[Potential pitfalls of anti-VEGF therapy of neovascular age-related macular degeneration]. / Vozmozhnye problemy anti-VEGF-terapii neovaskulyarnoi vozrastnoi makulyarnoi degeneratsii.

When administering anti-VEGF therapy for neovascular age-related macular degeneration (nAMD), it is necessary to take into account the fact that treatment outcomes - in addition to factors associated with the disease itself - may be affected by progressive concomitant conditions (for example, macular atrophy) and possible adverse events (AEs). The latter can be divided into two large groups: non-inflammatory and inflammatory. Intraocular inflammation (IOI) is a rare but potentially dangerous AE of anti-VEGF therapy, which can include endophthalmitis, early sterile inflammation and retinal vasculitis. Raising awareness about inflammatory AEs is becoming even more important due to the sheer number of intravitreal injections performed, as well as the frequency of cases of IOI when using new anti-VEGF drugs. The new anti-VEGF drug Brolucizumab is associated with the development of retinal vasculitis, which is considered a type III and IV hypersensitivity reaction (involving cellular and humoral immune responses, respectively). The article presents an overview of publications on the mechanisms, clinical manifestations, differentiation, and methods of treatment of various types of IOI.

[Protocol of intravitreal drug delivery. Consensus of the Expert Counsil of Retina and Optic Nerve Diseases of the All-Russian Public Organasation «Association of Ophthalmologists¼]. / Protokol vypolneniya intravitreal'nogo vvedeniya lekarstvennykh preparatov. Konsensus Ekspertnogo soveta po zabolevaniyam setchatki i zritel'nogo nerva Obshcherossiiskoi obshchestvennoi organizatsii «Assotsiatsiya vrachei-oftal'mologov¼.

Intravitreal drug administration is a procedure that has become widespread in modern ophthalmology. However, there is no global consensus on certain aspects of this manipulation, and practitioners feel the need for guidelines. In the Russian Federation, until now, such a document was not available. The expert council on diseases of the retina and optic nerve of All-Russian public organization «Association of Ophthalmologists¼, with participation of invited specialists, has studied and analyzed the existing foreign guidelines for performing intravitreal injections, as well as the regulatory framework in Russia. As a result, this Protocol was developed and approved for use in the healthcare system of the Russian Federation. The document regulates the requirements for specialists and organizations, the conditions for performing the procedure and the necessary material resources and presents an algorithm for performing intravitreal drug administration, a patient examination check-list for various conditions of the procedure, as well as parameters for evaluating and monitoring the quality of the procedure.

[Efficacy of conservative treatment in patients with dry form of age-related macular degeneration].

AIM: To evaluate the efficacy of conservative treatment in dry AMD patients by means of 3D computer-automated threshold Amsler grid testing (3D-CTAG; Fink & Sadun, 2004). MATERIAL AND METHODS: The study included 90 patients (180 eyes) with dry AMD divided into three groups. Group 1 (n = 30) was prescribed Vitrum Vision forte, 1 tablet b.i.d., group 2 (n = 30)--Vitrum Vision forte, 1 tablet b.i.d. and Vitrum Cardio Omega-3, 1 capsule b.i.d. Group 3 (n = 30), the controls, received Taurine 250 mg, 1 tablet b.i.d. Besides standard ophthalmic examination, all patients underwent 3D-CTAG before and after the treatment. The number of defects per eye (ND) and volume lost relative to the hill-of-vision (VLRH) were chosen as evaluation criteria. RESULTS: After 3 months of treatment ND decreased from 0.33 ± 0.02 to 0.22 ± 0.01 in group 1 (p < 0.01) and from 0.33 ± 0.02 to 0.2 ± 0.01 in group 2 (p < 0.01); VLRH decreased from 0.32 ± 0.02% to 0.15 ± 0.01% out of 693,000 [deg2%] in group 1 (p < 0.01) and from 0.32 ± 0.03% to 0.15 ± 0.01% out of 693,000 [deg2%] in group 2 (p < 0.01). In the controls both indices increased: ND from 0.32 ± 0.02 to 0.37 ± 0.02 and VLRH from 0.35 ± 0.24% to 0.49 ± 0.03% out of 693,000 [deg2%] (p < 0.01). CONCLUSION: The positive effect of Vitrum Vision forte in combination with Vitrum Cardio Omega-3 on macular function is comparable to that of monotherapy with Vitrum Vision forte. The maximum effect was achieved in patients with small scotomas (VLRH < 1.5% out of 693,000 [deg2%]).