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Predicting anatomical results of surgical treatment of idiopathic macular hole

International Journal of Ophthalmology(English edition) 2016年第2期9卷 253-257页

作者： Alexander A.Shpak Dmitry O.Shkvorchenko Ilias Kh.Sharafetdinov Olga A.Yukhanova The S. fyodorov eye microsurgery Federal State Institution Moscow 127486 Russia

AIM： To determine the parameters most informative in predicting the anatomical results of surgical treatment of idiopathic full-thickness macular hole （IMH）. METHODS： One hundred and sixty-two consecutive patients （170 eyes） after primary operation for IMH were enrolled. Outcomes were classified as anatomical success when both IMH closure and restoration of the outer retinal structure were achieved. ＂Prospective＂ group included 108 patients （115 eyes） followed with optical coherence tomography （OCT） and microperimetry for ly after surgery. Potential prognostic criteria, except microperimetry data, were tested in ＂retrospective＂ group （54 patients, 55 eyes）. Prognostic value of each parameter was determined using receiver operating characteristic （ROC） analysis. Combined predictive power of the best prognostic parameters was tested with the use of linear discriminant analysis. RESULTS： IMH closure was achieved in 106 eyes （92%） in the prospective group and 49 eyes （89%） in the retrospective group. Despite anatomical closure, the outer retinal structure was not restored in two eyes in the first group and in one eye in the second group. Preoperative central subfield retinal thickness demonstrated the best discriminatory capability between eyes with anatomical success and failure： area under the ROC-curve （AUC） 0.938 （95% Ch 0.881-0.995）, sensitivity 64% at fixed specificity 95% （cut-off value 300um） in the prospective group; sensitivity 57% and specificity 90% in the retrospective group. Other continuous parameters except tractional hole index （AUC： 0.796, 95% Ch 0.591- 1.000） had significantly lower AUCs （P〈0.05）. The best combination of the parameters, established by discriminant analysis in the prospective group, could not confirm its predictive value in the retrospective group. CONCLUSION： Preoperative central subfield retinal thickness is a strong and probably the best predictor of anatomical results of IMH surgical treatment.

关键词： idiopathic full-thickness macular hole optical coherence tomography anatomical surgery outcome prognosis central subfield retinal thickness receiveroperating characteristic analysis

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TNF-α gene polymorphisms: association with age-related macular degeneration in Russian population

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International Journal of Ophthalmology(English edition) 2019年第1期12卷 25-29页

作者： Valeriy Chernykh Alla Shevchenko Vladimir Konenkov Viktor Prokofiev Alena Eremina Alexander Trunov Novosibirsk Branch S.Fyodorov Eye microsurgery Federal State Scientific Institute of Clinical and Experimental Lymрhology

AIM: To study polymorphisms in promotor regions of tumor necrosis factor(TNF)-α TNF-863 A/C(rs1800630), TNF-308 A/G(rs1800629), and TNF-238 A/G(rs361525) in patients with age-related macular degeneration(AMD) and associations of complex TNF-α genotypes with AMD. METHODS: One hundred and two patients(82 women, 20 men; mean age 64.2±1.2 y) with AMD and 100 healthy age-and sex-matched controls(82 women, 18 men; 60±1.4 y) were included in the study. All subjects were Caucasian, all subjects and their parents were inhabitants of Russia. Genomic DNA was obtained from EDTA-preserved blood using the standard phenol-chloroform method. Polymorphisms were detected by polymerase chain reaction followed by the restriction fragment length polymorphism method. The following TNF-α genotypes were studied: TNF-α-238 AA, GA, GG, TNF-α-308 AA, GA, GG, TNF-α-863 AA, CA, CC. RESULTS: Differences in TNF-α-863 and TNF-α-238 genotypes frequencies in patients with AMD and healthy controls were not found. The distribution of TNF-α-308 AA and TNF-α-308 GA genotypes was significantly different between the studied group and the controls [odds ratios(OR) =0.22, P=0.0287 and OR=2.91, P=0.0063, respectively]. TNF-863 CC/TNF-308 GA and TNF-308 GA/TNF-238 GG genotypes were associated with the increased risk of AMD(OR=2.48, P=0.0332 and OR=2.51, P=0.0187, respectively). Five genotypes combinations appeared to be protective. CONCLUSION: In the present study, single nucleotide polymorphisms and complex polymorphisms of one of the key inflammatory cytokines TNF-α, and a number of significant associations of these polymorphisms with AMD in Russian population have been shown. Complexanalysis of genotypes could be important in AMD risk factors detection and studying pathogenesis.

关键词： tumor necrosis factor-a genetic polymorphisms age-related macular degeneration

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Fundamentals of Presbyopia: visual processing and binocularity in its transformation

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eye and Vision 2018年第1期5卷 1-10页

作者： Olga I.Rozanova Andrey G.Shchuko Tatyana S.Mischenko Irkutsk branch of S.fyodorov eye microsurgery Federal State Institution IrkutskRussian Federation Irkutsk State Medical University IrkutskRussian Federation

Background:The accommodation has considerable interactions with the pupil response,vergence response and *** transformation of visual reception processing and the changes of the binocular cooperation during the presbyopia development are still poorly ***,the regularities of visual system violation in the presbyopia formation need to be *** study aims to reveal the transformation of visual reception processing and to determine the role of disturbances in binocular interactions in presbyopia ***:This study included 60 people with emmetropic refraction,uncorrected distance visual acuity 1.0 or higher(decimal scale),normal color perception,without concomitant *** first group consisted of 30 people(from 18 to 27 years old)without presbyopia,the second cohort comprised 30 patients(from 45 to 55 years old)with *** eyeball anatomy and optics were evaluated using ultrasound biomicroscopy,aberrometry,and *** functional state of the visual system was investigated under monocular and binocular *** registration of the disparate fusional reflex limits was performed by the original technic using a diploptic device which facilitated investigation of the binocular interaction under natural conditions without the accommodation response,but with the different vergence *** disparate fusional reflex was analyzed using the proximal and distal fusion borders,and the convergence and divergence fusion *** calculation of the area of binocularity field was performed in ***:The presbyopia formation is characterized by a change in an intraocular anatomy,optics,visual processing,and *** processes of binocular interaction inhibition make a significant contribution to the misalignment of the visual *** modification of the proximal,distal and convergence fusion borders was *** was revealed that 87%of the presbyopic patients had binocularity sh

关键词： Presbyopia Binocularity Visual processing Visual reception

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NON-PENETRATING DEEP SCLERECTOMY WICH DRAINAGE SCHLEMM'S CANAL IN THE TREATMENT OF PRIMARY OPEN- ANGLE GLAUCOMA

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国际眼科杂志 2003年第1期3卷 98-99页

作者： V.Machehin S.Nicolashin Sv.fyodorov eye microsurgery Complex RussiaSv.Fyodorov Eye Microsurgery Complex Russia

To develop in experiment the technique of new operation which uses natural drainage passways for outflow of intraocular fluid, i. e. NDSE witch drainage Schlemm's canal we perfected the technique of probing Schlemm's ... 详细信息

关键词：原发性开角型青光眼治疗非穿透性巩膜切除术巩膜静脉穿引流

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High frequency of latent Chlamydia trachomatis infection in patients with rhegmatogenous retinal detachment

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International Journal of Ophthalmology(English edition) 2016年第6期9卷 863-868页

作者： Ernest V.Bolko Alexei L.Pozniak Dmitrii S.Maltsev Alexei A.Suetov Irina V.Nuralova St.Petersburg Branch of the Academician S.fyodorov IRTC "Eye Microsurgery"St.Petersburg 192283Russia Department of Ophthalmology Military Medical AcademySt.Petersburg 194044Russia

AIM： To determine the frequency of detection of ocular and extraocular Chlamydia trachomatis （CT） infection in non -high myopes with rhegmatogenous retinal detachment （RRD）. METHODS： This was a single-center, nonrandomized, prospective, case-control study. One hundred and four patients were divided into a study group with RRD （n= 63） and a control group with traumatic retinal detachment （n=41）. Samples of subretinal fluid （SFR）, conjunctival, urethral/cervical swabs, and blood were collected. The frequency of detection of CT infection in SRF samples was determined by polymerase chain reaction （PCR）, direct fluorescence assay （DFA） and cell culture, whereas that in conjunctival swabs was determined by PCR and DFA, and those in urethral/cervical swabs and blood were determined by DFA. Yates Chi-square test （with Bonferroni correction） and two-tailed Student＇s t-test were used for statistical analysis. RESULTS： SRF CT infection was detected more frequently in the study group （50.8%-71.4%） than in the control group （9.8%-12.2%） by all the methods used （P〈 0.01）. The frequency of detection of conjunctival CT infection by DFA was higher in the RRD patients compared with the controls （81.0% vs 24.4%, P=0.004）. The PCR detected conjunctival CT infection more often in the study group than in the controls （46.0% vs89.8%, P= 0.007）. The DFA detected CT in blood specimens almost as frequently as in urogenital specimens, for the RRD patients （61.2% vs 63.5%） and the controls （7.3% vs 9.8%）. CONCLUSION： CT infection is detected with high frequency in non-high myopes with RRD.

关键词： rhegmatogenous retinal detachment Chlamydia trachomatis myopia latent infection

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Scheimpflug Imaging of the Anterior eye Segment during Standardized Accommodation Stimulation in Patients with Emmetropia, Myopia and Hypermetropia

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Open Journal of Ophthalmology 2023年第1期13卷 73-82页

作者： Olga I. Rozanova Irkutsk Branch of S. fyodorov “eye microsurgery” Federal State Institution of Ministry of Health of Russian Federation Ir-kutsk Russia

Understanding of the biomechanics of the accommodative apparatus in the eyes with different refraction is important for solving the problems of theoretical and practical ophthalmology. Purpose: To determine the changes of anterior eye segment dimensions during accommodation response in normal eyes and in patients with myopia, hypermetropia. Methods and Material: 116 eyes (56 patients aged from 18 to 30 years, refraction from -2.0 to + 2.0 D) were examined. All the patients underwent a full ophthalmological examination. The ocular anterior segment was imaged using a rotational Scheimpflug camera Pentacam HR (Oculus, Wetzlar, Germany) under non- and 3.0 D of accommodative demands. The statistical data were represented as the mean value ± standard deviation (M ± SD). The Shapiro-Wilk test was used to assess the normality distribution. Wilcoxon test was used for comparison. Results: Results showed an increase in the optical density of the crystalline lens, a pupil diameter decrease and changing of the iris profile during accommodation in all patients. An increase in the total corneal aberrations and decrease in the corneal spherical aberration were revealed only in emmetropic eyes. Conclusions: The accommodative response is a multicomponent process. Scheimpflug visualization revealed the differences in the accommodative response in normal and ametropic eyes.

关键词： eye Accommodation Scheimpflug Imaging Pupil Response

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Diagnostics and Prediction of Glaucoma in Patients with Familial Congenital Iris Hypoplasia

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Open Journal of Ophthalmology 2015年第3期5卷 115-123页

作者： Tatiana Iureva Andrey Shchuko Yulia Pyatova Irkutsk Branch S. Fyodorov Eye Microsurgery Federal State Institution Irkutsk Russia Irkutsk State Medical Academy for Postgraduate Education Irkutsk Russia

Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 years. The first group (juvenile) consisted of males who had the first signs of glaucoma diagnosed before the age of 12 (n = 22). The average age of the group was 10.1 ± 2.4 years. The control group included healthy males (n = 30) in the same age range (average age 7.2 ± 1.6 years). The second group (adults) consisted of patients who had the first signs of glaucoma diagnosed after the age of 18 and elder. The average age of the group was 32.44 ± 6.28 years. The control group had males (n = 30) in the same age range (average age 26.59 ± 4.12 years). The inclusion criterion was: the presence of congenital bilateral mesodermal iris leaf hypoplasia, tra-becular dysgenesis signs, the presence of blood relatives on the maternal line (grandfather, uncle) male with similar changes iridociliary zone and glaucoma. Criteria of glaucoma formation were: increased IOP more than 21 mmHg with accompanying it expansion of the cup/disc ratio, reducing the thickness of the nerve fiber layer (RNFL) according to OCT. Results: It was found that Frank-Kamenetsky Syndrome had an X-linked with sex, recessive inheritance and was characterized by bilateral congenital irisdysgenesis and goniodysgenesis with the accession glaucoma. Predictors of glaucoma formation in early childhood are a combination of: 1) congenital subtotal atrophy of iris mesodermal layer (from 0 to 30 mkm) with signs of progressive dystrophy;2) nonprogressive congenital megalocornea (cornea diameter 12 - 14 mm);3) iridotrabecular dysgenesis of II-III degree;4) hyperopic refraction in axial myopia.

关键词： Glaucoma Megalocornea Congenital Mesodermal Iris Atrophy Goniodysgenesis

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THE EFFICACY OF LASER GONIOPUNC- TURE IN SHORT- AND LONGTERM PE- RIOD AFTER NONPENETRATING DEEP SCLERECTOMY

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国际眼科杂志 2003年第1期3卷 51-52页

作者： N.V.Strenev A.I.Ovchinnikov IRTC eye microsurgery Ekaterinburg Center RussiaIRTC Eye Microsurgery Ekaterinburg Center Russia

No reports about the efficacy of laser goniopuncture (LGP) in longterm period after nonpenetrating deep sclerectomy (NPDS) are available in literature; no investigations of filtering zone status before LGP have been undertaken. Aim of the paper is to estimate the efficacy of LGP in different periods of time after NPDS and its correlation with filtering zone status. Fifty eyes

关键词：非全层深层巩膜切除术术后激光前房角穿刺长期疗效短期疗效

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ADVANTAGES OF A NEW EXCIMER LASER FOR GLAUCOMA SURGERY

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国际眼科杂志 2003年第1期3卷 93-93页

作者： N.N.Ereskin K.P.Takhchidi S.K.Vartapetov A.V.Doga D.A.Magaramov T.V.Sokolovskaya IRT Complex eye microsurgery of fyodorov RussiaIRT Complex Eye Microsurgery of Fyodorov RussiaIRT Complex Eye Microsurgery of Fyodorov RussiaIRT Complex Eye Microsurgery of Fyodorov RussiaIRT Complex Eye Microsurgery of Fyodorov RussiaIRT Complex Eye Microsurgery of Fyodorov Russia

Last years the excimer laser surgery attracts more and more attention of researchers. At the end of 1999 a portable specialized excimer laser unit with a 193nm wavelength for glaucoma surgery was created under the leadership of Academician S.N. fyodorov and the Nobel Prize Winner, Academician A.M. Prokhorov. In contrast to well-known excimer lasers besides

关键词：青光眼准分子激光手术优点激光装置临床试验

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Ultrastructural and Immunohistochemical Characteristics of Corneal Lenticule Extracted during Correction of Residual Myopia in the Long-Term Period after SMILE

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Open Journal of Ophthalmology 2023年第1期13卷 122-135页

作者： Olesya Pisarevskaya Boris Malyugin Andrey Shchuko Tatiana Iureva Lyudmila Vasilieva Nikolay Sudakov Igor Klimenkov Elena Likhoshvay Irkutsk Branch of S. fyodorov “eye microsurgery” Federal State Institution of Ministry of Health of Russian Federation Ir-kutsk S. fyodorov “eye microsurgery” Federal State Institution of Ministry of Health of Russian Federation Moscow Russia Irkutsk State Medical University of Ministry of Health of Russian Federation Irkutsk Russia Irkutsk Branch of Russian State Medical Academy of Postgraduate Education of Ministry of Health of Russian Federation Irkutsk Russia Limnological Institute Siberian Branch of Russian Academy of Sciences Irkutsk Russia

Purpose: To evaluate ultrastructural characteristics of lenticule surface extracted during correction of residual myopia in patients after small-incision lenticule extraction (SMILE). Methods and material: This study had a prospective, consecutive, comparative design. Sixteen patients (16 eyes) underwent additional intervention for residual myopia correction after SMILE. 16 specimens of removed lenticules underwent morphological examination. Markers and reagents were used to determine actin microfilaments, neutral fats and cell nuclei. The tissue was analyzed in layers in 2D slices form, volumetric Z-stacks, or selected areas were formed in orthogonal projections. The surface of the extracted lenticule was analyzed using scanning electron microscopy. Patients’ refractive outcomes were measured postoperatively (1 day;1 and 3 months). Results: Postoperatively uncorrected distance visual acuity (20/20 or better) was in 100% cases 3 months after surgery. Ultrastructural studies have shown the difference in surfaces of the newly formed lenticule. Structural changes of the posterior lenticule surface were characterized by ruptures of collagen fibers on its surface, degenerative changes in keratocytes with signs of colliquation necrosis, cell apoptosis and F-actin in cell cytoplasm. Conclusion: Collagen fibers are immersed in the stroma on the anterior surface of the lenticule. There is no complete structure restoration of collagen fibers explaining the lack of tight adhesion of anterior and posterior surfaces of the intrastromal space even in the long-term postoperative period. There are no degenerative changes of keratocytes on the anterior lenticule surface, that is, their changes in SMILE are reversible in most cases.

关键词： SMILE Residual Myopia Correction Lenticule Ultrastromal and Immunohistochemical Analysis

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