Analysis of treatment results of endophthalmitis patients accordingto the data from the City Ophthalmology Center for 2014-2015

Aim. To estimate development terms, visual functions upon hospital admission and discharge, medical and surgical treatment results of different nature endophthalmitis. Materials and methods. Data of 40 patients were studied, which received treatment for postoperative, endogenous, posttraumatic endophthalmitis. Main age of patients was 61 year. Results and discussion. Patients with postoperative endophthalmitis have higher baseline visual acuity, and an emergency vitrectomy is a method of choice. Patients with endogenous severe endophthalmitis more often need enucleation. Intravitreal antibiotic injection in endophthalmitis by no means always brings an improvement, but could be used as an adjunct to systemic therapy or as a measure for a patient in anticipation of vitrectomy.

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Postoperative endophthalmitis

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-185-187 ◽

2021 ◽

pp. 185-187

Author(s):

I.A. Frolychev ◽

◽

N.A. Pozdeyeva ◽

◽

...

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Silicone Oil ◽

Angiogenesis Inhibitor ◽

Cataract Extraction ◽

State Institution ◽

Federal State ◽

Postoperative Endophthalmitis ◽

Ophthalmic Surgery ◽

Corrected Visual Acuity

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.

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Outcome of complete macular rupture (two clinical cases)

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-114-116 ◽

2021 ◽

pp. 114-116

Author(s):

S.I. Makogon ◽

◽

E.N. Kuznetsova ◽

Y.A. Bryukhanova ◽

◽

...

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Key Words ◽

Visual Functions ◽

Optical Media ◽

Surgical Methods ◽

Modern Methods ◽

Methods Of Treatment ◽

Management Tactics ◽

Clinical Cases

Purpose. To present the course of a complete macular rupture, depending on the management tactics. Material and methods. On the example of two clinical cases, the outcome of a complete macular rupture is presented: without surgical treatment and as a result of surgery. Results. Surgical methods of treatment made it possible to obtain high visual functions in the patient - visual acuity up to 0.9. Conclusions. Modern methods of surgical treatment of MR provide restoration of the structure of the outer layers of the retina and high visual functions, provided that the optical media of the eye are transparent. Key words: macular rupture, surgical treatment of macular rupture, course of macular rupture without treatment.

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Factors predicting 2-year treatment results of ranibizumab therapy for polypoidal choroidal vasculopathy in eyes with good baseline visual acuity

Medicine ◽

10.1097/md.0000000000011188 ◽

2018 ◽

Vol 97 (25) ◽

pp. e11188 ◽

Cited By ~ 3

Author(s):

Ryusaburo Mori ◽

Koji Tanaka ◽

Mitsuko Yuzawa

Keyword(s):

Visual Acuity ◽

Polypoidal Choroidal Vasculopathy ◽

Treatment Results ◽

Choroidal Vasculopathy ◽

Baseline Visual Acuity

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Optimized approach to surgical treatment of proliferative diabetic retinopathy in patients with permanent hemodialysis

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-26-30 ◽

2021 ◽

pp. 26-30

Author(s):

A.S. Golovin ◽

◽

O.A. Sinyavskiy ◽

R.L. Troyanovsky ◽

◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Surgical Treatment ◽

Key Words ◽

Intravitreal Injection ◽

Proliferative Diabetic Retinopathy ◽

Visual Functions ◽

Hemodialysis Session ◽

Anti Vegf ◽

Optimal Approach

Purpose. Optimization and identification of key conditions for successful surgical treatment of PDR in patients with permanent hemodialysis. Material and methods. The results of surgical treatment of 8 patients (10 eyes) with PDR who received permanent hemodialysis were analyzed. All patients underwent surgery 18-20 hours after the hemodialysis session. 25G vitrectomy with phacoemulsification 1-5 days after intravitreal injection inhibitor of anti-VEGF. Results. In 9 cases, an improvement in visual functions was achieved. Visual acuity of 0.08-0.1 in 5 cases, 0.1-0.2 in 3 cases and 0.3 in one case on a single eye. Conclusions. The described stereotype is the optimal approach for the surgical treatment of PDR in patients with permanent hemodialysis. Key words: proliferative diabetic retinopathy, hemodialysis, vitrectomy.

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Functional results of surgical treatment of retinal detachment

RUDN Journal of Medicine ◽

10.22363/2313-0245-2020-24-2-156-162 ◽

2020 ◽

Vol 24 (2) ◽

pp. 156-162

Author(s):

O. E. Ilyukhin ◽

M. A. Frolov ◽

K. V. Ignatenko

Keyword(s):

Blood Flow ◽

Visual Acuity ◽

Surgical Treatment ◽

Retinal Detachment ◽

Photoreceptor Cells ◽

Functional Results ◽

Scleral Buckling ◽

The State ◽

Visual Functions ◽

Outer Segments

The article analyzes the state of patients visual acuity after successful surgical treatment of retinal detachment. On the basis of gathered data, it was concluded that in case of detachment of the macula only in 50% of cases it is possible to increase visual acuity to 0.4 and higher. Restoration of visual functions continues for at least 6 months after the operation and is determined by the restoration of the structure of the outer segments of the photoreceptor cells. During this time, it is advisable to conduct drug therapy aimed at normalizing blood flow and functional activity of the retina. Visual functions recovery continues for at least 6 months after the operation and is connected with the restored structure of the outer segments of the photoreceptor cells. Important prognostic factors of central vision restoration in the postoperative period are visual acuity before surgery, duration of existence and height of macular detachment. Data on which of the methods of surgical treatment of retinal detachment allows to achieve higher visual acuity are contradictory. There is practically no data on the comparison of the effect on visual acuity of scleral buckling and vitrectomy in the long-term period, in patients with phakic eyes and with artiphakia. On visual acuity after fitting detachment of the macula may affect macular edema, epiretinal membrane formation and retinal folds, and edema of the peripapillary optic nerve head, progressive deterioration of blood flow in the basin of the central retinal artery, short posterior ciliary arteries and ophthalmic artery. It is believed that these factors are significantly more pronounced after scleral buckling than after vitrectomy. Some indicators of optical coherence tomography correlate with visual acuity after surgical treatment of retinal detachment: the state of the articulation line of the external and internal segments of the photoreceptors, as well as the state of the external limiting membrane.

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Modern extrascleral surgery in the treatment of regmatogenous retinal detachment: efficacy evaluation and functional results

Ophthalmology journal ◽

10.17816/ov18780 ◽

2020 ◽

Vol 12 (4) ◽

pp. 23-28

Author(s):

Andrey D. Shchukin

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Retinal Detachment ◽

20Th Century ◽

Functional Results ◽

Independent Method ◽

City Hospital ◽

Efficacy Evaluation ◽

Basic Principles ◽

The City

The basic principles of extrascleral surgery, which are currently used in the treatment of regmatogenous retinal detachment (RD), have not changed much since their heyday in the 7080s of the 20th century, and they remain relevant both as an independent method to treat this disease in certain clinical cases, and in combination with vitrectomy. The aim is to evaluate the efficacy of RD extrascleral treatment methods (anatomical result, visual acuity), as well as the frequency and timing of the relapses. Materials and methods. The study was carried out at the vitreoretinal department of the Ophthalmological Center of the City Hospital No. 2 of St. Petersburg. A sample of 466 patients with RD, operated with extrascleral methods in 20152016 has been analyzed. Anatomical results, visual acuity, number and timing of relapses have been assessed. Results. The efficacy of extrascleral surgery reaches 89%, RD recurrence after surgical treatment occurs in 21% of patients.

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Chronic Endophthalmitis after Cataract Phacoemulsification. Сlinical Case

Ophthalmology in Russia ◽

10.18008/1816-5095-2019-1-115-123 ◽

2019 ◽

Vol 16 (1) ◽

pp. 115-123

Author(s):

I. A. Frolychev ◽

N. P. Pashtaev ◽

N. A. Pozdeyeva ◽

D. V. Sycheva

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Intraocular Lens ◽

Cataract Extraction ◽

Treatment Method ◽

Postoperative Endophthalmitis ◽

Visual Functions ◽

Finger Counting ◽

New Treatment ◽

The Right

A clinical case of chronic postoperative endophthalmitis treatment after cataract phacoemulsification is described in the article. The patient received vitrectomy with lens posterior capsule discission and tamponade of vitreal cavity by perfluororganic compound (up to 14 days) and 1mg vancomicin +2.25 mg ceftazidim intravitreally, also anterior chamber washing by 0.5 ml saline containing 5 mg vancomicin. Anterior chamber washing by antibiotics and intravitreal injection of antibacterial medicine combination was repeated on the second and third day after the surgery. This tactics of treatment allowed to save lens capsular bag and intraocular lens. Purpose. To assess efficacy and safety of new treatment method in the patient with chronic postoperative endophthalmitis. Patient B, 65 years old applied to clinic with complaints on the pain in the right eye, visual acuity decrease up to finger counting near face. Symptoms started to disturb in 2 weeks after cataract extraction with IOL implantation. During 6 months courses of antibacterial therapy including vancomicin (antibiotic of reserve) there were no positive dynamics. Cornea edema, multiple precipitates at endothelium and intraocular lens were defined at biomicroscopy; 2.5 mm hypopyon in anterior camera; fibrin in pupil projection; exudation in vitreous cavity. Laser tyndalmetry data (albumen flow in anterior chamber) confirmed inflammation strong enough — 173 f/ms. Surgical treatment according the described method was rendered to the patient. In the postoperative period we saw stable visual functions, uncorrected visual acuity was 0.6, corrected — 0.8. Patient noted the absence of pain and eye’s reddening decrease. At biomicroscopy we observed considerable inflammation decrease, almost total absence of precipitates at cornea endothelium. Laser tyndalmetry data confirmed inflammation decrease, albumen flow in anterior chamber was 17.6 f/ms. Endothelial cells’ loss after surgery was 142 cells/1 mm2 (5.61 %). According to electrophysiologic investigation and ERG there was no deviation from normal values was revealed. This treatment method allows to restore visual functions rather quickly and can be used in case of inefficient lengthy conservative therapy.

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Comprehensive Treatment Plan for Idiopathic Neurovasculitis

Bulletin of Science and Practice ◽

10.33619/2414-2948/65/21 ◽

2021 ◽

Vol 7 (4) ◽

pp. 176-185

Author(s):

V. Usenko ◽

M. Umetalieva

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Immune Status ◽

Treatment Plan ◽

Comprehensive Treatment ◽

Symptomatic Therapy ◽

Retinal Vessels ◽

Complex Treatment ◽

Treatment Results ◽

Severe Degree

Goal is to develop a comprehensive treatment plan for patients with idiopathic retinovasculitis, taking into account etiopathogenetic and clinical data from the retina. 86 patients (172 eyes) with retinal angiitis of idiopathic genesis were examined and were subject to treatment. The average age of the patients was 22.0 ± 0.17. Clinical forms of retinal changes: angioretinopathy — 16 eyes, 8 patients — 9.3%; neuroretinopathies — 104 eyes, 52 patients — 60.5%; neurovasculitis — 24 eyes, 12 patients — 14%; retinal angiopathy — 28 eyes, 14 patients — 16.2%. According to the severity of fundus changes: mild — 33 patients (66 eyes) — 38.4%; average — 30 patients (60 eyes) — 34.9%; severe — 23 patients (46 eyes) — 26.7%. The special methods of examining patients included: autoperimetry, eye biomicroscopy, direct and reverse ophthalmoscopy, OST of the optic nerve disc and macula, autofluorescent OCT of the retinal vessels, and optic disc with calibrometry, ultrasound dopplerography of the retinal vessels. The main principles of the therapy: 1. Suppression of immune inflammation in the acute phase and in the relapsing phase (treatment with HA, the appointment of immunosuppressants and immunostimulants in a prolonged course). 2. Correction of hemostasis and hemocirculatory disorders in the vessels of the retina. 3. Drug, symptomatic therapy and surgical treatment. Discussion of treatment results: Significant increase in visual acuity: in angioretinopathy from 0.45±0.24 to 0.9±0.14 (P <0.01); with neuroretinopathies from 0.34±0.2 to 0.85±015 (P <0.01); with concomitant maculopathy from 0.44±0.2 to 0.7±0.23 (P <0.01) and macular degeneration from 0.02±0.063 to 0.3±0.24 (P <0.05). There was an increase in visual acuity after treatment with a severe degree from 0.02±0.054 to 0.3±0.24 (P<0.05), with an average - from 0.5±0.24 to 0.9±0.13 (P<0.01), with mild — from 0.7±0.23 to 1.0±0.10. A significant decrease in the frequency of retinal changes after treatment was revealed: angioretinopathies up to 3.5% versus 9.3%; neuroretinopathies up to 11.6% versus 60.5%; maculopathy up to 8.7% versus 26.2%. The effectiveness of the treatment is due to the normalization of indicators of the immune status and hemocirculatory disorders in the retinal vessels according to calibrometry data. Thus: Complex treatment aimed at the main pathogenetic links in the development of idiopathic retinovasculitis contributes to the relief of pathological processes, reduction of complications, and eye disability.

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