[Evaluation of the effect of prostaglandin analogues and a carbonic anhydrase inhibitor/ß-blocker combination on the ocular blood flow in patients with primary open-angle glaucoma]. / Otsenka vliianiia analogov prostaglandina i kombinatsii ingibitora karboangidrazy s ß-blokatorom na glaznoi krovotok u patsientov s pervichnoi otkrytougol'noi glaukomoi.

PURPOSE: To assess the effect of latanoprost and fixed combination of dorzolamide/timolol on ocular hemodynamics in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study examined 34 patients (56 eyes) aged 51 to 69 years (average - 62.4±9.7 years) diagnosed with POAG in the initial (31 eyes) or advanced stage (25 eyes). Patients of the first group (20 patients, 36 eyes) were receiving latanoprost (Glauprost, Rompharm Company, Romania). The second group (14 patients, 20 eyes) was assigned to receive a fixed combination of dorzolamide/timolol (Dorzopt plus, Rompharm Company, Romania). Patient examination before and at 6 and 12 months included tonometry (ICare PRO), perimetry (Heidelberg Edge Perimeter), HRT and OCT of the optic nerve (Heidelberg Retina Tomograph 3 and Spectralis OCT2), as well as measurement of the density of surface (SVL) and deep (DVL) vascular plexus, and the Bruch's membrane opening minimum rim width (BMO-MRW). Additionally, we evaluated microcirculation in the choroid (MC) according to our original technique that uses Spectralis OCT2, and calculated rheographic index (RI) and stroke volume using transpalpebral rheoophthalmography. RESULTS: The decrease in IOP in the Latanoprost group was on average 27% and in the control group receiving timolol and dorzolamide - on average 22% and remained stable until the end of the study. The value of the area and volume of the disc rim band, BMO-MRW did not exhibit statistically significant changes in both groups by the 12th month of observation. A tendency to increase the RI from 51.5±24.5 to 62.2±19 (p=0.084) and the median of the index of microcirculation of the choroid (MC) from 16476 up to 23767 (p=0.062) in 1st group was observed. CONCLUSION: The study confirms the feasibility of using latanoprost and a fixed combination of dorzolamide and timolol in ocular hypotensive therapy of glaucoma thanks to their pronounced hypotensive effect. Patients were noted to have a tendency for improvement of ocular hemodynamics when using latanoprost.

[Efficacy and safety of travoprost in patients with primary open-angle glaucoma]. / Éffektivnost' i bezopasnost' preparata 'Travapress' u patsientov s pervichnoi otkrytougol'noi glaukomoi.

PURPOSE: To study the hypotensive efficacy and safety of Travapress (0.004% travoprost) in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 50 patients (91 eyes) aged 45 to 74 years. The first group consisted of 23 patients (41 eyes) who received monotherapy with Travaprost. Patients of the second group (27 patients, 50 eyes) Travaprost was added to therapy with timolol 0.5% (17 patients, 32 eyes) or dorzolamide 2% (10 patients, 18 eyes). Travaprost was given for a period of 6 months. IOP was determined in 2 weeks, 1, 3 and 6 months from the beginning of treatment and daily IOP measurement was at 10.00, 12.00, 14.00 and 16.00. Subjective symptoms were evaluated in points by special scales. RESULTS: The study was completed by 42 patients (84%, 79 eyes). Two patients (4.7%) has stopped to use Travapress due to the side effects. Local side effects were observed in 9 patients (21.4%) with mild hyperemia being the most common and seen in 5 patients (11.9%). In the first group, the maximum IOP decrease was recorded for 3 months of the study and amounted to 7.3±1.2 mm Hg (27.5%) compared to baseline. By 6 months, IOP decreased by 6.8±1.5 mm Hg on average (25.6%). In the second group in the subgroup with timolol 0,5% IOP decreased by 4,9±1.7 mm Hg (20%) compared to baseline, in the subgroup with dorzolamid 2% - by 4,3±1,3 mm Hg (16,9%) compared to baseline. Evening use the drug was accompanied by significantly lower levels of daily IOP fluctuations compared with morning intake (3.0±1.2 and 3.8±1.7 mm Hg, respectively, p = 0,002). CONCLUSION: Travapress was established as highly efficient and safe. It can be recommended for wide use in the treatment of patients with POAG.

[Difficulties in diagnosing the syndrome of "aorto - mesenteric tweezers" (nutcracker syndrome) in a patient with macrogematuria].

The clinical observation of a patient with a rare pathology - "nutcracker syndrome". Difficulties of diagnosis verification are described.

[Experimental simulation for determining optimal design parameters of a transpalpebral tonometry sensor]. / Éksperimental'noe modelirovanie kak osnova opredeleniia optimal'nykh parametrov datchika dlia transpal'pebral'noi tonometrii.

PURPOSE: To determine optimal design parameters of a transpalpebral tonometry sensor (the weight and diameter of the rod) based on experimental simulation. MATERIAL AND METHODS: The study has been conducted in situ at the forensic analysis department with 12 eyes of 5 men and one woman aged 49 to 71 years. Comparison between the tonometric pressure and the true pressure measured with direct manometric technique ensured the accuracy of transpalpebral tonometry data and helped select optimal sensor parameters. For this purpose, an experimental assembly was designed and produced, comprised of a testing stand with a system of tubes filled with distilled water, an indicating pressure gauge calibrated by the height of the water column, a millimeter scale on a holder, as well as a needle with connecting tubes and two valves. RESULTS: No statistically significant differences between the tonometric and manometric level of pressure in the eye were observed when using a sensor weighing 16 g with rod diameter of 1.5 or 3 mm. Only an insignificant dependence of the tonometry data on the thickness of the eyelid was noted at high levels of intraocular pressure (IOP). CONCLUSION: The experimental study conducted on the developed assembly has allowed us to substantiate the choice of optimal design parameter for a transpalpebral IOP measurement sensor. A transpalpebral tonometer with such sensor characteristics can be recommended for comparative clinical study, as well as for determination of its effectiveness in dynamical monitoring of the IOP levels.

[Influence of treatment adherence on the progression of primary open-angle glaucoma in clinical setting]. / Vliianie priverzhennosti k lecheniiu na progressirovanie pervichnoi otkrytougol'noi glaukomy u patsientov v usloviiakh klinicheskoi praktiki.

According to various studies, treatment adherence of patients with primary open-angle glaucoma ranges from 5% to 80% and significantly influences the effectiveness of the therapy. Some authors report higher levels of adherence in patients receiving preservative-free medications. PURPOSE: To study the influence of treatment adherence in patients receiving preservative-free and preserved medications on the progression of primary open-angle glaucoma (POAG). MATERIAL AND METHODS: This prospective multicenter non-interventional study was conducted in clinical setting and included 504 patients with primary open-angle glaucoma receiving drug therapy; 51 ophthalmologist was involved in the management of patients' diaries. RESULTS: The percentage of patients who did not reach target IOP was three times lower in the group with high adherence, in comparison to patients with medium and low adherence (7% against 22%, respectively). Development of side effects was one of the factors influencing treatment adherence, their rates and expressiveness were much lower in the preservative-free group compared with the group receiving preserved medication (13.9% against 35.4%). The rate of patients who did not reach target IOP was two times lower in the group of preservative-free medication (10% against 21%). CONCLUSION: The study confirms that preservative-free glaucoma medication promotes higher adherence to treatment in clinical setting predominantly due to the reduction of quantity and severity of side effects leading to treatment gaps, which results in increased effectiveness and better stabilization of glaucoma.

[New algorithm of aqueous humor dynamics assessment in glaucoma].

The purpose of the study was to develop a new algorithm of aqueous humor dynamics assessment in glaucomatous eyes, which would take into account the shape of the tonographic curve and individual elastic properties of the corneoscleral capsule. Basic ophthalmic examination supplemented with tonography and differentiated tonometry was performed on 33 patients with primary open-angle glaucoma (POAG), 8 POAG suspects, and 9 healthy controls. Obtained data were processed in accordance with the developed algorithm. A new formula for calculating the coefficient of outflow facility and several additional parameters describing the condition of aqueous pathways were proposed. In POAG patients these parameters significantly differed from those in healthy controls.

[Biochemical, structural and biomechanical features of human scleral matrix in primary open-angle glaucoma].

The goal of the investigation was to study the changes of scleral matrix collagen in progressing primary open-angle glaucoma (POAG). In scleral samples of 16 patients aged 52-81 years with different stages of POAG amino acid composition, collagen content and cross-linking ratio characterizing tissue rigidity were estimated. Collagen I was found to be the dominant type in sclera of glaucomatous and normal eyes, though as POAG progressing the content and cross-linking increase, that underlies the scleral rigidity increase and permeability decrease. Similar ratio of collagen cross-linking with age and glaucoma progression give evidence of specific pathologic changes of the dominant matrix component, that may be one of significant pathogenic factor of POAG.

[Aggregation, deformation and morphology of erythrocytes in patients with ischemic heart disease after injection of ioversol, iodixanol and gadobutrol].

In patients with ischemic heart disease, the administration of contrast agents iodixanol, ioversol and gadobutrol improves (due to the effect of dilution) the aggregation of erythrocytes in vivo, but does not change their deformation ability and the percentage of different morphological forms of erythrocytes (discocytes and ehinocytes) in the blood. The effect of gadobutrol on the aggregation of erythrocytes is characterized by more expressed antiaggregant effect due special molecular properties of this drug.

[Relevance of the chronic tonsillitis problem].

This study was designed to analyse dynamic characteristics of planned and emergency surgical care provided to patients with chronic tonsillitis (CT) in 3 large hospital of Moscow during the period between 2002 to 2006. The number of planed surgical interventions for the treatment of chronic tonsillitis performed during 5 years decreased almost two-fold. In contrast, the total number of urgent operations for surgical drainage of paratonisillar abscess in all clinics of the city during the last 10 years increased by a factor of 2. Results of bacteriological studies of species composition of microflora in patients with CT suggest the relationship between the incidence of this pathology and acute rheumatic fever. Analysis of activities aimed at the prevention of chronic tonsillitis (based in the first place at specialized dispensary facilities) has demonstrated that the number of patients involved in relevant monitoring programs is rather small and those in need of radical sanation of inflammatory CT foci are not referred for surgical treatment at the early stages of the disease as required by the current diagnostic and therapeutic algorithm for the management of chronic tonsillitis.

[Deformation properties of human erythrocytes in the presence of x-ray contrast agents].

It is established that the x-ray contrast agents urografin (76 %), omnipaque-300, optiray-350, ultravist-300, and visipaque-270 produce a dose-dependent decrease in the deformation properties of human erythrocytes in vitro. The degree of manifestation of this negative influence increases with the osmotic activity of agents in the following order: visipaque = ultravist < or = omnipaque < or = optiray < urografin. The effect of these x-ray contrast agents on the deformation of erythrocytes is reversible. Erythrocytes restore their normal deformation properties upon removal of the osmotic pressure induced by the x-ray contrast agents.

[Results of a morphological study of the experimental use of polyglycolide fiber explants in the surgery of retinal detachment].

The paper presents the results of experimental use of a polyglycolide material-based filling for temporary episcleral filling in retinal detachment. Thorough comparative morphological and biomechanical studies of 120 experimental eyes in different periods after scleroplasty, by using an inflatable balloon catheter, homoscleral and polyglycolide fillings, have indicated that the polyglycolide filling material is completely lysed by ocular tissues within 60-90 days, which rules out a repeated surgical intervention for removal of temporary filling (for example, an inflatable balloon catheter), by preserving the constancy of the depth of scleral pressing-in. The short existence of a chemically indifferent polyglycolide filling in the ocular tissues excludes its negative effect on the surrounding structures of the eye, minimizes the likelihood of the occurrence of early postoperative complications, but thereby leading to a substantial increase in the biochemical stability of the scleral-and-chorioretinal complex in the early postoperative periods and ensuring increased resistance to dynamic loads, by forming a stable scleral-and-chorioretinal adhesion 3 months after surgery. The findings suggest that the designed polyglycolide explant has advantages and that it is expedient to introduce the new Russian resolving polyglycolide fiber explants into clinical practice (for scleroplastic operations).

Electrosurface properties of poly(ethylene terephtalate) track membranes.

The electrosurface properties of track membranes made from poly(ethylene terephtalate) were determined by streaming potential (SP) and electron spin resonance (ESR) methods. The membrane pore diameters were in range from 20 to 200 nm. The pore electrical charge surface density values calculated with data obtained with methods mentioned differed dramatically. This difference was explained with the gel layer located at pore surface. The pore possesses a high large surface amassing a large electrical charge arising as a result of carboxylic groups dissociation. This charge cannot be detected with SP method due to high hydraulic resistance of the gel layer. In contrast to SP method, ESR detects all active centres parental of electrical charge at gel surface.

[The morphological characteristics of the take of synthetic transplants following experimental scleroplasty]. / Morfologicheskie osobennosti prizhivleniia sinteticheskikh transplantatov posle skleroplastiki v éksperimente.

The morphology of taking in of synthetic transplants after scleroplasty is studied in 24 eyes of chinchilla rabbits. Polytetrafluorethylene-based materials (composite filtration fluoroplast membrane--Teflon) and polyester jersey with reticular structure (scleracod) were used for transplantation. Study of two materials showed common processes and differences in the grafts taking in. Implants made of both materials are characterized by good biocompatibility, which prompts further investigation of their probable use in sclera-fortifying treatment of progressive myopia.

[Restoration of retinal functional activity after surgical treatment of its detachment in patients with different eyeball injuries]. / Spetsifika vosstanovleniia funktsional'noi aktivnosti setchatki posle khirurgicheskogo lecheniia retinal'nykh otsloek pri razlichnom kharaktere povrezhdeniia glaznogo iabloka.

Nineteen case histories are analyzed: 1) 6 patients with postperforative detachment of the retina; 2) 8 patients with detachment of the retina after a penetrating wound with introduction of a foreign body; and 3) 6 patients with postcontusion detachment. The restoration of the alpha and beta ERG waves depended on the type of injury: after penetrating wounds, the changes in the retinal electrogenesis were the most manifest during the initial and early postoperative period; foreign bodies aggravated and decelerated the regeneration of visual function, contusion trauma of the eye is the most unfavorable factor complicating the restoration of visual functions; involvement of the paired (intact) eye is typical, as is changed functional reaction of the retina in injuries of all types.

[Modern methods of medical rehabilitation in traumatic detachment of retina]. / Sovremennye metody meditsinskoi reabilitatsii pri travmaticheskoi otsloiki setchatki.

The authors analyze the efficacy of treating patients with vitreoretinal diseases using a pathogenetically-based system of comprehensive medical rehabilitation and the results of ophthalmological examination recorded and processed in a special computer case history. Prognostic analysis making use of nonparametrical statistics method distinguished highly informative signs determining the results of medical rehabilitation in traumatic detachment of the retina. Basic methods of surgical rehabilitation are supplemented with preventive YAG laser surgery. Modern scleroplastic materials are offered. The authors emphasize the significance of two staged adequate postoperative rehabilitation during the immediate postoperative period with special emphasis on the agents regulating redox processes; later YAG lasers and other stimulators can be used. Other perspective trends of research are study of electroenesis and pathogenesis of vitreoretinal proliferation for drug development.

[Experimental morphological study of posttraumatic proliferative vitreoretinopathy prevention by cell adhesion peptide Arg-Gly-Asp-Ser]. / Peptid kletochoí adgezii (Arg-Gly-Asp-Ser) v profilaktike posttravmaticheskoí proliferativnoí vitreoretinopatii (éksperimental'no-morfologicheskoe issledovanie).

Proliferative vitreoretinopathy (PVR) was induced in 25 rabbits by injection of autologous adenosine phosphate-activated platelets in the vitreous. Injury to the internal interface retinal membrane as a result of adhesion of aggregated platelets to it, followed by the formation of an epiretinal membrane, underlies the morphogenesis of experimental PVR. Proliferative processes in the retina were paralleled by destructive atrophic changes in it, which might be due to active physiological substances released in the course of aggregation. The development of PVR was inhibited by a synthetic peptide of cell adhesion with Arg-Gly-Asp-Ser amino acid sequence, which was injected simultaneously with autologous activated platelets. Possible receptor mechanisms underlying the phenomenon of inhibition of the proliferative process in the retina of experimental animals are discussed.

[A new method of formation of chorioretinal adhesions in retinal detachment]. / Novyi sposob formirovaniia khorioretinal'noi adgezii pri retinal'noi otsloike setchatki.

A method of intrascleral transplantation of foam gel providing the creation of stable chorioretinal adhesion at the site of the retinal defect has been experimentally developed and clinically tried. A special injector has been designed for the realization of the method, permitting stratification of the scleral capsule at a given depth. The suggested method is recommended for practical use in patients with rheumatogenic detachment of the retina in the initial and moderate degrees of vitreoretinal proliferation.