[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.

[Preventive laser treatment of tractional symptomatic retinal flap tears: long-term outcomes]. / Otdalennye rezul'taty profilakticheskogo lazernogo lecheniya traktsionnykh simptomaticheskikh klapannykh razryvov setchatki.

Tractional flap tears are the main cause of the development of regmatogenic retinal detachment (RRD). The main immediate treatment method for it is laser retinal coagulation. PURPOSE: Case monitoring of tractional symptomatic flap tears after laser treatment. MATERIAL AND METHODS: From 2014 to 2019 we observed 119 patients (130 eyes) with peripheral flap (horseshoe) retinal tears in acute posterior vitreous detachment. Laser coagulation of the retina was performed using Navilas 577s (577 nm), OcuLight GL (532 nm). Laser retinotomy of horseshoe tear flap and dissection of overhanging vessels were performed using Nd:YAG-ultra Q Reflex laser (1064 nm) and controlled with RTVue XR Avanti. RESULTS: At the initial examination before the preventive laser coagulation, the following conditions were found: regmatogenous retinal detachment (RRD) - 8 eyes (6.2%), partial hemophthalmus - 29 (22.3%), preretinal hemorrhage - 15 (11.5%), epiretinal membrane - 9 (6.9%), non-full-thickness macular retinal breaks - 6 (4.6%), peripheral changes: retinal holes - 16 (12.3%), tears with operculum - 5 (3.8%), retinal degenerations - 40 eyes (30.8%). Observation for 5 years after laser retinopexy revealed new pathological changes: flap tears - 13 (10.6%); holes - 9 (7.4%); tears with operculum - 5 (4.1%); vitreoretinal tuft - 6 (4.9%); RRD - 3 cases (2.5%). In 16 patients (16 eyes) with horseshoe tear and pronounced vitreoretinal traction, the flap retinotomy was performed, which eliminated the traction component and prevented the development of RRD. CONCLUSION: Follow-up of tractional symptomatic flap tears for 5 years after preventive laser retinopexy revealed the appearance of retinal detachment in 2.5% of cases. Laser retinotomy of horseshoe tear after barrier retinopexy eliminated the traction component and helped prevent the development of RRD.

[Macular choroidal blood flow in concurrent age-related macular degeneration and primary open-angle glaucoma]. / Sostoyanie khorioidal'nogo krovotoka v makulyarnoi zone pri sochetanii vozrastnoi makulyarnoi degeneratsii i pervichnoi otkrytougol'noi glaukomy.

UNLABELLED: Ocular circulation disorders are an important factor in the development of primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD). To date, however, there have been no studies on choroidal blood flow peculiarities in case of concurrent AMD and POAG. AIM: to determine distinctive features of choroidal blood flow characteristic of concurrent AMD and POAG and to assess their role in disease pathogenesis. MATERIAL AND METHODS: Macular choroidal blood flow, including blood supply, was assessed in 54 patients (102 eyes) by means of Doppler ultrasound. Three groups were formed: group 1 - 38 eyes with both AMD and POAG; group 2 - 41 eyes with AMD and no signs of optic nerve pathology; and group 3 - 23 eyes with POAG and no signs of AMD. Groups 1 and 2 were subdivided into two subgroups each: А - atrophic AMD and B - macular drusen. The mean patient age was 78.7±8.4 years. The following parameters of choroidal blood flow were of interest: peak systolic velocity (Vps), end diastolic velocity (Ved), time-averaged maximum velocity (Vtamax), and resistance index (RI). RESULTS: Groups 1, 3, and 2A had an evident choroidal hypoperfusion in the macular area (decreased Vtamax) with uncompensated perfusion deficit, despite autoregulation efforts (decreased Vps, Ved, decreased or normal RI). Group 2B demonstrated a significantly higher rate of choroidal hyperperfusion (increased Vps, Ved, Vtamax, and RI). CONCLUSION: Concurrent AMD and POAG are notable for choroidal hypoperfusion in the macular area that leads to inadequate trophism of the neurosensory retina and can aggravate the course of AMD contributing to progression of its atrophic form.

[Optical coherence tomography angiography in the diagnosis of neovascular age-related macular degeneration].

AIM: to determine optical coherence tomography (OCT) angiography signs of classic and occult choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) and evaluate their information value in monitoring the effect of anti-VEGF therapy. MATERIAL AND METHODS: The study enrolled 76 patients (87 eyes), including 68 patients (72 eyes) with wet AMD and 8 patients (15 eyes) with no signs of neovascularization. All patients underwent spectral-domain OCT, OCT angiography, and fluorescein angiography (FA). OCT angiography was used to evaluate neovascular networks in terms of their location, shape, size, and extent of visualization. Sensitivity and specificity of the method were assessed separately in a group of 37 CNV eyes and 15 unsuspicious eyes, specific findings at FA being the main diagnostic criteria. To determine the information value of OCT angiography in monitoring the effect of intravitreal ranibizumab therapy, 9 patients (9 eyes) were selected, in whom the exam was performed the day before the injection and then at days 3, 10, 17, 24, and 31. RESULTS: The patients were divided into two groups. Group 1 consisted of 43 eyes with occult CNV, group 2--of 29 eyes with classic CNV. Neovascular loops underneath the retinal pigment epithelium were found in 76.74% of occult CNV cases. In patients with classic CNV, the neovasculature was clearly visible in 82.76% of eyes, loop-like and tree-like networks occurring with similar frequency (51.72% and 42.28% respectively). OCT angiography results obtained prior to and following ranibizumab injection revealed a change in not only the size of neovascularization, but also the density, thickness, and branching pattern of newly formed blood vessels. Sensitivity and specificity of OCT angiography has been shown to be 89.2% and 93.3% respectively. CONCLUSION: OCT angiography enables diagnosis of both classic and occult choroidal neovascularization in patients with AMD as well as dynamic assessment of the size of the neovascular complex during anti-VEGF treatment. The method has high sensitivity and specificity.

[Optical coherent tomography in diagnosis of peripheral retinal breaks].

The purpose of our study was to develop an optimal method of peripheral retinal breaks visualization and determine the presence of vitreoretinal traction using optical coherence tomography (OCT). A total of 152 patients (176 eyes) with peripheral retinal breaks were assessed, among them 57 men and 95 women, aged from 18 to 76. To visualize retinal periphery we used RTVue-100 optical coherent tomograph (USA). Photoregistration was done with Nikon NF-505 fundus camera (Japan). All patients were examined with Goldmann lens. OCT application enabled us to determine structural features and configuration of peripheral retinal breaks, the presence of vitreoretinal traction, and morphometric parameters of the defects: the average length and height, retinal thickness in three standard points (prior to the break, at its edge and at the bottom), and also the extent of vitreoretinal fusion and local detachment of retinal neuroepithelium (NE). Two groups of peripheral retinal tears were formed: group I (23 eyes)--retinal flap tears and group II (153 eyes)--perforated breaks. Optical coherence tomography is a highly informative method which enables in vivo evaluation of structural and morphometric characteristics of retinal defects and vitreoretinal fusion, as well as possible vitreoretinal traction and subclinical detachment of the retina. Its use will ensure proper documentation of study results and also provide the possibility to determine indications for laser and surgical treatment and perform a late follow-up.