[OCT visualization of hyporeflective lacuna in the retrolental space]. / OKT-assotsiirovannaya vizualizatsiya giporeflektivnoi lakuny v retrolental'nom prostranstve.

PURPOSE: To investigate the vitreo-lenticular interface and anterior vitreous using high-resolution optical coherence tomography (OCT). MATERIAL AND METHODS: This prospective single-center pilot study included 34 patients (68 eyes) - 6 males and 28 females with a mean age of 58.4±12.0 years (age range 24-81 years). OCT scanning was performed on the spectral domain optical coherence tomography (SD-OCT) device SOLIX (OPTOVUE, USA) in the Full Range AC mode with the following scan parameters: from 14 to 18 mm in horizontal length and 6.25 mm in the axial dimension. To improve the signal-to-noise ratio and increase image clarity of the final scan, averaging of eight simultaneous scans was performed. RESULTS: In all healthy volunteers, hyporeflective retrolental cavities-lacunae were observed in both eyes during visualization of the retrolental space in the horizontal and vertical planes. The median distance from the posterior pole of the lens to the lacuna was 697 µm. The median width of the lacuna was 157 µm. CONCLUSION: To the best of our knowledge, we consider this to be one of the first in vivo visualizations of a previously undescribed structure - hyporeflective retrolental lacuna - using SOLIX high-resolution OCT device. The retrolental lacuna may play the role of a buffer system, or belong to the lymphatic system of the vitreous body and the eye.

[Non-contact navigated laser retinopexy for peripheral retinal tears and rhegmatogenous degenerations: first experience]. / Pervyi opyt beskontaktnoi navigatsionnoi lazernoi retinopeksii perifericheskikh razryvov i regmatogennykh degeneratsii setchatki.

PURPOSE: To evaluate the first outcomes of non-contact navigated laser retinopexy for peripheral tears and rhegmatogenous degenerations of the retina. MATERIAL AND METHODS: This prospective single-center interventional pilot study included 58 patients (68 eyes), among which 19 males and 39 females aged 47.5±16.9 years with peripheral retinal degenerations and symptomatic retinal tears who received non-contact laser retinopexy with the Navilas 577s navigated laser system and non-contact PRP widefield objective. All patients (68 eyes) underwent laser treatment for the following disorders: horseshoe tear in 13 eyes, retinal hole in 11 eyes, operculated retinal hole in 3 eyes, lattice degeneration in 19 eyes, snail track degeneration in 1 eye, vitreoretinal tufts in 16 eyes, and progressing bullous retinoschisis in 5 eyes. Pain intensity was assessed using a four-point verbal rating scale. RESULTS: All patients were followed up for 5 to 21 months (9.0±3.3 months on average). Stable condition of the retina was observed in 65 cases (95.5%). In 3 eyes (4.4%), newly formed retinal tears prompted additional laser treatment: horseshoe tear in 2 eyes and retinal hole in 1 eye. The mean pain score during non-contact navigated laser retinopexy was 0.9±0.5. No complications associated with laser treatment were observed. CONCLUSION: Non-contact navigated laser retinopexy performed with the Navilas 577s navigated laser system is a safe and well-tolerated procedure with effectiveness comparable to conventional laser retinopexy.

[Preventive laser treatment of tractional symptomatic retinal flap tears: long-term outcomes]. / Otdalennye rezul'taty profilakticheskogo lazernogo lecheniya traktsionnykh simptomaticheskikh klapannykh razryvov setchatki.

Tractional flap tears are the main cause of the development of regmatogenic retinal detachment (RRD). The main immediate treatment method for it is laser retinal coagulation. PURPOSE: Case monitoring of tractional symptomatic flap tears after laser treatment. MATERIAL AND METHODS: From 2014 to 2019 we observed 119 patients (130 eyes) with peripheral flap (horseshoe) retinal tears in acute posterior vitreous detachment. Laser coagulation of the retina was performed using Navilas 577s (577 nm), OcuLight GL (532 nm). Laser retinotomy of horseshoe tear flap and dissection of overhanging vessels were performed using Nd:YAG-ultra Q Reflex laser (1064 nm) and controlled with RTVue XR Avanti. RESULTS: At the initial examination before the preventive laser coagulation, the following conditions were found: regmatogenous retinal detachment (RRD) - 8 eyes (6.2%), partial hemophthalmus - 29 (22.3%), preretinal hemorrhage - 15 (11.5%), epiretinal membrane - 9 (6.9%), non-full-thickness macular retinal breaks - 6 (4.6%), peripheral changes: retinal holes - 16 (12.3%), tears with operculum - 5 (3.8%), retinal degenerations - 40 eyes (30.8%). Observation for 5 years after laser retinopexy revealed new pathological changes: flap tears - 13 (10.6%); holes - 9 (7.4%); tears with operculum - 5 (4.1%); vitreoretinal tuft - 6 (4.9%); RRD - 3 cases (2.5%). In 16 patients (16 eyes) with horseshoe tear and pronounced vitreoretinal traction, the flap retinotomy was performed, which eliminated the traction component and prevented the development of RRD. CONCLUSION: Follow-up of tractional symptomatic flap tears for 5 years after preventive laser retinopexy revealed the appearance of retinal detachment in 2.5% of cases. Laser retinotomy of horseshoe tear after barrier retinopexy eliminated the traction component and helped prevent the development of RRD.

[Evaluation of YAG-laser vitreolysis effectiveness based on quantitative characterization of vitreous floaters]. / Otsenka éffektivnosti YAG-lazernogo vitreolizisa na osnove ob''ektivnoi kolichestvennoi otsenki plavaiushchikh pomutnenii v steklovidnom tele.

PURPOSE: To develop methods for evaluating effectiveness of YAG-laser vitreolysis of vitreous floaters. MATERIAL AND METHODS: The study included 144 patients (173 eyes) who had underwent YAG-laser vitreolysis and were under observation from 01.09.16 to 31.01.18. The patients were 34 to 86 years old (mean age 62.7±10.2 years), 28 (19.4%) patients were male, 116 (80.6%) - female. All patients underwent standard and additional examination: ultrasonography (Accutome B-scan plus, U.S.A.), optic biometry (Lenstar 900, Haag-Streit, Switzerland), spectral optical coherence tomography using RTVue XR Avanti scanner (Optovue, U.S.A.) in modes Enhanced HD Line, 3D Retina, 3D Widefield MCT, Cross Line, Angio Retina, and scanning laser ophthalmoscopy (SLO) using Navilas 577s system. Laser vitreolysis was performed using the Ultra Q Reflex laser (Ellex, Australia). RESULTS: This paper presents methods of objective quantitative and qualitative assessment of artifactual shadows of vitreous floaters with spectral optical coherence tomographic scanner RTVue xR Avanti employing an algorithm of automatic detection of non-perfusion zones in modes Angio Retina, HD Angio Retina, as well as foveal avascular zone (FAZ) measurement with Angio Analytics® software. SLO performed with Navilas 577s was used as method of visualizing floaters and artifactual shadows in retinal surface layers prior to surgical treatment and after YAG-laser vitreolysis. CONCLUSION: Suggested methods of quantitative and qualitative assessment of artifactual shadows of the floaters in retinal layers are promising and may prove to be highly relevant for clinical monitoring of patients, optimization of treatment indications and evaluating effectiveness of YAG-laser vitreolysis. Further research of laser vitreolysis effectiveness in patients with vitreous floaters is necessary.