[Idiopathic epiretinal membrane: definition, classification, current understanding of pathogenesis].

Idiopathic epiretinal membrane is a result of a complex biomechanical interaction of the retina and vitreous. This paper discusses classification problems, epidemiological data of multicenter studies, and current hypotheses of epiretinal membrane pathogenesis.

[Morphological characteristics of the macula in patients with retinal vein occlusion before and after the treatment: preliminary results].

The article presents examination results of 26 patients with macular edema (ME) due to retinal vein occlusion (RVO) before and 1 month after an intravitreal injection of ranibizumab (Lucentis). Besides routine assessment, retinal spectral-domain optical coherent tomography (OCT) was performed in all cases. In accordance with derived OCT patterns of macular edema the patients were devided into two groups: swelling of the inner and outer retinal layers with serous detachment of neuroepithelium (group 1) and intraretinal edema with pseudocysts (group 2). It is shown that initial OCT features of retina in patients with ME due to RVO are prognostic for treatment results (serous retinal detachment may serve as a preventing factor of photoreceptor damage) and that visual improvement in patients with ME and serous detachment of neuroepithelium anticipates morphological changes.

[Topical features of speech disorders in children with focal cortical dysplasia and symptomatic epilepsy].

We studied speech function in 11 patients with focal cortical dysplasia (FCD) of different localization. The character of speech disorders was strongly correlated with the time of seizure onset and their frequency, while the localization of dysplasia did not play a significant role. The speech remained intact during seizures in the school age and during the relatively rare (weekly or monthly) seizures. The complete disappearance of speech after the period of normal development occurred in the daily multiple secondary-generalized seizures and resembled the previously described Landau-Kleffner syndrome ("aphasia-epilepsy"). Based on the literature and own data, the authors suggest that such global speech disorders can not be considered as aphasia, i.e., the disorder due to the focal lesions of speech brain areas. The authors did not reject the possibility of the development of aphasia in epileptic patients but only in those cases when the epileptic activity confined to mostly speech areas. Global speech disorders (up to the complete disappearance of impressive and expressive speech) at any localization of epileptic focus developed during the negative rearrangement of the speech functional system as a whole. These speech disorders are often accompanied by the acquired epileptic frontal syndrome. That is, in the first place are the most phylo- and ontogenetically young functional systems, namely, speech and regulatory functions, the damage of which emerges as a frontal syndrome. At the same time, the old consolidated pre-speech connections remain. Presumably, in this view, in cases of global speech disorders and speech disappearance, it is more correctly to substitute the terms "aphasia-epilepsy" and "total aphasia" for the familiar term "regression of speech development".

[Hemostatic disorders caused by chronic use of valproic acid in neurosurgical patients. Thromboelastographic monitoring].

The paper gives the results of analyzing the hemostatic system in 26 patients with various neurosurgical diseases on the basis of routine laboratory biochemical tests and thromboelastographic indicators. In all the patients, the pattern of the disease contained an epilepsy syndrome that required mono- or combination therapy with valproic acid. Laboratory indicators of clinical hypocoagulation were found to develop during the use of valproic acid, and its monotherapy in particular. Hemorrhagic complications were also analyzed in not only the immediate, but also late postoperative period (for as long as 6 months after surgery). Two cases of severe late complications, such as formation of chronic subdural hematomas requiring surgical intervention, were diagnosed in the valproate monotherapy group. A tactic using a thromboelastographic technique is proposed to prepare these patients for further neurosurgical intervention.

[Retinal neuronal relationships in health and in optic neuropathy of glaucomatous genesis].

A new procedure is proposed to study oscillatory potentials (OP), by using long-term flash ERG. OPs for on- and off-ERG were isolated, by employing mathematical filters (80-200 Hz). This procedure was used to examine 25 healthy subjects and 40 patients with different stages of glaucoma. The procedure could ascertain the site of a pathological process in the on- or off-cone cell system, each showing a different sensitivity. The use of this study opens up new avenues for the study of both pathological processes in the on- and off-cone cell systems from distal to proximal portions and pathogenetic mechanisms responsible for development of retinal and optic nerve diseases.

[Oscillatory potentials and ischemic processes in glaucoma].

The paper presents the results of studies made in patients with different stages of primary open-angle glaucoma, by using oscillatory potentials (OP). A significant inverse relationship was established between the OP index and the intraocular pressure; the OPI index was decreased in progressive glaucoma. The findings suggest that neuronal relationships are impaired in the proximal retina in glaucoma due to its ischemic processes.