Vol 22, No 2 (2022)

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Full Issue


Pregnancy and childbirth in a patient with aortic coarctation

Kazakova A.V., Lineva O.I., Medvedskaya A.K., Kiyashko I.S., Tsyganova M.A., Guleczkaya L.I., Zorina E.A., Khalmetova A.A.


The article is devoted to one of the actual problems in obstetrics – the pregnancy follow-up in patients with structural cardiac pathology. The presented clinical case demonstrates a patient with congenital heart disease, inherited obstetrical and gynecological history and the COVID-19 infection during pregnancy.

Despite the clinically significant cardiac pathology, the patient delivered at full term of 37 weeks through the natural birth canal.

The analysis of the clinical case allows us to conclude that a favorable prognosis of pregnancy and childbirth in women with aortic coarctation is possible with the pregnancy follow-up and delivery in specialized cardiology centers.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):4-7
pages 4-7 views


Results of complex therapy of the central retinal vein occlusion using laser methods of treatment

Aksenova S.V., Khozina E.A., Vasilyeva O.A., Kumaksheva T.N.


Aim – to analyze and compare the effectiveness of conservative treatment and complex methods (intravitreal injections of angiogenesis inhibitors and retinal laser coagulation) of the central retinal vein occlusion treatment.

Material and methods. Based on the case histories, there were analyzed the results of central retinal vein occlusion treatment in 40 patients (the average age is 63) who were treated at the Republican Ophthalmological Hospital.

Results. The course of combined therapy including the anti-VEGF injections and retinal laser coagulation showed the best results: a more significant and persistent decrease of retinal edema and a more marked increase of visual acuity, if compared to conservative therapy of the central retinal vein occlusion.

Conclusion. The results obtained allow us to recommend the complex treatment of the central retinal vein occlusion as the best method for fast and persistent elimination of retinal edema, increased visual acuity and prevention of complications.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):8-14
pages 8-14 views

The treatment of cornea pathology using scleral lenses

Alhjouj J.K., Samoylov A.N., Usov V.A., Ganyatullina D.R.


This review focuses on the therapeutic use of scleral lenses in the treatment of corneal pathology described in the international scientific literature.

The potential of scleral lenses in the treatment of pathology of the cornea and anterior segment of the eye has been studied since the late 1980s. The scleral lenses were actively used both in the treatment of corneal pathology and in the treatment of diseases of the anterior segment of the eye. The use of scleral lenses in the treatment of corneal pathology may promise an area for development for this treatment modality. Contrary to eye-drops, which remain on the ocular surface for a relatively short time, the scleral lenses provide a long-term hydration of the corneal epithelium and paralimbal conjunctiva. Tarsorrhaphy and other surgical interventions limit visual acuity and the field of vision and provide poor cosmetic results. The scleral lenses, however, can provide 2-in-1 therapy as they protect the ocular surface and, in case of epithelial roughness, may improve visual acuity in patients with ocular surface diseases. The ability of scleral lenses to provide a continuous hydration and protection of the ocular surface, allowing patients to maintain functional visual acuity, as well as their ability to be used in combination with other forms of therapy, makes them a valuable option for the treatment of severe ocular surface diseases. Incorporating scleral lenses into a combined, multidisciplinary approach to treatment can bring relief to patients without resorting to more invasive treatment options.

Our analysis identified only a few studies on the use of scleral lenses in the treatment of corneal pathology, which is likely due to the complexity of customization of their fit. This indicates the need for scientific research aimed at developing universal scleral lenses for the treatment of the cornea based on the criteria of the radius of curvature and the diameter of the cornea of a healthy eye.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):15-21
pages 15-21 views

The presence of two fragments of Ozurdex implants in the vitreous body

Artemov M.A., Kazakov I.S., Zolotarev A.V.


Aim – to present a clinical case of the remnant of the Ozurdex implant in the vitreous body.

Material and methods. One patient was under observation. During the preoperative examination and surgical treatment, two fragments of the Ozurdex implant were found in the vitreous body.

Results. The presented clinical case shows that the remnants of the Ozurdex intravitreal implant can persist for 10 months or more after injection. This fact is clinically important for assessing the therapeutic effect and choice of further treatment tactics for a patient.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):22-25
pages 22-25 views

Cataract surgery in patients with extremely elongated eyeball

Grigoryeva Y.V., Kopaev S.Y., Khliyan K.G.


Aim – to evaluate the specific features of the phacoemulsification and IOL implantation, as well as clinical and functional outcomes in patients with extremely elongated eyeball.

Clinical cases. Two female patients were observed. Patient 1: 67 years, diagnosed OU complicated cataract, high myopia, moderate amblyopia, primary open-angle glaucoma 3A. Visual acuity at admission vis OD = 0.001 n.c.; vis OS = 0.04 sph +2.00 D cyl -2.50 D ax 105° = 0.1. Patient 2: 68 years, diagnosed OU complicated cataract, high hyperopia, moderate amblyopia, primary open-angle glaucoma 1A, operated. Visual acuity at admission OD = 0.01 sph +11.00 D cyl +1.50 D ax 110° = 0.2; OS = 0.01 sph +11.00 D cyl +1.00 D ax 105 = 0.1. The phacoemulsification and implantation of Asphina IOL (Carl Zeiss Meditec AG, Germany) was performed in both patients: on the right eye of patient 1 and on the left eye of patient 2.

Results. A month after the operation, patient 1 had the uncorrected visual acuity Vis OD = 0.15, patient 2 had visual acuity Vis OS = 0.04 sph (+) 11.0 D = 0.2. Both patients were subjectively satisfied with the obtained visual functions.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):26-30
pages 26-30 views

Comparative analysis of the use of a 3D imaging system and a standard analog microscope in lens surgery

Zhuravlev A.V., Stebnev V.S.


Aim – to evaluate the safety and efficacy of lens surgery using 3D imaging technologies in comparison with the standard analog imaging method.

Material and methods. The study involved 500 people (500 eyes). The main group of patients consisted of 250 eyes operated using a LEICA M844 operating microscope with an NGENUITY camera instead of optical eyepieces, equipped with both CONSTELLATION (Alcon) and MILLENNIUM (Bausch & Lomb) surgical systems. The control group consisted of 250 eyes operated on using the same microscope but with standard eyepieces. All patients underwent cataract phacoemulsification. The control points for the result evaluation were the maximum corrected visual acuity in patients, the time of operation and the number of complications.

Results. The patients in the main group, on average, had a higher maximum corrected visual acuity after surgery, as well as a shorter time for surgical intervention.

Conclusion. The technology of three-dimensional imaging is relevant for performing operations on the eye lens and has a potential for further development and research of the technology, and also has the prospect of replacing the analog microscope binoculars in the near future.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):31-34
pages 31-34 views

Experience of micropulse cyclophotocoagulation for treatment patients with early stages of glaucoma

Ioshin I.E., Tolchinskaya A.I., Rakova A.V.


Aim – to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) modality in patients with early stages of glaucoma.

Material and methods. We examined 38 patients with early stage of primary open-angle uncompensated glaucoma (POAG) (17 patients with early stage, 18 patients with advanced stage) before and during 12 months after the MP-TSCPC treatment (SUPRA device 810, Quantel Medical, France) using the modified laser parameters - power W=2000 MW, 31.3 % - exposure cycle, total treatment time in 4 sectors - 200 s, the total energy 125 J. Fluence - 121.8 J/m².

Results. There were no complications after the procedure. In all patients, BCVA did not change during the observation period. A decrease in IOP was achieved in all patients. In 6 months of follow-up, the level of IOP remained stable and averaged 15.5 ± 4.5 mm Hd. Up to 12 months of follow-up, the hypotensive effect persisted up to 31% of the initial IOP, which averaged 16.0 ± 3.5 mm Hg. As a result, the persistent hypotensive effect helped to reduce the number of IOP-lowering medications in general, and to cancel them in 6 cases of 17 patients with early stage glaucoma.

Conclusion. MP-TSCPC modified protocol showed high efficiency (up to 31% of the initial value during the year) in reducing the intraocular pressure in patients with early stages of glaucoma. The use of MP-TSCPC in patients with high visual acuity demonstrated a good safety profile due to areactive postoperative period. Further monitoring of patients after MP-TSCPC is necessary to develop practical recommendations for indications and regimens.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):35-39
pages 35-39 views

Eyelid ectropion: aesthetic and functional issues

Pakhomova R.A., Kochetova T.F., Kalashnikova N.G.


Aim – to present the results of the author's treatment method for postoperative complications in the lower eyelid after blepharoplasty.

Material and methods. Patients in the postoperative period after blepharoplasty were included in the study (n = 11). All patients had age-related changes in the skin of the upper and lower eyelids before the surgery. After surgery, the patients had a complication in the form of an inversion of the lower eyelid. In the early postoperative period (up to 6 months), all patients with ectropion underwent the author's treatment technique using an erbium laser (Er:YAG, 20940 nm).

Results. The errors in the diagnosis and planning of the volume of surgical intervention, surgical errors are the main causes of complications after blepharoplasty affecting the function of the eye. In order to avoid the complications, it is necessary to take into account not only the degree of atrophy of the eyelid skin, but also the structural features of the eyelids and the periorbital region. The study proved that the author's method of treatment using an erbium laser (Er:YAG, 20940 nm) gives positive results. Observation of patients during 6 months after the treatment revealed no recurrence of inversion of the lower eyelids and the need for additional therapy.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):40-43
pages 40-43 views

The location of eccentric fixation point in patients with central scotomas of various origin

Poroshina M.A., Pedanova E.K.


Aim – to study the predominant localization of the eccentric fixation point in various types of macular pathology accompanied by the presence of a central scotoma.

Material and methods. 94 eyes (90 people) with various macular pathologies leading to loss of central vision were examined. Fixation was recorded on several devices: an MP-1 and MP-3 microperimeter (Nidek Technologies, Italy) and a MAIA microperimeter (СenterVue, USA). To visualize and register the presence of macular pathology, all patients underwent optical coherence tomography using a Stratus OCT 3000 device (Carl Zeiss Meditec Inc., USA) and Spectralis (Heidelberg Engineering, Germany).

Results. The study revealed that in most cases the preferred retinal locus is positioned in the upper and upper-left sector around scotoma, regardless of the etiology.

Conclusion. The preferred retinal locus in most cases is located in the upper-left area of the retina near the central scotoma, the projection of which is in the lower-left side of the visual field. Knowing the preferred retinal locus, a doctor can more successfully adapt a patient with the absence of central vision.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):44-49
pages 44-49 views

Anatomical and morphological results of modified femtolaser refractive autokeratoplasty in patients with keratoconus

Tereshchenko A.V., Demyanchenko S.K., Timofeev M.A., Erokhina E.V.


Aim – to evaluate the anatomical and morphological outcomes of modified femtolaser refractive autokeratoplasty in patients with stage II keratoconus.

Material and methods. The study included 24 patients diagnosed with stage II keratoconus according to the Amsler – Krumeich classification. All patients underwent femtolaser refractive autokeratoplasty (FRAK) according to a modified technique.

Results. All operated patients noted an improvement in visual functions on the first day after surgery. The obtained images of optical coherence tomography showed a more uniform posterior profile in the central zone of the cornea, the absence of "folding" of the posterior surface. A characteristic feature of the postoperative period was the change in the depth of the anterior chamber – its pronounced decrease was noted with a tendency to a systematic increase. In 2 months after the removal of suture fixation, the depth of the anterior chamber remained stable throughout the follow-up period. The data of confocal microscopy of the central zone of the cornea after 12 months demonstrated the absence of additional (specific) morphological changes in the cornea. The characteristic morphological changes for keratoconus remained the same as before the FRAK.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):50-55
pages 50-55 views

The effect of the sulfated glycosaminoglycans complex on the human corneal epithelial cells proliferation: an in vitro experiment

Trifanenkova I.G., Petersen E.V., Novikov S.V., Usanova G.Y.


Aim – to study the proliferative effect of various concentrations of sulfated glycosaminoglycans (sGAG) on the culture of human corneal epithelial cells.

Material and methods. The study focused on the properties of a mixture of sGAG consisting of chondroitin-4-sulfate, chondroitin-6-sulfates and keratan sulfates obtained by isolation from the transparent unchanged stroma of the cornea of farm animals. The material for the in vitro study was the cells of the anterior epithelium of the human cornea.

In the experimental group No.1, a mixture of sGAG was added to the culture medium at a concentration of 0.1%, in the experimental group No.2 – at a concentration of 0.5%, in the experimental group No.3 – at a concentration of 1.0%. In the control group No.1, the medium was replaced without the addition of solutions, cell seeding was carried out similarly to seeding with experimental samples. The negative control group included the holes of the tablet without the addition of medium and solution.

Results. The highest levels of the cellular index (CI) were obtained in the experimental group No.3 (1.00% of sGAG) and amounted to 2.86± 0.11 (the total increase in indicators was 60.67%). In the experimental group No.2 (0.50% sGAG), the cellular index levels were 2.65±0.24 (the total increase in indicators was 52.29%), which was significantly different from the experimental group No.1 (0.10% sGAG) and the control group No.1, where these indicators were 2.54± 0.21 (35.81%) and 2.37±0.02 (25.39%) respectively.

Conclusion. The final CI indicators show that solutions of the sGAG mixture at concentrations of 0.5% and 1.0% have a more pronounced proliferative effect on human corneal epithelial cells in vitro from the range of concentrations under study. The results obtained open up the prospects for the use of sGAG in the development of new approaches to the treatment of patients undergoing a chronic drug therapy or patients with concomitant corneal diseases.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):56-61
pages 56-61 views


Anatomical and morphological characteristics of the authenticity of Astragalus zingeri Korsh. herb

Matvienko U.A., Isaev D.S., Denikaeva E.A., Savinova D.A., Durnova N.A., Berezutskii M.A.


Aim – to analyse the morphological and anatomical structure of the herb Astragalus zingeri, identifying the diagnostic signs of plant raw material.

Material and methods. The object of the study was plant raw materials – the herb Astragalus zingeri Korsh., harvested in July, 2020, in the Saratov region, Tatishchevsky district, nearby the Kurdyum station, during the mass flowering period. The State Pharmacopoeia XIV standard was used for macro and microscopic analysis.

Results. The macroscopic features of the raw material are: pronounced ribbing of the stem, a small number of pairs of leaflets (4–6) of an unpaired pinnate leaf, as well as the size of the leaf plate, more pronounced trichomes on the bottom-side of the leaf, shortened, capitate, dense racemes with a pale purple corolla and a long flag. The characteristic microdiagnostic distinguishing features include: sinuous walls of leaf epidermal cells with numerous anomocytic stomata; slightly sinuous walls of the cells of the calyx epidermis; trichomes of the outer side of the calyx with T-shaped hairs with characteristic outgrowths of the cuticle.

Conclusion. The revealed macro- and microscopic diagnostic features of the herb Astragalus zingeri make it possible to identify the plant raw material and distinguish it from similar species.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):62-66
pages 62-66 views

Spectrophotometric analysis of carvedilol in a medication based on aquacomplex of titanium glycerosolvate

Popova M.I., Kobeleva T.A., Sichko A.I.


Aim – to develop a methodology for quantitative spectrophotometric analysis of carvedilol in the "Carvedilosol" medication based on aquacomplex of titanium glycerosolvate.

Material and methods. During the analysis we used the pharmaceutical substance "Carvedilol", gel "Tizol", ointment "Carvedilosol" consisting of 0.5% beta-blocker in titanium glycerohydrogel. The spectrophotometry was applied, registration of optical density and electron spectra was performed on spectrophotometer SF-2000. The following parameters were chosen for validation of the methodology: specificity, linearity, precision, correctness.

Results. It is reasonable to analyze Carvedilol at a wavelength of 243 nm with the limit of quantitative determination of 0.761 µg/ml. The results of the study showed that the weight of carvedilol in the ointment is within acceptable limits (0.0404-0.0548 g) according to the regulatory documentation for soft dosage forms (Order of the Ministry of Health of the Russian Federation No. 751n dated 26.10.2015).

Conclusion. Optimal conditions for the implementation of spectrophotometric method of analysis were selected for detection of the content of carvedilol in the ointment "Carvedilosol" with a relative error not exceeding ± 1.80 %.

Aspirantskiy Vestnik Povolzhiya. 2022;22(2):67-72
pages 67-72 views

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