2 (13) 2021

https://doi.org/10.30702/Ophthalmology30062021-13.2.52-65/5-007.281
UDC 617.735-007.281

Ivanchenko A. Yu., Bezkorovayna I. M.

Poltava State Medical University, Poltava, Ukraine

Abstract
Introduction. Closed subtotal vitrectomy (CSV) is used to treat rhegmatogenous retinal detachment (RRD), but even with successful surgery performed at a relatively early stage, some patients still have low visual acuity and persistent color perception defects. Therefore, the combination of CVS with the internal limiting membrane (ILM) peeling in RRD can improve clinical outcomes in the postoperative period.

The aim. To determine the role of ILM peeling and its influence on the functional and morphological state of the macula after RRD surgery in order to maximize the results of visual acuity after retinal detachment and clarify the indications for ILM removal in RRD.

Materials and methods. Analysis of the literature shows that in many cases, despite the full ft of the detached retina, visual acuity is not restored in full. There are almost no data comparing the effect on visual acuity of ILM removal during vitrectomy in the remote period, hemodynamic disorders in the macular area according to optical coherence tomography (OCT) angiography in patients with RRD.

Results. Despite the fact that ILM peeling in RRD significantly reduces the incidence of epiretinal fibrosis the anatomical and morphological changes of the retina after ILM peeling and their impact on postoperative clinical outcomes should be taken into account. The determination of blood biomarkers has the potential to better predict the risk of proliferative vitreoretinopathy (PVR) after surgery to inhibit the pathological reaction that causes the formation of fibrous films on the retina, which in turn significantly worsen the clinical outcomes in the postoperative period.

Conclusions. Thus, a combination of appropriate surgical techniques and new diagnostic markers, both clinical and immunological, can help to improve the diagnosis and prognosis of RRD.

Keywords: rhegmatogenous retinal detachment, internal limiting membrane, surgical treatment, OCT angiography.

Read more: Improving the Clinical Effectiveness of Surgical Treatment of Rhegmatogenous Retinal Detachment by...

https://doi.org/10.30702/Ophthalmology30062021-13.2.47-51/681-07-037
UDC 617.7-007.681-07-037

Serdiuk V. MD, PhD, Maidenko K.

Dnipro State Medical University, Dnipro, Ukraine
Dnipropetrovsk Regional Ophthalmological Clinical Hospital, Dnipro, Ukraine

Abstract. Glaucoma is one of the widespread eye diseases causing visual disturbances and even blindness. Almost 15% of blindness worldwide is due to glaucoma. One of the factors of glaucoma development is heredity. Currently, identification and diagnosis of new glaucoma cases is achieved either by routine screening or examinations prompted by perceived risk. The factors associated with the pathogenesis of glaucoma include high intraocular pressure (IOP), aging, decreased blood flow and genetic factors. Traditional vision screening for disorders like primary open-angle glaucoma (POAG) is time-consuming and costly. POAG is the most common type of glaucoma which has no obvious abnormality in the eye that points to a cause. Although mutations in several genes, including myocilin, optineurin, and CYP1B1 are associated with the disease, these genes account for less than 10% of cases worldwide. The paper reviews genetic studies in POAG. The genetic basis for the development of glaucoma and a variety of its related syndromes is considered. CYP1B1 is a member of a family of cytochrome P450 genes known to encode enzymes that metabolize and detoxify both endogenous and exogenous molecules, although their activity is not limited to detoxification. The human CYP superfamily contains 57 functional genes and 58 pseudogenes. Two specific substrates of CYP1B1 (estradiols and retinoic acid) could contribute to ocular development and specifically to the development of the ocular anterior segment.

Keywords: primary open-angle glaucoma, gene, cytochrome 450 gene, glaucoma, CYP450.

Read more: Genetic Aspects of Primary Open-Angle Glaucoma

https://doi.org/10.30702/Ophthalmology30062021-13.2.39-46/17.7-05
UDC 617.7-053.8

Bezditko P. A.¹, Parhomets R. A.^1,2

¹Kharkiv National Medical University, Kharkiv, Ukraine
²Center for Pediatric Ophthalmology Raduzhka, Kramatorsk, Ukraine

Abstract. The progressive course of myopia is one of the most important medical and social problems worldwide. In Ukraine, the relative incidence of moderate myopia ranges from 8.9 to 30.8 % in schoolchildren and in final-year students, mild and moderate myopia is found, according to various data, in 30-68 % of individuals.

Some researchers have tried to determine the shape of the cornea and its relationship to the eye size in myopia, but conflicting data have been obtained, so the issue needs further investigation.

The aim. To analyze the effect of corneal eccentricity (Ex) in children with myopia on the increase of the axial length of the eye when using orthokeratology lenses (OKL).

Methods. The study involved 60 children (117 eyes) aged 7 to 15 years with uncomplicated mild and moderate myopia from –0.75 to –5.0 diopters by spherical equivalent. Biometry was performed using an ultrasound scanner before the start of refractive therapy or prescription of glasses and then every 6 months of observation. Corneal topography was also performed with determination of keratometry and Ex in flat and steep meridians (Oculus Easygraph topographer, Germany). MoonLens OKL with combined design were selected for all the subjects.

Results. In patients with mild myopia, there was direct strong correlation between the value of Ex, both in a flat and in a steep meridian, and the axial length at the beginning of the therapy which equaled to 0.28 (p = 0.011) There was also a strong direct relationship between the value of the initial Ex and the difference in refraction (ΔR) after 24 months of observation which equaled to 0.32 (p = 0.001). Assessment of the correlation between the initial value of keratometry and the axial length revealed negative correlation between –0.69 in the group with mild myopia (p<0.001) and –0.67 in children with moderate myopia (p<0.001). There was no correlation of the effect of Ex on the annual gradient of myopia progression in the study.

Conclusions. There is no correlation between the baseline Ex and the annual gradient of myopia progression on the background of the use of OKL because the corneal profile changes and there are other factors influencing the pattern of the axial length change. A direct correlation between the baseline Ex and the annual changes in refraction (ΔR) was revealed.

Keywords: myopia, keratometry, eccentricity, axial size of eye, orthokeratology lenses.

Read more: Analysis of the Influence of Corneal Parameters on the Pattern of Myopia Progression when Using...