bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical case of extensive subconjunctival rupture of the sclera with a favorable outcome
Authors:   Central City Hospital №23, Ekaterinburg, Subbotina S.N. , Stepanyants A.B. ,   Ural State Medical University, Ekaterinburg, Kolesnikova E.I. ,   Central City Hospital №23, Ekaterinburg, Shamkin S.S. ,   Central City Hospital №23, Ekaterinburg, Aladinsky E.B. ,   Central City Hospital №23, Ekaterinburg
Published: August 2021

Aim. To present a clinical case of severe open injury of the eyeball of a con-tusion nature with the presence of intraocular complications and to show that de-spite the significant severity of the injury, good results can be achieved. Material and methods. Patient injured his right eye at home with a metal tip on a rubber band, after which his vision sharply decreased, pain and lacrimation of the right eye appeared. Objectively: vision of the right eye pr. l. certae, intraocular pressure (palpation) - hypotension. No foreign body was found on the survey radi-ograph of the orbits. An ultrasound B-scan revealed hemophthalmus, and subse-quently (after 7 days) retinal detachment appeared. The patient underwent vitrec-tomy, tamponade of the vitreous cavity with silicone oil, endolaser coagulation of the retina. Results. On the 1st day after the operation, the visual acuity increased to 0.4 with correction (shp +8.0). 3 months after discharge from the hospital, the patient had complete safety of the eyeball and stable functional results were achieved, where the visual functions of the injured eye were 0.5 with correction (shp + 8.0). Conclusions. A clinical case of severe open eye injury with extensive sub-conjunctival rupture of the sclera, hemophthalmos and retinal detachment demon-strates that, despite the severity of the injury, with timely provision of high-tech surgical care, there is a real chance of saving the eyeball and get high visual func-tions. Key words: Traumatic vitreous haemorrhage; vitrectomy; subconjunctival rupture of the sclera; retinal detachment.
Retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Tereshchenko A.V. , Yudina N.N. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Sidorova Y.A. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Kulikov O.S. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Kodunov A.M. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Firsova V.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga
Published: August 2021

Purpose – to conduct a retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment. Material and methods. Patients diagnosed with rhegmatogenous retinal detachment whom were undergone episcleral filling from 2015 to 2020 at the S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, were performed to a detailed retrospective analysis. Additionally, cases were analyzed when, after episcleral filling, the retina did not attach and later vitreoretinal surgery was performed. Results. Episcleral surgery was performed to the 486 eyes, repeated interventions were required to 126 eyes (26%). The presence of peripheral chorioretinal dystrophy of the retina (PCHDR) in paired eyes was found in only 45% of patients. In these patients’ retinal attachment was achieved with only one episcleral filling. In cases of lack of retinal attachment after episcleral surgery, the proportion of the presence of PCHDR in the paired eye was 84%. The superior and temporal segments were the most frequent places of localization of retinal rupture. At the same time, there were retinal ruptures in the upper segment in 30% of patients. The proportion of rupture in the external segment was 32%. The retinal rupture was localized in the upper external segment at 18% of cases. At 20% of cases, retinal ruptures were localized in the lower external and lower segments. Conclusion. The success of episcleral surgery depends on the thoroughness of the diagnosis, the detection of all existing retinal ruptures and their blocking during the surgical treatment. Key words: rhegmatogenous retinal detachment, episcleral filling, intravitreal surgery.
Long-term results of delayed removal of the intraocular foreign body in open eyeball injury with damage to the posterior segment of the eye
Authors:   Clinical Ophthalmological Hospital at the Ministry of Health of the Republic of Uzbekistan, Fayzieva U.S. , Gulyamova M.D. ,   Clinical Ophthalmological Hospital at the Ministry of Health of the Republic of Uzbekistan, Ikramov O.I. ,   Clinical Ophthalmological Hospital at the Ministry of Health of the Republic of Uzbekistan
Published: August 2021

Purpose. To study the clinical efficacy of the long-term results of a step-by-step method of surgical treatment of open eye trauma complicated by the presence of the intraocular foreign body (IFB) in the posterior segment, including primary surgical treatment (PST) and delayed vitreoretinal surgery with IFB extraction within 24 hours after PST. Material and methods. The clinical efficacy of delayed IFB removal within 2 years was studied in 32 eyes with open trauma of the eyeball complicated by the presence of IFB in the posterior segment. Concomitant traumatic complications included partial hemophthalmos (84.4%) and rhegmatogenous retinal detachment (RD) (59.4%). Results. By the end of 2 years of follow-up, the anatomical effect was observed in all examined 21 eyes, including 15 eyes (71.4%) with hemophthalmos and 13 eyes (61.9%) with traumatic retinal detachment. In this case, recurrence of RD occurred in 7 eyes, post-traumatic traction RD- in 3 eyes. Functional effect with improved visual acuity was in 12 eyes (57.1%). At the same time, the MCVA was 0.3±0.05 (0.15–0.5). Conclusion. The presented method made it possible to achieve a stable anatomical effect and stable functional results, even in the presence of severe trauma complicated by total hemophthalmos and retinal detachment, in the long term. Key words: open eyeball injury, intraocular foreign body, primary surgical treatment, transvitreal intraocular foreign body extraction, post-traumatic traction retinal detachment.
Postoperative endophthalmitis
Authors:   Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary, Frolychev I.A. ,   State Autonomous Institution of additional professional education "The Postgraduate Doctors’ Training Institute" of Health Ministry of the Chuvash Republic, Cheboksary, Pozdeyeva N.A. ,   Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary,   State Autonomous Institution of additional professional education "The Postgraduate Doctors’ Training Institute" of Health Ministry of the Chuvash Republic, Cheboksary
Published: August 2021

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.
The results of treatment of serous retinal detachment in the optic nerve fossa. Clinical case
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Russian Federation, Khudyakov A.Y. , Kolenko O.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Russian Federation,   Postgraduate Institute for Public Health Workers, Khabarovsk, Russian Federation
Published: August 2021

Purpose. Demonstration of our own case of treatment of serous retinal detachment with a fossa of the optic nerve disc (OND). Material and methods. We observed patient B. at the age of 24 years with a diagnosis of optic nerve disc anomaly, central serous retinal detachment. Visual acuity on admission: 0.1, does not correct. A 25G endovitreal intervention was performed. With the help of tweezers, a flap of the internal limiting membrane (ILM) with a wide base was formed from the temporal part of the macula, within the vascular arcades. Then, liquid-air replacement was carried out, followed by placing the inverted flap of the ILM in the area of the OND fossa. Result. On the 5th day after the operation, visual acuity improved to 0.2, metamorphopsias decreased. According to the data of optical coherence tomography (OCT), a significant decrease in the height of neuroepithelial detachment was noted. After 4 months visual acuity reached 0.4. Complaints about metamorphopsia were stopped. The OCT picture showed a complete absence of retinal detachment. In this case, the inverted flap of the ILM in the area of the OND fossa was clearly visualized. Conclusion. 1. The displaced inverted flap of the ILM can be used to close the defect in the OND fossa. 2. This method made it possible to stop serous retinal detachment and significantly improve visual functions. 3. Given the rather rare occurrence of this pathology, further replication of this method is necessary to test its effectiveness. Key words: serous retinal detachment, fossa of the optic nerve disc, inverted flap of the internal limiting membrane.
A clinical case of surgical correction of post-traumatic aphakia
Authors:   Republican Specialized Scientific and Practical Center for Eye Microsurgery, Tashkent, Khusanbaev K.S. , Yusupov A.F. ,   Republican Specialized Scientific and Practical Center for Eye Microsurgery, Tashkent, Abdushukurova A.A. ,   Republican Specialized Scientific and Practical Center for Eye Microsurgery, Tashkent, Sultonmurodov T.F. ,   Republican Specialized Scientific and Practical Center for Eye Microsurgery, Tashkent, Ergashev N.A. ,   Republican Specialized Scientific and Practical Center for Eye Microsurgery, Tashkent
Published: August 2021

Purpose. To present a clinical case of surgical treatment of post-traumatic aphakia by the method of corneoscleral IOL fixation using the combined method of Kanabrava and Kozhukhov. Material and methods. In March 2021, patient A., born in 1992, turned to the RSSPCEM. diagnosed with OS Condition after a penetrating injury to the eye. Corneal scar. Post-traumatic aphakia. Foreign body (non-metallic) driven into the retina. A decision was made on OS surgical treatment of aphakia by the method of transscleral IOL fixation as the most gentle method, taking into account the paracentral scar of the cornea. And do not remove the foreign body, but additionally restrict it with laser coagulates. Results. On the 14th day after the operation, visual acuity OS 0.7, IOP 18. The eye is calm, there is a scar on the cornea in the paraoptic zone, transparent in the rest of the zone, the anterior chamber is deep, the iris is subatrophic, the pupil is 3 mm, deformed, the IOL is in the posterior chamber, centered. The fundus of the eye: the optic disc is pale pink, the boundaries are clear, the reflex is blurred in the macular zone, the foreign body is limited by pigmented laser coagulates. The standard postoperative drop regimen is recommended. Conclusions. 1. Corneoscleral fixation of the IOL according to the combined method of Canabrava and Kojuhov in the aphakic eye in complicated cases allows to achieve good refractive results with the developed technique of execution. 2. Preliminary laser limitation of an encapsulated non-metallic foreign body gives confidence in the stability of the retina in the intra- and postoperative period. 3. Further clinical observations are required using the above-described surgical technique for correcting aphakia Key words: сorneoscleral fixation, aphakia, Canabrava, Kojuhov.
A clinical case of transcleral fixation of an artificial iridochrustalic diaphragm during its decentration in a patient with aniridia and aphakia
Authors:   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, Shkvorchenko D.O. , Gorshkov I.M. ,   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, Kakunina S.A. ,   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, Norman K.S. ,   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, Obraztsova M.R. ,   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow, Drozdkov I.A. ,   S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow
Published: August 2021

Purpose. To evaluate the clinical and functional results of the technique of transcleral fixation of the artificial iridochrustalic diaphragm during its decentration in a patient with aniridia and aphakia. Material and methods. Under observation was a 32-year-old patient K. with a diagnosis on the right eye: iridochrustalic diaphragm decentralization, posttraumatic aniridia, posttraumatic aphakia, who underwent a method of transcleral fixation of a displaced artificial iridochrustalic diaphragm developed at the Academician S. N. Fedorov Eye Microsurgery of the Moscow Ministry of Health of the Russian Federation. Results. Patient K. is subjectively satisfied with the visual functions obtained in the right eye. Conclusion. Thus, this clinical case demonstrates a very successful implementation of the fixation of the iridochrustalic diaphragm with its displacement to obtain satisfactory visual functions in the patient. Key words: aniridia, iridochrustalic diaphragm, transcleral fixation.
Results of microinvasive combined laser-surgical technology in the treatment of rhegmatogenous retinal detachment
Authors:   S. Fyodorov Eye Microsurgery Federal State Institution, Shkvorchenko D.O. , Doga A.V. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Kryl L.A. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Taevere M.R. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Buryakov D.A. ,   S. Fyodorov Eye Microsurgery Federal State Institution
Published: August 2021

Rhegmatogenous retinal detachment (RRD) is one of the leading causes of vision loss world-wide. Despite advances in surgical techniques, rates of redetachment and vision loss remain high. Patients with RRD require a secondary surgery approximately 10 – 40% of the time. To achieve a high anatomical result, reduce the risk of reoperations and maintain high visual functions, it is necessary to develop and analyze microinvasive technologies to eliminate the main cause of RRD - the traction component. Purpose. To evaluate the results of microinvasive combined laser-surgical technology for RRD treatment. Material and мethods. The study included 43 eyes of 43 patients who underwent microinvasive laser-surgical technology for rhegmatogenous retinal detachment treatment, which included 3 consecutive steps: 1) YAG-laser excision of the horseshoe tear zone with vitreoretinal adhesion (VRA); 2) pneumatic retinopexy with 12% C3F8 (immediately after the first step); 3) barrier laser photocoagulation after complete retinal attachment (2-3 days after pneumatic retinopexy). The results were evaluated for anatomical efficacy (rates of retinal attachment and the occurrence of recurrent rhegmatogenous retinal detachment), functional efficacy (uncorrected (UCVA) and bestcorrected (BCVA) visual acuity, intraocular pressure (IOP)), and safety of technology (any intra- and postoperative complications). Results. In 40 patients (93%), the retina was attached with one surgical intervention. The success rate was significantly lower in patients with pseudophakia and a large retinal tear after YAG-laser excision of VRA zone. UNCA, BCVA and IOP after microinvasive combined laser-surgical technology was not significantly different from the initial values (p>0,05). Сlinically significant complications included gas migration into the subretinal space and epiretinal membrane formation. Conclusion. Microinvasive combined laser-surgical technology is characterized by high single surgery success rate (93%), preservation of initially high visual functions, a low rate of redetachment (7,5%) and clinically significant complications (7%). Key words: rhegmatogenous retinal detachment, optical coherence tomography, horseshoe tear, YAG-laser retinotomy, pneumatic retinopexy, vitreoretinal traction.
Method of surgical treatment of small and medium diameter macular holes with the foveal-sparing internal limiting membrane peeling
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Shpak A.A. , Kolesnik A.I. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Avakyan F.A. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Pismenskaya V.A. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Zhuravlev A.S. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow
Published: August 2021

Introduction and purpose. Idiopathic macular hole (IMH) is an urgent medical and social problem of the population of developed countries. It is known that microinvasive 3-port vitrectomy with gas-air tamponade is a generally accepted method of surgical treatment of IMH. There is still no clear understanding of the reasons for incomplete functional success in this category of patients, despite the anatomical success.Thus, there is a need to develop and implement in clinical practice a modification of the ILM peeling technique for the treatment of small and medium-diameter of IMH, which would not be inferior in anatomical effectiveness to existing methods and would be accompanied by a less damaging effect on the structures of the retina. Material and methods. The study included 10 patients with a diagnosis of IMH, who underwent a 3-port microinvasive 25G vitrectomy with the preservation of foveal ILM. Results. The analysis of the clinical and functional results of surgical treatment of IMH with the foveal fragment left revealed the complete closure of the macular tear, the absence of gross defects of the ellipsoid zone, an increase in the values of the average visual acuity and microperimetry from the 1st month of dynamic observation. Conclusion. The proposed low-traumatic method of fovea - sparing ILM peeling provides stable anatomical and functional result, the restoration of both morphological and functional parameters, and minimizes the mechanical impact on the retina in the fovea. Key words: macular rupture, internal limiting membrane, fovea-sparing ILM peeling.
Combined approach to the treatment of choroidal neovascularization in patients with chronic central serous chorioretinopathy
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga, Erohina E.V. , Sidorova Y.A. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, Kaluga
Published: August 2021

Purpose. To evaluate the effectiveness of combined treatment of chronic central serous chorioretinopathy (CCSCRP) complicated by 1st type choroidal neovascularization (CNV), using subthreshold micropulse laser exposure (SMILV) on the retina and intravitreal administration of angiogenesis inhibitors (IAOAI). Material and methods. In the period from 2017 to 2019, 37 patients (20 men and 16 women) with monolateral chronic recurrent CCSCRP complicated with CNV 1st type, were observed at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution. The aged of patients were from 35 to 57 years. In the main group were included 22 patients (22 eyes). In the main group, the anti-VEGF drug was injected once at the initial stage of treatment. During the follow-up examination before the next injection, while the detachment of the neurosensory retina persisted, the patients were immediately transferred to the combination therapy (SMILV + IAOAI). 15 patients (15 eyes) were included in the control group, whose treatment was started with 5 loading doses of the anti-angiogenic drug with an interval of 4 weeks. Results. In the main group, the number of IAOAI varied from 5 to 8 (6.1 ± 0.8). After a single injection of an angiogenesis inhibitor, a positive result was achieved in 3 cases (14%). These patients were performed two additional IAOAI with an interval of 4 weeks, then the interval was increased to 8 weeks. 19 patients (86%) had the detachment of the neurosensory retina with a height of 135-252 µm (177±28.2 µm). SMILV followed by IAOAI was performed for these patients. During the year of observation, from 8 to 10 injections of the inhibitor (8.8 ± 0.77) were performed in the control group of the study. The positive effect after injections of the anti-VEGF drug for 5 months was achieved only in 6 cases (42%). Conclusion. The proposed combination of laser exposure followed by the administration of an angiogenesis inhibitor is effective and can be used as an alternative and safe treatment for 1st type choroidal neovascularization in patients with chronic cerebrovascular accident. Key words: choroidal neovascularization, chronic central serous chorioretinopathy, intravitreal administration of angiogenesis inhibitors, subthreshold micropulse laser exposure.
The role of intracranial hypertension in the pathogenesis of central serous chorioretinopathy
Authors:   Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution, Ministry of health of the Russian Federation, Zlobina A.N. , Zhukova S.I. ,   Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution, Ministry of health of the Russian Federation, Iureva T.N. ,   Irkutsk Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution, Ministry of health of the Russian Federation,   Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education,   Irkutsk State Medical University, Zaika A.A. ,   Hospital of Irkutsk Scientific Center SB RAS
Published: August 2021

Central serous chorioretinopathy (CSCR) is a pachychoroid condition, but the causes of pachychoroid development remain unknown. Taking into account the anatomical features of the blood supply to the eyeball, it was suggested that the phenomena of pachychoroid can be caused by intracranial hypertension. Purpose. Evaluate blood supply disorders at the level of eyeball vessels, intracranial vessels and vertebrobasilar basin in patients with CSCR. Material and methods. 10 patients with CSCR were examined, 4 of them additionally underwent magnetic resonance imaging (МРТ) of the brain and cervical spine, intra-and extracranial arterio-and venography, and ultrasound of extra-and intracranial vessels. Results. By OCT data, all patients had significant increase in the choroidal thickness both in eyes with CSCR, and in fellow eyes. OCT of the optic disc revealed subarachnoid space expansion - a marker of intracranial hypertension. By ultrasound B-scan data, 8 patients with CSCR showed moderate expansion of the perineural space of the optic nerve and significant expansion of orbital vessels, which also indicates intracranial hypertension. By MRI data, all patients showed signs of internal hydrocephalus, which may indicate intracranial hypertension. In addition, the presence of signs of cervical osteochondrosis and asymmetry in the vertebral arteries was established. In 50% of cases, there was a decrease in intravascular blood flow along the orbital vein on the side of the affected eye, and an asymmetry of venous blood flow along the transverse and cavernous sinuses. By ultrasound dopplerography signs of intracranial venous hypertension of extra-and intracranial vessels were revealed. Conclusion. The role of pathological changes of central genesis in the development of CSСR has been established, requiring interdisciplinary research and expansion of therapeutic measures aimed at limiting the identified disorders. Key words: central serous chorioretinopathy, pachychoroid condition, intracranial hypertension.
Some aspects of diagnosis and treatment of a сircumscribed form of choroidal hemangioma complicated by macular edema
Authors:   S.N. Fedorov NMRC ", Magaramov J.A. ,   MNTK ",   Eye microsurgery",   , Moscow, Loginov R.A. ,   S.N. Fedorov NMRC "MNTK "Eye microsurgery", Moscow, Klepinina O.B. ,   S.N. Fedorov NMRC "MNTK "Eye microsurgery", Moscow
Published: August 2021

Introduction. The interest are rare cases of a сircumscribed choroidal hemangioma located juxtapapillary (JP) on the nasal side of the optic nerve disc (OND) and complicated by macular edema. Purpose. Studying the possibility of timely diagnosis and evaluating the effectiveness of treatment of a сircumscribed choroidal hemangioma complicated by macular edema. Material and methods. A retrospective analysis of the diagnostics and treatment results of 5 patients (5 eyes) with JP сircumscribed choroidal hemangioma, localized on the nasal side of the optic disc, complicated by macular edema, was carried out. Results. As a result, in all patients, already 1 month after the session of selective laser transpupillary thermotherapy (TTT), an increase in visual acuity and quality was observed, which was accompanied by pronounced resorption of intraretinal cysts and / or subretinal fluid in the macula. Conclusion. The purposeful use of modern diagnostic methods and the use of a sparing method of laser TTT makes it possible to identify and cure patients with CPCH complicated by macular edema without loss of visual functions. Key words: сircumscribed choroidal hemangioma, selective transpupillary thermotherapy, cystic macular edema.
Intravitreal antiVEGF injections combined with laser retinopexy in acute and chronic central serous chotioretinopathy
Authors:   International Vietnamese-Russian ophthalmological clinic, Naidiuk D.O. , Nguyen Q. ,   International Vietnamese-Russian ophthalmological clinic, Merzlov D.E. ,   International Vietnamese-Russian ophthalmological clinic
Published: August 2021

Purpose. To evaluate the efficacy of combined treatment (anti-VEGF intravitreal injection followed by laser retinopexy) compered with conservative treatment in patients with central serous chorioretinopathy (CSR). Methods. A retrospective study included 191 patients with CSC. Patients were divided into 3 groups. 104 patients (1st group) were treated with intravitreal anti-VEGF injections followed by laser retinopexy. 50 patients (2nd group) received a conservative treatment. 37 patients (3rd group) were switched from conservative treatment to intravitreal anti-VEGF injections. Best corrected visual acuity (BCVA), central foveal thickness (CFT) and resolution of subretinal fluid on optical coherence tomography (OCT) were assessed. Results. Resolution of CRF in all patients in the 1st group was achieved by the 3rd month of treatment, from 3 to 6 months in the 2nd group and the 3rd groups. Mean BCVA improved more rapidly in the 1st group. A well-defined IS/OS line on final OCT was more frequently detected in the 1st group. Conclusion. Intravitreal antiVEGF injections followed by laser retinopexy in patients with CSR results in shorter treatment period and better functional results. Key words: аnti-vascular endothelial growth factor, central serous chorioretinopathy.
Clinical profile of a patient with wet form of age-related macular degeneration at the stage of disease detection
Authors:   Kursk State Medical University, Androsova E.A. ,   "Ophthalmological clinical hospital – ophthalmological center", Kursk, Brezhnev A.Y. ,   Kursk State Medical University,   "Ophthalmological clinical hospital – ophthalmological center", Kursk, Tolmacheva E.M. ,   "Ophthalmological clinical hospital – ophthalmological center", Kursk
Published: August 2021

Purpose. To study the phenotypic features and systemic correlations at the stage of detection of wet age-related macular degeneration (AMD). Material and methods. A prospective comprehensive clinical study included 197 patients with newly diagnosed wet AMD (82 (41.6%) males and 115 (58.4%) females). All patients underwent standard ophthalmological examination and a survey based on a specially developed questionnaire. Results. The average age of wet AMD manifestation varied widely (from 42 to 95 years), averaging 69.9±7.1 years. There was no statistically significant difference in the timing of the onset of the disease in males and females (67.91±8.2 and 70.22±6.9 years, respectively, p>0.05). Light colors of the iris (blue and gray) were found in 108 (54.8%) and 57 (28.9%) cases, respectively. In all cases, the development of wet AMD proceeded asymmetrically with the primary lesion of one of the eyes. The incidence of the disease in the right and left eyes was almost the same (49.7% and 50.3%, respectively). In all age groups, the body mass index exceeded normal values. Arterial hypertension was observed in most patients with wet AMD - in 91.9% of cases, coronary heart disease – in 10.2% of patients. The prevalence of diabetes mellitus (mainly type 2) in patients with wet AMD was 5.6%. Among the cerebrovascular disorders, cerebral atherosclerosis and dyscirculatory encephalopathy prevailed, accounting for 11.4%. Conclusion. The data obtained indicate a variety of phenotypic correlations of wet AMD and the need to study them to address the issues of early diagnosis and the formation of appropriate risk groups. Key words: age-related macular degeneration, cardiovascular pathology.
Evaluation of the dynamics of resorption of diabetic macular edema during steroid therapy
Authors:   Research Institute of Eye Diseases, Moscow, Russia, Arzhukhanov D.D. , Petrachkov D.V. ,   Research Institute of Eye Diseases, Moscow, Russia, Budzinskaya M.V. ,   Research Institute of Eye Diseases, Moscow, Russia
Published: August 2021

Purpose. To identify the dominant topographic resorption zones of diabetic macular edema, as well as their hierarchy, which determines a favorable postoperative outcome. Material and methods. We examined 21 patients (27 eyes) aged 26 to 79 years (mean age 64.4±11.2 years) with a diagnosis of diabetic retinopathy, diabetic macular edema. All patients underwent a standard ophthalmological examination, as well as a segment-by-segment analysis of optical coherence tomography scans (OCT Spectralis Heidelberg, Germany) before and 1 month after steroid therapy. The retinal thickness (RT) and volume (RV) were analyzed in 9 segments of the macular region with a diameter of 6 mm. Statistical processing of the obtained material was carried out using the IBM SPSS Statistics v. 21 program, using standard methods of descriptive statistics. Results. During the analysis of optical coherence tomography data, the following results were obtained: the average maximum corrected visual acuity after steroid therapy significantly increased from 51.5±14.7 to 65±9 letters ETDRS (p<0.0001). The percentage ratio of macular edema regression in the analyzed segments revealed the following proportional pattern of changes in RT and RV: in the fovea zone – a decrease of 31%; 4 segments of a concentric circle with a diameter of 3 mm – on average by 20.6±1.2% and 21.0±1.8%; 4 segments of a concentric circle with a diameter of 6 mm – on average by 10%. Conclusion. The present study revealed the absence of dominant topographic zones of resorption, against the background of steroid therapy, while the proportionality and uniformity of the reduction of macular edema was observed. Key words: diabetic retinopathy, diabetic macular edema, optical coherence tomography, steroid therapy, ozurdex.
Approaches to antiangiogenic therapy for aneurysmal type 1 neovascularization
Authors:   Scientific Research Institute of Eye Diseases, Moscow, Afanasyeva M.A. , Plyukhova A.A. ,   Scientific Research Institute of Eye Diseases, Moscow, Shelankova A.V. ,   Scientific Research Institute of Eye Diseases, Moscow
Published: August 2021

Purpose. To study the primary response to anti-VEGF therapy with Aflibercept in patients with aneurysmal type 1 neovascularization (AN type 1). Material and methods. 11 patients with type I AN were examined. All patients underwent a standard ophthalmological examination and additionally underwent: determination of the maximum corrected visual acuity according with ETDRS (Early Treatment Diabetic Retinopathy Study) charts, OCT, OCT-angiography and indocyanine-green angiography to clarify the diagnosis. Results. According to the results of the study, against the background of three loading injections, there is a significant decrease in the height of RPE detachment (p=0.029), an unreliable decrease in the central retinal thickness (p=0.088) due to resorption of sub- and intraretinal fluid, and an increase in BCVA (p=0.285), due to compliance with the regime. At the 12th month of the study, there was an increase in the central thickness of the retina and the height of RPE detachment. The achieved results were not preserved, which can be explained by compliance with loading doses and further non-compliance with the interval between injection. On average, 6.5 IVIs were performed per year. Conclusions. Against the background of anti-VEGF therapy with aflibercept in patients with type I aneurysmal neovascularization, a positive effect of treatment is observed. But it is necessary to carry out regular monitoring and treatment to maintain the achieved results. Key words: polypoidal choroidal vasculopathy, aflibercept, anti-VEGF, retinal epithelium pigment detachment, aneurysmal neovascularization.
Diagnostic difficulties of myopic staphyloma
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Russian Federation, Bushnina L.V. , Pomytkina N.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Russian Federation, Sorokin E.L. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Russian Federation,   Far Eastern State Medical University, Khabarovsk, Russian Federation
Published: August 2021

Purpose. Comparative analysis efficiency of diagnostic of myopic staphylomas using optical coherence tomography (OCT) with scan protocols different lengths. Material and methods. A 52-year-old patient with high axial myopia with myopic staphyloma was examined. Profound ophthalmological examination was carried out using OCT of the posterior pole of the eye using scans protocols of various lengths, ultrasound ocular echography. The presence and localization of scleral staphyloma was assessed. Results. When examining the posterior pole of the eye using 12 mm linear OCT scanning, no signs of staphyloma were detected in both eyes. Radial OCT scans 10 mm in length, 3D OCT scans size 12×9 mm scan made it possible to suspect the presence of large macular myopic staphyloma. Examination of patient using 16.5 mm linear OCT scanning revealed distinct prolapse of the posterior pole of the eye, capturing the optic disk and the macular area in both eyes. Ultrasound B-scan confirmed the presence of staphyloma of the posterior pole of the eye in both eyes. Conclusions. 1. To identify the presence and localization of myopic staphyloma, the most informative method is 16.5 mm OCT scanning. 2. For the diagnosis of myopic staphilomas, it is possible to use 12 mm OCT scanning. Key words: optical coherence tomography, myopia, myopic staphyloma, scleral staphyloma.
Features of chorioretinal hemodynamics against the background of correction of endothelial dysfunction in women after preeclampsia
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk, Russia, Kolenko О.V. ,   Postgraduate Institute for Public Health Specialists, Khabarovsk, Russia, Sorokin Е.L. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk, Russia,   Far Eastern State Medical University, Khabarovsk, Russia, Fil А.А. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk, Russia
Published: August 2021

Purpose. To assess the clinical efficacy of drug correction of endothelial dysfunction in women at risk using the study of chorioretinal hemodynamic parameters. Material and methods. Using the prediction algorithm developed by us, 60 women were selected at risk of developing vascular retinal pathology. All women were divided into two subgroups. 1st group – 30 patients who underwent courses of drug correction of endothelial dysfunction; 2nd group included 30 women who did not receive courses of prophylactic treatment. The control group was represented by 30 women who underwent physiological pregnancy. The entire population of women underwent a study of the parameters of chorioretinal hemodynamics. Results. By the end of the follow-up period (3–4.5 years) in the 1st group there was a statistically significant improvement in the parameters of chorioretinal hemodynamics in comparison with both the 2nd group in the period 3 years after childbirth, and with the indicators of the 1st group after 6–8 months after childbirth. Conclusion. It can be argued that in the group of women who underwent long-term drug correction of endothelial dysfunction, there was a statistically significant improvement in a number of indicators of chorioretinal hemodynamics compared with women who did not receive prophylactic treatment (p<0.01). Key words: chorioretinal hemodynamics, macular blood flow, linear blood flow velocity, preeclampsia, endothelial dysfunction, drug correction of endothelial dysfunction.
Pachychoroid neovasculopathy with normal subfoveal choroidal thickness
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Pedanova E.K.
Published: August 2021

Pachychoriod neovasculopathy and typical neovascular age-related macular degeneration often look similar, but some differences have been described both genotypically and in the level of cytokine profile, which explains the difference in response to antiangiogenic therapy. It is known that pachychoriod diseases are characterized by choroidal subfoveolar thickening. However, there is currently no data on the structural features of the choroid in the presence of pachychoriod neovasculopathy outside the fovea. Purpose. To perform a detailed analysis of choroial structure on OCT scans of patients with neovascular AMD with normal choroidal subfoveolar thickness and to reveal the frequency of pachychoriodal neovasculopathy identification. Material and methods. In retrospective study, the data of 30 treatment-naive patients (30 eyes) aged 71.5±7.6 years with CNV type 1 were analyzed, including 18 women and 12 men, with a subfeolar thickness of the choroidal membrane not exceeding 250 µm. The patients underwent OCT and OCT-angiography using a Spectralis device (Heidelberg Engineering, Germany). In the foveolar zone and under the neovascular complex, if it is located outside the fovea, the structure of the choroid was analyzed: the choroidal thickness, Haller layer and choriocapillaries / layer of Sattler vessels were measured. Results. The average thickness of the choroid in the fovea in all patients was 170.1±40 µm. The thickness of Haller vessels layer was on average 112.3±20 μm, and the layer of choriocapillaries / Sattler vessels was 57.8±12 μm. In 22 eyes, the structure of the choroid and the ratio of all layers were similar in all analyzed OCT scans. However, in 8 eyes, under the CNV located extrafoveally, a thickening of the choroid was revealed up to 210.5±51 µm, the main volume of the choroid was presented by pachyvessels – dilated and enlarged vessels of the Haller layer which thickness was 189.4 ± 48 µm, and thinning of the choriocapillary / Sattler layer to 21.1±16 µm. Conclusion. Among 30 patients with normal subfoveolar thickness of the choroid, the frequency of PNV was 26.6%. Taking into account the literature data on different responses to antiangiogenic therapy in patients with PNV and typical AMD, we can once again emphasize the importance of a detailed assessment of changes in the choroid not only in the foveolar zone, but also specifically in the area of the neovascular complex. Key words: pachychoriod neovasculopathy, choroid, OCT.
Immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk, Povalyaeva D.А. , Egorov V.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk,   Postgraduate Institute for Public Health Workers, Khabarovsk, Smoliakova G.P. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk,   Postgraduate Institute for Public Health Workers, Khabarovsk, Danilova L.P. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk Branch, Khabarovsk,   Postgraduate Institute for Public Health Workers, Khabarovsk
Published: August 2021

Purpose. Evaluation clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including methods of immunotherapy. Material and methods. The clinical study involved 26 people (26 eyes) with acute ON associated with HVI. The treatment regimen for all patients within 10 days included delivery through irrigation system implanted into the retrobulbar space to optic nerve: solutions Dexamethasone on decreasing scheme, Emoxypine 1% 0.5 ml and Dicynone 12.5% 0.5 ml. All patients were divided into 2 groups depending on characteristics of therapy. The 1st group consisted of 12 patients, who were treated according to the standard method. 2nd group consisted of 14 patients who received additional intramuscular Imunofan. The duration of immunotherapy was 10–12 days. Results. Analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 2nd group of observation in comparison with the 1st group. Conclusion. The developed strategy of etiotropic and pathogenetic immunotherapy at ON associated with HVI infection, allows shortening recovery time and improving functional results of treatment in absence of relapses of disease within 1 year of follow-up. Key words: optic neuritis, herpesvirus infection, corticosteroid therapy, immunotherapy.
Study retinal blood flow in pregnant women with diabetes mellitus and gestational diabetes mellitus
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk, Pomytkina N.V. , Sorokin E.L. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk,   Far Eastern State Medical University, Khabarovsk, Pashentsev Y.E. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk
Published: August 2021

Purpose. To study retinal blood flow in pregnant women with diabetes mellitus and gestational diabetes mellitus using optical coherence tomography angiography (OCTA). Material and methods. 203 pregnant women in the third trimester were examined: 24 – with type 1 and 2 diabetes mellitus (T1DM and T2DM), 143 – with gestational diabetes mellitus (GDM), and 36 apparently healthy women with physiological pregnancy, who consisted the control group. OCTA imaging was performed using the RTVue XR Avanti OCT 6 mm × 6 mm "Angio Retina" scan protocols (Optovue, USA). The whole image vessel density (wiVD), foveal vessel density (FVD), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. FVD in pregnant women with diabetes mellitus was significantly less than in pregnant women with GDM and in the control group, in this connection, it can be assume changes of the retinal microvascular regulation because of chronic disturbances of carbohydrate metabolism in such patients and due to microangiopathy development. FAZ area extension and wiVD diminution were revealed in patients with diabetic retinopathy (DR) compared to datas of the group of pregnant women with diabetes mellitus and absence of DR, in the absence of differences in FVD indexes. In 2 patients with T1D and the absence of ophthalmoscopic signs of DR, OCTA revealed areas of nonperfusion in the posterior pole of the eye. Conclusions. A significant FVD decrease in the superficial capillary plexus was revealed in pregnant women with diabetes mellitus, compared with pregnant women with GDM and healthy women with physiological pregnancy in the absence of significant difference in wiVD in the superficial capillary plexus and FAZ area. Patients with DR showed an expansion of FAZ area and decrease in wiVD in the superficial capillary plexus relative to the group of pregnant women with diabetes mellitus without DR. OCTA helps to identify areas of retinal nonperfusion in the posterior pole of the eye in pregnant women with diabetes in the absence of ophthalmoscopic signs of DR. Keywords: optical coherence tomography angiography, pregnancy, diabetic retinopathy, gestational diabetes, foveal avascular zone, retinal blood flow.