Liudmyla Venger
@onmedu.edu.ua
Ophthalmology department
Odesa National Medical University
EDUCATION
Odessa National Medical University
RESEARCH INTERESTS
Refractive surgery, ophthalmology, cataract, glaucoma, reconstructive surgery, ophthalmic surgery.
Scopus Publications
Scopus Publications
Л.В. Венгер, Олексій Ковтун, and В.В. Савко
Ukrainian Society of Ophthalmologists
Background: An objective assessment of factors for ocular inflammation and its sequelae and diagnostic assessment of possible development of the sequelae in early phases of uveitis are essential for early and effective treatment of endogenous uveitis. Purpose: To determine whether it is possible to predict optic atrophy in patients with anterior uveitis using computed tomography (CT)-based assessment of optic nerve diameter. Material and Methods: Patients with anterior uveitis underwent a routine eye examination (ophthalmoscopy, biomicroscopy, intraocular pressure (IOP) measurement, and Humphrey perimetry). In addition, they underwent CT-based assessment of optic disc diameter at 3-5 mm from the entrance into the orbit in the affected eye and the contralateral healthy eye. Patients received treatment as per the protocol. Results: The percentage difference in optic nerve diameter between patients with uveitis complicated by optic neuritis and those with uveitis only for affected eyes was large (33.1%) and statistically significant. At 3 months and 6 months after initiation of treatment, mean optic disc diameter in patients with optic neuritis decreased by 37.2% and 49.1%, respectively, compared to baseline values. At 6 months, a decrease in optic nerve diameter among optic neuritis patients was observed both in those who received treatment and in those who failed to receive treatment, but was less marked in the former patients. Particularly, from 3 months to 6 months, optic nerve diameter decreased by 17.3% in treated optic neuritis patients versus 23.5% in those who remained untreated. Conclusion: CT-based data on the change in the optic nerve diameter at the entrance into the orbit in patients with optic neuritis is an objective characteristic of the presence and grade of atrophic process. Early identification of the potential for development of optic atrophy in individuals with optic neuritis will make it possible to treat them early and, consequently, to prevent or stabilize the process.
L. V. Venher, O. V. Kovtun, and N. I. Khramenko
Odessa National Medical University
Aim. Identify changes in the optic disc and vascular membrane by OCT, as well as features of hemodynamics and the possibility of communication between these parameters. Materials and methods. In 150 patients with idiopathic monolateral anterior uveitis, ophthalmic (visometry, refractometry, tonometry, perimetry, biomicroscopy, direct, reverse ophthalmoscopy), examination, rheophthalmography (ROG) and optical coherence tomography (OCT) of structures were performed. Patients received treatment according to the protocol, including, if necessary, antibacterial, antiviral, steroidal and nonsteroidal anti-inflammatory, immunosuppressive, desensitizing, vasodilating, immunomodulatory drugs. Statistical analysis was performed using Statistica 10.0 using Student's coefficient, pairwise correlation and Spearman's rank correlation Research results. The OCT results of the eyes of patients with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane by 34.3 and 38.9% relative to the data in anterior uveitis without complications. ROG revealed a significant increase in the tone of small and large vessels of the eye in neuritis on the background of anterior uveitis by 14.2 and 17.2% compared to those without neuritis. There was a direct significant strong relationship between the thickness of peripapillary fibers and the thickness of the vascular membrane with volumetric pulse blood filling, the volume of volumetric blood filling, tonic properties of large and small vessels (r = 0,699-0,909); average - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG (r = 0,647-0,797); weak - determined in the retrobulbar and middle department (r = 0.241-0.453). The development of neuritis in uveitis is accompanied by an increase in the thickness of the peripapillary fibers and vascular membrane, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle department, as well as volumetric pulse blood filling, volumetric connection in all cases (Spearman r 0.421-0.754). Conclusions 1. The results of OCT of the eyes with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane relative to the data in persons with anterior uveitis without complications. 2. The horn of the tonic properties of the vessels revealed a significant increase in the tone of small and large vessels of the eye with optic neuritis on the background of anterior uveitis relative to those without neuritis. 3. The direct strong reliable correlation of indicators of thickness of peripheral fibers and a vascular cover with volume pulse blood filling, speed of volume blood filling, tonic properties of large and small vessels is revealed. Average connection - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG, weak connection with the diameter of the optic nerve in the retrobulbar and middle department. 4. The development of optic neuritis against the background of anterior uveitis is accompanied by an increase in the thickness of the peripheral fibers and choroid, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle section. The tonic properties of large and small vessels, volumetric pulse blood filling, and the speed of volumetric blood filling, as indicated by the presence of a significant direct correlation. Key words: chronic anterior idiopathic uveitis, optic neuritis, OCT, eye hemodynamics.
L. V. Venger, , I. V. Khubetova, and
Ukrainian Society of Ophthalmologists
L. V. Venger, , O. V. Kovtun, V. V. Savko, , and
Ukrainian Society of Ophthalmologists
E-mail: kvnkonovalova@gmail.com Background: It is clinically important to review the state of patient’s paranasal sinuses, because a paranasal sinus disease creates the conditions for the onset of infection and its spread to the eyes and nose. This is especially important given a significant rise in the incidence of ocular inflammatory disease in recent years. Purpose: To identify computed tomography (CT) features of the paranasal sinuses in patients with idiopathic anterior uveitis. Material and Methods: One hundred and fifty patients with unilateral idiopathic anterior uveitis were involved in the study. Of these, 114 did not have signs of optic neuritis, and 36 had optic neuritis in the presence of uveitis. Patients underwent a routine eye examination (best-corrected visual acuity, ophthalmoscopy, biomicroscopy, intraocular pressure measurement, and Humphrey perimetry). Sinus CT scans were performed on a Philips Brilliance 16-slice scanner. Patients received treatment as per the Protocol for the Diagnosis and Treatment of Anterior Uveitis. Results: On the basis of CT reports, we identified CT features of the paranasal sinuses in patients with idiopathic anterior uveitis complicated by optic neuritis. There was CT evidence of maxillary sinus mucosal thickening and cerebrospinal fluid space expansion in all patients (n=36) with anterior uveitis complicated by optic neuritis. Fluid accumulation in the maxillary, frontal, and sphenoid sinuses was diagnosed in 41.7%, 11.1%, and 5.6%, respectively, of patients with anterior uveitis complicated by optic neuritis, which was significantly higher, than in patients with uncomplicated anterior uveitis. We found a significant and strong positive correlation of (a) maxillary sinus mucosal thickening with fluid accumulation in the maxillary sinus and cerebrospinal fluid space expansion and (b) decreased frontal sinus pneumatization and fluid accumulation in the frontal sinus. Conclusion: Sinus CT data enabled to find a significant association between the pattern of changes in the paranasal sinuses and the development of optic uveitis in patients with idiopathic anterior uveitis, which, generally, argues for performing sanitation of the sinuses when treating ocular inflammation.
O. V. Kovtun, L. V. Venger, and N. І. Khramenko
Odessa National Medical University
Aim. To determine the nature and direction of changes in the hemodynamics of the eyes of patients with chronic anterior idiopathic uveitis complicated by optic neuritis with transition to atrophy. Materials and methods. The study involved 18 people with chronic anterior idiopathic uveitis complicated by optic neuritis with transition to atrophy. Ophthalmological (ophthalmoscopy, biomicroscopy, intraocular pressure, perimetry, visual acuity with maximum correction) and electrophysiological (volumetric pulse blood filling, vascular tone of the eye, volumetric blood flow rate) studies were performed before and after treatment for a year. The treatment was carried out according to the protocol: at the first visit — non-steroidal anti-inflammatory drugs, antibiotics, immunosuppressant, corticosteroids and immunomodulatory; with subsequent — metabolic and vitamin therapy, physiotherapy. Statistical analysis was performed using Statistic 12. 0 software. The t-test of Student and Wilcoxon was used. Research results. As a result of treatment, the visual functions of patients are improved: the number of people with higher visual acuity is increasing. In the period up to 6 months after treatment, the number of patients with low visual acuity (0.12–0.5) decreased from 94.4 to 50 %; in 11 of 13 visual acuity increased to 0.3–0.5 (66.7 % of all subjects). A year after the treatment, the visual acuity in the diseased eyes remained the same. The study of eye hemodynamics showed a significant (p<0. 000) increase in all parameters in the diseased eye relative to the healthy one before treatment: volumetric pulse blood filling — by 64.8; the tone of large eye vessels — by 10.1, small — by 17.5; the rate of volumetric pulse blood filling — by 37.8 %. Comparative analysis of the hemodynamic data of sick eyes at different periods after treatment revealed a significant decrease in volumetric pulse blood filling to 66.4 and 52.4 %, the rate of volumetric pulse blood filling to 60. 2 and 44. 4 %. A decrease in the tone of large vessels by 3.1 and 6.4 %, and small — up to 94.6 and 92.7 % at the time of up to six months and up to a year relative to the initial data (p <0.000 in all cases). Conclusions 1. As a result of treatment, the visual functions in the diseased eye improve without deteriorating until a year after treatment. 2. Before treatment, hemodynamic indices are increased (p<0.000) in the diseased eye relative to the healthy one. 3. Six and 12 months after treatment, the volumetric pulse blood filling, the rate of volumetric pulse blood filling, the tone of large and small vessels were significantly reduced relative to the initial data.
L. V. Venger, , V. V. Savko, O. V. Kovtun, V. M. Sokolov, , , and
Ukrainian Society of Ophthalmologists
T. M. Muratova, , L. V. Venger, D. M. Khramtsov, Iu. M. Vorokhta, V. D. Teliushchenko, , , , and
Ukrainian Society of Ophthalmologists
I. Yakymenko, , N. Ulianova, L. Venger, K. Shakun, , , , and
Ukrainian Society of Ophthalmologists