Comparative characteristics of the outcomes of the use of multidirectional intravitreal pharmacotherapy in the treatment of diabetic macular edema

Purpose. To conduct a comparative analysis of the effectiveness of intravitreal injection of dexamethasone-containing implant and aflibercept in macular edema in patients with diabetes mellitus.Material and methods. The study involved 80 patients (80 eyes) with macular edema. The group 1 included 38 patients (38 eyes) who underwent a single intravitreal injection of dexamethasone-containing biodegradable implant «Ozurdex» in a dose of 0.7 mg according to the standard technique. In the group 2, 42 patients (42 eyes) received 5 loading doses of aflibercept with an interval of one month. All patients underwent monthly spectral optical coherence tomography (OCT) of the macular area, as well as visometry and tonometry during the observation period.Results. One month after intravitreal injection of the studied drugs in both groups, no inflammatory reactions were detected in any case. According to OCT data, cystic edema of the macular area with a tendency to decrease the thickness in the fovea was preserved. After treatment with aflibercept, the average retinal thickness in the macula was 186.4±15.1 μm, and visual acuity averaged 0.48±0.05 in 85.7% of patients. During therapy with intravitreal injection of Ozurdex, an increase in visual acuity was noted in 89.4% of patients.Conclusion. This study found that intravitreal pharmacotherapy with an angiogenesis blocker and a dexamethasone implant in patients with diabetic macular edema are comparable in its effectiveness – 85.7 and 89.4% respectively. If systematic anti-angiogenesis therapy is not possible for a number of reasons, it is advisable to use a prolonged dexamethasone implant

The prevalence of cataract surgery and the assessment of postoperative visual function in the population of the Republic of Bashkortostan

Purpose. Studying the prevalence and functional results of cataract surgery and factors that negatively affect postoperative visual functions in the population of the R epublic of Bashkortostan.Material and methods. The study was carried out on the basis of a pilot descriptive population study – Ural Eye and Medical Study (UEMS), conducted on the basis of the Ufa Research Institute of Eye Diseases. This analysis included 5 885 people aged 40 and over with data on performing cataract surgery. Poor visual outcome after cataract surgery was defined with uncorrected visual acuity below 0.3. Statistical data analysis was performed using the IBM SPSS Statistics application package.Results. The prevalence of cataract surgery was 6.1% (95% confidence interval (95% CI) 5.5–6.8%). A higher frequency of operations was associated with the age factor (odds ratio – OR 1.13, 95% CI 1.11– 1.15%, p<0.001), male gender (OR 1.92, 95% CI 1.43–2.59, p=0.003), urban living (OR 1.37, 95% CI 1.04–1.80, p=0.02) and widowhood (OR 1.57, 95% CI 1.13–2.17, p=0.006). Low visual results after cataract surgery, considering the maximum postoperative correction, were found in 16.1% of cases (81 eyes). The main reasons for the low postoperative outcome: refractive error (40.4%), macular degeneration (18.5%), glaucoma (16.0%), posterior capsule opacification (13.6%) and diabetic retinopathy (12.3%).Conclusion. The obtained results of good postoperative uncorrected visual acuity amounted to 73.1% and turned out to be quite close to international standards (80%). The main reasons for the low visual results of cataract surgery were refractive error and age-related macular degeneration

Сomparative Analysis of the Long-Term Results of Diabetic Macular Edema and Epiretinal Membrane Surgical Treatment

The purpose of the study — to conduct a comparative analysis of structural and functional indicators of the central zone of the retina in patients with diabetic macular edema and epiretinal membrane in the remote period after surgical treatment. Patients and Methods. We examined 97 patients with diabetic macular edema in combination with the epiretinal membrane aged 53 to 68 years (mean age 61 ± 5.4 years). All patients underwent vitrectomy with an internal limiting membrane peeling (ILM). Patients were divided into 3 groups depending on the intravitreal use of an angiogenesis inhibitor. The analysis of the remote anatomical and functional results of patients of different groups during 1 year of observation was carried out. Results. In patients after treatment using the proposed technique, the central retinal thickness was reduced by 16.19 % (p = 0.031) compared with monotherapy and by 11.51 % (p = 0.039) compared with a phased treatment method. Visual acuity significantly increased in the treatment group by the single-step method by 1.53 times (p = 0.024) compared with the group where only vitrectomy was performed, and also 1.44 times (p = 0.029) compared with the delayed administration of angiogenesis inhibitor in avital eye. Patients in all groups have showed an improvement in central photosensitivity 1 month after surgery, followed by a slight decrease in performance. However, by 12 months, the level of central photosensitivity in group 2 was significantly higher than in other groups (p < 0.05). A comparative analysis of the spatial distribution of macular pigment has showed that, along with the development of the pathological process, macular pigments were dispersed in the retinal tissue. On the background of treatment, their concentration was normalized in the central zone of the retina, without increasing the quantitative composition. Conclusion Analysis of the morphofunctional parameters of the retina central section in patients with diabetic macular edema and epiretinal membrane in the dynamics of treatment with various techniques led to the creation of an algorithm for managing patients. It allows to achieve high clinical and functional results in an overwhelming percentage of cases and, thereby, significantly improve medical and social rehabilitation, and also the quality of life of this contingent

About waste disposal problem in Russian Federation

© 2019 IOP Publishing Ltd. All rights reserved. The article discusses the problems of waste disposal methods that do not cope with the task of environmentally friendly disposal of municipal solid waste (MSW). The comparison of destruction and thermal destruction methods (plasma gasification in particular) are given

About waste disposal problem in Russian Federation

© 2019 IOP Publishing Ltd. All rights reserved. The article discusses the problems of waste disposal methods that do not cope with the task of environmentally friendly disposal of municipal solid waste (MSW). The comparison of destruction and thermal destruction methods (plasma gasification in particular) are given