Session Title: Vitreoretinal Surgery III
Session Date/Time: Friday 27/09/2013 | 11:00-12:30
Paper Time: 11:40
Venue: Hall 3 (Level 0)
First Author: N.Aliyeva AZERBAIJAN
Co Author(s): E. Qasimov A. Mammadzadeh
The purpose of our work is to identify the opportunities of quantitative echography in diabetic hemophthalmia.
National Center of Ophthalmology named after academician Zarifa Aliyeva, Baku, Azerbaijan
35 patients (38 eyes) with a diagnosis of proliferative diabetic retinopathy complicated by hemophthalmia aged 38-69 have been examined. Among them there were 21 women (22 eyes) and 14 men (16 eyes). Patients with the traction retinal detachment, massive vitreoretinal bands were not included in the research. All patients underwent ophthalmologic research methods: visometry, tonometry, ophthalmic biomicroscopy using Volk 78 diopter (USA) biconvex lens and with the use of Goldmann three-mirror lens in the patient with dilated pupil (width not less than 4-6 mm), and ultrasound: B-scanning and quantitative echography. Ultrasound B-scanning was performed at the device of «Alcon» company (U.S.) through the sensor with a frequency of 10 MHz. Quantitative echography was performed using ultrasound diagnostic system «Nemio XG SSA-580A» by «TOSHIBA» (Japan) with a linear sensor with a frequency of 7.5 MHz.
Our work identified such hemophthalmic criteria as prescription, density, volume. To determine the density we used ratio SD - distribution of the greyest color shade corresponding to most echointensity which is most informative to determine the echographic density. While distributing hemophthalmia by density we followed 2006 international classification by Ronni M. Lieberman, J.A. Gow, Lisa R. Grillone. Hemophthalmic patients corresponding to I stage by classification were not included in our study, as use of YAG-laser vitreolysis was not planned in their treatment scheme. Hemophthalmus of II stage was characterized as low-density (3,1±0,3), III stage as average density (4,5±0,3), and IV stage as high-density (6,7±0,4). The prescription of hemophthalmia was 10 days, 1, 2 and 3 months. Using ultrasound research, in particular, quantitative echography the density of hemophthalmia in accordance with these terms was determined. Using ultrasound studies the area of hemorrhage was also measured, volume of hemophthalmia was estimated as partial (<25 mm²), subtotal (25-70 mm²) or total (70 - 160 mm²). While choosing a treatment strategy including YAG-laser vitreolysis, laser parameters were determined depending on prescription and density of hemophthalmia. In high density hemophthalmi the pulse energy was 9-12J, in an average density – 6-8J, low density - 2-5J.
The conducted research of the patients with proliferative diabetic retinopathy complicated by hemophthalmia detected diagnostic criteria that are important for the planning of treatment strategy and predicting the outcomes. With due regard to the data of quantitative echography there were parameters determined for laser action to conduct YAG-laser vitreolysis. Thus, conducting of quantitative echography in patients with diabetic hemophthalmia is a necessary diagnostic procedure to select treatment strategy in order to increase its efficacy.