Vol 15, No 4 (2022)

BACKGROUND: Information on retinal capillary perfusion in idiopathic full-thickness macular hole (FTMH) is limited, and there are no data on the possible effect of blood supply to individual areas and layers of the retina on their functional activity.

AIM: To study the relationship between vascular perfusion in the superficial and deep capillary plexuses (SCP and DCP) and the bioelectrical activity of the retina in full-thickness macular hole.

MATERIALS AND METHODS: Multifocal electroretinography (mfERG), optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed in 18 eyes with FTMH and 10 intact eyes. In the projection of individual hexagons of the mfERG pattern, parameters of bioelectrical activity were compared with structural changes (hole, cystic changes), capillary density in the SCP and DCP.

RESULTS: In the FTMH group, the density of capillaries in the superficial capillary plexuses correlated with P₁ implicit time in the R₂ ring hexagons (R = –0.23, p < 0.05), in the hole zone and intraretinal cystic changes (R = –0.21 and R = –0.22, p < 0.05), P₁ amplitude in the hole zone (R = 0.24, p < 0.05). In deep capillary plexuses, the capillary density correlated with N₁ implicit time at the fixation point and the hole zone (R = –0.57 and R = –0.19, p < 0.05), P₁ implicit time at the hole zone (R = –0.2, p < 0.05), P₁ amplitude in the hexagons of the R₂ and R₃ rings (R = 0.46 and R = 0.44, p < 0.05), more pronounced in the hole zone and cystic changes (R = 0.54 and R = 0.29, p < 0.05).

CONCLUSIONS: There is a correlation between capillary perfusion in different layers of the retina and its bioelectrical activity in FTMH. A decrease in perfusion in the deep capillary plexus of the macula with a chronic macular hole may be a predictor of a low functional prognosis in the outcome of surgical treatment of FTMH.

BACKGROUND: The MyoRing implantation into a corneal transplant can significantly compensate for irregular post-keratoplastic astigmatism. However, the cataract that occurs in this category of patients and the lack of information in the literature on its phacoemulsification and the calculation of a toric intraocular lens (tIOL) power in them determines the relevance of our study.

AIM: The aim of the study is to conduct a clinical and functional analysis of phacoemulsification in patients after previously performed implantation of a MyoRing into a corneal transplant.

MATERIALS AND METHODS: We operated on 21 patients (21 eyes) who had previously undergone the MyoRing implantation into a corneal transplant. According to keratotopography, all patients were diagnosed with a regular form of corneal astigmatism. All patients underwent phacoemulsification with tIOL implantation. When calculating the tIOL power, its diopter value was corrected depending on the average value of the corneal transplant keratometry according to the keratotopogram data. The observation period duration was 6 months.

RESULTS: One month after the procedure, there was an increase in uncorrected visual acuity by 0.2 ± 0.9 LogMAR, best corrected visual acuity by 0.3 ± 1.0 LogMAR, the spherical component of refraction — up to –0.4 ± 0.44 D, the cylindrical component of refraction — up to –0.62 ± 0.18 D, all of which did not change later on.

CONCLUSIONS: Phacoemulsification with tIOL implantation, with its power calculated taking into account an additional correction for its diopter value, is an effective, predictable and safe method of treating patients after previously performed MyoRing implantation into a penetrating corneal transplant.

BACKGROUND: Anti-angiogenic therapy for diabetic macular edema (DME), recognized as the “gold standard”, is not always effective. When compensating for the general somatic status, it is necessary to search for local causes of DME resistance to anti-angiogenic therapy.

AIM: To study the effectiveness and features of anti-angiogenic therapy for DME in normal and pathological vitreoretinal interface (VRI).

MATERIALS AND METHODS: Patients who received anti-angiogenic therapy for 12 months, in addition to the standard examination, underwent optical coherence tomography with an assessment of morphometric parameters and VRI.

RESULTS: In addition to the groups of normal and pathological VRI, a group of transformation from pathological to normal VRI was identified. Visual acuity increases with normal VRI, decreases with pathological. OCT scores decrease in both groups. In the transformation group, an increase in vision and a decrease in OCT parameters were observed only after VRI transformation.

CONCLUSION: The pathologic condition of the VRI reduces effectiveness of anti-angiogenic therapy for DME, except for 10% of cases in which VRI is transformed into normal within 5-6 months from the start of treatment. These data should be taken into account when choosing a treatment strategy for DME.

BACKGROUND: The use of platelet-rich plasma (PRP) and its modifications are a promising treatment method for chronic inflammatory diseases of the cornea.

AIM: To evaluate and compare the clinical and morphological features of the corneal regeneration during experimental chronic persistent corneal erosion with the use of PRP and two-component autofibrin glue (TAFG).

MATERIALS AND METHODS: The studies were conducted in 18 rabbits (36 eyes). After modeling chronic persistent corneal erosion, the animals of the 1^st group were treated with TAFG; animals of the 2^nd group — with instillations of PRP, animals of the 3^rd group — with standard medical therapy.

RESULTS: By Day 14 of the experiment, the restoration of the transparency of the cornea, no erosion and new vessels in animals of the 1^st and 2^nd group were noted. This pattern persisted until Day 60. By Day 30 of the experiment, the presence of corneal clouding in optical zone, neovascularization over the whole cornea and an epithelial defect (3,85 [3,50; 4,47] %) in animals of the 3^rd group were recorded. By Day 60, a complete epithelialization of the cornea was observed.

CONCLUSIONS: The use of PRP and TAFG allows reducing the time of corneal epithelialization by 2,5 times in conditions of experimental chronic persistent corneal erosion. There were no significant differences between the use of PRP (within 5 days) and TAFG, however, treatment with an adhesive composition is more convenient for both the doctor and the patient — a single use that does not require multiple use of expensive consumable materials.

The literature review deals with the analysis of the timing and surgical techniques of macular hole closure in patients with retinal detachment complicated by macular hole. Modern concepts of treatment tactics for this disease, its efficacy are analyzed. Benefits and drawbacks of each of the discussed surgical treatment methods are specified.

Inflammatory diseases of the retina and choroid (chorioretinitis), including those of toxoplasmosis etiology usually occur against a background of decrease in immunity. We present two clinical cases of ocular inflammation at different times after the vaccination with “Sputnik V”. An analysis of the occurrence of ocular pathologic condition after vaccination to prevent coronavirus infection caused by the SARS-CoV-2 virus will help determine the criteria for prophylactic ophthalmological examination of patients before vaccination.

AIM: To perform the analysis of the age composition of patients with a planned in-patient surgical procedure — “cataract phacoemulsification”.

MATERIALS AND METHODS: Three cohorts of patients diagnosed with “age-related senile cataract” were analyzed for the periods 2000–2003 (n = 6737), 2007–2009 (n = 13,015), and 2015–2017 (n = 1363) on the basis of “age at the time of planned surgery” in the ophthalmology hospital “S.V. Belyaev Kuzbass Clinical Hospital”. Persons with a diagnosis of “congenital, complicated, traumatic cataract” and persons operated as out-patients were excluded from all samples.

RESULTS: At the first stage, the average age of patients at the time of surgical treatment of patients diagnosed with senile cataract was calculated. At the second stage, the age of operated patients was analyzed by decades of human life. At the third stage, the assessment of the judgment about the “rejuvenation” of the age of operated patients with incipient cataract according to professional indications was carried out.

CONCLUSIONS: The average age of patients operated on with senile cataract during a fifteen-year period is a stable value in the range of 66–68 years. In the dynamics from 2000 to 2017, there was a redistribution of patients with senile cataract within the cohort by age. Rejuvenation of the age composition of persons with cataracts occurred due to an increase in patients aged 51–60 years by 2 times and a decrease in patients aged 71–80 years by 1.6 times. The proportion of patients undergoing surgical treatment for senile cataract in a hospital setting with visual acuity of 0.1 or less is stable and amounts to 78.4–87.5 %.

The article is concerned with the life journey of the phtisioophthamologist Professor Elena Ivanovna Ustinova who celebrated her 95^th anniversary on October 19^th, 2022