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1.
Klin Monbl Augenheilkd ; 237(10): 1187-1193, 2020 Oct.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-33059378

RESUMO

In recent years, an increasing incidence of laser pointer-associated retinal injuries has been observed, likely due to easy access to incorrectly classified laser pointers, their labelling as toys, and lack of awareness concerning the associated risk. Laser pointer exposure can lead to irreversible retinal damage and associated vision loss, depending on the wavelength, radiation power, duration of exposure, localization, and spot size. Pronounced retinal laser damage is especially seen in children and teenagers. The structural appearance of retinal laser pointer damage varies and, in some cases, may be a diagnostic challenge. Besides often subtle findings on optical coherence tomography examination, characteristic alterations on near-infrared autofluorescence imaging may be valuable for the diagnosis of retinal laser pointer injuries and for differentiating other retinal lesions with similar appearance. The increase in laser pointer injuries indicates that regulatory actions and increased public awareness are required regarding the dangers of laser pointers.


Assuntos
Retina , Doenças Retinianas , Adolescente , Criança , Humanos , Lasers , Retina/diagnóstico por imagem , Doenças Retinianas/etiologia , Tomografia de Coerência Óptica , Acuidade Visual
2.
Vestn Oftalmol ; 136(5): 58-66, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33056965

RESUMO

PURPOSE: To evaluate the influence of prolonged neuroprotective therapy on disease progression in patients with primary open-angle glaucoma (POAG) with compensated intraocular pressure (IOP). MATERIAL AND METHODS: The study included 147 patients with stages I-II POAG (249 eyes) who were randomized into the main (69 patients, 119 eyes) and control groups (78 patients, 130 eyes). Patients of the main group underwent retinalamin treatment course every 6 months. Patients were examined before enrolling and then every 3 months during the 24-months follow-up including optical coherence tomography (OCT; RNFL - retinal nerve fiber layer, NRR - neuroretinal rim, GCL - ganglion cell layer) and static perimetry (MD - mean deviation, PSD - pattern standard deviation). RESULTS: Visual acuity and refraction did not change in either group (p>0.05). IOP increased in the control group (p=0.033). There was no difference between the groups by the 24th month (p=0.87). No MD changes were noted in the main (p=0.45) and control groups (p=0.27). PSD changed in the main (4.84±3.21 and 6.01±2.584 dB in the beginning and the end, respectively, p=0.0004) and the control groups (3.46±2.23 and 5.86±2.26 dB, respectively; p<0.0001). The groups differed in MD and PSD initially (p=0.15; p=0.02) and became equal by the end (p=0.59; p=0.53). RNFL did not change significantly in the main group (p=0.078) and decreased from 83.5±22.47 to 76.7±20.7 µm in the control group (p=0.001); no differences between the groups were noted in the beginning (p=0.276) or in the end of the study (p=0.524). NRR increased in the main group from 222±88.94 to 231±99.3 (p=0.012), and decreased in the control group from 248±87.09 to 234±96.2 (p=0.0006); no differences were found between groups in the beginning or in the end of the study (p=0.109; p=0.909). GCL thickness did not change either in the main, or in the control group (p=0.211; p=0.16), with no difference between the group noted in the beginning or the end of the study (p=0.44; p=0.51). CONCLUSION: Regular treatment with retinalamin arrests the development of glaucomatous optic neuropathy. Longer-term research is required to study its influence on the visual function and the quality of life.


Assuntos
Glaucoma , Peptídeos , Qualidade de Vida , Progressão da Doença , Humanos , Fibras Nervosas , Peptídeos/uso terapêutico , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Acuidade Visual
3.
Vestn Oftalmol ; 136(5. Vyp. 2): 170-176, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063960

RESUMO

PURPOSE: To clinically evaluate the results of one-piece mushroom-shaped keratoplasty. MATERIAL AND METHODS: A total of 10 patients (10 eyes) were enrolled, all having corneal perforations and deep stromal opacities with involvement of Descemet's membrane. For transplantation, hypothermic preserved donor corneas with mean endothelial cell density of 2896±327 cells per 1 mm2 were used. Surgical technique. Recipient tissues as well as the graft were cut with the Moria trephine. For that, the 8.5-mm blade was replaced by a 6.5-mm one and vice versa, respectively, with attention paid not to violate the vacuum while making the cuts. RESULTS: Transparent cornea engraftment was achieved in all patients. Best corrected visual acuity averaged 0.55±0.22. Spherical component of refraction varied from -4.25 to +2.75 diopters. Mean corneal astigmatism was 3.35±1.73 diopters. At 6 months after surgery, the mean endothelial cell density was 2355±336 cells/mm2, at 1 year - 2141±304 cells/mm2. CONCLUSION: One-piece mushroom keratoplasty is an effective surgical treatment of corneal perforations and deep stromal opacities with involvement of Descemet's membrane that ensures a high rate of transparent corneal engraftment. The use of the Moria vacuum trephine in combination with blades of different diameters and secure fixation of the vacuum part of the trephine eliminate the risk of the 'mushroom stem' decentration relative to its 'head'.


Assuntos
Agaricales , Transplante de Córnea , Córnea , Epitélio Posterior , Humanos , Acuidade Visual
4.
Vestn Oftalmol ; 136(5. Vyp. 2): 237-240, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063971

RESUMO

The authors present a clinical case of central opacification of the intraocular lens (IOL) optic associated with a significant uncorrectable visual acuity decrease. Due to high surgical risks of IOL exchange, corectopia was achieved through sectoral laser photomydriasis. Stable dilation of the lower nasal sector of the pupil enabled the optical zone to be shifted outside the opaque area of the IOL. As shown by the perimetry results, the visual field borders enlarged through sectoral laser photomydriasis were comparable with the topography of the asymmetrically dilated pupil.


Assuntos
Lentes Intraoculares , Falha de Prótese , Olho Artificial , Humanos , Óptica e Fotônica , Acuidade Visual
5.
Vestn Oftalmol ; 136(5. Vyp. 2): 248-253, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063973

RESUMO

The review presents the history of development and improvement of methods for intraocular lens (IOL) exchange. Existing techniques of IOL exchange are comparatively analyzed.


Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Olho Artificial , Estudos Retrospectivos , Acuidade Visual
6.
Vestn Oftalmol ; 136(5. Vyp. 2): 254-259, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063974

RESUMO

The review discusses modern problems of intraocular lens (IOL) exchange. Making an adequate choice between IOL reposition and IOL exchange in pseudophakic patients with problems of lens fixation remains a largely unsolved issue. The literature data shows a noticeable increase in the number of supporters of retropupillary fixation of an iris-claw lens during the exchange procedure.


Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Olho Artificial , Humanos , Iris , Acuidade Visual
7.
Vestn Oftalmol ; 136(5. Vyp. 2): 301-307, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063981

RESUMO

The review presents the main pathogenetic mechanisms of cataract development in an avitic eye as well as anatomical and functional changes of the eye in the state of avitria. The authors have also analyzed distinctive behavior of such eyes during phacoemulsification and surgical techniques used to answer specific avitreal phenomena.


Assuntos
Extração de Catarata , Facoemulsificação , Humanos , Complicações Intraoperatórias , Facoemulsificação/efeitos adversos , Acuidade Visual , Vitrectomia
8.
Vestn Oftalmol ; 136(5. Vyp. 2): 308-316, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063982

RESUMO

Keratectasias are non-inflammatory dystrophic diseases of the cornea characterized by progressive bilateral thinning of the cornea that lead to deterioration in the quantitative and qualitative characteristics of vision reducing patient's quality of life. The changes can be asymmetrical and destructive. A number of surgeries have been proposed to reduce the negative effects of keratectasia including penetrating keratoplasty and its modifications, implantation of corneal ring segments, corneal cross-linking - alone and in combination with other methods, intrastromal keratoplasty. These methods can improve visual acuity to a certain degree and help slow the progression of keratectasia. This article studies various surgical methods used for treating keratectasia and analyses possible assessment of the quality of vision before and after the treatment.


Assuntos
Ceratocone , Córnea/cirurgia , Dilatação Patológica , Humanos , Ceratocone/diagnóstico , Ceratocone/cirurgia , Qualidade de Vida , Acuidade Visual
9.
Vestn Oftalmol ; 136(5. Vyp. 2): 226-231, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063969

RESUMO

Progressive hyperopia development in the long-term period after radial keratotomy (RC) is associated with not only surgical effects, but also individual biomechanical features of the fibrous tunic of the eye, its age-related changes, and hydrodynamic disturbances. When choosing a method of correction, one should take into account a number of features characteristic of this induced refractive disorder: instability and irregularity of refraction, coexisting presbyopia, and, in some cases, anisometropia. Correction of progressive hyperopia after RC can be achieved with eyeglasses, or contacts, or intraocular lenses depending on the subjective factor - the so-called patient adherence. The most effective in terms of functionality is contact correction with scleral rigid gas-permeable lenses, and in the presence of pronounced lens opacities - intraocular correction.


Assuntos
Hiperopia , Ceratotomia Radial , Erros de Refração , Humanos , Hiperopia/diagnóstico , Hiperopia/etiologia , Hiperopia/cirurgia , Refração Ocular , Acuidade Visual
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(8): 966-972, 2020 Aug 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33053540

RESUMO

OBJECTIVES: To observe the clinical results of orthokeratology therapy in adolescents with low to moderate myopia after wearing the lens for 6 months. METHODS: The data of 69 adolescents with low to moderate myopia were retrospectively analyzed. According to the degree of spherical power before treatment, the adolescents were divided into a low myopia group (34 cases, with spherical diopter from -3.00 to -0.75 D) and a moderate myopia group (35 cases, with spherical diopter from -5.75 to -3.25 D). The changes of the uncorrected distance visual acuity (UDVA), intraocular pressure, count of endothelial cell, eye axis length, Strehl ratio (SR), modulation transfer function (MTF), Q value, and wavefront aberrations before the treatment and 6 months after the treatment were compared and analyzed between the 2 groups. RESULTS: Compared with before the treatment, the UDVA improved significantly in the 2 groups (both P<0.05); the intraocular pressure and the count of endothelial cell did not change obviously in the 2 groups (all P>0.05), the eye axial length in the 2 groups was increased significantly (both P<0.05), but there was no significant difference between the 2 groups (all P>0.05); the Q value in the 2 groups was increased significantly, and the change was more obvious for the moderate myopia group (all P<0.05); the SR and MTF were increased remarkably in the 2 groups (all P<0.05), and there were no significant difference in the changes of SR and MTF between the 2 groups (both P>0.05); a considerable decrement was found for the total aberration, the total low-order aberration, and defocus (all P<0.05), and the changes were more significant in the moderate myopia group (all P<0.05); the total high-order aberrations were increased in the low myopia group (P<0.05); the increment of the vertical astigmatism, spherical aberration, horizontal coma, vertical coma, and horizontal trefoil were noticeable (all P<0.05), and the changes of the spherical aberration, vertical coma, and horizontal trefoil were more obvious in the moderate myopia group (all P<0.05). CONCLUSIONS: Orthokeratology can effectively improve the visual results of the adolescents with low to moderate myopia, and the corrective effect is more obvious for the adolescents with moderate myopia than those with low myopia.


Assuntos
Miopia , Adolescente , Humanos , Miopia/terapia , Estudos Retrospectivos , Acuidade Visual
11.
Vestn Oftalmol ; 136(5): 123-128, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33056973

RESUMO

This review was conducted due to the growing number of patients with keratoconus requiring cataract surgery and the complexity of surgical planning. The article reviews preoperative planning, intraoperative options, and postoperative management, which can help obtain high functional results. Treatment of cataracts in keratoconic eyes requires a multifaceted approach. In some cases, in the preoperative period, interventions such as crosslinking and implantation of intrastromal segments or corneal ring may be required to ensure stable keratometry values for accurate intraocular lens (IOL) calculations. The use of stabilizing procedures prior to optical biometrics can assist in preoperative lens selection and provide predictable surgical outcomes. To achieve targeted refraction and reduce unwanted optical effects, it is necessary to take a critical approach when choosing the type of lens (toric, monofocal). This is due to the appearance of aberrations of different order after preliminary surgical interventions on the cornea. The intraoperative decision plays important role in choosing the position of the corneal incisions, how to use sutures for wound adaptation, choosing scleral approaches to minimize possible postoperative complications. In the postoperative period, the degree of irregular astigmatism and the need for rigid gas-permeable or scleral lenses should be assessed.


Assuntos
Astigmatismo , Extração de Catarata , Ceratocone , Lentes Intraoculares , Astigmatismo/cirurgia , Humanos , Ceratocone/complicações , Ceratocone/diagnóstico , Ceratocone/cirurgia , Acuidade Visual
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5106-5110, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019135

RESUMO

Amblyopia is a medical condition in which the visual inputs from one of the eyes is suppressed by the brain. This leads to reduced visual acuity and poor or complete loss of stereopsis. Conventional clinical tests such as Worth 4-dot test and Bagolini striated lens test can only detect the presence of suppression but cannot quantify the extent of suppression, which is important for identifying the effectiveness of treatments for amblyopia. A novel approach for quantifying the level of suppression in amblyopia is proposed in this paper. We hypothesize that the level of suppression in amblyopia can be measured by measuring the symmetry/asymmetry in the suppression experienced during a dichoptic image recognition task. Preliminary studies done on fifty one normal subjects prove that the differences between the accuracies of the left and right eyes can be used as a measure of asymmetry. Equivalence test performed using 'two-one-sided t-tests' procedure shows that the equivalence of the accuracies of left and right eyes for normal subjects is statistically significant (p = .03, symmetric equivalence margin of 5 percentage points). To validate this method, six amblyopic children underwent this test and the results obtained are promising. To the knowledge of the authors, this is the first work to make use of VR glasses and dichoptic image recognition task for quantifying the level of ocular suppression in amblyopic patients.


Assuntos
Ambliopia , Realidade Virtual , Ambliopia/diagnóstico , Criança , Óculos , Humanos , Visão Binocular , Acuidade Visual
13.
Vestn Oftalmol ; 136(4. Vyp. 2): 201-206, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880140

RESUMO

There are currently no reliable biomarkers for predicting the response to treatment of diabetic macula edema (DME). PURPOSE: To asses the predictive role of neurodegenerative biomarker of the response to anti-VEGF therapy of DME. MATERIAL AND METHODS: Examination and treatment was carried out on 14 patients (20 eyes) with DME. The eyes were divided into 2 groups by the type of diabetes: 6 eyes with type 1 diabetes and 14 eyes with type 2 diabetes. The duration of diabetes was 16.5±7.9 years, the level of glycated hemoglobin was 8.4±2%. A number of indicators were evaluated using optical coherence tomography (OCT) in order to determine the neurodegenerative biomarkers of the response to anti-VEGF treatment. All patients underwent standard loading course of Aflibercept (5 intravitreal injections). RESULTS: Significant improvement in Best Corrected Visual Acuity (BCVA) and decrease of central retinal thickness (CRT) was seen after the treatment course. Data analysis revealed a correlation between functional outcomes of the treatment, and the following pathological changes in the retina: thickness of retinal nerve fiber layer (RNFL), thickness of the complex of ganglion cell and inner plexiform layers in the macular region (GCL+), thickness of the RNFL and GCL+ complex (GCL++) in the macular region, ΔCRT, as well as BCVA, patient age, and type of diabetes. Anatomical outcomes correlate with the stage of diabetic retinopathy, RNFL, GCL+, GCL++, violation of the integrity of the ellipsoid zone before treatment. CONCLUSION: The course of intravitreal administration of the Aflibercept drug has been established to be an effective method of treating patients with clinically significant DME. Neurodegenerative biomarkers of the response to the anti-VEGF drug therapy have been determined: thickness of the peripapillary RNFL, GCL+ and GCL ++, as well as integrity of the ellipsoid zone.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Edema Macular , Biomarcadores , Humanos , Células Ganglionares da Retina , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
14.
Vestn Oftalmol ; 136(4. Vyp. 2): 289-295, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880153

RESUMO

Postsurgical macular edema, known as Irvine-Gass syndrome, is one of the possible causes of reduced visual acuity in ophthalmic surgery. The article reviews and summarizes data on the main approaches to the treatment of this pathology, discusses the main groups of drugs used to manage postoperative macular edema.


Assuntos
Extração de Catarata , Edema Macular/tratamento farmacológico , Humanos , Injeções Intravítreas , Acuidade Visual , Vitrectomia
15.
Vestn Oftalmol ; 136(4. Vyp. 2): 296-299, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880154

RESUMO

Retinitis pigmentosa (PR) is manifested by decreased vision, night blindness and narrowing of the visual field. In RP, the level of docosahexaenoic acid (DHA) in blood plasma and red blood cells is significantly reduced. The largest amount of DHA is contained in the retina (30-40% of phospholipids). DHA increases membrane permeability, accelerates the release of vital proteins and retinal enzymes, provides differentiation of photoreceptors, and slows down apoptosis. The introduction of DHA in isolation or in combination with other fatty acids into the body increases its concentration and can be used for metabolism. While there is a known correlation between the level of DHA in the blood and certain retinal functions (visual acuity, light sensitivity, the value of bioelectric potential), many years of multicenter studies have not produced reliable data on the direct effect of isolated or combined use of DHA in maintaining retinal functions in PR. Despite inconsistent outcomes, the clinical trials should continue.


Assuntos
Retinite Pigmentosa , Campos Visuais , Ácidos Docosa-Hexaenoicos , Eletrorretinografia , Humanos , Retina , Acuidade Visual
16.
Vestn Oftalmol ; 136(4. Vyp. 2): 359-366, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880162

RESUMO

Analysis of the current understanding of the role of internal limiting membrane in the pathogenesis of diabetic macular edema and the feasibility of its surgical removal is based on data from domestic and international literature on pathogenesis, clinical manifestations, outcomes of multicenter studies of treatment and prognosis of this disease. The advantages and disadvantages of both peeling and preservation of the inner limiting membrane are described. The limitations and inconsistencies of data provided by the authors of each theory requires more complete functional studies in the pre- and postoperative periods, increasing the selection of patients, modifying the criteria for inclusion in groups, and microscopic examination of removed membranes. Thus, this issue requires further study due to the ambiguity of the conclusions and the lack of comparative data on the long-term prospects of each of the methods.


Assuntos
Diabetes Mellitus , Retinopatia Diabética/cirurgia , Membrana Epirretiniana/cirurgia , Edema Macular , Humanos , Resultado do Tratamento , Acuidade Visual , Vitrectomia
17.
Croat Med J ; 61(4): 366-370, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32881435

RESUMO

Spontaneous posterior capsule rupture with lens-nucleus dislocation is a very rare entity, as is the development and spontaneous closure of a full thickness macular hole (FTMH) after vitrectomy. The occurrence of these two entities in one eye has not been previously described. A 79-year-old woman was referred because of the right eye intermittent pain and progressive visual loss. Best corrected visual acuity (BCVA) with correction for aphakia was 20/20. Intraocular pressure was normal with therapy. The cornea, anterior chamber, and vitreous were clear. Gonioscopy was normal. The capsular bag was clear, with rolled-up anterior and posterior lens capsule, and the nucleus dislocated in the vitreous. As surgery waiting time was prolonged due to administrative problems, the patient's intraocular pressure (IOP) increased and cystoid macular edema (CME) with lamellar macular hole developed. The patient underwent pars plana vitrectomy with endophacofragmentation and epiretinal membrane peeling. Postoperative optical coherence tomography was normal, BCVA was 20/40, and IOP was normal with topical therapy. One month after surgery, the eye was without signs of inflammation and IOP started rising in spite of maximum therapy. CME reoccurred and progressed to a FTMH, which started closing spontaneously in one month. One year after surgery, IOP normalized and FTMH closed completely. A dislocated crystalline lens in a quiet eye with normal BCVA, which rapidly developed into intractable glaucoma and FTMH, is an unusual finding. The deterioration was followed by spontaneous IOP normalization and macular hole closure. Such unexpected disease course, suggesting a possible autoimmune reaction, has not yet been described.


Assuntos
Catarata/complicações , Núcleo do Cristalino/patologia , Subluxação do Cristalino/etiologia , Ruptura da Cápsula Posterior do Olho/etiologia , Perfurações Retinianas/etiologia , Idoso , Feminino , Humanos , Pressão Intraocular , Subluxação do Cristalino/diagnóstico , Subluxação do Cristalino/cirurgia , Edema Macular/diagnóstico , Edema Macular/etiologia , Ruptura da Cápsula Posterior do Olho/diagnóstico , Ruptura da Cápsula Posterior do Olho/cirurgia , Perfurações Retinianas/fisiopatologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia/métodos
19.
J Cataract Refract Surg ; 46(9): 1326-1327, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32898112

Assuntos
Olho , Acuidade Visual
20.
Niger J Clin Pract ; 23(9): 1243-1247, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913163

RESUMO

Aim: This study aimed to determine the effects of strabismus surgery on choroidal thickness in paediatric patients with Spectral Domain-Optical Coherence Tomography (SD-OCT). Material and Methods: Sixty eyes of 60 children with esotropia were included. The mean age was 9.5 ± 3.1 years. The choroidal thickness was measured using SD-OCT, which was performed before the surgery and 1 week, 1 month and 3 months postoperatively. At the same time, the patients' visual acuity was evaluated. Results: There were no statistically significant differences between the preoperative and postoperative values in terms of the visual acuity (P > 0.05). When compared to the preoperative values, decreases were found in the choroidal thicknesses in all of the areas measured during the first week evaluation (P < 0.05). In the postoperative first month, significant decreases were also found in the choroidal thicknesses in all the areas measured (P < 0.05); however, in the postoperative third month, there were no changes in any of the areas (P > 0.05). Conclusions: We observed that there was a significant decrease in the choroidal thickness during the early postoperative period and no significant change in the late postoperative period in paediatric patients of double horizontal muscle surgery. Moreover, these early changes in the choroid in paediatric patients show that it does not cause a functional loss.


Assuntos
Corioide/diagnóstico por imagem , Corioide/patologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Estrabismo/cirurgia , Tomografia de Coerência Óptica/instrumentação , Adolescente , Criança , Corioide/anatomia & histologia , Feminino , Humanos , Masculino , Tamanho do Órgão , Período Pós-Operatório , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento , Acuidade Visual/fisiologia
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