Features in dynamics of macular pigment status and central retinal sensitivity in vitreoretinal surgery for diabetic macular edema

Purpose. To identify the features of macular pigment and sensitivity of the central retina in case of vitreoretinal surgery for diabetic macular edema. Material and methods. Vitreoretinal interventions were performed in 31 patients (31 eyes) with diabetic macular edema combined with vitreomacular traction syndrome. All patients underwent the seamless closed 3-port vitrectomy with peeling of internal limiting membrane using the 25G systems. The analysis of retinal changes was carried out according to results of evaluation of optical density of macular pigment and retinal sensitivity pre- and post-operatively. Results. There was revealed a sharp decrease in the parameters of the optical density of macular pigment (ODMP) associated, apparently, with their screening in case of vitreomacular traction syndrome combined with diabetic macular edema. Vitreoretinal intervention led to an increase in the average optical density of the macular pigment by 50.24% indicating a normalization of vitreoretinal interface. Correlative analysis between the parameters of retinal sensitivity and ODMP showed an average correlation (r=-0.66, p<0.05). This indicates a decrease in the functional activity of the retina with the development of the pathologic process in the macular zone. The light sensitivity of the central retina in the examined patients averaged 7.83±0.09 dB before the suergery, and 11.66±0.11 dB (p<0.05) after the surgery. Conclusion. Vitrectomy with peeling of internal limiting membrane depending on diabetic macular edema leads to an increase of light sensitivity and normalization of macular pigment status, that pathogenetically proves an advisability of this surgical technique

Трансплантация сердца и коронавирусная инфекция (COVID-19) в раннем послеоперационном периоде у пациента с гипертрофической обструктивной кардиомиопатией: клинический случай

Hypertrophic cardiomyopathy (HCM) is a disease that is usually unresponsive to conservative pathogenetic therapy. It does not have clearly developed surgical correction algorithms. Heart transplantation (HTx) is the sole therapeutic option when drug therapy is ineffective and surgical reduction of hypertrophic myocardium is not feasible. There are only sporadic reports in the literature about HTx for HCM. The novel coronavirus disease 2019 (COVID-19) pandemic has significantly affected the work of cardiac surgical units and, in particular, organ transplantation activities. This paper presents a clinical case of an HCM patient who underwent HTx, complicated by COVID-19 infection in the early postoperative period.Гипертрофическая кардиомиопатия – это заболевание, в большинстве случаев трудно поддающееся консервативной патогенетической терапии и не обладающее четко разработанными алгоритмами хирургической коррекции. Конечным вариантом лечения при неэффективности медикаментозной терапии и невозможности проведения хирургической редукции гипертрофированного миокарда является трансплантация сердца, о которой в литературе имеются лишь единичные сообщения. Пандемия новой коронавирусной инфекции существенно повлияла на работу кардиохирургических подразделений и в особенности на работу по пересадке органов. В данной статье представлен клинический случай пациента с гипертрофической кардиомиопатией, которому произведена трансплантация сердца, осложнившаяся инфекцией COVID-19 в раннем послеоперационном периоде

Prevalence and associated factors of anemia in a Russian population: the Ural eye and medical study

Background: Although anemia is one of the leading causes of the global burden of disease, information about its prevalence in Russia is mostly missing. We therefore assessed its prevalence and associated factors in a Russian population. Methods: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age:59.0 ± 10.7 years;range:40–94 years) who underwent a standardized interview and detailed general examination. The definition of anemia was based on the hemoglobin concentration (definition #1:hemoglobin concentration < 140 g/L in men,< 130 g/L in women; definition #2:hemoglobin concentration < 130 g/L in men,< 120 g/L in women [World Health Organization definition]). Results: Higher hemoglobin concentration (mean:142.6 ± 14.8 g/L; range:80-171 g/L) was associated (multivariable analysis) with male gender (P < 0.001; standardized regression coefficient beta:-0.20), higher waist-hip circumference ratio (P < 0.001;beta:0.05), higher prevalence of car ownership (P < 0.001;beta:0.05), higher blood concentrations of bilirubin (P < 0.001;beta:0.05) and triglycerides (P < 0.001;beta:0.06), lower erythrocyte sedimentation rate (P < 0.001;beta:-0.32), and shorter blood clotting time (P < 0.001;beta:-0.39). Using definition #1 and #2, anemia was detected in 1385 individuals (23.6%;95% confidence interval CI)CI:22.5,24.7) and in 453 individuals (7.7%;95%CI:7.0,8.4), respectively. Prevalence of moderate anemia (hemoglobin concenttration:110 g/L-80 g/L), detected in 165 individuals (2.8%;95%CI:2.4,3.2), increased with younger age (P = 0.008;odds ratio (OR):0.98;95%CI:0.96,0.99), female gender (P < 0.001;OR:2.52;95%CI:1.47,4.33), higher erythrocyte sedimentation rate (P < 0.001;OR:1.08;95%CI:1.06,1.09), longer blood clotting time (P < 0.001;OR:8.56;95%CI:5.68,12.9), and marginally significantly, with a lower waist-hip circumference ratio (P = 0.058;OR:0.13;95%CI:0.02,1.07). In women, it was significantly (P < 0.001) higher before menopause (8.8%;95%CI:6.4,11.1) than after menopause (3.5%;95%CI:2.8,4.3). Conclusions: In this Russian population as compared to populations from countries with a similar socio-demographic index, anemia prevalence was relatively low. As in other populations, higher anemia prevalence was strongly and inversely associated with menopause, and to a minor degree, with lower waist-hip circumference ratio and lower socio-economic background

Macular oedema as manifestation of diabetic retinopathy

Diabetes mellitus is the third most dangerous disease of our time preceded by cardiovascular diseases and oncologic pathology. According to the International Diabetes Federation (January 1, 2016), worldwide approximately 415 million people aged 2079 years suffer from diabetes. The most significant manifestations of diabetes mellitus are lesions of the retina and blood vessels, which manifest as diabetic retinopathy and macular oedema, which lead to the inevitable loss of vision and disability in patients of working age. The existence of multile diagnostic methods and a broad classification provide an evidence of the complex nature of the pathological process of the macular zone in diabetes mellitus. However, to date, a single, generalised and accepted classification does not exist. Difficulties in the treatment of diabetic maculopathy are attributed to various forms of retinal lesions and ambiguities in the approach used to choose the disease management. It determines the importance of the development of diagnostic methods for the further correction of the standard treatment approach. New directions of surgical treatment allow relying on the best results of diabetic maculopathy treatment

Prevalence, awareness and control of diabetes in Russia: The Ural Eye and Medical Study on adults aged 40+ years.

PurposeNon-communicable chronic diseases have become the leading causes of mortality and disease burden worldwide. With information about the frequency of diabetes as a major non-communicable chronic disease in Russia being scarce, we assessed the prevalence of diabetes and its associated factors in a rural and urban population in Russia.MethodsThe Ural Eye and Medical Study is a population-based study in the city of Ufa/Russia and in villages in a distance of 65 km from Ufa. Inclusion criterion was an age of 40+ years. All study participants underwent a standardized interview and a detailed general examination. Diabetes mellitus was defined by a plasma glucose concentration ≥7.0 mmol/L or self-reported history of physician diagnosis of diabetes.ResultsOut of a population of 7328 eligible individuals, 5899 individuals (2580 (43.7%) men) (participation rate:80.5%) participated (mean age:59.0±10.7 years (range:40-94 years)). Diabetes mellitus was present in 687 individuals (11.7%;95% confidence interval (CI):11.9,12.5). Awareness rate of having diabetes was 500/687 (72.8%;95%CI:69.0,76.0), with mean known duration of diabetes of 10.0±9.4 years. Known type 1 diabetes was present in 44 subjects and known type 2 diabetes in 358 subjects. Prevalence of undiagnosed diabetes was 3.2% (95%CI:2.7,3.6) in the study population. Among patients with diabetes, 59.1% (95%CI:55.4,62.8) received treatment for diabetes, among whom 237 (58.5%;95%CI:53.7,63.3) individuals had adequate glycemic control. In multivariable analysis, higher prevalence of diabetes mellitus was associated with older age (PConclusionsIn this ethnically mixed, urban and rural Russian population aged 40+ years, the awareness rate of diabetes (72.8%) was relatively high, while the diabetes prevalence (11.7%) was comparable with that of other countries such as China and the USA. Factors associated with higher diabetes prevalence were similar in Russia and these other countries and included older age, higher body mass index and higher serum concentration of triglycerides, lower prevalence of vigorous daily work, arterial hypertension and cardiovascular diseases

Prevalence and associated factors of osteoarthritis in the Ural Eye and Medical Study and the Ural Very Old Study

Abstract To determine the prevalence of osteoarthritis and its associated factors in populations from Russia. The population-based Ural Eye and Medical Study (UEMS) and the population-based Ural Very Old Study (UVOS) were conducted in a rural and urban region in Bashkortostan/Russia and included participants aged 40+ and 85+ years, respectively. As part of a detailed systematic examination, we assessed the osteoarthritis prevalence in an interview including questions on the self-reported presence of osteoarthritis, the joints affected and osteoarthritis-related pain-relieving therapy taken. Out of 5898 participants of the UEMS, 1636 individuals had osteoarthritis [prevalence: 27.7%; 95% confidence interval (CI) 26.7, 28.7], with 816 individuals (13.8%; 95% CI 12.8, 14.8) taking pain-relieving medication. A higher osteoarthritis prevalence was associated (multivariable analysis) with older age [odds ratio (OR 1.04; 95% confidence interval (CI) 1.03, 1.05], urban region of residence (OR 1.25; 95% CI 1.07, 1.45), higher body mass index (BMI) (OR 1.04; 95% CI 1.03, 1.06), lower monthly income (OR 0.78; 95% CI 0.68, 0.90), higher physical activity score (OR 1.02, 95% CI 1.01, 1.03), higher prevalence of a history of cardiovascular disease including stroke (OR 1.55; 95% CI 1.33, 1.81), previous bone fractures (OR 1.20; 95% CI 1.04, 1.40) and previous falls (OR 1.22; 95% CI 1.03, 1.45), higher hearing loss score (OR 1.01; 95% CI 1.01, 1.02), and less alcohol consumption (OR 0.78; 95% CI 0.65, 0.93). Out of 1526 UVOS participants, 567 individuals had osteoarthritis (prevalence: 37.2%; 95% CI 35.0, 40.0), with 195 (12.8%; 95% CI 11.3, 14.3) individuals taking pain-relieving medication. Higher osteoarthritis prevalence was associated with rural region of habitation (OR 1.69; 95% CI 1.20, 2.38), lower monthly income (OR 0.62; 95% CI 0.46, 0.84), higher prevalence of cardiovascular disease (OR 1.75; 95% CI 1.30, 2.36), and higher anxiety score (OR 1.04; 95% CI 1.03, 1.06). Osteoarthritis and use of pain-relieving medication are common in these populations in Russia. Main associated factors were older age and lower monthly income in both study populations, female sex, higher BMI, urban region, and previous falls and bone fractures in the UEMS population, and rural region and a higher anxiety score in the UVOS study population

Axial length and its associations in a Russian population: The Ural Eye and Medical Study.

PURPOSE:To assess the normal distribution of axial length and its associations in a population of Russia. METHODS:The population-based Ural Eye and Medical Study included 5,899 (80.5%) individuals out of 7328 eligible individuals aged 40+ years. The participants underwent an ocular and systemic examination. Axial length was measured sonographically (Ultra-compact A/B/P ultrasound system, Quantel Medical, Cournon d'Auvergne, France). RESULTS:Biometric data were available for 5707 (96.7%) individuals with a mean age of 58.8±10.6 years (range:40-94 years; 25%, 50%, 75% quartile: 51.0, 58.0, 66.0 years, respectively). Mean axial length was 23.30±1.10 mm (range: 19.02-32.87mm; 95% confidence interval (CI): 21.36-25.89; 25%, 50%, 75% quartile: 22.65mm, 23.23mm, 23.88mm, resp.). Prevalences of moderate myopia (axial length:24.5-26.5mm) were 555/5707 (8.7%;95%CI:9.0,10.5) and 78/5707 (1.4%;95%CI:1.1,1.7), respectively. Longer axial length (mean:23.30±1.10mm) was associated (correlation coefficient r2:0.70) with older age (P<0.001;standardized regression coefficient beta:0.14), taller body height (P<0.001;beta:0.07), higher level of education (P<0.001;beta:0.04), higher intraocular pressure (P<0.001;beta:0.03), more myopic spherical refractive error (P<0.001;beta:-0.55), lower corneal refractive power (P<0.001;beta:-0.44), deeper anterior chamber depth (P<0.001;beta:0.20), wider anterior chamber angle (P<0.001;beta:0.05), thinner peripapillary retinal nerve fiber layer thickness (P<0.001;beta:-0.04), higher degree of macular fundus tessellation (P<0.001;beta:0.08), lower prevalence of epiretinal membranes (P = 0.01;beta-0.02) and pseudoexfoliation (P = 0.007;beta:-0.02) and higher prevalence of myopic maculopathy (P<0.001;beta:0.08). In that model, prevalence of age-related macular degeneration (any type: P = 0.84; early type: P = 0.46), diabetic retinopathy (P = 0.16), and region of habitation (P = 0.27) were not significantly associated with axial length. CONCLUSIONS:Mean axial length in this typically multi-ethnic Russian study population was comparable with values from populations in Singapore and Beijing. In contrast to previous studies, axial length was not significantly related with the prevalences of age-related macular degeneration and diabetic retinopathy or region of habitation