scholarly journals Visual Functions in Children in Remote Postoperative Period after Laser Treatment of Threshold Stages of Retinopathy of Prematurity

2018 ◽  
Vol 15 (2S) ◽  
pp. 18-23
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
V. V. Egorov ◽  
E. L. Sorokin
Keyword(s):  
Visual Acuity ◽  
Postoperative Period ◽  
Retinopathy Of Prematurity ◽  
Vision Loss ◽  
State Institution ◽  
Laser Coagulation ◽  
Visual Functions ◽  
Functional Changes ◽  
Continuous Sampling ◽  
High Degree

Purpose.Analysis of visual functions in children in remote postoperative period after laser coagulation (LC) of threshold stages of retinopathy of prematurity (ROP).Patients and methods. In 2017, we selected and investigated 18 children, who previously had an LC of threshold stages of ROP in 2008–2009 in the Khabarovsk branch of the S.N. Fyodorov State Institution Eye Microsurgery Complex (continuous sampling method). There were 5 boys and 13 girls aged from 8 to 9 years at the time of LC. Anterior and posterior eye segments of the eyes (biomicroscopy, ophthalmoscopy), visual acuity, clinical refraction, concomitant pathology were evaluated.Results. We have revealed that regressive ROP after LC is characterized by the presence of serious anatomical and functional changes in the eyes. First, these are refractive disorders, which revealed in 90.5% of cases. Most often revealed: myopic refraction — 61% of all cases, of which more than half (53%) is its high degree; or its combination with compound myopic astigmatism (77% eyes); anisometropia was detected in 39% children. These refractive disorders led to the development of strabismus (61% children) and mixed amblyopia (60%). Despite the combined ophthalmologic pathology, 17% children developed visual functions with achievement of binocular vision, in most children visual functions still continue to develop, although they are not high due to amblyopia. High visual acuity (from 0.8 and above) in both eyes was formed in 22% children; visual acuity in the range of 0.5–0.7 in both eyes was formed in 17% children. Unfortunately, 44.5% children at the time of examination had low visual functions (in the range of 0.05–0.4) in both eyes. Extremely low visual acuity (from 0.01 to 0.04) in both eyes was identified in 11% children; absolute blindness in one of the eyes was in 11% children.Conclusions. LC is reliable way to prevent vision loss from retinal detachment in children with threshold stages of ROP. 

scholarly journals Myopia and age-related macular degeneration: structural and anatomical changes of the eye

2019 ◽  
Vol 12 (3) ◽  
pp. 5-12
Author(s):  
I. B. Alekseev ◽  
Ju. A. Nam
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Pigment Epithelium ◽  
Central Zone ◽  
Age Related Macular Degeneration ◽  
Visual Functions ◽  
Chorioretinal Atrophy ◽  
Age Related ◽  
High Degree ◽  
The Impact

The purpose of the study was to find out how age-related macular degeneration and medium-high degree myopia affect the structural and anatomical parameters of the eyeball, and to find whether a relationship exists between various types of myopic staphylomas and changes of visual functions.Material and methods. 120 patients (236 eyes), with medium and high degree myopia and age-related retinal changes, aged 44 to 81 years were tested for two groups of parameters: quantitative and qualitative. The former included the patients’ age, best corrected visual acuity (BCVA), computer perimetry data, the axial length, and the thickness of the retina in the central zone. The latter included retinal changes, in particular pigment epithelium (PE) defects, drusen, PE detachment, choroidal neovascular membrane (CNV), Fuchs spot and diffuse chorioretinal atrophy. The impact of various types of staphylomas on visual functions was evaluated. Results. Visual functions were found to directly depend on retinal PE integrity. If defects, detachment, or drusen are present, computer perimetry parameters and BVCA are reducing. Fuchs spot presence and diffuse chorioretinal atrophy reduces BCVA and causes an MD decrease. The lowest visual acuity and considerable light sensitivity loss was noted in patients with combined staphylomas. Conclusion. The obtained data confirm that retinal dystrophic processes directly affect visual functions: BCVA and retinal photosensitivity levels drop in all retinal changes studied. The presence of staphyloma, being a factor that aggravates myopia, undoubtedly worsens the most of the parameters studied. 

Choosing optimal anesthetic and method of general anesthesia for laser surgery retinopathy of prematurity

2021 ◽  
pp. 196-201
Author(s):  
S.I. Utkin ◽  
◽  
M.V. Stolyarov ◽  
D.Y. Ignatenko ◽  
E.A. Bachinin ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Laser Surgery ◽  
Breathing Circuit ◽  
Face Mask ◽  
Laser Coagulation ◽  
Efficacy And Safety ◽  
Continuous Sampling ◽  
Low Concentrations

Purpose. Comparative analysis of clinical efficacy and safety of inhalational general anesthesia (GA) with halothane and sevoflurane in premature infants with retinopathy of prematurity (ROP) during laser coagulation (LC) of the avascular retina. Material and methods. The clinical material included 284 children who underwent laser surgery of ROP in the period from 2008 to 2017 (method of continuous sampling). Introduction to anesthesia and maintenance of anesthesia was performed by inhalation of anesthetic (halothane or sevoflurane) with O2 using face mask and Mapleson breathing circuit. Two groups were formed: in the 1st group (167 people) halothane was used at anesthetic at oxygen concentration of 0.3 vol%, in the 2nd group (117 people) – sevoflurane at concentration of 1–1.5 vol%. Results. In case of GA with halothane in children of the 1st group, in 68 children (40.7%) developed negative reactions during anesthesia in the form of of respiratory depression, in several cases – up to pronounced bradypnea, bradycardia, prolonged awakening after surgery. In the 2nd group with GA with sevoflurane, negative reactions in the form of moderate bradycardia and bradypnea were observed only in 14 children (11.9%). All complications and reactions were promptly eliminated in all cases. Conclusion. Based on the obtained results, the optimal inhalation anesthetic for LC of retina in premature infants is sevoflurane in low concentrations (at the sedation level) using the Mapleson breathing circuit and face mask. With this method of anesthesia, the frequency of side effects of sevoflurane, negative reactions during anesthesia and the degree of their severity are extremely low. Key words: premature infants, retinopathy of premature, sevoflurane, general anesthesia, laser coagulation of the retina.

Tactics and treatment results for uveal complications of laser coagulation with retinopathy of prematurity

2021 ◽  
pp. 375-379
Author(s):  
Y.D. Kuznetsova ◽  
◽  
I.B. Astasheva ◽  
I.E. Hatsenko ◽  
A.N. Zvereva ◽  
...  
Keyword(s):  
Birth Weight ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Retinopathy Of Prematurity ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Cataract Extraction ◽  
Laser Coagulation ◽  
Complete Relief ◽  
Iol Implantation

A pronounced inflammatory process from the anterior and posterior parts of the eye may occur, as a complications after laser coagulation in retinopathy of prematurity (ROP), in which there is a need for surgical treatment. Purpose. To determine the optimal tactics for the treatment of uveal complications of laser coagulation in ROP. Material and methods. For 2014-2020 we examined and performed surgical intervention in 21 children with uveal complications after laser coagulation (27 eyes), Most of the children were deeply premature (born at 24-26 weeks of gestation) with a birth weight of 500 g to 900 g with concomitant pathology from the central nervous system. Сomplicated cataracts developed for all children. All children underwent surgical treatment: reconstruction of the anterior chamber, microinvasive cataract extraction, vitrectomy (if necessary, schvartectomy). A single surgical intervention was performed on 24 eyes. In 3 eyes with a post-aggressive form of ROP and a history of sepsis, reoperative treatment was required. All children had no primary IOL implantation. IOL implantation was performed in one childe at an older age. Results. As a result of the treatment, in 89% of cases (24 eyes), there was a complete relief of the inflammatory process and restoration of the transparency of the media after a single surgical intervention. In childe who underwent secondary IOL implantation in the long term, there was a complicated course of early postoperative period and repeated reconstructive surgery required. Conclusions. Uveal complications after laser coagulation of the retina for ROP are observed mainly in children born in early gestation (24-26 weeks) with low birth weight (less than 1000 g). When carrying out the surgical treatment of uveal complications - cataract extraction, which has developed as a result of laser coagulation for ROP, vitrectomy is mandatory, and, if necessary, schwartectomy. When deciding on the secondary implantation of IOLs, it is necessary to take into account the high probability of an unfavorable course of the postoperative period in children with previous uveitis after laser treatment for retinopathy and prematurity. Key words: retinopathy of prematurity, uveal complications, cataract.

On the question of choosing the optimal method of anesthesia for laser coagulation of the retina in infants with retinopathy of prematurity

2021 ◽  
pp. 5-10
Author(s):  
A.V. Konstantinov ◽  
◽  
S.V. Chistyakov ◽  
I.G. Trifanenkova ◽  
◽  
...  
Keyword(s):  
Heart Rate ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
State Institution ◽  
Laryngeal Mask ◽  
Federal State ◽  
Laser Coagulation ◽  
Central Position ◽  
Airway Patency

Purpose. To evaluate the method of anesthesia used in the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution for retinal laser photocoagulation in premature infants with retinopathy of prematurity. Materials and methods. The data of children diagnosed with retinopathy of prematurity was analyzed for the period 2017– 2019. These children underwent retinal laser photocoagulation under general anesthesia at the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution. As an anesthetic aid, inhalation monoanesthesia with sevoflurane by the method of «bolus» induction was carried out starting from 6–8 vol% with a Mapleson circuit filled with a gas-narcotic mixture of oxygen and air. Induction with using a face mask with reaching the surface level of the surgical stage of anesthesia was fixed by 4–5 minutes. Then, for better airway patency, the laryngeal mask was fixed. Results. With «bolus» induction, the surgical stage of anesthesia occurred within 3–4 minutes. The patient was in the optimal anesthetic condition for laser surgery during the entire surgical process. The eyeballs had a fixed central position, muscle tone was reduced, breathing was even, and there was no reaction to pain stimulus. No significant changes in the heart rate were revealed when monitoring the parameters of the state of the cardiovascular system during induction was being performed. In children with profound prematurity, a slight increase in heart rate was determined (10–15%) in the intraoperative period. The heart rate returned to its original values at the end of anesthesia. The exit from the narcotic state was characterized by smoothness and was carried out immediately after the elimination of the anesthetic within 4–8 minutes. Severe complications from vital systems and pronounced changes in behavioral reactions were not observed, in the immediate postoperative period. Conclusion. The use of this technology makes it possible to provide high-quality anesthetic treatment for premature infants during laser treatment of ROP, minimize the negative impact of anesthesia on the patient's body and optimize the work of an anesthesiologist. Key words: retinopathy of prematurity, retinal laser photocoagulation, anesthetic aid, sevoflurane, Mapleson's contour, laryngeal mask.

scholarly journals Experiences of treatment of age related macular degeneration with concomitant myopia

2019 ◽  
Vol 12 (1) ◽  
pp. 81-85
Author(s):  
I. B. Alekseev ◽  
Ju. A. Nam
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Visual Functions ◽  
Age Related ◽  
Treatment Type ◽  
Retinal Pathology ◽  
Uncorrected Visual Acuity ◽  
Before And After ◽  
High Degree

Purpose: to assess the changes in visual functions in patients with age related macular degeneration (AMD) and medium to high degree myopia treated with a peptide bioregulator and a multivitamin complex. Material and methods. 60 patients (120 eyes) aged 44 to 79 with age-related changes in the retina treated with peptide bioregulator and/or multivitamin complex were tested for changes of visual functions. The patients, examined before and after treatment with both, were divided into 2 groups depending on treatment type (peptide plus multivitamin vs. multivitamin alone), which were further subdivided into two subgroups depending on the axial length of the eyeball (less than 26.5 mm vs. 26.5 mm or more). Results. A positive response to the therapy (increased visual acuity and improved perimetic parameters) was revealed in patients of both groups with AL < 26.5 mm), which may be accounted for by an initially better state of the retina. The patients of the subgroup with AL  26.5 mm) showed a significant improvement of uncorrected visual acuity, but best corrected visual acuity remained practically the same. Conclusions. The proposed treatment with a polypeptide bioregulator in combination with a multivitamin complex can be used in AMD and myopic patients with retinal pathology.

scholarly journals The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period

2017 ◽  
Vol 10 (3) ◽  
pp. 22-28 ◽  
Author(s):  
Nigina N Berdieva ◽  
Eleonora V Shapovalova ◽  
Inna A Riks
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Graft Survival ◽  
Postoperative Period ◽  
Penetrating Keratoplasty ◽  
Intraoperative Complications ◽  
Average Density ◽  
High Rate ◽  
Visual Functions

Introduction. Until the 2000s, in diseases leading to corneal blindness, it was expediently to perform subtotal keratoplasty in order to provide an organ-sparing effect and restore visual functions. Such procedures were not widely spread due to a great number of problems; they were performed with extended depressurization of the eye, and had a high risk of intraoperative complications. Nowadays, many ophthalmologists face the remote consequences of subtotal keratoplasty. Aim. The purpose is to evaluate the transplant after subtotal penetrating keratoplasty (SPK) and visual functions in the remote postoperative period. Materials and methods. We have examined 14 patients (14 eyes), aged from 28 to 81 years, at 6-10 years after SPK. Visual acuity (VA) testing, autorefractometry and confocal microscopy (Confoscan 4) were performed. Results. According to visual acuity testing results, patients were divided into 3 groups: 1st group with high VA (more than 0.2 - in 7.2% of patients), 2nd group with medium VA (from 0.2 to 0.005 - in 21.4% of patients), and 3rd - low VA (less than 0.005 - in 71.4% of patients). Before the SKP, VA was 0.004-0.7. After the SKP, the indices varied from light sensation with correct light projection to 1.0. High rate was in 21.5%, medium - in 35.7%, low in 42.8% of cases. According to autorefractometry data, the cylindrical component was in average 6.5 ± 3.0. Most often, astigmatism was revealed in the low (up to 3) and high degree (more than 6). According to confocal microscopy data, the average density of endothelial cells was 1700 ± 50 cells/mm2. Conclusion. More than a half of patients has preserved good visual functions and a transparent transplant at 6-10 years after the SKP, and this significantly improves the quality of patients´ life. (For citation: Berdieva NN, Shapovalova EV, Riks IA. The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period. Ophthalmology Journal. 2017;10(3):22-28. doi: 10.17816/OV10322-28).

Long-term Follow-up of Visual Acuity in Eyes With Stage 5 Retinopathy of Prematurity After Closed Vitrectomy

1995 ◽  
Vol 120 (3) ◽  
pp. 308-316 ◽  
Author(s):  
YUKI FUCHINO ◽  
HIDEYUKI HAYASHI ◽  
TOSHIHIRO KONO ◽  
KENJI OHSHIMA
Keyword(s):  
Visual Acuity ◽  
Retinopathy Of Prematurity ◽  
Long Term Follow Up

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

Postoperative endophthalmitis

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.

Clinical analysis and efficacy of bimanual surgical treatment of retinal detachment in severe forms of proliferative diabetic retinopathy with preoperative preparation with anti-VEGF drugs in combination with the use of the Ngenuity ALCON 3D imaging system

2021 ◽  
pp. 195-198
Author(s):  
D.V. Chernykh ◽  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
3D Imaging ◽  
Imaging System ◽  
3D Visualization ◽  
Preoperative Preparation ◽  
Anti Vegf

The purpose of the study was to evaluate the effectiveness of bimanual surgery with anti-VEGF preparation of patients with severe forms of PDR complicated by traction retinal detachment, with intraoperative use of 3D visualization. Material and methods. Operated on 18 patients with a diagnosis of PDR complicated by traction retinal detachment. Of these, there were 7 patients with type 1 diabetes, type 2 diabetes. There were 5 men and 13 women. The average age was 58 + -2 years. All patients underwent a three-port vitrectomy, using an additional light source, with preoperative preparation with anti-VEGF drugs, using bimanual technique and 3D visualization, using air tamponade. Results and its discussion. As a result of the study, it was found that the visual acuity before the treatment was 0.03 [0.01; 0.1], and 4-6 months after the surgical treatment, 0.3 [0.15; 0.5]. The performed statistical analysis made it possible to establish a statistically significant increase in visual acuity 4-6 months after the treatment. (p = 0.001) Achieved complete anatomical retinal fit. With increased visual acuity. There were 5 complications in the postoperative period. Recurrent hemophthalmos was diagnosed in 3 people, which required repeated surgical intervention. In 2 patients in the postoperative period, DMO developed, which required IVI biodegradable dexamethasone implant. Conclusion. Bimanual, surgical treatment of traction retinal detachments, in severe forms of PDLP, with preoperative preparation with anti-VEGF drugs, and the use of the Ngenuity ALCON 3D imaging system, is one of the effective methods of treatment in this group of patients, and is aimed at reducing both intra and postoperative complications. Key words: рroliferative diabetic retinopathy, vitrectomy, 3D imaging, bimanual surgery, anti-VEGF drugs.

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