ОфтальмологияOphthalmology иабетическая ретинопатия (ДР) -микрососуди-стое осложнение сахарного диабета (СД) с пер-вичным поражением прекапиллярных артериол, капилляров и посткапиллярных венул с возможным вовле-чением сосудов более крупного калибра и развитием ми-кроаневризм, кровоизлияний, экссудативных изменений, с макулопатией и пролиферацией новообразованных со-судов на глазном дне [1]. В экономически развитых странах одной из ведущих причин слепоты у лиц трудоспособного возраста является ДР, на долю которой приходится 80-90% всей инвалидности по зрению, обусловленной СД [2].
ЭпидемиологияСогласно данным эпидемиологического исследова-ния Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR), при длительности СД 1 типа (СД1) более 20 лет частота ДР достигает почти 100% [3], с полной потерей зре-ния у каждого 30-го больного [4]. В целом признаки ДР по-являются через 5 лет после начала СД1 у 20% больных, через 10 лет -у 60%, а через 20-30 лет -практически у всех.При СД 2 типа (СД2) через 20 лет после начала за-болевания примерно 2/3 больных имеют ДР, при этом
Структурно-функциональный анализ центральной зоны сетчатки у пациентов с диабетическим макулярным отекомБикбов М.М., Файзрахманов Р.Р., Ярмухаметова А.Л., Зайнуллин Р.М.
ГБУ Уфимский НИИ глазных болезней АН РБ, УфаОдним из наиболее значимых проявлений сахарного диабета является поражение сетчатки в виде диабетического макулярного отека (ДМО)
Purpose. To evaluate the effect of intravitreal implant with dexamethasone on the morphological changes of macular area in patients with central retinal vein occlusion.Materials and methods. Results of optical coherence tomography of the central retinal area of 5 patients (5 eyes) with newly diagnosed central retinal vein occlusion complicated by macular edema (ME) are presented. All the patients underwent single intravitreal injection of dexamethasone implant. Maximal follow-up period – 12 months.Results. In 1 month after dexamethasone implant injection, we observed a decrease of foveal retinal thickness from 425.36 ± 57.87 to 273.75 ± 36.65 µm. In 1 year after treatment, foveal retinal thickness increased by 1.2 times compared to results got in 1 month after dexamethasone implant injection. The transformation of the macular area under the implant action was mainly due to changes in thickness and structure in the outer and inner nuclear and plexiform retinal layers.Conclusion. Intravitreal injection of dexamethasone implant provides a decrease in post-thrombotic macular edema in 1 month since implantation. Retinal layers transform selectively at various pathological conditions of the retina, including macular edema. Retinal thickness changes in post-thrombotic ME, including those occurring under the dexamethason implant action are mainly related to changes in the outer and inner nuclear and plexiform retinal layers. The duration of morpho-functional effect persists not less than 12 months after treatment.
Purpose. To evaluate the effect of the scleral crosslinking with riboflavin and ultraviolet A (UVA) on the scleral tissue structure in vitro experiments. Material and methods. The study was conducted on 7 porcine cadaver eyes. Two parallel scleral strips were excised from each eyeball, one of which was subjected to crosslinking procedure (instillation of 0.1% aqueous solution of riboflavin mononucleotide for 20 minutes, ultraviolet irradiation of 3 mW /cm2 for 30 minutes), second was used as control. Scleral structure was evaluated by light (Van Gieson’s stain) and electron microscopy. Morphometric analysis of the microphotographs was performed using special software. Results. As a result of crosslinking, the average packing density of collagen fibers increased by 8.2%, the area of the intermediate space decreased by 5.2%, the average diameter of collagen fibrils increased by 12%. There were no pathological changes in scleral structures. Conclusion. Obtained results confirm the efficacy of scleral crosslinking with riboflavin/UVA in the formation of additional crosslinks, and the procedure safety for the scleral tissue.
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