glazmagThe EYE ГЛАЗThe EYE GLAZ2222-44082686-8083Академия медицинской оптики и оптометрии10.33791/2222-4408-2019-1-33-40glazmag-96Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSСклеральные газопроницаемые контактные линзы как возможный способ зрительной реабилитации пациентов с возрастной макулярной дегенерацией (обзор литературы)Scleral gas permeable contact lenses as a possible way of visual rehabilitation of patients with age-related macular degenerationМягковА. В.MyagkovA. V.

Доктор медицинских наук, профессор, директор

125438, Москва, ул. Михалковская, д. 63Б, стр. 4

Med.Sc.D., Professor, Director

63B, bld. 4 Mikhalkovskaya, Moscow, 125438, Russian Federation

КовалевскаяМ. А.KovalevskayaM. A.

Доктор медицинских наук, профессор, заведующая кафедрой офтальмологии

394036, Воронеж, ул. Студенческая, 10

Med.Sc.D., Professor, Head of the Ophthalmology Department

10 Studencheskaya st., Voronezh, 394036, Russian Federation

ПерерваО. А.PerervaO. A.

Перерва Оксана Александровна, клинический ординатор

125438, Москва, ул. Михалковская, д. 63Б, стр. 4

Clinical resident

63B, bld. 4 Mikhalkovskaya, Moscow, 125438, Russian Federation

oxana.pererva@yandex.ruНОЧУ ДПО «Академия медицинской оптики и оптометрии»РоссияAcademy of Medical Optics and OptometryRussian FederationФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава РоссииРоссияVoronezh State Medical University named after N.N. BurdenkoRussian Federation201902102019211 (125)3340Copyright © Академия медицинской оптики и оптометрии, 20192019Академия медицинской оптики и оптометрииАкадемия медицинской оптики и оптометрииhttps://www.theeyeglaz.com/jour/about/submissions#copyrightNoticehttps://www.theeyeglaz.com/jour/article/view/96

Снижение качества остроты зрения у пациентов с возрастной макулярной дегенерацией (ВМД) обусловлено наличием низкой остроты зрения, выпадением центрального поля зрения, метаморфопсиями, искажением линий, снижением контрастности. Существующие на данный момент способы вспомогательной коррекции зрения у пациентов с ВМД, такие как телескопические интраокулярные и склеральные линзы, функционально и косметически неприемлемы. Использование интраокулярных телескопических линз ограничивается большим риском послеоперационных осложнений, низкими функциональными показателями, а также затруднённой офтальмоскопией и длительной адаптацией пациентов. Телескопические склеральные линзы имеют низкое разрешение, газонепроницаемые части и требуют ношения специальных переключающих очков. Однако склеральные линзы обладают потенциалом в разработке оптимального метода коррекции зрения у пациентов с ВМД за счет наличия широкой оптической зоны, газопроницаемости, коррекции рефракционного астигматизма у пресбиопических пациентов и облегчения симптомов сухости глаз. Таким образом, требуются дальнейшие клинические исследования по разработке метода улучшения качества зрения у пациентов с ВМД с помощью склеральных линз с применением объективного метода оценки эффективности коррекции – 3D-компьютерного порогового теста Амслера (3D-CTAG).

Low visual acuity, loss of the central visual field, metamorphopsia, distortion of lines and decreased contrast sensitivity cause reduced quality of vision in patients with age-related macular degeneration (AMD). Currently existing methods of visual rehabilitation for patients with AMD, such as telescopic intraocular and scleral lenses, are functionally and cosmetically unacceptable. The use of intraocular telescopic lenses is limited by the high risk of postoperative complications, low functional parameters, as well as by difficult ophthalmoscopy and lasting adaptation of patients. Telescopic scleral lenses have а low resolution, contain parts impermeable to oxygen and require wearing special switching glasses. However, scleral lenses have potential in developing an optimal method for vision correction in patients with AMD due to the presence of following advantages: wide optical zone, gas permeability, correction of refractive astigmatism in presbyopic patients and alleviation of dry eye symptoms. In conclusion, further clinical research is required to develop a method for improving the quality of vision in patients with AMD by using scleral lenses with an objective test for evaluating the effectiveness of correction – the 3D computer-automated threshold Amsler grid test (3D-CTAG). 

ВМДсклеральные контактные линзыоптическая коррекцияслабовидениетелескопические очкиоптическая реабилитацияAMDscleral contact lensesoptical correctionlow visiontelescopic spectaclesoptical rehabi-litationReferencesColeman H.R. et al. Age-related macular degeneration. The Lancet. 2008;372(9652):1835-1845. doi:10.1016/S0140-6736(08)61759-6Coleman H.R. et al. Age-related macular degeneration. The Lancet. 2008;372(9652):1835-1845. doi:10.1016/S0140-6736(08)61759-6Wong W.L. et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. The Lancet Global Health. 2014;2(2):e106-e116. doi:10.1016/S2214-109X(13)70145-1Wong W.L. et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. The Lancet Global Health. 2014;2(2):e106-e116. doi:10.1016/S2214-109X(13)70145-1Bourne R.A. et al. Causes of vision loss worldwide, 1990-2010: a systematic analysis. The Lancet Glo-bal Health. 2013;1(6):e339-e349. doi:10.1016/S2214-109X(13)70113-XBourne R.A. et al. Causes of vision loss worldwide, 1990-2010: a systematic analysis. The Lancet Glo-bal Health. 2013;1(6):e339-e349. doi:10.1016/S2214-109X(13)70113-XRoh M. et al. Visual acuity and contrast sensitivity are two important factors affecting vision-related quality of life in advanced age-related macular degeneration. PloS One. 2018;13(5). e0196481. doi: 10.1371/journal.pone.0196481Roh M. et al. Visual acuity and contrast sensitivity are two important factors affecting vision-related quality of life in advanced age-related macular degeneration. PloS One. 2018;13(5). e0196481. doi: 10.1371/journal.pone.0196481Xu K. et al. Metamorphopsia and vision-related quality of life among patients with age-related macular dege-neration. Can J Ophthalmol. 2018; 53(2):168-172. doi: 10.1016/j.jcjo.2017.08.006Xu K. et al. Metamorphopsia and vision-related quality of life among patients with age-related macular dege-neration. Can J Ophthalmol. 2018; 53(2):168-172. doi: 10.1016/j.jcjo.2017.08.006Owsley C., Sloane М.Е. Contrast sensitivity, acuity and the perception of real world targets. Br J Ophthalmol. 1987;71:791–796.Owsley C., Sloane М.Е. Contrast sensitivity, acuity and the perception of real world targets. Br J Ophthalmol. 1987;71:791–796.Schmidt-Erfurth U. et al. Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE stu-dy. Ophthalmology. 2011;118(5):831-839. doi: 10.1016/j.ophtha.2010.09.004Schmidt-Erfurth U. et al. Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE stu-dy. Ophthalmology. 2011;118(5):831-839. doi: 10.1016/j.ophtha.2010.09.004Mitchell P. et al. Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials. Br J Ophthalmol. 2010;94(1):2-13. doi:10.1136/bjo.2009.159160Mitchell P. et al. Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials. Br J Ophthalmol. 2010;94(1):2-13. doi:10.1136/bjo.2009.159160Kaiser P.K. et al. Ranibizumab for predominantly clas-sic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol. 2007;144(6):850-857. doi: 10.1016/j.ajo.2007.08.012Kaiser P.K. et al. Ranibizumab for predominantly clas-sic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol. 2007;144(6):850-857. doi: 10.1016/j.ajo.2007.08.012Holz F.G. et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration. Am J Ophthalmol. 2007;143(3):463-472. e2.Holz F.G. et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration. Am J Ophthalmol. 2007;143(3):463-472. e2.Sunness J.S., Applegate C.A. Long-term follow-up of fixation patterns in eyes with central scotomas from geographic atrophy that is associated with age-related macular degeneration. Am J Ophthalmol. 2005;140(6):1085-1093. doi:10.1136/bjo.2009.159160/Sunness J.S., Applegate C.A. Long-term follow-up of fixation patterns in eyes with central scotomas from geographic atrophy that is associated with age-related macular degeneration. Am J Ophthalmol. 2005;140(6):1085-1093. doi:10.1136/bjo.2009.159160/Fletcher D.C. Scanning laser ophthalmoscope macular perimetry and applications for low vision rehabilitation clinicians. Ophthamol Clin North Am. 1994;7:257-265.Fletcher D.C. Scanning laser ophthalmoscope macular perimetry and applications for low vision rehabilitation clinicians. Ophthamol Clin North Am. 1994;7:257-265.Cheung S.H., Legge G.E. Functional and cortical adaptations to central vision loss. Vis Neuroscience. 2005;22(2):187–201.Cheung S.H., Legge G.E. Functional and cortical adap-tations to central vision loss. Vis Neuroscience. 2005;22(2):187–201.Педанова Е.К. Ценность микропериметрии как метода оценки эффективности лечения у пациентов с очень низкими зрительными функциями. Современные технологии в офтальмологии. 2014;1:81-82.Pedanova E.K. The value of microperimetry as a method for evaluating the effectiveness of treatment in patients with very low visual functions. Modern Technology in Ophthalmology. 2014;1:81-82. (In Russ.)Ковалевская М.А., Богатырева Е.С., Милюткина С.О. Комбинированная функциональная диагностика при болезни Беста. Российский медицинский журнал. Клиническая офтальмология. 2013:4:181-184.Kovalevskaya M.A., Bogatyreva E.S., Milyutkina S.O. Combined functional diagnostics of Best dystrophy. Russian medical journal. Clinical Ophthalmology. 2013:4:181-184. (In Russ.)Amsler M. L’examen qualitatif de la fonction maculaire. Ophthalmologica. 1947;114:248-261.Amsler M. L’examen qualitatif de la fonction maculaire. Ophthalmologica. 1947;114:248-261.Bolz M. et al. Morphological and functional analysis of the loading regimen with intravitreal ranibizumab in neovascular age-related macular degeneration. Br J Ophthalmol. 2010;94(2):185-189. doi: 10.1136/bjo.2008.143974Bolz M. et al. Morphological and functional analysis of the loading regimen with intravitreal ranibizumab in neovascular age-related macular degeneration. Br J Ophthalmol. 2010;94(2):185-189. doi: 10.1136/bjo.2008.143974Kovalevskaya M. et al. 3D-CTAG testing of functional and structural changes of the macula. AOVS. 2016;4(2):00103. doi: 10.15406/aovs.2016.04.00103Kovalevskaya M. et al. 3D-CTAG testing of functional and structural changes of the macula. AOVS. 2016;4(2):00103. doi: 10.15406/aovs.2016.04.00103Grzybowski A. et al. Intraocular lenses in age-related macular degeneration. Graefe’s Arch Clin Exp Ophthalmol. 2017;255(9):1687-1696. doi:10.1007/s00417-017-3740-8Grzybowski A. et al. Intraocular lenses in age-related macular degeneration. Graefe’s Arch Clin Exp Ophthalmol. 2017;255(9):1687-1696. doi:10.1007/s00417-017-3740-8Arianpour,A. et al. Wearable telescopic contact lens. Applied optics. 2015;54(24):7195-7204. doi: 10.1364/AO.54.007195Arianpour A. et al. Wearable telescopic contact lens. Applied optics. 2015;54(24):7195-7204. doi: 10.1364/AO.54.007195Orzalesi N. et al. The IOL-Vip System: a double intraocular lens implant for visual rehabilitation of patients with macular disease. Ophthalmology. 2007;114(5):860-865. doi: 10.1016/j.ophtha.2007.01.005Orzalesi N. et al. The IOL-Vip System: a double intraocular lens implant for visual rehabilitation of patients with macular disease. Ophthalmology. 2007;114(5):860-865. doi: 10.1016/j.ophtha.2007.01.005Agarwal A. et al. Mirror telescopic intraocular lens for age-related macular degeneration: design and preli-minary clinical results of the Lipshitz macular implant. J Cataract Refract Surg. 2008; 34(1):87-94. doi:10.1016/j.jcrs.2007.08.031Agarwal A. et al. Mirror telescopic intraocular lens for age-related macular degeneration: design and preli-minary clinical results of the Lipshitz macular implant. J Cataract Refract Surg. 2008; 34(1):87-94. doi:10.1016/j.jcrs.2007.08.031Roberts B. et al. Higher order aberrations induced by soft contact lenses in normal eyes with myopia. Eye & Contact Lens. 2006;32(3):138-142. doi:10.1097/01.icl.0000195570.73454.a5Roberts B. et al. Higher order aberrations induced by soft contact lenses in normal eyes with myopia. Eye & Contact Lens. 2006;32(3):138-142. doi:10.1097/01.icl.0000195570.73454.a5Мягков А.В., Игнатова Н.В. Наш опыт оптической коррекции последствий радиальной кератотомии с помощью склеральных линз. Клинические случаи. Российский офтальмологический журнал. 2017; 10(2):92-96. doi: 10.21516/2072-0076-2017-10-2-92-96Myagkov A.V., Ignatova N.V. Our experience in optical correction of radial keratotomy consequences by scleral lenses. Clinical cases. Russian Ophthalmological Journal. 2017;10 (2):92-96. (In Russ.) doi: 10.21516/2072-0076-2017-10-2-92-96Belda-Salmerón L., Drew T., Hall L., Wolffsohn J.S. Objective analysis of contact lens fit. Cont Lens Anterior Eye. 2015;38(3):163-167.Belda-Salmerón L., Drew T., Hall L., Wolffsohn J.S. Objective analysis of contact lens fit. Cont Lens Anterior Eye. 2015;38(3):163-167.Young C., Kading D.L., Brujic M. Strategies for Success with Specialty Multifocal Contact Lenses. Go beyond the rack to customize lenses to meet the needs of your presbyopic patients. Review of Cornea and Contact Lenses. 2013.Young C., Kading D.L., Brujic M. Strategies for Success with Specialty Multifocal Contact Lenses. Go beyond the rack to customize lenses to meet the needs of your presbyopic patients. Review of Cornea and Contact Lenses. 2013.Van der Worp Eef. A Guide to scleral lens fitting. 2015.Van der Worp Eef. A Guide to scleral lens fitting. 2015.Arianpour A. et al. Wearable telescopic contact lens. Applied Optics. 2015;54(24):7195-7204. doi: 10.1364/AO.54.007195Arianpour A. et al. Wearable telescopic contact lens. Applied Optics. 2015;54(24):7195-7204. doi: 10.1364/AO.54.007195Isen A. Feinbloom miniscope contact lens. Encyclopedia of Contact Lens Practice. 1963;13:53-55.Isen A. Feinbloom miniscope contact lens. Encyclopedia of Contact Lens Practice. 1963;13:53-55.Schuster G.M. et al. Wink-controlled polarization-switched telescopic contact lenses. Applied Optics. 2015;54(32):9597-9605. doi: 10.1364/AO.54.009597Schuster G.M. et al. Wink-controlled polarization-switched telescopic contact lenses. Applied Optics. 2015;54(32):9597-9605. doi: 10.1364/AO.54.009597Butt T. et al. Simulation contact lenses for AMD health state utility values in NICE appraisals: A different reality. Br J Ophthalmol. 2015;99(4):540-544. doi: 10.1136/bjophthalmol-2014-305802Butt T. et al. Simulation contact lenses for AMD health state utility values in NICE appraisals: A different reality. Br J Ophthalmol. 2015;99(4):540-544. doi: 10.1136/bjophthalmol-2014-305802Jivrajka R.V. et al. Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler grid testing. Graefe’s Arch Clin Exp Ophthalmol. 2009;247(2):165-170. doi:10.1007/s00417-008-0971-8Jivrajka R.V. et al. Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler grid testing. Graefe’s Arch Clin Exp Ophthalmol. 2009;247(2):165-170. doi:10.1007/s00417-008-0971-8

The authors declare that there are no conflicts of interest present.