165 research outputs found
Pharmacotherapy for POAG. Individual approach
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S.V. Balalin, V.P. Fokin
S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd branch, Volgograd, Russian Federation
Glaucoma is still one of the leading causes of the blindness and low vision. According to the World Health Organization, an estimated number of glaucoma patients is 60.5 to 105 million and is growing steadily. In many highly developed countries, glaucoma accounts for 13–28% of blindness. High intraocular pressure (IOP) is the most important risk factor for glaucomatous optic neuropathy and low vision in primary open-angle glaucoma (POAG). It was demonstrated that IOP lowering to the individual tolerant level in POAG preserves vision for a long time.
The paper discusses potential adoption of of the software for the calculation of tolerant IOP in POAG. Tolerant IOP calculations will help to adjust treatment in time to achieve individual IOP normal ranges, to predict glaucoma stabilization or progression as well glaucoma progression rate. The algorithm of treatment strategy for POAG is described.
Key words: glaucoma, primary open-angle glaucoma, intraocular pressure, tolerant IOP, glaucomatous optic neuropathy, prostaglandin analogue, latanoprost, Trilactan.
For citation: Balalin S.V., Fokin V.P. Pharmacotherapy for POAG. Individual approach. Russian Journal of Clinical Ophthalmology. 2019;19(1):43–48.
About the authors:
Sergey V. Balalin — MD, PhD, Head of the Scientific Department of the Volgograd branch;
Viktor P. Fokin—MD, PhD, Professor, Director of the Volgograd branch.
S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd branch. 80, Zemlyachki str., Volgograd, 400138, Russian Federation. Contact information: Sergey V. Balalin, e-mail: [email protected]. Financial Disclosure: no author has a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 23.10.2018.<br
Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma
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A.S. Balalin, V.P. Fokin, S.V. Balalin, B.G. Dzhashi
Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd, Russian Federation
Aim: to develop a combined technology of optimized YAG-laser trabeculostomy and selective laser trabeculoplasty and to evaluate its efficacy and safety in the treatment for primary open-angle glaucoma (POAG).
Patients and Methods: this study enrolled three groups of patients. Group 1 (study group, prospective) included 87 patients (87 eyes) with early and moderate POAG before and after optimized YAG-laser trabeculostomy. Group 2 (control, prospective) included 78 patients (78 eyes) with early and moderate POAG before and after selective laser trabeculoplasty (SLT). Group 3 (control) included 60 healthy individuals (60 eyes). A technique to determine the topography of the collector channels and Schlemm's canal was developed to perform YAG-laser trabeculostomy. The location of the collector channels was determined with regard to Schlemm's canal using anterior segment optical coherence tomography (OCT). Patients were followed up after 1 day, 1, 6, 12, and 24 months.
Results: after combined optimized YAG-laser trabeculostomy and SLT, a significant IOP-lowering effect (reduction in IOP level by 30.1%) was reported as early as day 1 after surgery. Meanwhile, after SLT, the maximum IOP-lowering effect (by 21.5%) was observed only 1 month after surgery. Over a year, a gradual decrease in the IOP-lowering effect (17.2%) was reported after SLT. After optimized YAG-laser trabeculostomy, the IOP-lowering effect was stable (by 30.1%) being 26.2% after 2 years. When comparing the percentage of IOP-lowering regimen, group 1 (after optimized YAG-laser trabeculostomy) patients used less combined medications (by 27.7%) than group 2 (after SLT) patients. Moreover, IOP-lowering therapy was canceled in 18.4% and 10.3% of patients, respectively.
Conclusion: YAG-laser and OCT optimize trabeculostomy by providing an alternative non-invasive laser treatment for patients with early and advanced POAG. Optimized YAG-laser trabeculostomy along with SLT (in contrast to SLT alone) reduces IOP faster, provides a more significant and stable IOP-lowering effect, and allows the surgery to be performed in the projection of the collector channels more accurately using acceptable laser energy values.
Keywords: glaucoma, trabeculostomy, selective laser trabeculoplasty, primary open angle glaucoma.
For citation: Balalin A.S., Fokin V.P., Balalin S.V., Dzhashi B.G. Long-term outcomes of combined optimized YAG-laser trabeculostomy and selective laser trabeculoplasty for primary open-angle glaucoma. Russian Journal of Clinical Ophthalmology. 2023;23(4):181–191 (in Russ.). DOI: 10.32364/2311-7729-2023-23-4-2.
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Расширение возможностей специализированных сайтов
No full textMuravyov Gennady Leonidovich; Fokin V.P.; Mukhov Sergey Vladimirovich. Expanding the capabilities of specialized site
On the importance of attentive reading of research articles: The case study of Frontonia (Peniculia, Oligohymenophora, Ciliophora) species descriptions and redescriptions
No full textA commonly encountered problem of ignoring or inattentive reading of scientific articles by some protistologists of the past and present has been revealed using the case study of taxonomy of the ciliate genus Frontonia. The comparison between materials from literature and own investigations allowed the author to conclude that F. vernalis Ehrenberg, 1833 cannot to be a valid species and assume that it is rather a cluster of closely related freshwater ciliates with one contractile vacuole and a stable ability to accommodate green algae as the cytoplasmic symbionts. "F. vernalis", as described by Bullington (1939), was shown to have little in common with the original description by Ehrenberg and most likely is a brackishwater ciliate similar to F. fusca. F. oculiaris described by the same author (Bullington, 1939) is obviously F. fusca, and the name "F. oculiaris" should be considered as a younger synonym of the latter. Thus, redescription of F. oculiaris (Pan et al., 2013b) should be treated just as a morphological study of the local Chinese population of F. fusca. The redescription of F. canadensis from brackish waters by the same authors can be considered as a description of a new species that has little in common with the original description of this freshwater ciliate (Roque and Puytorac, 1972). Recent phylogenetical reconstructions indicate the necessity to split Frontonia into several genera
The Use of Contractual Arrangements by the U.S. International Tax Law to Distinguish between Royalties and Remuneration for Services
No full textThis article written by Artem Fokin (LL.M.), a New York tax attorney practicing in the area of international taxation, taxation of mergers and acquisitions, and taxation of derivatives, discusses the interplay between U.S. international tax law and other areas of American law as well as foreign law. In particular, the article focuses on how the U.S. tax law uses characterization of transactions prescribed by other areas of law. The author has chosen the distinction between royalties and remuneration for services as the basis for his article. He walks readers through the importance of proper characterization of transactions by the U.S. tax law and how such characterization could be different from characterization and titles elected by taxpayers and illustrates his points by discussing benchmark court decisions in the area of the U S international taxation
The Valery Fokin Festival at the Alexandrinsky Theatre, St Petersburg
No full textOne of Russia's foremost theatre directors, Valery Fokin graduated from the Shchukin School at the Vakhtangov theatre in Moscow. At the Sovremennik and Yermolova theatres, of which he was the artistic director, he staged a wide repertoire that included contemporary writers (Mikhail Roshchin, Aleksandr Vampilov, Viktor Rozov), Soviet classics (Gorky), Russian classics (Gogol, Dostoevsky), and, from the international arena, Nabokov and Albee. He taught at the renowned school GITIS from 1975 to 1979 and in Krakow and Tokyo in 1993 and 1994. He has increasingly directed abroad, including Poland, Hungary, France, Germany, Japan, and Korea. In this article Maria Shevtsova focuses on his most recent productions at the Aleksandrinsky Theatre, where he has become a St Petersburg director while maintaining his professional links at the Meyerhold Centre in Moscow, which he founded in 1991 – aptly, since it is with Meyerhold that Fokin's name is most closely connected. Maria Shevtsova is co-editor of New Theatre Quarterly and author of Dodin and the Maly Drama Theatre: Process to Performance (Routledge, 2004)
Transformation of Expressive Means of Classical Dance: the Conception of Mihail Fokin
No full textУ статті досліджено закономірності трансформації виразових засобів класичного танцю у створенні балетних вистав початку ХХ ст. на прикладі творчості хореографа-новатора М. М. Фокіна. Визначено загальне коло джерел, які характеризують творчий доробок і джерела хореографічного стилю балетмейстера. Особливу увагу приділено характеристиці нових пластичних і художніх завдань, поставлених музикою І. Стравінського перед балетмейстером-постановником, та шляхи їх реалізації на прикладі балету «Петрушка» як характерного зразка балетного спектаклю свого часу. Ключові слова: класичний танець, балетний театр, хореографічний образ, балетна реформа.The article is devoted to studying of laws of transformation of expressive means of classical dance in creation of ballet plays of the beginning of XX century on the example of creative works of choreographer–innovator M. M. Fokin. The author of the article defines a general circle of sources that characterize creative works and sources of choreographic style of the ballet master. Great attention is paid to characteristics of new plastic and artistic tasks that were posed by music of I. Stravinskiy and ways of their realization on the example of the ballet «Petrushka» as a characteristic example of ballet performance of that time. Key words: classical dance, ballet theatre, choreographic image, ballet reform.У статті досліджено закономірності трансформації виразових засобів класичного танцю у створенні балетних вистав початку ХХ ст. на прикладі творчості хореографа-новатора М. М. Фокіна. Визначено загальне коло джерел, які характеризують творчий доробок і джерела хореографічного стилю балетмейстера. Особливу увагу приділено характеристиці нових пластичних і художніх завдань, поставлених музикою І. Стравінського перед балетмейстером-постановником, та шляхи їх реалізації на прикладі балету «Петрушка» як характерного зразка балетного спектаклю свого часу. Ключові слова: класичний танець, балетний театр, хореографічний образ, балетна реформа.The article is devoted to studying of laws of transformation of expressive means of classical dance in creation of ballet plays of the beginning of XX century on the example of creative works of choreographer–innovator M. M. Fokin. The author of the article defines a general circle of sources that characterize creative works and sources of choreographic style of the ballet master. Great attention is paid to characteristics of new plastic and artistic tasks that were posed by music of I. Stravinskiy and ways of their realization on the example of the ballet «Petrushka» as a characteristic example of ballet performance of that time. Key words: classical dance, ballet theatre, choreographic image, ballet reform
Experience of modified procedure treatment of progressive keratoconus based on corneal collagen cross-linking with femtosecond formation of intrastromal pocket
No full textAim: analysis of clinical and functional results, histomorphological changes of corneas in the application of the method of corneal collagen crosslinking with the formation of a femtosecond intrastromal pocket. Material and Methods. We studied 20 patients (20 eyes) that were operated for progressive keratoconus (1-2 stage) with a peripheral zone of maximum ectasia arrangement via corneal collagen cross-linking with femtosecond formation of intrastromal pocket for introduction of a photosensitizerand local ultraviolet radiation. Results. The result was a decrease of surgery duration and reduction of the severity of pain in the early postoperative period. Conclusion. This method allows to increase the safety of the treatment of keratoconus, reducing the risk of postoperative complications.</p
Clinical significance of determining individual intraocular pressure in patients with primary open-angle glaucoma in ophthalmological practice
No full text
S.V. Balalin1, V.P. Fokin1, O.V. Yuferov1, S.Z. Boskhomdzhieva2
1 S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd branch, Volgograd,
Russian Federation
2 Zhemchuev Republican Clinical Hospital, Elista, Russian Federation
Aim: to determine tolerant IOP in patients with primary open-angle glaucoma (POAG) and to evaluate the effectiveness of drug therapy for glaucoma.
Patients and Methods: tolerant IOP was determined using software and the effectiveness of drug treatment was analyzed in 341 patients with primary open-angle glaucoma (498 eyes). The average age of the patients was 69.5±0.39 years. Patients were divided into groups according to the level of IOP (P0, mm Hg), which was measured against the background of the initial drug therapy: with normal values of ophthalmotonous (fr om 11 to 21 mm Hg) — 69.7% (347 eyes), with moderately increased IOP values (fr om 22 to 32 mm Hg) — 26.5% (132 eyes) and high IOP values (over 32 mm Hg) — 3.8% (19 eyes). Prognosis of the progression rate of the glaucomatous process was estimated by the intolerance index (Iint).
Results: the mean value of true IOP against the background of the initial drug therapy was 19.5±0.3 mm Hg, and the mean value of the tolerant pressure was 16.3±0.05 mm Hg, the difference between them was statistically significant (t=10.7; p=0.001). The mean value of the intolerance index was 3.1±0.27 mm Hg. Prognosis of the progression rate of glaucoma was detected in 164 eyes (32.9%), wh ere the intolerance index exceeded 4.7 mm Hg. Slow progression of the disease was found in 154 eyes (30.9%), wh ere the intolerance index ranged from 0.5 mm Hg to 4.7 mm Hg. Prognosis of stabilization of the glaucomatous process was determined in 180 eyes (36.1%).
Conclusions: software application for the tolerant IOP determination in 36.9% of cases allowed to identify those needed to strengthen antihypertensive treatment among patients with POAG with normal ophthalmotonus values on the background of drug therapy and in 35,9% of cases to select patients for surgical treatment of glaucoma.
Key words: open-angle glaucoma, individual and tolerant intraocular pressure, evaluation of the effectiveness of antihypertensive treatment.
For citation: Balalin S.V., FokinV.P. , Yuferov O.V., Boskhomdzhieva S.Z. Clinical significance of determining individual intraocular pressure in patients with primary open-angle glaucoma in ophthalmological practice. RMJ “Clinical ophthalmology”. 2018;4:199–202.<br
Safety and efficacy of Tobramycin 0.3% + Fluormetholone 0.1% (eye drops) fixed combination as a preoperative preparation and postoperative management of patients with wet AMD after intravitreal injection of ranibizumab. An observational, noncomparative single-center study
No full textPurpose. To evaluate safety and efficacy of Floas-T® (Tobramycin 0.3% + Fluormetholone 0.1%) as a preoperative preparation and postoperative management of patients with wet form of age-related macular degeneration (AMD) before and after intravitreal injection (IVI) of anti-VEGF drugs. Material and methods. 50 patients (50 eyes) with the wet form of AMD were examined and divided into two groups. The first group included 32 patients (32 eyes) with wet form of AMD. The second group consisted of 18 patients (18 eyes) with primary (11 eyes) and advanced (7 eyes) stages of primary open angle glaucoma with normalized IOP and wet form of AMD. Results. There were no significant changes in ВСVA and tonometric IOP values in the two groups before and within 7 days after IVI of ranibizumab and Floas-T® instillations. Average value of individually tolerable true IOP in patients of the second group was 16,3±1,1 mm Hg, while average value of initial true IOP (14,7±2,56 mm Hg) pre-op was lower than tolerable pressure, indicating that individual norm of ophthalmotonus in glaucoma patients was reached. The difference between the mean values of ocular hydrodynamics in both groups before and 1 week after surgery was also statistically unsignificant (p>0.05). The difference between the mean values of the Schirmer I test was statistically unsignificant in patients in the two groups (p>0.05) before and after surgery, indicating the absence of Floas-T® effect on tear production. There were no local and systemic side effects of Floas-T® in 50 patients (50 eyes) during the observation period. Conclusion. Floas-T® had an anti-inflammatory effect without a decrease in the aqueous humor outflow, did not cause a significant increase in IOP in the early postoperative period, did not decrease tear production, and did not cause adverse local and systemic side effects. Floas-T® can be used as a preoperative preparation and postoperative management drug in patients with wet type of AMD as well as in combination with primary open angle glaucoma when achieving an individual level of intraocular pressure
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