Hyperbaric Oxygen Therapy in Patients with COVID-19

The aim of the study is to evaluate the efficacy of hyperbaric oxygen therapy and its effect on oxidative stress and apoptosis in patients with new coronavirus infection COVID-19.Materials and methods. 90 patients diagnosed with new coronavirus infection caused by SARS-CoV-2 virus were examined. Hyperbaric oxygen therapy sessions were conducted in 57 patients (38 in severe condition (CT 3-4), 19 in moderate condition (CT 1-2)). The procedures were performed in 1.4-1.6 ATA mode for 40 minutes, 247 sessions in total were performed. The effect of hyperbaric oxygenation was assessed by measuring the level of oxygen saturation, the severity of oxidative stress and apoptosis of blood lymphocytes.Results. In all examined patients with new coronavirus infection caused by SARS-CoV-2, positive changes such as dyspnea reduction and improvement of general well-being were registered after hyperbaric oxygen therapy sessions. The level of oxygen saturation after the end of the hyperbaric oxygen therapy course was 95.0±1.6% (before the course — 91.3±5.9%), which allowed to return almost all patients to spontaneous respiration without the need for further oxygenation therapy. Hyperbaric oxygen therapy did not reduce the total antioxidant activity, however, it was associated with a decrease in the blood malone dialdehyde from 4.34±0.52 pmol/l to 3.98±0.48 pmol/l and a decrease in open circuit potential of platinum electrode from -22.78±24.58 mV to -37.69±17.4 mV. Besides, the positive effect of hyperbaric oxygen therapy was manifested in normalization of blood cell apoptosis.Conclusion. Hyperbaric oxygen therapy in patients with new coronavirus infection caused by the SARS-CoV-2 virus is an effective treatment method with multiple effects resulting in improvement of subjective indicators of the patients' condition, increase of hemoglobin oxygen saturation, decrease of lipid peroxidation intensity, activation of antioxidant system, restoration of pro- and antioxidant balance and apoptosis normalization

MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY

“Balanced” bone  decompression of the  orbit was  performed in a patient  with endocrine ophthalmopathy, CAS3, OD=30 mm,  OS=31 mm with the use of minimally invasive transconjunctival approaches and frameless neuronavigation. At the first stage the preoperative computed  tomography  of  the  orbits   was  imported   into  the  navigation  software,  and  then   marked  the  area of  the  proposed resection of the  orbit  walls. Further, in the  operating room,  the  patient  was  registered in the  navigation system. To perform  bone decompression of the orbit and lipectomy, we used  preseptal, transcaruncular and lateral retrocanthal approaches. These approaches are  transconjunctival and  do not  leave postoperative scars. Upon completion  of the  orbitotomy, its accuracy and  dimensions were determined by the intraoperative pointer of the neuronavigation system.Results. The postoperative period was uneventful. In the early postoperative period there was a regression of exophthalmus OD=26 mm,  OS=27  mm,  closure  of the  eye gap,  but retraction of the eyelids remained. When examined 3 months after the operation, the exophthalmic regression was OD=23 mm, OS=24 mm, retraction of the  eyelids — 1 mm,  with lead — finishing to the  lateral  adhesion. When  examined  after  6 months — the  position of the  eyeballs in orbit: ОD=21 mm,  ОS=22  mm,  retraction of the  eyelids is not present, there is no violation of oculomotorics, complications were not recorded. A satisfactory result  was  obtained.Conclusion. Minimally invasive transorbital approaches allow the  transconjunctival acces to all orbital walls to perform  decompression of the  orbit and lipectomy without cutaneous incisions,  to achieve good cosmetic and functional results. And the intraoperative use  of the neuronavigation system ensures  the bone decompression of the orbit in full. The technique is promising  and requires further  randomized  studies

Diagnostic Possibilities of Standard Automatic and FunctionSpecific Perimetry (HFA, Octopus) in the Study of the Visual Field in Patients with Compression in the Chiasm-Sellar Region

The literature review presents the results of a static perimetry for the study of the visual field in patients with compression in the chiasm-sellar region on the Humphrey Visual Field Analyzer (HFA) and Octopus. These models of perimeters are recognized as the “gold standard” and are most widely used in the global ophthalmic practice. The analysis of research results using traditional and function-specific perimetry with selective stimulation of the magnocellular and koniocellular (frequency-doubling technology perimetry, FDT; short-wavelength automated perimetry, SWAP) visual pathways was performed. The literature data analysis allows us to conclude that the static perimetry for the study of the visual field in patients with chiasmatic compression is carried out quite widely and is informative. But despite this, there are no generally accepted recommendations on the use of certain testing strategies and programs for the diagnosis and further dynamic observation of changes in the visual field in patients with this pathology. In this regard, it is advisable to conduct further studies that will allow the formation of standard perimetric protocols for diagnosing and monitoring visual field defects in patients with compression in the chiasm-sellar region based on a comparative analysis of the diagnostic informativity of various strategies and programs