[Combined revascularizing method for treating central atherosclerotic chorioretinopathy]. / Sochetannyi revaskuliariziruiushchii metod lecheniia tsentral'nykh ateroskleroticheskikh khorioretinopatii.

The authors present a new surgical method for treatment of central atherosclerotic chorioretinopathies, consisting of choroid revascularization followed by crossing of the surface temporal artery. Combined revascularizing method improved local ocular hemodynamics and the visual function in 64% patients with pseudotumorous condition and in 81% patients with the "dry" form, stabilizing the process for up to 12 months (period of observation). Morphological analysis showed that after choroid revascularization, a full-value functioning vascular network forms at the interface between the vascular membrane and implanted tissues, and therefore crossing of the surface temporal artery should be performed no earlier than 3 months after choroid revascularization.

[Use of complex compression diagnostic test for defining the indications for surgical treatment of atherosclerotic chorioretinal dystrophy]. / Primenenie kompleksnoi kompressionnoi diagnosticheskoi proby dlia opredeleniia pokazanii k khirurgicheskomu lecheniiu ateroskleroticheskoi khorioretinal'noi distrofii.

Complex compression diagnostic test was carried out in 38 patients (72 eyes) with atherosclerotic maculodystrophy in order to define the indications for and predict the results of treatment by direct laser phoresis. The results of the test were assessed for 4 parameters: vision acuity, critical frequency of fusion of flashes, visocontrastometry, and rheography. The preoperative values did not reliably differ from the postoperative ones. Complex compression test can be used to predict the results of surgery for atherosclerotic maculodystrophies aimed at improving the hemodynamics and microcirculation in the posterior compartment of the eye.

[Efficacy of direct revascularization of choroid in the treatment of atherosclerotic macular dystrophies]. / Effektivnost' priamoí revaskuliarizatsii khorioiei pri lechenii ateroskleroticheskikh makulodistrofií.

The operation of direct revascularization of the choroid in atherosclerotic maculodystrophy was modified. The method of choroid revascularization is based on the formation of numerous anastomoses with vessels from the basin of the external carotid artery and with various branches of the orbital artery. The authors analyze the results of vascularization in 21 patients (27 eyes) aged 60 to 75 with atherosclerotic maculodystrophy. Vision acuity improved by 0.06 diopters on average in 80% of patients, the difference being statistically reliable (p < 0.05). The peripheral visual field (the sum of grades for 8 meridians) extended by 97% on average in 96% of patients. The index of the critical frequency of fusion of flashes increased directly after treatment by 4 Hz on average, which is 13% of the initial level (p < 0.05). The rheographic coefficient increased by 35% of the initial level. Hence, revascularization is an effective method for the treatment of atherosclerotic maculodystrophies, stabilizing the visual functions, and is recommended for clinical use.

[Results of direct revascularization of choroid: an experimental study]. / Rezultaty operatsii priamoi revaskuliarizatsii khoroidei v éksperimene.

The morphology of histological slices of tissue at the site of direct revascularization of the choroid was assessed in various periods (15 days, 1, 3, and 6 months) after surgery. The surgical method was as follows: a collagen hemostatic sponge, a strip of subconjunctival tissue, and tissue of the external rectal muscle were put onto an exposed 4 x 4 mm site of the choroid and closed with an episcleral flap fixed with nodular sutures without pulling. Experiments were carried out on 13 rabbits (26 eyes). Direct revascularization of the choroid was performed in all animals. The animals were sacrificed by air embolism 15 days, 1, 3, and 6 months after surgery. Vascular filling was carried out. The eyes were enucleated, paraffin slices were prepared from tissues at the site of operation, and the slices were stained with hematoxylin-eosin, tholuidine blue, and after Van Gieson. After direct revascularization of the choroid with episcleral, muscular, and subconjunctival tissue and collagen sponge numerous full-value vascular formations are seen at the site of the intervention as early as 3 months after surgery; these vascular formations connect the extraorbital tissues rich in vessels with the vascular coating; the number of newly formed vessels increases by 6 months postoperation. The results of experiments give good grounds for clinical use of the method.