18 research outputs found
MICROPERIMETRY AND MORPHOMETRIC PARAMETERS OF OPTIC NERVE HEAD AND MACULAR AREA IN PATIENTS WITH PRIMARY OPEN ANGLE GLAUCOMA
No full textMICROPERIMETRY AND MORPHOMETRIC PARAMETERS OF OPTIC NERVE HEAD AND MACULAR AREA IN PATIENTS WITH PRIMARY OPEN ANGLE GLAUCOMA
No full textPurpose: To study by using microperimetry a degree of functional disorders of retinal peripapillary area in patients with initial stage of primary open angle glaucoma (POAG), to analyze correlation relationship of the microperimetry parameters and the main morphometric parameters of the optic nerve head (OND).Patients and methods. There were 51 patients (98 eyes) in the study aged from 50 to 72 years (average age 58,37 ± 9,41 years) with the initial stage of POAG. The control group consisted of 50 somatically healthy persons (99 eyes) without ophthalmological pathology. In addition to the standard ophthalmologic examination, the special methods included: optical coherence tomography (OCT) of the posterior segment of the eye (Optovue Avanti RTVue XR, USA) and microperimetry (Macular Integrity Assessment (MAIA), USA). Statistical analysis of the received data were processed with the IBM SPSS Statistics v.21 program (standard methods of descriptive statistics).Results. Microperimetry has shown a significant statistical difference of MI parameters (29,68 ± 23,18) and AvTh (27,63 ± 3,38 dB) in patients with initial stage of POAG from those in the control group (p <0,01). The highest correlation of morphometric parameters and microperimetry parameters was defined in MI patients with POAG with the focal loss of volume (FLV) of ganglion cells complex (GCC) (ρ = 0,642, p <0,001). A significant positive relationship of moderate strength was found between microperimetry parameter MI in patients with POAG and the FVL GCC (ρ = 0,346, p <0,01), a moderate negative relationship with the index of MI was obtained with an average GCC thickness (ρ = -0,378, p <0 , 01), and an average RNFL thickness (ρ = -0,355, p <0,01). In patients with POAG a significant moderate positive relationship of AvThr parameter was identified with BCVA (ρ = 0,324, p <0,01), a moderate negative relationship of AvThr parameter with age (ρ = -0,401, p <0,01).Conclusion. Application of microperimetry confirms involvement of the macular area in the pathological process in POAG. In the early stages of glaucoma neuroretinopathy is manifested both as regarding microperimetry functional data and OCT morphometric parameters
25G Ultrasonic Vitrectomy in Surgical Treatment of Idiopathic Macular Hole
No full textIntroduction. Idiopathic macular hole (IMH) is a frequent disorder of the posterior segment of the eye that impacts on visual functions leading to the reduction of visual acuity and the manifestation of metamorphopsia. In the majority of cases the basic treatment technique for IMH is a three-port transconjunctival guillotine vitrectomy. In the key of the further development of vitrectomy the latest and most interesting is the use of ultrasonic energy for vitreous fragmentation. Members of staff of the Department of Ophthalmology with the Course of Additional Professional Education of Bashkir State Medical University jointly with the Department of Microsurgical Equipment of CJSC Optimedservice have built a 25G ultrasonic vitrectomy system with the mechanism of action that turns the vitreous body into easy-to-remove emulsion with the use of ultrasound.Materials and methods. This paper presents a clinical case of idiopathic macular hole successfully treated with the method of 25G subtotal ultrasonic vitrectomy.Results and discussion. The data obtained through comprehensive ophthalmological examination and supported by fundus-camera, OCT and OCTA images made it possible to make a diagnosis of vitreomacular traction syndrome, idiopathic macular hole, J. D. Gass stage 3. 25G subtotal ultrasonic vitrectomy was performed on the universal ophthalmic surgery system Optimed Profi (Optimedservice, Russia) with intraoperative OCT-controlled internal limiting membrane staining and peeling, and apposition of the macular hole edges with gas tamponade. A good outcome, both anatomical and functional, was achieved; IMH has closed and a positive visual acuity dynamic has been recorded.Conclusion. We can thus conclude that 25G subtotal ultrasonic vitrectomy with ILM peeling and gas tamponade is an effective IMH treatment method that ensures high visual functions
Post-occlusion surge parameters during <i>ex vivo</i> phacoemulsification with a new method of adaptive infusion control
No full textA new method of adaptive control of infusion during phacoemulsification (PE) based on the Optimed Profi (Optimedservice) surgical system was developed, allowing calculation of the predicted volume of post-occlusion surge (POS) by monitoring aspiration and infusion flow rates. Purpose. To compare POS amplitude, predicted and actual volumes of POS during experimental ex vivo PE on cadaveric porcine eyes, between Optimed Profi and Centurion Vision surgical systems. Material and methods. For two experimental PE series of 10 operations on porcine eyes, the mean POS amplitude (mm Hg) was measured using a pressure sensor in the anterior eye chamber. Predicted and actual POS volumes were assessed using a non-contact aspiration-line flowmeter sensor by varying aspiration flow rate depending on the phaco needle patency. The parameters were compared between the series using the Student t-test. Results. The mean POS amplitude during PE by Optimed Profi and Centurion Vision System was 12.10 ± 0.21 and 13.3 ± 0.3 mm Hg, respectively (p < 0.001). The mean value of the predicted POS volume during PE by Optimed Profi and Centurion Centurion Vision System was 136.80 ± 9.59 and 146.00 ± 9.46 μm, respectively (p > 0.01). The mean value of the actual POS volume during PE by Optimed Profi and Centurion Vision System was 135.30 ± 4.97 and 158.50 ± 8.63 μm, respectively (p < 0.01). Conclusion. The lower values of POS amplitude and predicted and actual volumes of POS in the series using the new method of adaptive infusion control may indicate a better hydrodynamic stability in experimental PE
Results of Vitreous Floaters Treatment Using a Yag-Laser Device with a Coaxial Light Splitter
No full textPurpose: to evaluate the efficiency of vitreous floaters removal using the Nd: YAG-laser DIXION LPULSA SYL-9000 with a coaxial light splitter. Patients and Methods. The study involved 24 patients (24 eyes) with Weiss ring-type floating vitreous opacities. All patients underwent laser vitreolysis on a Nd: YAG-laser DIXION LPULSA SYL-9000 with a coaxial light splitter. Laser procedures were performed at OPTIMED Laser Recovery Center. The age of the patients was from 47 to 81 years (average 58.3 ± 8.9 years). Among the patients 15 (62.5 %) were women and 9 (37.5 %) — men. Before procedure, a complete ophthalmological examination including registration of best corrected visual acuity (BCVA), autorefractometry, pneumotonometry, biomicroscopy, fundus examination, ultrasonic biometry, ultrasound B-scan was performed. Statistical processing was performed using Statistica v.10.0.0 (StatSoft®, Inc.) and Excel (Microsoft Office Professional 2016) software. The patients were observed for three months before the procedure. Follow-up examination was performed one day after the procedure. Results. After laser vitreolysis procedure all patients had a subjective vision quality improvement. In 18 (75 %) patients, floating “flies” completely disappeared. The remaining patients noted the disappearance of a large floating spot. Conclusion. The laser vitreolysis on the Nd: YAG-laser with a coaxial light splitter allows to improve the quality and visual acuity in patients with vitreous floater. The obtained results demonstrated that Nd: YAG-laser DIXION LPULSA SYL-9000 is effective and could be recommended for treatment of symptomatic vitreous floaters
Electron Microscopic Changes of Rabbit Retina after Chromovitrectomy Using Combined Dyes (Experimental Study)
No full textAdvantages of dynamic bi-directional applanation tonometry in primary open-angle glaucoma diagnostics
No full textPurpose. To study tonometry parameters features, measured by different methods, taking into account individual morphometric eye parameters and biomechanical properties of the corneoscleral shell in patients with the initial and the advanced stages of primary open angle glaucoma (POAG).Material and methods. 51 patients (99 eyes) aged 48–82, with the initial (45 eyes) and advanced stages (54 eyes) of POAG were examined. The control group consisted of 31 patients (62 eyes) aged 47–83 without ophthalmic pathology. In addition to standard ophthalmologic examination, tonometry was performed using the Ocular Response Analyzer (ORA, Reichert Inc., the USA).Results. The main tonometry parameters of ORA revealed significant differences between POAG patients and the control group. No significant difference in the central corneal thickness (CCT) was found between the POAG and the control group. Patients with I and II stages of glaucoma taken separately showed differences in CCT and tonometry parameters.Conclusion. Dynamic bi-directional applanation tonometry enables to take into account the changes in viscoelastic properties of the corneoscleral eye shell, and definitely has diagnostic advantages in examining patients with various stages of POAG
Electron Microscopic Changes of Rabbit Retina after Chromovitrectomy Using Combined Dyes (Experimental Study)
No full textPurpose: to evaluate on experimental model electron-microscopic changes of rabbit retina after staining of the posterior eye segmentwith combined dyes based on Trypan blue and Brilliant blue G for the assessment of their safety. Methods. The study was performed onChinchilla breed rabbits. Combined dyes based on Trypan blue and Brilliant blue were used: MembraneBlue-Dual (DORC, Netherlands)and “Staining solution for ophthalmic surgery” (JCS “Optimedservis”, Russia). Standard three-port vitrectomy technique was used. After vitreous removal dyes were injected in vitreous cavity and exposed for 10 seconds and then removed. The vitreous cavity was filled by a balanced salt solution. An electron-microscopic evaluation was performed on 5, 14 and 30 days after surgery. Eyes were enucleated in 20 minutes after animal was killed by air embolization. Intact eyes were used as a control, all samples were prepared in same сonditions. The damage of the retina architectonics and the presence of intracellular inclusions were evaluated. Results. The staged character of pathomorphological changes was revealed. On the 5th day moderate edema and hydropic dystrophy of neurons were registered. On the 14th day, there was no negative dynamics. On day 30, the signs of edema and dystrophy of neurons practically disappeared, which may indicate a fundamental reversibility of the registered changes. Conclusion. Investigated dyes for staining intraocular structures based on Trypan blue and Brilliant blue did not cause significant histomorphological changes and toxic effects on retinal cell structures. Detected electron microscopic changes were insignificant, had reversible character and could be mostly caused by a surgical injury
Correlation of Corneoscleral Membrane Biomechanical Properties and Eye Morphometric Parameters in Patients with Primary Open-Angle Glaucoma
No full textPurpose: to study a correlation between morphometric parameters of the eye and tonometry data, taking into account viscoelastic properties of the cornea in patients with primary open-angle glaucoma (POAG), as well as in practically healthy individuals using different methods of tonometry. Patients and Methods. Correlations between morphometric parameters of the eye and tonometry data were studied in view of viscoelastic properties of the cornea in 51 patients with POAG who were observed at the “Optimed” Laser Vision Recovery Center in Ufa (99 eyes) and in 31 practically healthy individuals (62 eyes). Various methods of tonometry were used: tonometry according to Maklakov, contactless tonometry, tonometry with the Ocular Response Analyzer (ORA, Reichert Inc., USA), as well as ultrasound echobiometry, pachymetry. Results. The CH and CRF parameters reflecting the biomechanical properties of the corneoscleral membrane of the eye were close in value to each other with a high degree of positive correlation in the control group (ρ = 0.783, p < 0.001), with an average correlation in the group with POAG (ρ = 0.545, p < 0.001). In eyes with POAG, a negative CH correlation of average degree with corneal-compensated IOP (ρ = -0.572, p < 0.001), a negative CRF correlation of moderate degree with IOP by the Maklakov method (ρ = -0.346, p < 0.001) and corneal-compensated IOP with dynamic bi-directional applanation tonometry (ρ = -0.327, p = 0.001), low correlation with IOP using contactless tonometry (ρ = 0.243, p < 0.015) were observed. In the group of patients with POAG, a positive average correlation was found between the central thickness of the cornea and CRF (ρ = 0.398, p < 0.001), and CH (ρ = 0.368, p < 0.001), low correlation with IOP using contactless tonometry (ρ = 0.266, p = 0.008). Conclusion. Correlations of biomechanical properties of the corneoscleral membrane and morphometric parameters of the eye in patients with POAG were revealed using different methods of tonometry. In the group of patients with POAG and in the control group, positive correlations of the central thickness of the cornea with the IOP level in tonometry were determined by the contactless method, as well as with the main ORA parameters reflecting the visco-elastic properties of the fibrous membrane of the eye — the corneal resistance factor, corneal hysteresis
Electron Microscopic Retina Changes in Rabbit Eyes with Perfluorocarbon Liquids Intravitreal Tamponade
No full textPurpose. Analysis of electron microscopic changes in rabbit eyes with intravitreal tamponade of perfluorocarbon liquids (PFCL) (perfluoro-1,3-dimethylcyclohexane and perfluorodecalin). Material and Methods. The study was performed on Chinchilla breed rabbits. 25G vitrectomy with PFCL intravitreal tamponade was performed on 12 eyes of 6 rabbits (perfluorodecalin (Bausch+Lomb «Dk-line», USA) and perfluoro-1,3-dimethylcyclohexane (ZAO “Optimedservis”, Russia). Standard three-port vitrectomy technique was used. After removal of the vitreous body 2.5 ml of PFCL were injected in vitreous cavity. Research studies were performed in 5, 14 and 30 days after surgery by electron microscopy. Eyes were enucleated in 20 minutes after animal was killed by air embolization. Intact eyes were used as a control. All samples were prepared in same conditions. The damage of the retina architectonics and the presence of intracellular inclusions were evaluated. Results. Tamponade of the vitreous cavity by both types of PFCL in 5, 14 and 30 day caused following similar electron microscopic changes at date: swelling ganglion layer and dystrophy of inner and outer nuclear layer. Electron microscopic changes in outer nuclear layer appeared at 30 days. The photoreceptor neurons were characterized by single ultrastructural changes. Retina pigment epithelium cells had a typical ultrastructure. Conclusion. Intravitreal perfluoro-1,3-dimethylcyclohexane tamponade caused similar electron microscopic changes as well as perfluorodecalin in the experiment and it was relatively harmless to rabbit retina for up to 14 days. Irreversible changes in the retinal ultrastructure were not observed
