Purpose: to assess the biophysical properties of the sclera by measuring its acoustic density in keratoconus, highly myopic, and healthy eyes. Material and methods. We examined 34 patients (67 eyes) aged 15–45 with keratoconus of various stages, 15 patients (30 eyes) aged 17–28 with high myopia and 15 people (30 eyes) aged 28–37 without ophthalmic pathology. The acoustic density of the sclera (ADS) was measured on the Voluson Е8 ultrasound device (GE Healthcare, USA) in the posterior eye pole (ADS-1) and in the equatorial area (ADS-2). The axial length (AL) of the eye, corneal thickness (CT), anterior chamber depth (ACD), and lens thickness (LT) were determined using Galilei G6 (Ziemer Group, Switzerland). The vitreal chamber depth (VCD) was calculated according to the formula: VCD = AL – СT – ACD – LT. Results. In keratoconus patients, the average ADS-1 value was 242.5 ± 7.4 conventional units (CU), ADS-2 averaged 234.1 ± 12.1 CU, AL was 24.6±1.1 mm long, and VCD was 17.1 ± 0.4 mm. In high myopia group, the average value proved to be significantly lower: ADS-1 was 210.3 ± 15.7 CU, ADS-2 — 201.2 ± 11,2 CU, while AL and VCD were higher: resp. 27.0 ± 0.7 mm and 19.2 ± 0.5 mm (p < 0,05). In the control group (healthy eyes), ADS-1 was 247.5 ± 2.8 and ADS-2 was 238.1 ± 0.6 CU, which practically showed no difference to the keratoconus group (p > 0.05). AL was 23.7 ± 0.6 mm, and VCD was 16.0 ± 0.6 mm. An insignificant tendency toward ADS drop in keratoconus eyes with AL over 25.0 mm was observed. Probably, we are dealing here with a combination of keratoconus with axial myopia. Conclusion. The acoustic density of the sclera of keratoconus patients approaches the respective parameter of healthy eyes and is significantly higher than that of highly myopic eyes. The analysis of acoustic density of the sclera and vitreal chamber depth may be considered as a method of additional differential diagnostics of keratoconus and congenital myopia with high corneal refraction and astigmatism.

BACKGROUND: Relevant keratometric and biometric indicators are necessary for intraocular lens (IOL) power calculation, which is difficult to verify in young children. AIM: Evaluation of the accuracy of various ultrasound methods and optical biometry for axial length measurement in young children with congenital cataracts. MATERIAL AND METHODS: Forty-six children (74 eyes) with congenital cataracts (43 eyes) and pseudophakia (31 eyes) at the age of 6 months to 4 years were examined. Various methods measured the axial length: ultrasound A-scan under general anesthesia by US-4000, ultrasound B-scan without general anesthesia by Voluson E8, and optical biometry by AL-Scan in cases of transparent optics. RESULTS: The greater axial length difference was observed between A-scan and optical biometry (less by 0,78 mm) than between B-scan and optical biometry (more by 0,27 mm). The median axial length difference between A-scan and B-scan was equal for infants and young children with congenital cataracts (0,525 mm and 0,535 mm, respectively). CONCLUSION: Axial length should be measured by different methods in young children with their further comparison to obtaining more accurate biometric indicators for IOL power calculation. The decrease of 12 mm in axial length, which occurs during the A-scan, can lead to errors in the IOL calculation of 36 diopters and unplanned refraction in the long-term period.

Purpose: to study the possibilities of complex ultrasound examination in the assessment of hemodynamic and structural features of retinal capillary hemangioma (RCH).Patients and methods. 26 patients (35 eyes) with RCHs at the age of 11 to 53 years (mean 26.6 ± 9.4 years) were examined. Ultrasound examination was performed using B–mode image, echodensitometry, Color Doppler Imaging (CDI) and pulsed Doppler (PD). The peak systolic velocity (Vsyst), the end-diastolic velocity (Vdiast) of the blood flow, and the resistance index (RI) in the orbital vessels were examined using CDI and PD. Qualitative and quantitative assessment of blood flow in a feeding artery and a draining vein of the RCHs were performed. The follow-up efficiency evaluation of the laser coagulation of RCH was performed in 12 eyes. Results. The elevation of RCH was 1.7 ± 0.7 mm (from 0.5 to 3.3 mm) on average, the base diameter — 5.4 ± 2.1 mm (from 1.8 to 11.5 mm). The acoustic density varied from 42 to 176 (mean 109.6 ± 30.9) in relative units. The indices of Vsyst were from 5.5 to 21.4 cm/s (mean value — 10.6 ± 4.2 cm/s) in the feeding arteries, from 3.06 to 14.3 cm/s — in veins (mean value — 4.9 ± 2.4 cm/s). A significant increase in the blood flow velocity in the central retinal vein (CRV), a decrease in RI in the central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) were determined. In 3 (8.6 %) eyes, in the absence of echographic manifestations of small RCHs of optic nerve head (ONH), there was an increase of the blood flow velocity in the CRV (the mean value was 8.95 ± 1.15 cm/s). After treatment, B-scan ultrasonogram showed no visualization of RCHs in 3 eyes. A significant decrease (31 %) of prominence compared to the baseline values was registered in 9 eyes (66.7 %). A decrease of the tumor base the diameter by an average of 37.7 % was also registered in 7 eyes (58.3 %). A significant decrease (26.3 %) in Vsyst in arterial-type feeding vessels was determined. Conclusion. Significant changes in regional ocular blood flow in RCH were registered. The increase of blood flow in the CRV at the localization of RCH on the ONH can be an additional differential diagnostic criterion of the disease. The hemodynamic instability in the retinal vessels feeding the RCH and the positive dynamics of the blood flow after laser coagulation were determined.

Purpose:to evaluate, using transpalpebral rheoophthalmography (TP ROG), the effectiveness of sclera-strengthening and trophic treatment of progressive myopia with a new biologically active chitosan-containing transplant.Patients and methods. 40 children and adolescents with moderate or high progressive myopia, averagely aged 12.6 ± 0.38 years, were examined after receiving low invasive sclera-strengthening surgery on one eye with a biologically active chitosan-containing transplant. The initial refraction of the operated eye was — 6.25 ± 0.23 D, while that of the fellow eye was — 5.85 ± 0.28 D. The yearly gradient of myopia progression averaged 1.10 ± 0.04 D. Hemodynamic parameters were measured using TP ROG) prior to intervention, then 1, 6 and 12 months after intervention. At the same time points, scleral acoustic density (SAD) was determined by analyzing tissue histograms obtained with a multipurpose ultrasound device, VOLUSON 730 Pro «GE».Results. One year after sclera-strengthening treatment, a 4.4-fold reduction of myopia progression rate on the operated eye was noted, supplemented by a 2.2-fold reduction of same on the fellow eye. Stabilization of refraction was accompanied by an increase of SAD: 6 months after the surgery, SAD was averagely 19.7 conventional units higher than the original figure in the posterior pole of the operated eye, and 16.2 conventional units higher in the equatorial area. One year after the surgery, the figures were, respectively, 15.9 (p < 0.05) and 14.0 conventional units (p < 0.01). The rheographic index of TP ROG increased with regard to the initial value by 139 % after one month, by 69.8 % after 6 months, and by 34.6 % after 1 year. On fellow eyes, the index also tended to increase: by 123.3 % after 1 month, by 65.2 after 6 months, and by the end of the follow-up period it exceeded the original value by 28.7 %, which is an evidence of a pronounced trophic effect of sclera-strengthening myopia treatment with chitosan not only on the operated eye but also (to a lesser extent) on the fellow eye.Conclusion. TP ROG is an effective evaluation method of sclera-strengthening treatment of progressive myopia. This method can also be used to study eye hemodynamics in a variety of ophthalmic pathologies, including those managed in pediatric clinical practice.

Purpose. To study the state of refraction, accommodation, and blood flow in eye vessels of children with habitually excessive accommodation stress (HEAS) and pseudomyopia practicing badminton.Material and methods. The study involved 11 patients (20 eyes) aged 7 to 11 years (average M±SD: 9.24 ± 1.06 years) with pseudomyopia and HEAS: 4 patients with myopia (7 eyes), 3 children with hyperopia (6 eyes), 4 children with emmetropia (7 eyes) before they started practicing badminton and after playing it for a certain time. All patients were tested for visual acuity, subjective and objective accommodation, optical biometry, aberrometry, velocity of blood flow in eye vessels, and choroidal thickness.Results. After 1 year of regular badminton workout, the subjects revealed a 0.92 ± 0.82 D weakening of manifest refraction, a decrease in accommodation tone by 0.85 ± 0.77 D, an increase in blood flow rate in ophthalmic artery and the central retinal artery, an increase in positive spherical aberration, a decrease in aberrations associated with mismatch and irregularity ofoptical system elements (tilt, trefoil, coma), which indirectly indicates a strengthening of the ligamentous apparatus of the lens.Conclusion. Practicing sports (badminton) contributes to the elimination of pseudomyopia, improvement of uncorrected visual acuity, accommodative ability, and ophthalmic hemodynamics indicators.

Purpose: to evaluate subfoveal choroidal thickness (SFCT) and other anatomical parameters of the eye in the early stages after orthokeratological correction of myopia. Material and Methods. The study was conducted on 20 myopic Caucasian patients (40 eyes) with moderate myopia. The main group consisted of 10 children with myopia -4.5 ± 1.03 D aged 11 ± 2.26 years, who were examined before the correction with orthokeratological lenses (OK-lenses) ESA-DL (Dr Lens Tehno, Russia) and 3 weeks after it. The control group comprised 10 patients (20 eyes) with myopia -3.84 ± 1.12 D aged 11.6 ± 1.17 years, who wore monofocal glasses as a correction. SFCT was measured with RS-3000 Advance optical coherent tomograph (OCT) (Nidek, Japan), while axial length (AL), peripheral eye length (PEL), and anterior chamber depth (ACD) was measured with IOL Master 500 optical biometer (Carl Zeiss, Germany), and central cornea thickness (CCT), epithelial thickness (ET) and corneal stroma (ST) thickness, with OCT Avanti Rtvue XR (Optovue, USA). All patients were tested before and 3 weeks after the start of wearing lenses or glasses. Results. SFCF increased by 24.25 ± 19 μm as compared with changes in the control group (p < 0.001) after 3 weeks of wearing OK-lenses. A notable negative correlation of changes in AL and SFCT was revealed in the main group (r = -0.48). CCT decreased by 14.6 ± 2.54 μm in the group wearing OKlenses. The main OK-lens contribution to the statistically significant change in the CCT concerned the epithelium, whose thickness showed a 12.7 ± 1.58 μm (22.6 %) change as compared with the initial data (p < 0.001) and with the change in the control group (p < 0.001). The decrease in AL showed an insignificant correlation with the decrease in the CCT: r = 0.16. ACD, PEL and ST did not change significantly (p > 0.05). Conclusion. SFCT shows an increase in the early stages after OK correction. When controlling the growth of the eye in patients with OK lenses, we need to take into account the impact of the choroid on the results of AL measurement.

Purpose. To propose the major differential diagnostic criteria of retinal capillary hemangioma (RCH) and vasoproliferative tumor (VPT) aimed at increasing the efficiency of the diagnosis of these diseases.Material and methods. A comprehensive ophthalmologic examination off 19 (26 eyes) patients, aged 19 to 66 (ave. 31.89 ± 11.30 yrs), with vascular neoplasms of peripheral localization included, beside the standard techniques, fundus photoregistration, fluorescent angiography (FAG), optical coherence tomography of the retina and a combined ultrasound testing using B scanning, echographic densitometry, colour Doppler imaging (CDI), and pulse Doppler imaging.Results. Based on the analysis of the clinical picture and the results of the tests performed, the following differential diagnostic criteria were proposed: the age at which RCH and VPT developed, their localization in the eye fundus, and the value of the maximal systolic blood flow velocity in the central vein of the retina.Conclusion. Differential diagnostics of RCH and VPT requires combined approaches and should take into account, in addition to case history and the clinical picture, also the results of instrumental testing techniques: FAG, echography and CDI.

The literary review presents the results of domestic and foreign studies of blood flow in the arteries and veins of the eye and orbit using color Doppler Imaging (CDI) and pulsed dopplerography. These methods are used to obtain the data on linear blood flow velocity and vascular resistance in different areas of the ocular vascular system and detect the correlation thereof with the severity of vascular disorders. CDI demonstrates the possibilities of multiple application in order to obtain reliable results in the diagnosis and evaluation of the effectiveness of treatment of the vascular pathology of the eye. For citation: Kiseleva T.N., Zaitsev M.S., Ramazanova K.A., Lugovkina K.V. Possibilities of color Duplex Imaging in the diagnosis of ocular vascular pathology. Russian ophthalmological journal. 2018; 11 (3): 84-94 (In Russian). doi: 10.21516/2072-0076-2018-11-3-84-94

Objective: to study the data of ocular blood flow in patients with different clinical variants of the complications proliferative diabetic retinopathy, and regarding to intraoperative hemorrhagic complications. Material and methods. Through Duplex ultrasonography 62 persons were investigated: 42 (68%) patients (42 eyes) with complicated forms of proliferative diabetic retinopathy and 20 (32%) healthy individuals (20 eyes). Results. The results showed deficiency of retinal blood flow, correlating with the severity of proliferative diabetic retinopathy. The most severe cases of the disease, intraoperative hemorrhagic complications were associated with peak systolic velocity (PSV) reducing (32.14 ± 4.2 cm/s), end-diastolic velocity (EDV) increasing (9.24 ± 2.35 cm/s), resistive index (RI) decreasing (0.71 ± 0.07 cm/s) in ophthalmic artery. Conclusion. The Duplex ultrasonography with the color Doppler imaging and pulced-wave Doppler model can be used for predicting of intraoperative hemorrhagic complications in patients with proliferative diabetic retinopathy.

AIM To study the effect of resveratrol on ocular blood flow in vivo in healthy rats and those that underwent retinal ischemia/reperfusion. MATERIAL AND METHODS The experimental study was performed on 40 Wistar rats (40 eyes). For ocular blood flow evaluation, color Doppler imaging (CDI), power Doppler (PD), and pulsed-wave spectral Doppler ultrasonography were performed using the Voluson E8 Expert ultrasonic diagnostic system (GE Healthcare). All rats were given resveratrol per os for 2 months of the study. Retinal ischemia/reperfusion injury was induced by a subconjunctival injection of endothelin-1. The control group included 10 intact animals. RESULTS Signs of ischemic damage of the anterior and posterior eye segments were less pronounced in rats that were given resveratrol during both pre-ischemic (30 days) and post-ischemic (30 days) periods of follow-up. There was also a statistically significant increase in the peak systolic and end diastolic velocity of blood flow as well as a decrease in the resistive index of retrobulbar arteries in those rats that underwent ischemia/reperfusion as compared to the controls. CONCLUSION Long-term resveratrol use (2 months) has proved effective in improving ocular blood flow in a rat model of retinal ischemia/reperfusion injury.

AIM:to investigate correlations between changes in ocular hemodynamics revealed by color Doppler flow mapping (CDFM) and pulsed-wave (PW) Doppler imaging, one the one hand, and electrical activity of the retina, on the other, in patients with early, moderate, and severe retinitis pigmentosa (RP).MATERIAL AND METHODS:A total of 20 patients (40 eyes) aged from 16 to 40 years (28.4 ± 8.2 years on average) with retinitis pigmentosa were enrolled. The control group consisted of 20 healthy volunteers of the same age range. All participants underwent full-field electroretinography (ERG), flicker ERG, and macular ERG as well as blood flow assessment in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCA) by means of CDFM and PW-Doppler.RESULTS:Ocular blood flow in CRA and SPCA appeared disturbed in patients with early RP. In cases of moderate and severe RP, the peak systolic velocity of CRA and SPCA blood flow was significantly decreased. Systolic and end diastolic blood flow velocities in CRA and SPCA has been shown to be directly related to full-field ERG a-wave and b-wave amplitudes, correspondingly, but negatively correlated with their implicit times.CONCLUSION:The revealed decrease in CRA and SPCA blood flow indices proves retinal and choroidal circulation deficit in patients with advanced RP. As shown, moderate blood flow changes are already present in early RP and progress as retinal photoreceptors and bipolar cells become suppressed, which may be useful for RP diagnosis and monitoring.

Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD).Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI) and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s), end-diastolic velocity (V diast, cm / s), and resistance index (RI) of blood flow in the central retinal artery (CRA), the short posterior ciliary arteries (PCA), and the ophthalmic artery (OA). All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05), RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

The article presents the results of a complex study on ultrasonography which included high-resolution grey scale B-scan, color Doppler imaging, and ultrasonic density measurement of eyelids and periorbital tissues. A total of 48 patients were enrolled. Echographic anatomy of eyelid layers, i.e. skin, orbicularis oculi muscle, tarsus, and orbital fat, is described in detail. Depth and ultrasonic density values for all layers are provided. The authors suggest performing an ultrasound examination of eyelids prior to reconstructive and plastic surgery in order to facilitate the choice of surgical tactics.

We observed 73 patients with anophthalmos with different types of intraorbital implants, and subatrophy of the globe. For three- dimensional ultrasound image of the orbit we used a new immersion substation on the basis of compressed polyvinyl alcohol, which was placed between the probe and the eyelids, excluding «dead zone». Acoustic density of the orbital structure and orbital blood flow were estimated.

A comprehensive echographic study of the orbit using an immersion environment, including high-gray-scale scanning, echo densitometry, volumetric ultrasound scan and color Doppler mapping in 19 patients with post-traumatic subatrophy and 7 patients with congenital microphthalmia. Found that low rates of eye prosthesis in anophthalmia in the late periods is due to insufficient volume of the musculoskeletal stump; if in the orbit exist a reduced in size eye (anteroposterior axis of 10.0 mm or more), the using of prosthesis does not develop deformation of the facial skeleton; the visualization of bloodstream in the great vessels at 2nd — 3rd stages of subatrophy and microphthalmia testifies the preservation of blood supply of the structures of the eye and orbit, presence of trophic.

We observed 73 patients with anophthalmos with different types of intraorbital implants, and subatrophy of the globe. For three- dimensional ultrasound image of the orbit we used a new immersion substation on the basis of compressed polyvinyl alcohol, which was placed between the probe and the eyelids, excluding «dead zone». Acoustic density of the orbital structure and orbital blood flowwere estimated.

The review discusses some of the most common methods of ocular microcirculation assessment in animals: fluorescent and indocyanine green angiography, scanning laser ophthalmoscopy with various dyes, laser Doppler flowmetry and velocimetry, color and power Doppler imaging, and pulsed-wave spectral Doppler ultrasonography. Each method possesses certain advantages and disadvantages, thus, the choice between them depends on the purposes and objectives of the given experimental study.

A comprehensive echographic study of the orbit using an immersion environment, including high-gray-scale scanning, echo densitometry, volumetric ultrasound scan and color Doppler mapping in 19 patients with post-traumatic subatrophy and 7 patients with congenital microphthalmia. Found that low rates of eye prosthesis in anophthalmia in the late periods is due to insufficient volume of the musculoskeletal stump; if in the orbit exist a reduced in size eye (anteroposterior axis of 10.0 mm or more), the using of prosthesis does not develop deformation of the facial skeleton; the visualization of bloodstream in the great vessels at 2nd — 3rd stages of subatrophy and microphthalmia testifies the preservation of blood supply of the structures of the eye and orbit, presence of trophic.