[Experimental study of hyaluronic acid gel fillers biodegradation in orbit]. / Eksperimental'noe issledovanie biodegradatsii fillerov na osnove gelya gialuronovoi kisloty v orbite.

INTRODUCTION: Recently, hyaluronic acid gel (HAG) fillers were proposed as an effective alternative treatment option for surgical orbital volume augmentation. Several authors reported about long-standing effect of the filler. PURPOSE: To assess the features of HAG biodegradation after intraorbital injection in experimental environment. MATERIAL AND METHODS: In the course of the experiment, 7 chinchilla rabbits (14 eyes) received a single 1ml intraorbital HAG injection (Restylane SubQ, Galderma, Sweden) using a cannula. The animals' orbits were examined by ultrasound scan after the injection and at 1, 3, 6, 9, 12 and 18 months. The animals were subsequently sacrificed for morphological study of orbital tissue containing the HAG filler. RESULTS: The HAG filler persisted in the orbit of experimental animals during the whole follow-up period. The volume of HAG depot and its density diminished gradually till the 18th month, after which the particles of HAG could still be detected with the morphological study and ultrasound. CONCLUSION: The HAG filler persisted in the orbit of experimental animals up to 18 months. Incomplete biodegradation explains the longstanding duration of the injection effect.

[Acoustic analysis of the lacrimal gland in sarcoidosis]. / Akusticheskii analiz struktury sleznoi zhelezy pri sarkoidoze.

PURPOSE: To analyze the condition of the lacrimal gland in patients confirmed to have sarcoidosis. MATERIAL AND METHODS: The study included 46 patients (92 orbits) with verified diagnosis of systemic sarcoidosis that were examined during the period of 2009 to 2014. The age of patients ranged from 23 to 65 years and the average was 45.1 years. Among the examined patients, 66% were female and 34% male. In all patients, the diagnosis was verified according to modern criteria. RESULTS: Acoustic structure of 46 lacrimal glands of patients with systemic sarcoidosis (92 orbit), and lacrimal glands of 30 healthy individuals (60 orbits) were examined. In-depth in vivo examination of morphological changes was done using 'advanced' analysis of three-dimensional images. CONCLUSION: The analysis of a large number of studies devoted to changes in the lacrimal glands caused by sarcoidosis revealed a difficult problem: are there any differences between isolated involvement of the lacrimal gland tissue and the defeat of various organs and tissues? For now, the question remains unanswered.

[Three-dimensional acoustic analysis in diagnostics of structural and morphological changes of the eye in certain congenital pathologies]. / Mul'tiplanarnyi akusticheskii analiz v diagnostike strukturno-morfologicheskikh izmenenii glaza pri nekotorykh vidakh vrozhdennoi patologii.

Changes in ocular anatomy and topography that occur due to congenital development anomalies are often of complex, composite nature. Such pathologies are accompanied by not only refractive errors, but also changes in eye's macrostructure. Careful analysis of the changes is necessary to better understand the clinical picture. PURPOSE: To study the specifics of structural and morphological changes of the eye in certain ocular congenital pathologies and in some orphan diseases using the results of three-dimensional ultrasound analysis and digital acoustic imaging. MATERIAL AND METHODS: The study included 60 patients (119 eyes) with congenital ocular changes, some of which are registered as independent orphan diseases, as well as with systemic manifestations including congenital changes in eye membranes, lens and the vitreous body. The examination involved three-dimensional scanning followed by digital processing of the imaging data obtained using general medical ultrasound systems Voluson 730 Pro Kretz and Voluson E8. RESULTS: Digital ultrasound technologies significantly expand the scope of data on eye morphology in various congenital changes obtainable in vivo. CONCLUSION: The advantage of this investigation method is the possibility to reliably detect congenital spatially complex morphological deformations in the eye tissues, which in some cases are impossible to observe with other methods.

[Giant cavernous hemangioma of the orbit (case report)].

The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

[Results of intraocular lens implantation on top of the anterior capsule in cases of phaco complications].

UNLABELLED: Posterior capsule rupture during cataract extraction requires that the intraocular lens (IOL) implanted on top of the capsular bag was stable and well-centered. The objective of this study was to evaluate the results of Rayner C-flex aspheric and M-flex aspheric (United Kingdom) IOLs implantation on top of the capsular bag and their stability in patients with phaco complications. MATERIAL AND METHODS: A total of 2556 phacoemulsification cases were analyzed. Posterior capsule rupture as a complication occurred in 7 cases, that is 0.27%. In all patients Rayner C-flex (5) and M-flex (6) IOLs were implanted on top of the capsular bag according to the initial calculations and with no modifications in the procedure. The 2nd-year follow-up included measurement of the corneal compensated intraocular pressure (IOP) and B-mode and 3D grey-scale ultrasound in order to assess the structures of the anterior segment and to check the position of the IOL. RESULTS: All surgeries yielded positive clinical results. In 2 years after the intervention uncorrected visual acuity averaged 0.7-0.13, corrected-- 0.91+0.07; clinical refraction: sphera-- +0.46 +/- 0.26 diopters, cylinder-- 0.71 +/- 0.29 diopters. The shape and other parameters of Rayner IOLs contribute to their long-term stability. Postoperative lOP in the treated eye was higher than in the fellow nonoperated eye (13.9 +/- 0.76 and 11.8 +/- 0.59 mmHg correspondingly) but the difference lied within the range of normal asymmetry. CONCLUSION: The 3D ultrasound technology is an informative mean of monitoring the position of the IOL in case of its extracapsular implantation; a comparatively higher IOP in the operated eye does not exceed the range of normal asymmetry between the two eyes; Rayner C-flex and M-flex IOLs remain stable and well-centered after being implanted on top of the capsular bag.

[Differentiation of concomitant glaucomatous optic neuropathy in optic disc drusen].

Characteristics of ocular blood flow (OBF) in primary open-angle glaucoma (POAG) in eyes with optic disc drusen have been investigated. The study enrolled 21 patient (35 eyes) with optic disc drusen, of which 7 (8 eyes) were diagnosed with POAG. Besides the standard tests, the ophthalmological assessment included evaluation of OBF (flowmetry) and an individual normal range of intraocular pressure (IOP). The results showed that optic disc drusen are not associated with OBF changes. Concomitant POAG might be suspected in a patient with optic disc drusen whose OBF is significantly decreased and IOP is above the individual normal range. Differentiation of morphofunctional changes in chronic optic neuropathy, which might be due to either glaucomatous optic neuropathy or optic disc drusen, is complicated when actual IOP lies within the average normal range. Ocular blood flow evaluation by means of flowmetry with calculation of an individual normal range of IOP has been demonstrated as a highly effective predictor of concomitant POAG in patients with optic disc drusen.

[Basics of spatial diagnostic acoustic analysis of ocular and orbital tissues by the example of a study on local changes in systemic sarcoidosis].

The study enrolled 39 patients (78 orbits) with verified sarcoidosis. Acoustic analysis of pathological changes in ocular and orbital tissues was performed in all cases. A new evaluation method based on a combination of different modes of digital ultrasound techniques has been proposed. New data on intravital changes in sarcoidosis has been obtained. Formerly unknown deformities of acoustic images of the globe, lacrimal gland, vitreous, optic nerve, and ophthalmic artery, that could be recommended to ophthalmologists and other specialists studying sarcoidosis, have been identified.

[Features of clinical manifestations of the globe, adnexal and orbital sarcoidosis].

86 patients with verified diagnosis of sarcoidosis with globe, adnexa and orbit manifestations were observed. The age of the patients ranged from 21 to 43 years old (average 35,1+/-1,2 years), among them 25 males and 61 females with disease duration from 1 month till 12 years and 15 years follow-up. The study is based on different variants of globe, adnexal and orbital sarcoidosis. In our practice we observed sarcoidosis as a combination of several manifestations simultaneously. In 32 patients of 38 patients examined HLA-B-7, B-8, DR-2, DR-3, DR-15 were detected, that confirms genetic predisposition to sarcoidosis and determines the course of the disease. In 27 patients cellular and humoral immunity disbalance was found, that confirms the immune etiology of sarcoidosis as well. However the treatment of patients was pathogenic as the etiology of sarcoidosis is still unknown.

[Lacrimal gland changes in sarcoidosis according to the results of spatial digital ultrasonography].

Clinical changes of lacrimal gland (LG) in sarcoidosis are studied. 33 patients (66 orbits) with verified systemic sarcoidosis were examined using digital ultrasound. Different varieties of LG structural changes in sarcoidosis are studied. Different types of LG structural changes were determined in patients with sarcoidosis defined as pseudoedematous and combined forms. Analysis of the results let us reveal characteristic local acoustic changes. Obtained results may be useful for diagnosis of LG changes in patients with sarcoidosis.

[Specific damage of ocular and orbital structures in sarcoidosis].

Complex damage of ocular and orbital structures is an important manifestation of sarcoidosis. Incidence of ocular sarcoidosis varies among the different groups of patients. Nevertheless all patients should undergo specific examination of eye and orbit. Delayed diagnosis of ocular sarcoidosis and improper treatment may result in severe complications. Orbital changes should be also revealed in time and properly evaluated. These are the reasons for searching of new methods of eye and orbit examination in patients with sarcoidosis.

[Sarcoidosis: etiology, pathogenesis, epidemiology, risk factors, clinical presentation].

Sarcoidosis is a chronic idiopathic multisystem granulomatous inflammatory disease of unknown etiology. Prevalence of this condition is approximately 3-5: 100 000 with the highest incidence at the age of 25-40 years old and no gender predomination. Early morbidity, disability and severe prognosis worsen patient's condition and make them socially limited. In some cases ocular involvement and vision loss aggravate general condition of the patients. Ocular involvement in sarcoidosis occurs in 10-75% patients. At the same time some data confirm the fact that in 7% of patients ocular damage is the presenting sign making them come to an ophthalmologist whereas orbital involvement may present in systemic disease only. Unclear etiology and clinical similarity with other conditions cause difficulties in early diagnosis and monitoring of patients with sarcoidosis.

[Normal and pathological structural features of lacrimal gland based on spatial ultrasound digital examination].

For the first time vital morphological structure of lacrimal gland was investigated based on spatial ultrasound digital examination. Structural characteristics of lacrimal gland are described considering anatomic topography and blood supply. These characteristics are analyzed based on planar and volumetric sonography depending on the patient age and pattern of changes. Their correlation is studied. The results of lacrimal gland examination allowed us to analyze a number of ultrasound diagnostic signs and compare them with changes in acute dacryoadenitis, MALT-lymphoma, Sjogren disease, sarcoidosis and thyroid eye disease. Revealed features may be useful for understanding of nature of clinical presentation. The results of the study may help to interpret diagnostic signs and follow up their evolution in a clinical course of a disease.