Research Institute of Eye Diseases
Recent publications
Purpose. To estimate the accuracy of IOP measurement using artificial intelligence (AI) technologies and applanation tonometry with fixed strength. Material and methods. 290 patients (576 eyes) underwent applanation tonometry according to Maklakov with tonometer weights of 5, 10, and 15 g using a modified elastotonometry technique followed by an analysis of impression quality and diameter measurements by three independent ophthalmologist experts. The prints were then fed into a neural network to check the repeatability and reproducibility of the measurements. Results. The comparison of the diameters of the Maklakov tonometer prints determined by AI based on the neural network with the measurements data provided by three experts showed that neural network underestimates the measurement results by an average of 0.27 (-3.81; 4.35) mm Hg. At the same time, the intraclass correlation coefficient for all prints was 98.3%. The accuracy of diameter measurements of prints by neural network differs for tonometers of different weights, e.g. for a 5 g tonometer the difference was 0.06 (-3.38; 3.49) mm Hg, for 10 g and 15 g tonometers was 0.14 (-3.8; 3.51) and 0.95 (-3.84; 5.74) mm Hg, respectively. Conclusion. High accuracy and reproducibility of the measurements by the neural network, was shown to surpass the reproducibility of human-implemented measurements.
Purpose. To evaluate the clinical and functional results of a combined intervention - one-stage cataract phacoemulsification and a newly developed version of partially fistulizing antiglaucoma surgery (PFS) of patients with primary open-angle glaucoma (POAG) as compared with those of phacoemulsification in combination with penetrating and non-penetrating antiglaucoma intervention. Material and methods. 61 patients (65 eyes) with a combination of incomplete complicated cataract and previously unoperated stages I–III POAG. were divided into 3 groups: group 1 (control, 17 patients, 17 eyes) with ultrasonic cataract phacoemulsification (PEC) and non-penetrating deep sclerectomy (NPDS); 2 group 2 (control, 25 patients, 28 eyes patients with PEC and trabeculectomy (TE); group 3 (main, 19 patients, 20 eyes) with PEC and the newly developed PFS. Results. The best long-term results, with approximately equal hypotensive parameters were achieved with combined operations, which included PEC with TE (the absolute effect achieved in 65% of cases) and PFS (in 60%). However, the number of early postoperative complications after PFS turned out to be almost 2 times as small as after a simultaneous intervention with penetrating TE, and was wholly comparable with that after NPDS (15 and 11.8%). At the same time, the best visual results over the relevant period were observed in the main (0.78 ± 0.06) group and the control group 1 (0.64± 0.05). Conclusion. Combined simultaneous intervention, including cataract phacoemulsification with the newly developed partially fistulizing antiglaucoma surgery, is an effective way to improve visual acuity, normalize intraocular pressure and stabilize glaucomatous optic neuropathy, as well as to reduce the drug load on the patient.
Abstract Information about prevalence and associated factors of non-alcoholic fatty liver disease (NAFLD) has been scarce for the Russian, Eastern European and Central Asian world region. We assessed prevalence and associated factors of NAFLD in two population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)), which were conducted in rural and urban regions in Bashkortostan/Russia and included participants aged 40 + years and 85 + years, respectively. Defining NAFLD by an absence of regular alcohol consumption, and by abnormally high alanine transaminase (ALT) and aspartate transaminase (AST) concentrations or an AST/ALT ratio of > 1.0, 2341 out of 5852 UEMS participants (40.0%; 95% confidence intervals (CI) 38.8, 41.3) had NAFLD. A higher NAFLD prevalence correlated (multivariable analysis) with older age (odds ratio (OR) 1.02; 95%CI 1.01, 1.03; P
Introduction . The article considers an objective assessment of the state of morphofunctional status of cornea in keratoconus after a corneal collagen crosslinking procedure. Aim . To assess changes in cornea structure after corneal collagen crosslinking in keratoconus. Materials and methods. The study included 24 patients: 30 eyes with KC stage I–III aged 17 to 42 years. The patients were examined before and after the corneal collagen crosslinking procedure. The postoperative follow-up period was 12 months. The patients underwent anterior segment OCT (AS-OCT) imaging to assess the demarcation line depth. The cornea and cornea nerve fibers were assessed layer-by-layer using сonfocal laser scanning microscopy, followed by the analysis of resulting confocal images through the author’s analysis algorithm. Results and discussion . The epithelialization of the cornea completed on day 3–5 after the procedure. According to OCT findings, the depth of the demarcation line averaged to 260 µm in the center and 140 µm in the periphery. The pronounced edema of the outer stroma was observed during the first-week follow-up, and a decrease in the density and apoptosis of keratocytes was noted during the first month. Over a 3–12-month postoperative follow-up period, the transient lacunar edema regressed and the density of keratocytes was restored to the baseline level. During the first three months, a pronounced disruption of the direction and structure of the cornea nerve fibres is seen. Conclusion . The crosslinking procedure results in changes in the cornea structure, one of which is appearance of the demarcation line in the stroma, which indicates the depth of penetration of the photochemical corneal collagen crosslinking process. The laser corneal confocal microscopy allows to objectively assess the depth of this effect, while the values obtained in the same follow-up periods are comparable with the findings of OCT imaging.
Objective: To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years. Methods: The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function. Setting: A rural and urban area in Bashkortostan, Russia. Participants: Out of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated. Primary and secondary outcome measures: Prevalence of vision, hearing and DSI and cognitive dysfunction. Results: The study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85-98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001). Conclusions: In this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.
Cataract (partial or complete violation of the transparency of the lens) is one of the main causes of low vision and reversible blindness in the world. It is a known fact that at present the only effective way to eliminate the clouding of the lens is its surgical treatment. About 18 million cataract-related surgical interventions are performed annually in the world. This literature review is devoted to studies examining important aspects of surgical treatment for age-related cataracts, such as the number and quality of operations performed on a population scale. The paper presents data on the impact of global trends, local territorial and social characteristics on the number of surgical interventions for cataracts. A review of key indicators of monitoring cataract surgery has been carried out, the main factors affecting the target indicators of the cataract surgery frequency on a regional scale (age structure of the population, normative indications for surgical treatment, threshold values for visual acuity indicating the need for surgical intervention, and the proportion of people in need in surgical treatment of cataracts). The main achievements and aspects of the modern technique of surgical treatment of cataracts are described, which can reduce the time of surgery, use more gentle surgery technology, significantly reduce the number of complications and achieve the highest functional results. This review also details the results of the largest epidemiological studies on the causes of low visual acuity after cataract surgery. Literature data on the prevalence of low visual acuity in different populations are reflected, its higher prevalence in countries where most of the operated cataracts were mature or complicated was revealed, the surgical technique of large incisions and a longer operation time prevailed. It was noted that low vision after cataract surgery is most often associated with the elderly patient, concomitant systemic and ocular pathology, surgical complications, inadequate intraocular correction.
Neurotrophic keratitis (also called neurotrophic keratopathy) (NTK) is a degenerative disease of the cornea, accompanied with neurogenic inflammation. It caused by a sensitive innervation loss of the trigeminal nerve and characterized by reduced sensitivity of the cornea and a retardation of its healing process. NTC-causing damage to the trigeminal nerve can occur at different levels-from the nucleus to the terminals located in the cornea, and can be caused by ocular and systemic diseases both. The most common causes include herpetic keratitis, diabetes, chemical burns and iatrogenic injuries during ophthalmic operations, intracranial neoplasms, disorders of cerebral circulation and neurosurgical interventions. Corneal changes include epitheliopathy (grade I), persistent erosion (grade II), ulcer and its complications (grade III). The determining diagnostic sign of NTK is a decrease or loss of corneal sensitivity. The morphological characteristics of the corneal nerves can be studied using confocal microscopy.
Introduction . Vision plays a key role in the development of newborns and children. Early and severe visual impairment can affect motor skills, cognition, communication and social abilities. One of the main diagnostic indicators of the development of the eye in children is the central visual acuity. Purpose : To suggest an improvement of the visual acuity assessment system in children aged 2 to 5 years by introducing a fundamentally new eye chart intended to improve the accuracy and reliability of measurements. Materials and methods . The study included 40 children (80 eyes) aged 2 to 5 years, without previously diagnosed ocular pathology. Visual acuity test was performed using standard Orlova eye chart and a fundamentally new Just Evident Images / Jonnazarov Eldor Ihtiyorovich eye chart (abbreviated as JEI/JEI). The results obtained were later compared. The JEI/JEI chart consists of 13 color and black optotypes of various sizes, equal in width and height, that represent objects that are well-known and easily recognizable by children even at an early age: “Sun”, “Flower”, “Christmas Tree”, “House”, “Chicken”, “Child”, “Star”, “Horse”, “Bear”, “Car”, “Kitten”, “Ball”, “Hare”. Results . The results of vision acuity tests in 29 (72.5%) and 31 (77.5%) matched, and the effectiveness of both methods was evaluated as identical. In 11 cases (27.5%) of assessing VA in the right eye and 9 cases (22.5%) in the left eye, the results obtained differed, yet correlated directly: the difference between VA values obtained using JEI/JEI and Orlova eye charts amounted to 0.1–0.2. Conclusion . The results obtained indicate the prospects of using the JEI/JEI eye chart in clinical practice for vision acuity tests in young children. The suggested method simplifies the perception of the objects and increases the accuracy of assessing visual acuity in children due to the selection and geometry of optotypes.
Purpose: To assess the macular pigment optical density (MPOD) and its associations with ocular and systemic parameters and diseases. Methods: The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. As part of ophthalmological and systemic examinations, MPOD was measured by reflectometry. Results: Macular pigment optical density (MPOD) data were available for 4889 (82.9%) individuals (mean age:57.8 ± 10.1 years;range: 40-94). Mean values for MOPD, maximal MOPD, macular pigment (MP) area and MP volume were 0.13 ± 0.04 d.u. (density units), 0.36 ± 0.09 d.u., 60 791 ± 14 826 pixel and 8033 ± 2888 d.u.pixel, respectively. A higher MP density was correlated (regression coefficient r: 0.63) with older age (standardized regression coefficient beta: 0.59; non-standardized regression coefficient B: 0.23; 95% confidence interval (CI): 0.22, 0.23; p < 0.001), female sex (beta: 0.08; B:0.63; 95%CI: 0.44, 0.83; p < 0.001), rural region of habitation (beta: 0.13; B: 1.02; 95%CI: 0.83, 1.22; p < 0.001), lower body mass index (beta: -0.04; B: -0.03; 95%CI: -0.05, 0.01; p = 0.004), lower prevalence of chronic obstructive pulmonary disorder (beta: -0.03; B: -0.43; 95%CI: -0.79, -0.08; p = 0.02), higher erythrocyte sedimentation rate (beta: 0.03; B: 0.01; 95%CI: 0.002, 0.02; p = 0.03), lower leukocyte cell count (beta: -0.04; B: -0.10; 95%CI: -0.16, -0.03; p = 0.003), thinner temporal parafoveal retinal thickness (beta: -0.06; B: -0.01;95%CI: -0.01, -0.003; p < 0.001), thinner central corneal thickness (beta: -0.06; B: -0.006; 95%CI: -0.009, -0.004; p < 0.001), higher prevalence of pseudophakia (beta: 0.09;B:2.08; 95%CI: 1.50, 2.65; p < 0.001) and reticular pseudo drusen (RPD) (beta: 0.03; B: 0.56; 95%CI: 0.13, 0.98; p = 0.01) and lower stage of open-angle glaucoma (beta: -0.03; B: -0.39; 95%CI: -0.74, -0.04; p = 0. 03). Prevalence (p = 0.44; beta: -0.01) and degree (p = 0.70; beta: -0.01) of angle-closure glaucoma, prevalence (p = 0.31; beta: 0.01) of age-related macular degeneration (AMD) without RPD and prevalence (p = 0.95; beta: 0.001) of diabetic retinopathy were not significantly associated with the mean MP density in that model. Conclusions: A higher RPD prevalence and lower stage of open-angle glaucoma were ophthalmological disorders associated with a higher MPOD in a multivariable analysis, including parameters of older age, pseudophakia, female sex, rural region, lower body mass index and lower perifoveal retinal thickness.
The density of macular pigment in the central retina is the total concentration of lutein, zeaxanthin and meso-zeaxanthin. Normally, the average value of the optical density of macular pigment can vary significantly as it depends on the person's lifestyle, the total amount of pigment in the body, nutrition, gender, age, as well as concomitant diseases such as diabetes, obesity, arterial hypertension. Differences in the level of optical density of macular pigment between different countries were revealed and it was showed that this parameter drops in cases of retinal pathology, cataract, glaucoma, myopia, macular degeneration, or diabetic macular edema. The level of macular pigment may be considered as a significant diagnostic criterion in many ophthalmic pathologies, so any changes of this parameter require attentive consideration.
The review discusses the treatment methods based on physical phenomena in clinical ophthalmology. The physical nature and treatment techniques using electric current and electromagnetic field, light and laser radiation, mechanical energy and sound waves, high and low temperature in various ocular pathologies are considered. It is noted that reliable evaluation of the effectiveness of physical treatment methods for the different diseases and pathological conditions requires the implementation of protocols that include objective testing methods of the structure and functioning of the visual system. Once the clinical effectiveness of the particular physical treatment methods and techniques is confirmed, further development and improvement of the most efficient ones becomes possible.
The prevalence of diabetes mellitus has increased in recent decades. The most common ophthalmic manifestations of diabetes mellitus are retinopathy, epitheliopathies, corneal erosion and dry eye syndrome, the symptoms of which are more pronounced than in people without diabetes. The meibomian glands, which are the producer of various lipids, participate in the formation of the lipid layer of the tear film, which prevents the evaporation of the water-mucin phase and ensures the preservation of homeostasis of the ocular surface. Meibum is a lipid-rich secret produced by fully differentiated meibocytes. Impaired insulin secretion, insulin resistance, absolute insulin deficiency, as well as hyperglycemia, potentiate the development of oxidative stress and a cascade of metabolic changes, leading to a change in the anatomical and functional state of the meibomian glands, which affects the qualitative and quantitative secretion. Cytological abnormalities, as well as the structure of the excretory ducts of the meibomian glands in patients with long-term diabetes mellitus, were established using the method of laser scanning microscopy. Using the method of mass spectrometry, it is possible to determine the patterns of changes in the chemical composition of meibum in patients with diabetes mellitus. The data obtained can become one of the criteria for predicting the course, reflect the degree of compensation and / or progression of diabetes mellitus.
Objective — To evaluate the effect of the frequency of retinoprotective therapy courses on perimetry parameters, to compare Octopus 900 perimeter with Octopus 600 perimeter, and to assess threshold perimetry results of G-dynamic versus 24-2 programs. Material and Methods — The study involved 17 patients (34 eyes) diagnosed with primary open-angle glaucoma of advanced stage. Group 1 included subjects receiving a course of Retinalamin every 3 months. Group 2 comprised patients undergoing Retinalamin therapeutics every 6 months. Results — At the onset of the study via G-dynamic and 24-2 programs, we did not observe any statistically significant differences between the groups in mean deviation of retinal photosensitivity (MD) and pattern standard deviation of mean retinal photosensitivity (PSD). However, the absolute values differed between groups and between programs. On average, the differences in MD and PSD values obtained in the photosensitivity study with G-dynamic vs. 24-2 programs were -0.36 dB (CI 95%: -4.27; 3.54) and 0.63 dB (CI 95%: 2.37; -1.11), respectively. Hence, studies performed via 24-2 and G-dynamic programs yielded comparable results (no statistically significant differences). However, they could not be identical due to different spatial arrangement of points in different programs. Conclusion — As a result of conducted treatment, retinal photosensitivity did not exhibit statistically significant changes; however, we observed positive dynamics in both groups in MD and PSD parameters of mean retinal photosensitivity. Different devices (Octopus 600 and Octopus 900 perimeters) and different programs (24-2, G-dynamic) yielded different outcomes due to their technical features and capabilities of reproducibility; however, these differences were not statistically significant.
Background . Pterygium is ubiquitous and multifactorial; today, information on the prevalence of pterygium, risk factors, the relationship of its development with concomitant pathology and the type of life activity of patients in various regions of Russia is limited. All of the above led to the conduct of this epidemiological study in the Republic of Bashkortostan. The aim of the study : to study the prevalence of pterygium, as well as to identify the relationship of risk factors for its development with the type of life activity and concomitant diseases in the urban and rural population of the Republic of Bashkortostan. Methods . On the basis of the Ufa Research Institute of Eye Diseases, within the framework of the Ural Eye and Medical Study (UEMS) research project, a population study of people living in urban and rural regions of the Republic of Bashkortostan was carried out. The study involved 5899 people, including men – 43.7 % (2585 people), women – 56.3 % (3314 people), urban residents made 42.3 % (2491 people), rural – 57.7 % (3408 people). Results . As a result of our study, pterygium was diagnosed in 138 people (204 eyes – 2.3 %) (95% CI: 2.0–2.7 %). One-way analysis showed a higher prevalence of pterygium associated (p˂0.10) with a number of systemic and ophthalmic parameters. However, according to the results of multivariate analysis, it was revealed that the prevalence of pterygium was significantly associated with older age (p = 0.006), rural area of residence (p = 0.001) and low educational level (p = 0.03). Conclusion . The prevalence of pterygium in Republic of Bashkortostan according to the UEMS study was 2.3 %, or 23 people per 1000 population among people over 40 years old. The nature of the settlement influences the prevalence of pterygium in the Republic of Bashkortostan. Pterygium was more common among older people among all respondents who took part in the study. In the study, pterygium was not a biomarker of general somatic diseases.
The article presents an overview of modern publications on epidemiology, risk factors, and the main links of the etiology and pathogenesis of age-related macular degeneration (AMD). The nonexudative or “dry” form of age-related macular degeneration is a multifactorial progressive pathological process caused by hereditary predisposition, general and local disorders of lipid metabolism, negative changes in the blood supply to the eye, age-related destruction of the Bruch’s membrane and retinal pigment epithelium, the appearance of signs of local and systemic inflammation, the development of oxidative stress with the impact of toxic lipoperoxidation products on the structures of the posterior segment of the eye. Recent studies have discovered new ways of retinal pigment epithelial cell death in response to oxidative stress in AMD, in particular necroptosis, which, in addition to classical apoptosis, is considered the main mechanism of this process. It is noted that the development of AMD may be associated with an age-related decrease in the level of estrogen in women. The analysis of the data on the etiopathogenesis of age-related macular degeneration presented in the modern literature indicates the need for further research and generalization of local and general pathological processes developing in the dynamics of retinal visual function disorders by specialists of various scientific disciplines.
Aim. To evaluate the incidence and severity of acute kidney injury (AKI), as well as its ability to reclassify the risk of premature mortality and association with inhospital mortality in patients with pulmonary embolism (PE) in the Russian population. Material and methods . From April 2018 to April 2019, the SIRENA Russian Multicenter Registry included patients with PE, as well as the deceased, in whom the PE was detected by autopsy. AKI was diagnosed according to current KDIGO guidelines (2012). Creatinine calculated according to the MDRD equation and corresponding to a glomerular filtration rate of 75 ml/min/1,73 m2 (baseline) was taken as the initial one, with subsequent assessment relative to the parameter value upon admission. The risk stratification of early death was carried out in accordance with the current ESC clinical guidelines (2019). Results. A total of 604 patients with PE were examined (men — 293 (49%), women — 311 (51%), mean age — 64±15 years). AKI was diagnosed in 223 (37%) of them. Stage 1 AKI was detected in 146 (65%), 2 — in 55 (25%), 3 — in 22 (10%) patients. Prior chronic kidney disease was recorded in 61 (10%) patients. Seventy-one (12%) patients had a high risk of death, 364 (61%) — intermediate risk, and 164 (27%) — low risk. The AKI incidence increased as the severity of PE increased: at low risk of death — 26%, intermediate — 38%, high — 59% (p<0,0001). In total, 107 (18%) patients died in the hospital. AKI led to an increase in mortality within following risk groups: at low risk, this effect was a trend (6 (5%) vs 6 (14%); p=0,052); at intermediate and high risk, significant differences was obtained (30 (13%) vs 41 (30%), p<0,001; 4 (14%) vs 19 (45%), p=0,006, respectively). Multivariate Cox regression demonstrated that AKI is a predictor of inhospital death (odds ratio (OR), 3,66 (95% confidence interval (CI): 2,37-5,66; p<0,0001), regardless of increased troponin levels (OR, 1,31 (95% CI: 0,80-2,14; p=0,28) and right ventricular dysfunction (OR, 1,23 (95% CI: 0,74-2,04; p=0,42). Conclusion. Thirty-seven percent of Russian patients with PE have AKI diagnosed by baseline creatinine. In 2/3 of the examined patients, stage 1 AKI is observed. The AKI incidence increases as the severity of PE increases. The presence of AKI reclassifies patients into a higher risk category for death and is associated with a significant increase in inhospital mortality.
PURPOSE . To evaluate the potential impact of herpesvirus infection (carriage) on early postoperative outcomes of antiglaucoma surgeries. MATERIAL AND METHODS . The study included 95 patients with stage I, II and III primary open-angle glaucoma (POAG), with indications for surgical treatment. The patients were divided into the main group (group 1, 31 patient) and the control group (group 2, 64 patients). The groups were formed on the basis of information obtained from the anamnesis about a transferred herpes simplex virus of any localization (as a rule, it was labial, oral-facial herpes and its skin manifestation). The indication for surgical treatment was the absence of persistent normalization of intraocular pressure and a decrease in visual functions. Depending on the clinical situation, patients underwent one of the two types of surgical interventions: trabeculectomy and non-penetrating deep sclerectomy. Analysis of postoperative complications was performed on day 7 after surgery. RESULTS . The most frequent complications in the early postoperative period were ciliochoroidal detachment, hyphema, increased intraocular pressure, shallow anterior chamber syndrome, excessive vascularization in the surgery site, clinical signs of conjunctival-scleral and sclerascleral scarring. On day 7 after antiglaucoma surgery, the IOP level was 9.1±0.8 mm Hg on average in the groups. IOP was 1–2 mm Hg higher in case of non-penetrating surgery. In the same patients, normalization of IOP by the same date was obtained in 63.15% of cases, which required goniopuncture; needling was indicated and performed in 84.2% of patients. Ciliochoroidal detachment was diagnosed in both groups with the same frequency: 9.7 and 9.4%, respectively. Presence of minor hyphema was observed only after trabeculectomy, in 16.1 and 10.9% of cases, respectively. CONCLUSION . Results of this study, firstly, do not indicate that HSV activates in response to surgical intervention; secondly, in patients who had been infected with it previously, only a tendency for the number of most common intra- and postoperative complications to increase was noted. The obtained results are insufficient for an unambiguous answer to the question posed in this study, which indicates the need for further research.
Background: In 2021, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) validated a new equation for estimated glomerular filtration rate (eGFR) without race as an explanatory variable. Because the prevalence of chronic kidney disease (CKD) in Asians is known to differ from other ethnicities, this manuscript compares prevalence of CKD in multiple Asian cohorts using the 2009 and 2021 creatinine-based eGFR equations. Methods: Eight population-based studies from China, India, Russia (Asian), Singapore and South Korea provided individual-level data (n=67,233). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m ² (G3-G5). GFR was estimated using both the 2009 CKD-EPI equation developed using creatinine, age, sex, and race (eGFRcr [2009, ASR]) and the 2021 CKD-EPI equation developed without race (eGFRcr [2021, AS]). Prevalence of eGFR categories was compared within each study and within subgroups of age, gender, body mass index (BMI), diabetes, and hypertension status. The extent of reclassification was examined using net reclassification improvement (NRI). Results: Of 67,233 adults, CKD prevalence was 8.6% (n=5800/67,233) using eGFRcr (2009, ASR) and 6.4% (n=4307/67,233) using eGFRcr (2021, AS). Within individual studies, all 8 studies saw a reduction in CKD prevalence, ranging from -7.0% (95% CI -8.5% to -5.4%) to -0.4% (-1.3% to 0.5%). A reduction in CKD prevalence when using eGFRcr (2021, AS) was observed in all subgroups, except those in the BMI < 18.5% subgroup. Net reclassification index (NRI) was significant at -2.33% (p<0.001). No individuals were reclassified as a higher (more severe) eGFR category, while 1.7-4.2% of individuals with CKD were reclassified as one eGFR category lower when eGFRcr (2021, AS) rather than eGFRcr (2009, ASR) was used. Conclusions: eGFRcr (2021, AS) consistently provided reduced CKD prevalence and GFR estimates among Asian cohorts than eGFRcr (2009, ASR). Comparison of both equations to predict progression to renal failure or adverse outcomes using prospective studies are warranted for accurate validation within Asian populations.
Antibodies to myelin-oligodendrocyte glycoprotein (anti-MOG-IgG) is a specific biomarker that has been detected in peripheral blood from children with acute multiple encephalomyelitis (ADEM) as well as in adults with aquaporin-4 (AQP4), associated with seronegative opticoneuromyelitis spectrum disease (NMOSD), brainstem encephalitis, longitudinally disseminated transverse myelitis, and optic neuritis. Most experts now consider MOG-IgG-associated disorder (MOG-AD) an independent disease immunopathogenetically distinct from classical multiple sclerosis (MS) and aquaporin-4 (AQP4)-IgG-positive optomyelitis. Isolated, bilateral, and less frequently unilateral OH, with simultaneous or sequential involvement of the eyes, is the most frequent clinical manifestation of MOG-AD. Because of the significant overlap in the clinical and radiological picture, MOG-AD is often misdiagnosed as MS. Timely diagnosis is critical to ensure appropriate treatment. This article describes a clinical case of anti-MOG-IgG encephalomyelitis with late-onset ON initially diagnosed as MS.
Adherence to treatment is one of the major challenges posed by modern medicine. Today, cataract is the leading cause of reversible blindness and visual disability. The study was aimed to assess adherence to timely surgical treatment in individuals with cataract. The data of the cross-sectional, population-based Ural Eye and Medical Study were assessed. Among 546 participants, there were 46.3% men and 53.7% women, 59.6% urban resudents, 40.4% rural residents. Their average age was 66.36 ± 9.47 years (40–88 years). Statistical data analysis was performed using the IBM SPSS Statistic software package. The findings showed that the lack of awareness of the disorder and low interest in surgery were the main factors, affecting the patients' motivation for cataract treatment. At the same time, the frequency of ophtalmology visits was inversely related to the patients' age (OR 1.24; 95% CI 1.04–1.49) and the duration of vision loss (OR 1.08; 95% CI 0.81–1.43), and directly related to the cataract diagnosis age (OR 1.20; 95% CI 1.04–1.38), the presence of ophthalmologist in the community clinic (OR 1.71; 95% CI 1.29–2.26), trust in the doctor (OR 3.62; 95% CI 3.02–4.35), ophthalmologist's explanation of the cataract complications and advanced treatment methods (OR 1.62; 95% CI 1.34–1.97). Understanding the main factors, contributing to low treatment adherence in patients with cataracts, would make it possible to optimize the measures to improve healthcare delivery to such patients, associated with the increased coverage of surgical treatment.
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27 members
Sergey Petrov
  • Glaucoma Department
Natalia Sheremet
  • Department of clinical investigation in ophthalmology
Anastasia Subbot
  • laboratory of fundamental research in ophtalmology
A.A. Antonov
  • Glaucoma
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Moscow, Russia