[Diagnosis of choroidal nevus following multiple intravitreal anti-VEGF injections (case study)]. / Diagnostika nevusa khorioidei posle mnogokratnykh intravitreal'nykh in"ektsii anti-VEGF-preparata (klinicheskoe nablyudenie).

This article describes a clinical case of a female patient with choroidal nevus, who was previously diagnosed in another clinic with "subretinal neovascular membrane as a result of central serous chorioretinopathy" and subsequently underwent multiple intravitreal anti-VEGF injections. Based on the analysis of OCT angiography images, the macular changes in this case were interpreted as a polypoidal form of neovascularization in a patient with subfoveolar choroidal nevus.

[Application of optical coherence tomography in the assessment of the posterior lens capsule during anti-angiogenic therapy]. / Primenenie opticheskoi kogerentnoi tomografii v otsenke zadnei kapsuly khrustalika na fone provedeniya antiangiogennoi terapii.

Intravitreal injection (IVI) of anti-angiogenic drugs is one of the most common therapeutic procedures in ophthalmology. In recent years, a new non-contact study method has been developed - anterior segment optical coherence tomography (AS-OCT), which allows the formation of three-dimensional images of the lens and provides more detailed information about its structure and morphology. PURPOSE: This study uses optical coherence tomography method to analyze the risks of developing changes in the posterior lens capsule in patients after IVI of an anti-angiogenic drug. MATERIAL AND METHODS: The study involved 100 people (14 men and 86 women) with a natural lens and neovascular age-related macular degeneration (nAMD). The average age was 70.57±7.98 years. During the study (12 months), all patients underwent IVI of an anti-angiogenic drug aflibercept in the treat-and-extend (T&E) mode. All subjects were divided into 2 groups: with a total number of IVI less than 10 - group 1 (50 patients), and more than 10 IVI - group 2 (50 patients, of which 49 were included in the study). All patients underwent OCT using the Optopol REVO NX device (Poland) with the Anterior B-scan Wide protocol before inclusion in the study, as well as after 3, 6 and 12 months. RESULTS: It was found that the risk of developing a posterior lens capsule rupture, visualized using OCT, depends on the total number of IVI (correlation coefficient 0.473 p=0.001): the more IVI, the higher the probability that damage to the posterior capsule will occur after the next IVI, and after the 15th injection the risk of developing damage to the posterior capsule increases sharply. CONCLUSION: The astudy analyzed the risk factors for the development of posterior lens capsule damage that can be detected using OCT, and presented three risk groups for the development of rupture (or damage) of the posterior lens capsule depending on the number of intravitreal injections performed.

[Effectiveness of anti-VEGF therapy for neovascular age-related macular degeneration in different types of exudative fluid localization]. / Effektivnost' anti-VEGF-terapii neovaskulyarnoi formy vozrastnoi makulyarnoi degeneratsii pri razlichnykh tipakh lokalizatsii ekssudativnoi zhidkosti.

PURPOSE: To assess the effectiveness of anti-VEGF therapy in different types of fluids localization in neovascular age-related macular degeneration (AMD). MATERIAL AND METHODS: The study included 16 people (16 eyes) with exudative AMD. The study included patients with fibrovascular detachment of the retinal pigment epithelium (RPE), subretinal and intraretinal fluid. The patients were divided into two groups: in the first group, fibrovascular RPE detachment was combined with subretinal fluid (9 eyes); in the second group, fibrovascular RPE detachment was accompanied by both sub- and intraretinal fluid (7 eyes). All patients underwent standard ophthalmological examination, which included visometry, biomicroscopy, and ophthalmoscopy under conditions of drug-induced mydriasis. Additionally, OCT of the macular region and OCT-angiography were performed. RESULTS: Over the entire observation period, the first group of patients received an average of 5.11 intravitreal injections (IVI), the second group - 5.14 IVI. Visual acuity was comparable in both groups at the beginning of the study. Subsequently, the treatment resulted in an increase in visual acuity after 3 months in the first (p=0.066) and second (p=0.043) groups, as well as after 12 months in both groups (p=0.043). In the first group of patients, after 12 months, an increase in RPE detachment was observed (p=0.942), which suggests that the disease activity remains underestimated on OCT when RPE detachment and subretinal fluid are combined. In the first group, complete resorption of subretinal fluid occurred in 2 people. In the second group, resorption of subretinal and intraretinal fluid occurred in 6 people. CONCLUSION: Regardless of the subtype of fluid, anti-VEGF therapy is an effective method for treating exudative AMD. Intravitreal injections are necessary both in the presence of intra- and/or subretinal fluid, and fluid under RPE. The greatest difficulty is assessment of the fluid under the RPE.

[Real clinical practice of antiangiogenic therapy in patients with age-related macular degeneration. Retrospective analysis of functional results]. / Real'naya klinicheskaya praktika primeneniya antiangiogennoi terapii u patsientov s vozrastnoi makulyarnoi degeneratsiei. Retrospektivnyi analiz funktsional'nykh rezul'tatov.

PURPOSE: To assess the functional results of antiangiogenic therapy in patients with exudative form of age-related macular degeneration (AMD) in real clinical practice. MATERIAL AND METHODS: The study included 90 people (90 eyes) with active choroidal neovascularization (CNV) on the background of AMD. All patients were divided into 6 groups depending on the year of treatment - from 2013 to 2018, all patients were divided into 6 groups and overall the retrospective study sited at Research Institute of Eye Diseases (Moscow) lasted 8 years. All patients underwent standard ophthalmological examination including visometry, biomicroscopy and ophthalmoscopy under drug-induced mydriasis, as well as optical coherence tomography, fundus angiography and OCT-angiography. RESULTS: According to the results of the analysis of OCT data obtained from 2013 to 2017, among all patients with exudative AMD, patients with types I and II of CNV and single patients with RAP prevailed, which explains the high visual acuity - about 0.5 - in all groups after the start of the treatment (table 1 and 2). In 2018, 33.3% of patients were diagnosed with RAP (the same number of eyes as with types I and II of CNV), which can be explained by the introduction of OCT-angiography into wide clinical practice. The lack of increase in visual acuity is most likely associated with a small amount of intravitreal injections (IVI) - 4.8 IVI in the first year and 3.3 IVI in the second injection year. In patients who received more than three IVI in the first year of observation, visual acuity increased from 0.49±0.03 to 0.6±0.03 (p=0.04), in the case of less than three IVI in the first year, visual acuity was not changed, amounting to 0.42±0.1 before and 0.44±0.1 (p=0.655) after the treatment. CONCLUSIONS: Patients of all groups exhibited proportional stabilization of visual acuity, a decrease in the thickness of the retina and total macular volume. The lack of improvements of visual acuity is most likely associated with a small amount of IVI.

[Effect of intravitreal injections of ranibizumab and aflibercept on the retinal nerve fiber layer in patients with concomitant neovascular age-related macular degeneration and glaucoma]. / Vliianie intravitreal'nykh in''ektsii ranibizumaba i aflibertsepta na sloi nervnykh volokon setchatki pri sochetanii neovaskuliarnoi vozrastnoi makuliarnoi degeneratsii i glaukomy.

PURPOSE: To study the effect of ranibizumab and aflibercept on the thickness of retinal nerve fiber layer (RNFL) in patients with neovascular age-related macular degeneration (nAMD) and primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 62 patients (62 eyes) with nAMD and comorbid POAG. Patients were divided into two groups depending on the anti-VEGF treatment. The first group included 42 patients (42 eyes) who received injections of ranibizumab. The second group consisted of 20 patients (20 eyes) who received aflibercept. All patients received three injections of ranibizumab or aflibercept with one-month intervals. In addition to standard ophthalmic examination, patients underwent optical coherence tomography of the macular area and peripapillary RNFL. RESULTS: After anti-VEGF treatment, patients of both groups exhibited improvements expressed in reduced macular edema, increased visual acuity and absence of intraocular pressure (IOP) changes, as well as no statistically significant changes in the width and depth of excavation. There was a statistically significant decrease of peripapillary RNFL thickness in the temporal quadrant after treatment. CONCLUSION: The decrease of peripapillary RNFL thickness in the temporal quadrant occurs due to resorption of macular edema. In the absence of statistically significant changes in IOP, width and depth of excavation, intravitreal injections of ranibizumab and aflibercept can be considered safe treatment options for patients with concomitant nAMD and POAG.

[Electrophysiological study of the visual pathway in anti-VEGF therapy of neovascular age-related macular degeneration combined with glaucoma]. / Élektrofiziologicheskoe issledovanie zritel'nogo puti pri anti-VEGF-terapii neovaskuliarnoi vozrastnoi makuliarnoi degeneratsii v sochetanii s glaukomoi.

PURPOSE: To assess the effect of intravitreal administration of anti-VEGF drugs ranibizumab and aflibercept on the functional state of the visual pathway in patients with neovascular age-related macular degeneration (nAMD) and primary open-angle glaucoma (POAG) using the method of recording visual evoked potentials (VEP). MATERIAL AND METHODS: A total of 54 patients (54 eyes) with nAMD and POAG were examined. The control group consisted of 39 healthy patients (39 eyes). The study included 24 patients (24 eyes) with stage IA POAG, 23 patients (23 eyes) with stage IIA POAG, 7 patients (7 eyes) with stage IIIA POAG. All patients with nAMD and POAG were given intravitreal injection of anti-VEGF drug: 35 patients received ranibizumab, 19 patients received aflibercept. Injections were performed monthly for 3 months. Ophthalmologic examination included visometry, biomicroscopy, retinal OCT using SPECTRALIS tomograph ('Heidelberg Engineering GmbH', Germany). VEP were recorded on EP-1000 Multifocal ('Tomey', Germany). All ophthalmologic studies were performed prior to administration of the anti-VEGF preparation and after the 3rd injection. RESULTS: After the third intravitreal injection of anti-VEGF drugs, best corrected visual acuity (BCVA) increased to 0.46±0.1 (p=0.001). According to OCT, central retinal thickness decreased by an average of 110.6 µm, the total volume of the retina decreased by 1.3 mm3, total thickness RNFL - by 3.8 µm (p<0.05). A decrease in the peak latency and an increase in the amplitude of the component P100 of VEP were noted. Statistically significant differences in indicators of VEP between antiangiogenic drugs ranibizumab and aflibercept were not detected (p>0.05). CONCLUSION: Intravitreal administration of anti-VEGF drugs ranibizumab and aflibercept has no negative influence on the functional state of the visual pathway in patients with nAMD and POAG. Intravitreal injections of ranibizumab and aflibercept can be considered a safe treatment option for patients with nAMD and POAG.

[Pathogenesis and diagnostics of postsurgical macular edema]. / Patogenez i diagnostika posleoperatsionnogo makuliarnogo oteka.

Postsurgical macular edema, known as Irvine-Gass syndrome, is one of the possible causes of reduced visual acuity in phaco surgery. The literature review provides summarized data on pathogenesis, risk factors, clinical manifestations, classification and basic approaches to diagnosis based on modern techniques.

[Evaluating the efficacy of anti-VEGF therapy in patients with exudative age-related macular degeneration and concomitant glaucoma].

AIM: to evaluate the efficacy of anti-VEGF therapy in patients with exudative age-related macular degeneration (AMD) and glaucoma. MATERIAL AND METHODS: The study enrolled 117 patients (117 eyes) with exudative AMD and concomitant non-operated primary open-angle glaucoma (POAG). All patients were divided into several groups depending on their intraocular pressure (IOP) and stage of POAG. Hypotensive therapy included carbonic anhydrase inhibitors, beta-adrenergic antagonists (beta blockers) and alpha(2)-adrenergic agonists (alpha-2 mimetics). Lucentis (ranibizumab) was intravitreally injected thrice at monthly intervals. All patients underwent a standard ophthalmic examination, fluorescent retinal angiography, and optical coherence tomography. IOP was measured before the first and after the last injection by means of Icare PRO reboud tonometer. RESULTS: There was no statistically significant difference between groups Ia, IIa, Ib, and IIb in terms of IOP elevation. Glaucoma IIc and IIIa patients showed just a moderate increase in IOP that did not require regimen adjustment. There was, however, a single IIIb case of persistent IOP elevation, in which one-step penetrating trabeculectomy with intravitreal ranibizumab injection was later performed. Resolution of macular edema was achieved in all patients. Visual acuity (VA) varied between the groups demonstrating a tendency toward improvement in glaucoma Ia patients (p = 0.062) and stabilization in glaucoma IIa (p = 0.61), Ib (p = 0.07), and IIb (p = 0.29) patients. In some cases of low vision at baseline and subretinal fibrosis, VA changes were of no clinical significance. CONCLUSIONS: Intravitreal ranibizumab therapy proved effective in exudative age-related macular degeneration with concomitant glaucoma. Timely treatment of both AMD (i.e. before the development of subretinal fibrosis) and glaucoma contributes to therapeutic success in these patients.

[Effects of plasmid pKM101 on the expression of Escherichia coli and Salmonella typhimurium genes under ultraviolet irradiation]. / Deistvie plazmidy pKM101 na ékspessiiu genov pri UF-obluchenii bakterii Escherichia coli i Salmonella typhimurium.

The study focused on plasmid pKM101, which is a necessary component of the short-term test of Eim's system (Salmonella-microsome test), to detect the potential carcinogens through their mutagen activity. We found a previously unknown feature of the plasmid to enhance the expression of certain plasmid and chromosome genes. The purpose of the present study was to examine and specify the role of operon mucAB responsible for the mutation properties of the plasmid in activating the expression of bacterial genes. An ultraviolet-induction examination of bacterial genes, with the mutants of plasmid pKM101 affecting operon mucAB being used, showed that the function of genes mucAB did activate, but, on the contrary, suppressed the induction of genes elt (i.e. of genes controlling the formation of LT-toxin of Escherichia coli) and of sfiA (SOS-regulated gen E. col controlling the cell division.

Precise excision of transposons and point mutations induced by chemicals.

The ability of 23 chemicals (carcinogens and non-carcinogens) to induce precise excision of Tn10 and point mutations was studied in experiments with a single strain. The mutation assay was shown to detect a wider spectrum of genotoxic agents than the assay of Tn10 precise excision. The latter was induced only by potent SOS mutagens, which is in accordance with data on the SOS dependence of the induction of precise excision of Tn10. The precise excision assay as an additional test contributing to the knowledge of particular features of the action of a tested mutagen is discussed. The induction of precise excision of Tn10 by pyrene (and its failure to induce point mutations in this strain) demonstrates the value of using the transposon excision assay in cases of 'problem' mutagens.

[The toxic and immunomodulating properties of the somatic O-antigen polysaccharide of typhoid bacteria]. / Toksicheskie i immunomoduliruiushchie svoistva polisakharida O-somaticheskogo antigena bakterii briushnogo tifa.

In experiments on random bred mice and mice of various strains it was shown that when administered parenterally typhoid bacteria O-somatic antigen polysaccharide possesses the immunomodulatory properties. It stimulates the non-specific resistance of the organism to bacterial infection, produces the polyclonal activation of beta-lymphocytes, possesses the adjuvant properties, activates cells of the mononuclear phagocytic system. At administration in therapeutic doses the drug is not toxic, possesses no carcinogenic, mutagenic and allergenic properties.

[Effect of plasmid pKM101 on the mutability of salmonella strains exposed to polycyclic aromatic hydrocarbons]. / Vliianie plazmidy pKM101 na mutabel'nost' shtammov sal'monell pod deistviem politsiklicheskikh aromaticheskikh uglevodorodov.

The carcinogenic polycyclic aromatic hydrocarbons have been shown to induce frameshift mutations rather than base-pair substitutions in Ames test strains devoid of pKM101 plasmid. This plasmid enhances the frequency of induced frameshift mutations and mediates the induction of base-pair substitutions during the action of these carcinogens. No correlation was observed between the degree of mutagenesis induced in plasmid-containing and in plasmid-free strains by the test agents and their reported carcinogenic activity.

[Effect of plasmids col I and pKM101, alone or in combination, on spontaneous and induced mutability of salmonellae]. / Izmenenie spontannoi i induktsirovannoi mutabil'nosti sal'monell pod vliianiem plazmid col I i pKM101, prisutstvuiushchikh v bakteriiakh razdel'no ili sovmestno.

Comparative studies of plasmids col I and pKM101 effect on lethal and mutagenic response to UV-light and chemical agents (4NQ0, EMS, agent N012074) has been carried out in Salmonella strains used for screening of mutagens (potential carcinogens). It has been found that the plasmid pKM101 has more pronounced effect as compared with coll plasmid. Contrary to plasmid pKM101-mediated ability to form UV-induced frameshift mutation, colI factor lacks this ability and very slightly enhances the rate of frameshift mutagenesis induced by chemical agents under study. The colicinogenic factor is found to enhance only the rate of base-pair substitutions, whereas plasmid pKM101 enhances the rate of both base-pair substitutions and frameshift mutations. We were unable to demonstrate combined effect of these two plasmids on the rate of either spontaneous or induced mutations. Possible mechanisms of plasmid-mediated bacterial mutagenesis and repair are discussed.