-term experience of intravitreal brolucizumab in treatment of diabetic macular edema]. / Kratkosrochnyi opyt primeneniya brolutsizumaba v lechenii diabeticheskogo makulyarnogo oteka.

PURPOSE: This study examines the efficacy and safety of brolucizumab in the treatment of diabetic macular edema (DME) in real clinical practice in the Russian Federation. MATERIAL AND METHODS: The study included 14 consecutive treatment-naïve DME patients, among them 7 males and 7 females (21 eyes in total) with mean age of 65.1±8.0 years. Patients underwent standard ophthalmological examination and multimodal imaging, including optical coherence tomography. All patients received intravitreal injections of brolucizumab every 6 weeks. A total of 73 injections were performed. A data analysis was performed for 10 eyes of 10 patients 6 months after initiation of the treatment. RESULTS: After 4 injections of brolucizumab, best-corrected visual acuity (BCVA) increased statistically significantly from 35.8±13.7 to 41.5±11.9 ETDRS letters (p=0.03), central retinal thickness (CRT) and macular volume (MV) decreased from 411.5±107.4 to 280.2±64.6 microns (p=0.014) and from 7.39±0.92 to 6.16±7.37 mm3 (p=0.0006), respectively. The average gain of visual acuity was 5.7±7.0 letters, average decrease of CRT was -131.3±91.2, and average decrease of MV was -1.21±0.75 mm3. There were no adverse events associated with intraocular inflammation. CONCLUSION: Intravitreal injections of brolucizumab provide significant anatomical and functional improvement to DME patients in real clinical practice with results comparable to that of randomized clinical trials.

The Influence of Spatial Effects on the Dynamics of Solutions in Keynes' Mathematical Model of the Business Cycle.

We consider the special case of the mathematical model of Keynes' business cycle with the spatial interaction. In this model we assume that macroeconomic factors affect a certain geographical region and economic indicators. The dependence occurs on the spatial (geographical) coordinates in addition to the dependence on the temporal evolution, even if the economic subject is externally homogeneous in space. Spatial interaction led us to analyze a system of two differential equations of the 'reaction-diffusion' type, which replaces a system of two ordinary differential equations. This method is often used to analyze the dynamics of complex nonlinear systems and macroeconomic entities. An analysis of such a mathematical model is based on the use of modern methods of the theory of dynamical systems indicate the presence of new nonlinear effects in addition to those used in the traditional version of the Keynes model. We encountered the loss of stability of the homogeneous economic equilibrium state and the occurrence of economic cycles for some values of the parameters while investigating the characteristics of such a system. Meanwhile, another version of instability of a homogeneous economic equilibrium state with a different choice of parameters occurs, which in many cases leads to the appearance of a spatially non-homogeneous equilibrium state, which is characterized by the dependence of the corresponding economic indicators on the spatial (geographical) coordinates of the area in which the assigned macroeconomic entity is located.

[Informativeness estimation for the main clinical and laboratory parameters in patients with severe COVID-19].

AIM: To conduct a retrospective assessment of the clinical and laboratory data of patients with severe forms of COVID-19 hospitalized in the intensive care and intensive care unit, in order to assess the contribution of various indicators to the likelihood of death. MATERIALS AND METHODS: A retrospective assessment of data on 224 patients with severe COVID-19 admitted to the intensive care unit was carried out. The analysis included the data of biochemical, clinical blood tests, coagulograms, indicators of the inflammatory response. When transferring to the intensive care units (ICU), the indicators of the formalized SOFA and APACHE scales were recorded. Anthropometric and demographic data were downloaded separately. RESULTS: Analysis of obtained data, showed that only one demographic feature (age) and a fairly large number of laboratory parameters can serve as possible markers of an unfavorable prognosis. We identified 12 laboratory features the best in terms of prediction: procalcitonin, lymphocytes (absolute value), sodium (ABS), creatinine, lactate (ABS), D-dimer, oxygenation index, direct bilirubin, urea, hemoglobin, C-reactive protein, age, LDH. The combination of these features allows to provide the quality of the forecast at the level of AUC=0.85, while the known scales provided less efficiency (APACHE: AUC=0.78, SOFA: AUC=0.74). CONCLUSION: Forecasting the outcome of the course of COVID-19 in patients in ICU is relevant not only from the position of adequate distribution of treatment measures, but also from the point of view of understanding the pathogenetic mechanisms of the development of the disease.

[Short-term efficacy and safety of Brolucizumab for neovascular age-related macular degeneration in the Russian Federation]. / Kratkosrochnye dannye effektivnosti i bezopasnosti primeneniya preparata «Brolutsizumab¼ pri lechenii neovaskulyarnoi vozrastnoi makulyarnoi degeneratsii na territorii Rossiiskoi Federatsii.

PURPOSE: To analyze the short-term efficacy and safety of Brolucizumab in the treatment of patients with neovascular age-related macular degeneration (nAMD). MATERIAL AND METHODS: This retrospective pilot study included 154 patients (51 males and 103 females, mean age 73.9±8.1 years). Among the 154 patients, 97 (63.0%) had previously been treated with anti-VEGF drugs and were included in this study due to continuing disease activity. All study patients underwent standard ophthalmological examination and optical coherence tomography at the initial visit as well as at each monthly visit. RESULTS: A total of 283 Brolucizumab injections were performed in two ophthalmic care centers. In total, 49.4%, 24.0%, 20.1%, 6.5% of patients received 1, 2, 3 and 4 injections, respectively. Central retinal thickness has significantly decreased from 301±79 to 230±41 µm (p<0.05) in the ophthalmic center of the Military Medical Academy (site 1), and from 418±102 to 217±50 µm (p<0.05) in the ophthalmic center of the Institute of the Human Brain (site 2). The prevalence of subretinal and sub-RPE fluid has decreased statistically significantly (p<0.05) in patients of both sites. Visual acuity has not changed significantly (p>0.05) in patients of both sites. One case of mild vitreitis was registered, it was successfully treated with topical steroids. CONCLUSIONS: Both treatment-naive nAMD patients and those with the disease remaining active despite anti-VEGF therapy showed a significant decrease in disease activity. In this short-term study, the cumulative risk of intraocular inflammation associated with brolucizumab therapy amounted to 0.65%.

[Activity of the Russian antitumor compound chlonisol in models of eyelid tumors (experimental study)]. / Aktivnost' otechestvennogo protivoopukholevogo soedineniya khlonizol na modelyakh opukholei vek (eksperimental'noe issledovanie).

Eyelid tumors are the most common neoplasms in everyday ophthalmic practice and cover a wide range of benign and malignant lesions. Surgical methods, cryodestruction, laser therapy and radiation therapy are used in the treatment of malignant eyelid tumors. Chemotherapy does not occupy a prominent place in the treatment of malignant eyelid tumors, its use is limited to sensitive tumors. OBJECTIVE: To assess the antitumor activity of the Russian-developed chemical compound 2-[3-(2-chloroethyl)-3-nitrosoureido]-1.3-propandiol (chlonisol) on the models of transplantable tumors of various histogenesis implanted into the lower eyelid. MATERIAL AND METHODS: The study was carried out on 67 mice of lines 129/SN, BALB/c and C57BL/6 that had Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and B16 melanoma transplanted into the eyelid. Tumor transplantation was done by injecting 0.05 ml of sterile sodium chloride solution containing 106 cells of Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1, or 10% suspension of tumor tissue of B16 melanoma. The injection was performed into the right lower eyelid in the direction from the outer towards the inner corner of the eye using a thin needle (29G). Chlonisol was administered at the maximum tolerated dose of 20 mg/kg or at the lower dose of 15 mg/kg intraperitoneally 24 hours after tumor transplantation. RESULTS: In mice with Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and melanoma B16 transplanted under the skin of the lower eyelid, a single intraperitoneal injection of chlonisol at the dose of 20 or 15 mg/kg caused significant inhibition of tumor growth reaching 100%. Chlonisol significantly increased overall survival in animals with Ehrlich carcinoma (log rank test, p=0.0464), sarcoma 37 (log rank test, p<0.0001), lymphosarcoma LIO-1 (log rank test, p=0.0122) and B16 melanoma (log rank test, p<0.0001); the proportion of animals that were fully healed was 25, 78, 67 and 25%, respectively. CONCLUSION: Chlonisol has a pronounced antitumor effect in mice with Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and B16 melanoma transplanted into the eyelid.

Ruxolitinib versus dexamethasone in hospitalized adults with COVID-19: multicenter matched cohort study.

BACKGROUND: Several anti-cytokine therapies were tested in the randomized trials in hospitalized patients with severe acute respiratory syndrome coronavirus 2 infection (COVID-19). Previously, dexamethasone demonstrated a reduction of case-fatality rate in hospitalized patients with respiratory failure. In this matched control study we compared dexamethasone to a Janus kinase inhibitor, ruxolitinib. METHODS: The matched cohort study included 146 hospitalized patients with COVID-19 and oxygen support requirement. The control group was selected 1:1 from 1355 dexamethasone-treated patients and was matched by main clinical and laboratory parameters predicting survival. Recruitment period was April 7, 2020 through September 9, 2020. RESULTS: Ruxolitinib treatment in the general cohort of patients was associated with case-fatality rate similar to dexamethasone treatment: 9.6% (95% CI [4.6-14.6%]) vs 13.0% (95% CI [7.5-18.5%]) respectively (p = 0.35, OR = 0.71, 95% CI [0.31-1.57]). Median time to discharge without oxygen support requirement was also not different between these groups: 13 vs. 11 days (p = 0.13). Subgroup analysis without adjustment for multiple comparisons demonstrated a reduced case-fatality rate in ruxolitnib-treated patients with a high fever (≥ 38.5 °C) (OR 0.33, 95% CI [0.11-1.00]). Except higher incidence of grade 1 thrombocytopenia (37% vs 23%, p = 0.042), ruxolitinib therapy was associated with a better safety profile due to a reduced rate of severe cardiovascular adverse events (6.8% vs 15%, p = 0.025). For 32 patients from ruxolitinib group (21.9%) with ongoing progression of respiratory failure after 72 h of treatment, additional anti-cytokine therapy was prescribed (8-16 mg dexamethasone). CONCLUSIONS: Ruxolitinib may be an alternative initial anti-cytokine therapy with comparable effectiveness in patients with potential risks of steroid administration. Patients with a high fever (≥ 38.5 °C) at admission may potentially benefit from ruxolitinib administration. Trial registration The Ruxolitinib Managed Access Program (MAP) for Patients Diagnosed With Severe/Very Severe COVID-19 Illness NCT04337359, CINC424A2001M, registered April, 7, 2020. First participant was recruited after registration date.

Synchronization of Fluctuations in the Interaction of Economies within the Framework of the Keynes's Business Cycle Model.

In this paper, we will study two independent economies in a country (national, regional and urban), where the dynamics of fluctuations in each economy is described by Keynes's mathematical business cycle model. This is an interaction of two economies which include trade and competition. In the resulting system that consists of two independent economic entities, we show that fluctuations can emerge as two possible types of economic indicators (synchronous and antiphase) when the peaks and downturns of business activities in each of the economies are completely synchronized or on the contrary when the rise of one economy is accompanied by a recession (antiphase cycles). Our aim is to examine the stability question of solutions of the cognate mathematical model. Our analysis of the mathematical model will render methods of the theory of dynamical systems, such as the method of integral manifolds and the Poincare normal forms. This approach will provide a sufficient analysis of the dynamics of solutions of a system of differential equations, which is used as a mathematical model. Asymptotic formulas will be obtained for solutions that depict economic cycles.

[AL-amyloidosis with cardiac involvement. Diagnostic capabilities of non-invasive methods].

There are presented the literature data and a description of the clinical course of the disease in isolated/predominant cardiac amyloidosis. Amyloid cardiomyopathy is the most common phenocopy of hypertrophic cardiomyopathy. The modern possibilities of non-invasive diagnostics using osteoscintigraphy for the differential diagnosis between amyloid cardiomyopathy caused by AL- and transthyretin amyloidosis are described in detail.

[Evaluation of choriocapillaris with high-speed spectral-domain optical coherence tomography angiography and image averaging]. / Otsenka statusa khoriokapillyarisa s pomoshch'yu vysokoskorostnoi spektral'noi opticheskoi kogerentnoi tomografii s funktsiei angiografii i tekhnologii usredneniya izobrazhenii.

PURPOSE: To study the capabilities of high-speed spectral-domain optical coherence tomography angiography (SD-OCTA) with image averaging in the evaluation of choriocapillaries in healthy individuals and patients with central serous chorioretinopathy (CSC). MATERIAL AND METHODS: All participants underwent OCTA examination on the SOLIX tomograph (Optovue, USA) using quadruplicate 3×3 mm scan with image averaging. Image analysis was performed in 9-µm custom slab with Phansalkar auto local threshold algorithm and calculation of flow voids larger than 5000 µm2 and 10 000 µm2. The optimal slab depth was determined in healthy eyes by consecutive analysis of the slabs with a 3-µm shift from zero position to 33 µm below Bruch's membrane. RESULTS: The study included 18 eyes of 18 healthy volunteers (40.4±6.0 years old) and 18 fellow eyes of 18 unilateral CSC patients (37.4±10.7 years old). The slab 12 µm below the Bruch's membrane showed the minimal number of flow voids (23.1±7.0 of >5000 µm2 voids per scan) and was chosen for further analysis. The number of flow voids of >5000 µm2 in healthy paired eyes of CSC patients was statistically significantly higher than in the eyes of healthy individuals (32.7±10.7 and 25.3±8.1 voids/scan, respectively; p=0.022). The number of flow voids of >10000 µm2 was also statistically significantly higher in CSC eyes compared to healthy eyes (5.6±3.3 and 3.5±1.9 voids/scan, respectively; p=0.045). There was no statistically significant difference in total area of the voids between the eyes of healthy individuals and CSC patients (96406.1±3924.5 µm2 and 95395.7 ± 3615.1 µm2, respectively; p=0.42). CONCLUSION: The optimal settings for choriocapillaris imaging on the SOLIX tomograph include 9-µm slab 9 to 18 µm below the Bruch's membrane. Using a 9-µm slab 12 µm below the Bruch's membrane, a substantial difference was found in choriocapillaris perfusion between eyes of healthy individuals and CSC patients.

[Professor Veniamin Vasilievich Volkov (to the 100th anniversary of his birth)]. / Professor Veniamin Vasil'evich Volkov (k 100-letiyu so dnya rozhdeniya).

The article presents the main stages of the career of Professor V.V. Volkov - the Hero of Socialist Labor, USSR State Prize Laureate, Honored Scientist of the RSFSR, Honorary Doctor of the Military Medical Academy, and describes his scientific and practical contribution to the development of modern ophthalmology. The authors reviewed his life journey, clinical, scientific and educational activities.

[Urinary miRNA expression in cynomolgus macaques (Macaca fascicularis) fed high salt rations].

High food intake of sodium chloride is associated with damage not only the cardiovascular system, but also the kidneys. The mechanisms of the potential negative effects of high-salt diets on the kidneys have not been established. The aim of the study was to trace the changes in relative expression of miRNA-21, 203 and 133 in urine of cynomolgus macaques (Macaca fascicularis) fed high-salt diet with and without isolated soy proteins. Material and methods. The object of the study was 18 male cynomolgus macaques (Macaca fascicularis) aged 6-8 years with a body weight of 5.1-9.7 kg. The animals were divided in 3 groups (6 individuals each). The animals of the first (control) group received a standard diet (2 g NaCl/kg feed). The animals of the second group were fed high-salt diet (8 g NaCl/kg feed), of the third - high-salt diet combined with SUPRO 760 isolated soy protein (200 g/kg feed; instead of milk and egg proteins, corn gluten). Access to water was free. The follow-up period in this study was 4 months. In animals blood pressure (BP) and relative level of microRNA (miRNA) expression in urine were measured. Results and discussion. Keeping monkeys on the studied diets for 4 months did not lead to significant changes in systolic or diastolic BP compared with the initial level. In the control group, there were no distinct changes in the expression of miRNA-21 in urine during observation. In the other two groups, there was a significant increase (approximately equally) of this parameter in comparison with the initial values. Both high-salt diets resulted in a significant increase in the relative level of expression of miRNA-133 and miRNA-203 in urine compared to basal values. However, the increase in these parameters in the group of animals fed a high-salt diet in combination with soy isolate was significantly less than in monkeys fed only a high-salt diet. Conclusion. Possible, potentially negative effects of high-salt diets on kidney may be mediated by epigenomic mechanisms and partially modulated by the inclusion of isolated soy proteins in the diet.

[OCT visualization of hyporeflective lacuna in the retrolental space]. / OKT-assotsiirovannaya vizualizatsiya giporeflektivnoi lakuny v retrolental'nom prostranstve.

PURPOSE: To investigate the vitreo-lenticular interface and anterior vitreous using high-resolution optical coherence tomography (OCT). MATERIAL AND METHODS: This prospective single-center pilot study included 34 patients (68 eyes) - 6 males and 28 females with a mean age of 58.4±12.0 years (age range 24-81 years). OCT scanning was performed on the spectral domain optical coherence tomography (SD-OCT) device SOLIX (OPTOVUE, USA) in the Full Range AC mode with the following scan parameters: from 14 to 18 mm in horizontal length and 6.25 mm in the axial dimension. To improve the signal-to-noise ratio and increase image clarity of the final scan, averaging of eight simultaneous scans was performed. RESULTS: In all healthy volunteers, hyporeflective retrolental cavities-lacunae were observed in both eyes during visualization of the retrolental space in the horizontal and vertical planes. The median distance from the posterior pole of the lens to the lacuna was 697 µm. The median width of the lacuna was 157 µm. CONCLUSION: To the best of our knowledge, we consider this to be one of the first in vivo visualizations of a previously undescribed structure - hyporeflective retrolental lacuna - using SOLIX high-resolution OCT device. The retrolental lacuna may play the role of a buffer system, or belong to the lymphatic system of the vitreous body and the eye.

[Retrolental amyloidosis of the vitreous body (case study)]. / Retrolental'nyi amiloidoz steklovidnogo tela (klinicheskoe nablyudenie).

Accumulations of pathological amyloid protein in the vitreous can be a pathognomonic morphological sign of systemic amyloidosis, which is characterized by deposition of insoluble fibrillar protein aggregates (amyloid) in various organs and tissues. The article describes a clinical case of a female 65-year-old patient with bilateral vitreous floaters and histologically confirmed vitreous amyloidosis on the right eye. The patient had undergone YAG laser vitreolysis of the right eye 3 years ago on the Ultra Q Reflex system («Ellex¼, Australia) to treat an atypical Weiss ring. Diagnosis of vitreous amyloidosis was confirmed using the following equipment: video slit lamp SL9900 («CSO¼, Italy), optical coherence tomography system Solix («Optovue¼, USA), B-scan Plus («Accutome¼, USA), microscope CX41RF («Olympus Corporation¼, Japan). Due to significant visual deterioration in the right eye, the patient underwent vitrectomy. Microscopic examination of the surgical sample showed the presence of amyloid deposits revealed by the brick-red specific staining with congo red dye and apple-green birefringence of the stained areas in polarized light.

[Non-contact navigated laser retinopexy for peripheral retinal tears and rhegmatogenous degenerations: first experience]. / Pervyi opyt beskontaktnoi navigatsionnoi lazernoi retinopeksii perifericheskikh razryvov i regmatogennykh degeneratsii setchatki.

PURPOSE: To evaluate the first outcomes of non-contact navigated laser retinopexy for peripheral tears and rhegmatogenous degenerations of the retina. MATERIAL AND METHODS: This prospective single-center interventional pilot study included 58 patients (68 eyes), among which 19 males and 39 females aged 47.5±16.9 years with peripheral retinal degenerations and symptomatic retinal tears who received non-contact laser retinopexy with the Navilas 577s navigated laser system and non-contact PRP widefield objective. All patients (68 eyes) underwent laser treatment for the following disorders: horseshoe tear in 13 eyes, retinal hole in 11 eyes, operculated retinal hole in 3 eyes, lattice degeneration in 19 eyes, snail track degeneration in 1 eye, vitreoretinal tufts in 16 eyes, and progressing bullous retinoschisis in 5 eyes. Pain intensity was assessed using a four-point verbal rating scale. RESULTS: All patients were followed up for 5 to 21 months (9.0±3.3 months on average). Stable condition of the retina was observed in 65 cases (95.5%). In 3 eyes (4.4%), newly formed retinal tears prompted additional laser treatment: horseshoe tear in 2 eyes and retinal hole in 1 eye. The mean pain score during non-contact navigated laser retinopexy was 0.9±0.5. No complications associated with laser treatment were observed. CONCLUSION: Non-contact navigated laser retinopexy performed with the Navilas 577s navigated laser system is a safe and well-tolerated procedure with effectiveness comparable to conventional laser retinopexy.

Efficacy of navigated focal laser photocoagulation in diabetic macular edema planned with en face optical coherence tomography versus fluorescein angiography.

AIM: To analyze the efficacy of navigated focal laser photocoagulation (FLP) of microaneurysms in diabetic macular edema (DME) planned using en face optical coherence tomography (OCT) as against fluorescein angiography (FA). METHODS: Twenty-six eyes of 21 DME patients (12 males, 9 females, 69.5 ± 12.3 years) with mean BCVA of 0.52 ± 0.44 LogMAR were included. En face OCT images of deep capillary plexus slab and FA images were used to plan FLP targeting of leaky microaneurysms. The primary outcome measures were central retinal thickness (CRT) and macular volume. The secondary outcome measure was best-corrected visual acuity (BCVA). RESULTS: The difference in the change of CRT and macular volume between en face OCT and FA-planned FLP after 1 month and at the end of follow-up was not statistically significant (p > 0.05), except for a higher CRT reduction in the en face OCT-planning group (p = 0.007) at the end of mean follow-up of 2.6 ± 0.9 months. There was no difference in BCVA change between the two planning options (p = 0.42). CONCLUSION: En face OCT is a non-inferior alternative for FA in the planning of navigated FLP of microaneurysms in DME.

[Selective panretinal laser photocoagulation in ischemic central retinal vein occlusion]. / Selektivnaya panretinal'naya lazernaya koagulyatsiya pri ishemicheskikh okklyuziyakh tsentral'noi veny setchatki.

PURPOSE: To compare the effectiveness and safety of panretinal laser photocoagulation targeting far-periphery (sPRP) versus conventional panretinal laser photocoagulation (cPRP) in patients with ischemic central retinal vein occlusion (iCRVO) in terms of the degree of macular edema. MATERIAL AND METHODS: The study included eight (5 males and 3 females, mean age 59.4±17.2 years) and seven (6 males and 1 female, mean age 75.7±9.1 years) patients in sPRP and cPRP groups, respectively. iCRVO was defined as a CRVO case with baseline best corrected visual acuity (BCVA) of <0.2, central retinal thickness (CRT) of >500 µm and severe intraretinal hemorrhages. sPRP included dense photocoagulation of far-periphery over 360˚ and standard photocoagulation of the mid-periphery. Primary outcome measures were CRT and macular volume at the end of the follow-up. BCVA served as the secondary outcome measure. RESULTS: The median of the follow-up period was 9.5 months (ranged from 1.5 to 19 months). In the sPRP group, at the end of the follow-up both CRT and macular volume significantly decreased from 892.0±149.4 µm to 391.8±131.2 µm (p<0.001) and from 16.6±4.1 mm3 to 9.7±1.4 mm3, respectively (p=0.008). In the cPRP group, at the end of the follow-up CRT and macular volume changes were statistically insignificant: from 761.0±162.1 µm to 705.0±181.8 µm (p=0.46) and from 13.6± 3.2 mm3 to 11.8±1.7 mm3, respectively (p=0.38). At the end of the follow-up, cPRP group did not have changes in BCVA, while in the sPRP group BCVA increased statistically significantly from 1.45±0.6 LogMAR (≈0.06) to 1.1±0.6 LogMAR (≈0.14) (p=0.03). There were no adverse events or complications associated with laser treatment in any of the study patients. CONCLUSION: This study demonstrates the superiority of sPRP compared with cPRP for treatment of patients with iCRVO, showing that selective laser treatment of the far-periphery results in significant reduction of macular edema associated with severe retinal ischemia.

[Algorithm for predicting axial displacement of the optic part of IOL after phacoemulsification]. / Algoritm prognozirovaniya aksial'nogo smeshcheniya opticheskoi chasti intraokulyarnoi linzy posle fakoemul'sifikatsii.

PURPOSE: To test a prediction algorithm for deflection of the optical part of IOL after uncomplicated phacoemulsification. MATERIAL AND METHODS: The study included 226 patients (287 eyes) who underwent phacoemulsification with implantation of intracapsular AcrySof IOL. Preoperative examination included IOLMaster, Lenstar LS 900 biometry and Pentacam HR keratotopography. All measurement were repeated one month postoperatively. To determine the tilt and deflection of the IOL's optical part, anterior segment optical coherence tomography (OCT) was performed on Topcon 3DOCT-2000. RESULTS: OCT data analysis helps identify the slope and deflection of the IOL's optical part relative to the pupil plane. In the previous study we built logistic regression models for predicting the deflection of the IOL's optical part with high predictive quality based on the calculated IOL power and preoperative biometry measurements. When checked with new patient data, the areas under the ROC curves have changed slightly. Large area under the ROC curves with small deviation rates, as well as retention of the level of true positive responses with little increase in false negative responses verify the high quality of the models. CONCLUSION: Logistic regression models based on the optical power of the implanted IOL, as well as on a combination of preoperative biometry data from IOLMaster and Lenstar LS 900, make it possible to predict the probability of deflection of the optical part of IOL with high reliability and promptly correct the IOL power.