[Pathogenetic basis of optic nerve atrophy in methanol poisoning]. / Patogeneticheskie osnovy razvitiya atrofii zritel'nogo nerva pri toksicheskom porazhenii metanolom.

Optic nerve atrophy is a pathomorphological consequence of diseases of the peripheral neuron of the visual pathway, manifested as atrophy of nerve fibers of varying severity. The toxic effect of methanol is mainly associated with formic acid and formaldehyde, which suppress the cytochrome system, inhibit oxidative phosphorylation, and thereby cause a deficiency of adenosine triphosphoric acid, to which brain and retinal tissues are especially susceptible. When formiate accumulates, tissue respiration is disrupted, leading to pronounced tissue hypoxia. As a result of such methanol metabolism, metabolic acidosis occurs. Tissue hypoxia develops in the first few hours as a result of the action of formic acid on the respiratory enzyme chain at the cytochrome oxidase level. Hypoxia and, as a consequence, a decrease in energy supply lead to a disruption of biological oxidation and the development of apoptosis in the optic nerve fibers. Understanding the process of optic nerve atrophy development at the pathogenetic level in methyl alcohol intoxication will help make a correct early diagnosis and prescribe timely treatment.

[Methods for predicting the risks of development, course and recurrence of rhegmatogenous retinal detachment]. / Metody prognozirovaniya riskov razvitiya, techeniya i retsidivov regmatogennoi otsloiki setchatki.

Rhegmatogenous retinal detachment (RRD) is a severe disease of the visual organ that is one of the leading causes of blindness worldwide. Without surgical treatment, RRD almost always leads to vision loss and blindness. Surgical treatment in the early stages of the disease reduces the risk of blindness. This article analyzes scientific publications reflecting the issues of prognosis and prevention of RRD. Literature analysis showed that there are few prognostic matrices in ophthalmology in general, and specifically related to RRD. Most prognostic matrices for RRD are aimed at preventing its recurrence and predicting the development or progression of peripheral vitreochorioretinal dystrophy in the operated or fellow eye. Building a prognostic matrix for the risk of occurrence and development of such a serious disease as RRD in adults will allow early prediction, enabling surgical treatment in the shortest possible time and positively influencing the functional outcome of treatment.

[Assessment of environmental and genetic risk factors for the development of primary open-angle glaucoma]. / Sredovye i geneticheskie faktory riska razvitiya pervichnoi otkrytougol'noi glaukomy.

Primary open-angle glaucoma (POAG) is a multifactorial disease with both environmental and genetic factors involved in its pathogenesis. PURPOSE: The study evaluates the role of a number of environmental and genetic risk factors in the risk of POAG development and builds a prognostic model. MATERIAL AND METHODS: The study group included 197 patients aged 44 to 90 years (98 - patients with POAG, 99 - the control group), who were treated in the Republican Clinical Ophthalmological Hospital of the Ministry of Health of the Republic of Tatarstan named after Prof. E.V. Adamyuk. RESULTS: Age, family history of the disease, presence of type 2 diabetes mellitus, arterial hypertension were revealed to be associated with an increased risk of POAG development. The polymorphisms of matrix metalloproteinase MMP9 and vitamin D receptor (VDR) genes were shown to influence the development of POAG. The prognostic model considering these factors had high sensitivity and specificity (72.0% and 82.6% respectively). CONCLUSION: The prognostic model based on environmental and genetic factors is important for assessing the risk of POAG and early detection of the disease.

[Experimental study of the effectiveness of terbinafine in the treatment of fungal keratitis]. / Eksperimental'noe izuchenie effektivnosti terbinafina v lechenii gribkovykh keratitov.

Methods of treatment of fungal keratitis in the Russian Federation currently consist of non-standardized off-label methods due to the lack of licensed commercial antifungal solutions designed for use in ophthalmology. The article presents the results of successful treatment of fungal keratitis in experimental animals with a terbinafine solution, with effectiveness comparable to voriconazole lyophilizate diluted to 1%. PURPOSE: The study analyzed the effectiveness of terbinafine solution in the experimental treatment of fungal keratitis. MATERIAL AND METHODS: The study was conducted on Soviet chinchilla rabbits with signs of keratomycosis modeled during the experiment. Fifteen experimental animals were randomly divided into three comparison groups: group 1 received treatment with 1% voriconazole, group 2 - 0.1% terbinafine, group 3 did not receive treatment. RESULTS: Groups of rabbits treated with voriconazole and terbinafine showed comparable positive treatment results, but in the terbinafine group epithelization was completed earlier, and complete sanitation of the fungal microflora was achieved on day 3. CONCLUSION: One important advantage of 0.1% terbinafine suspension lies in availability of a local form designed for ophthalmological application. The advantage of local 0.1% terbinafine suspension is supported by the combination of signs and results, and the obtained data may be used for introducing it into practice after further clinical trials.

[Keratitis associated with contact lens correction in children and adolescents]. / Keratity, assotsiirovannye s kontaktnoi korrektsiei, u detei i podrostkov.

Currently, the number of contact lens users in the world is approximately 10% of the total population of developed countries. Despite the undeniable advantages of contact lenses over eyeglasses, complications are an unpleasant aspect of their use. An analysis of the literature showed that purulent-inflammatory complications have not been fully described. PURPOSE: To study the prevalence of keratitis associated with contact lenses, its clinical manifestations, microbial etiology, and sensitivity to antibiotics. MATERIAL AND METHODS: The study analyzes case histories of 171 patients with infectious keratitis treated at the Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan in 2016-2018. RESULTS: The retrospective analysis revealed an increase in both the number of infectious keratitis and the keratitis associated with contact correction. All patients had a severe course of keratitis with the formation of gross opacity. The leading pathogens were Pseudomonas aeruginosae and Klebsiella oxytoca. The pathogens were not 100% sensitive to any one of the 7 studied antibiotics. The smallest percentage of resistant strains (12.5%) was determined for fluoroquinolones of the 2nd and 3rd generation (ciprofloxacin and levofloxacin), as well as meropenem. CONCLUSION: Considering the number of contact lens users in the world, keratitis associated with contact lenses poses a serious problem.

[Epidemiology and treatment of fungal keratitis]. / Epidemiologiya i metody lecheniya gribkovykh keratitov.

Infectious keratitis in most cases is caused by bacterial, viral or fungal agents, but their structure is changing. Some researchers have noted a substantial increase in fungal corneal lesions in recent decades, but important local etiological therapy remains unavailable in developing countries. While bacterial keratitis and ophthalmoherpes are controlled by widely available local etiotropic therapy, treatment of keratomycosis in the Russian Federation is carried out with off-label medicine. Lack of skills and availability of diagnostic methods and official etiotropic therapy creates unequal conditions for ophthalmology specialists in the fight against ophthalmomycosis. In part, this causes a reduced level of «myco-caution¼, which leads to long-term ineffective treatment using antibacterial drops, lasting suffering of patients, and results in the loss of the eye functionally and - in some cases - anatomically. Therefore, the study of fungal keratitis remains relevant. The article provides an overview of research data on current epidemiology in different regions of the world, analyzes available antifungal drugs and the prospects for development of affordable and effective treatment of fungal keratitis.

[Idiopathic macular hole: history and status quo review]. / Idiopaticheskii makuliarnyi razryv: istoriia i sovremennoe sostoianie problemy.

The article reviews the literature on one of the topical problems of vitreoretinal surgery - idiopathic macular holes. The history, concept, classification and diagnostics, as well as surgical and alternative treatment methods of macular holes are explored.

[On the importance of multidrug-resistant strains of pathogenic microorganisms in ophthalmic practice].

This is a review of epidemiological, microbiological and ophthalmological publications on the importance of multidrug-resistant bacterial strains in medical, particularly ophthalmological, care. Current state of pharmaceutical market and wide variety of generics confuses doctor's (including ophthalmologist's) sense of decision-making on the optimum antibiotic for the treatment of purulent inflammation. Indiscriminate use of antibiotics contributes to multiple drug resistance in bacteria. The world returns to the pre-antibiotic era, in which there was no treatment for severe infectious and inflammatory diseases. The most dangerous multiresistant strains known to medical science and their role in etiology of inflammatory eye diseases are listed in the article. Since neonatal conjunctivitis and postoperative endophthalmitis are the most common ocular inflammatory diseases caused by nosocomial multiresistant bacteria, their etiological classification is also described. Emergence of antibiotic resistance to most frequently used ophthalmic agents and prevention strategies are discussed.