[Hereditary optic neuropathy associated with demyelinating diseases of the central nervous system]. / Nasledstvennaya opticheskaya neiropatiya v sochetanii s demieliniziruyushchimi zabolevaniyami tsentral'noi nervnoi sistemy.

Demyelinating optic neuritis and hereditary optic neuropathy (HON) take a leading place among the diseases, the leading clinical syndrome of which is bilateral optic neuropathy with a simultaneous or sequential significant decrease in visual acuity. Optic neuritis can occur at the onset or be one of the syndromes within multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOGAD). HON are a group of neurodegenerative diseases, among which the most common variants are Leber's hereditary optic neuropathy (LHON), associated with mitochondrial DNA (mtDNA) mutations, and autosomal recessive optic neuropathy (ARON), caused by nuclear DNA (nDNA) mutations in DNAJC30. There are phenotypes of LHON «plus¼, one of which is the association of HON and CNS demyelination in the same patient. In such cases, the diagnosis of each of these diseases causes significant difficulties, due to the fact that in some cases there are clinical and radiological coincidences between demyelinating and hereditary mitochondrial diseases.

[Long-term changes in morphological and functional parameters of the optic nerve in patients with various genetic variants of hereditary optic neuropathies]. / Dolgosrochnaya dinamika morfofunktsional'nykh pokazatelei zritel'nogo nerva u patsientov s razlichnymi geneticheskimi variantami nasledstvennykh opticheskikh neiropatii.

Leber's hereditary optic neuropathy (LHON) and autosomal recessive optic neuropathy (ARON) are degenerative diseases of the optic nerve caused by mutations in nuclear or mitochondrial DNA (nDNA, mtDNA). The clinical picture of these diseases is similar, but there are some differences in how the visual functions change in patients with different molecular genetic variants of hereditary optic neuropathies (HON). PURPOSE: This study evaluates the long-term changes in morphological and functional parameters in patients with different genetic variants of HON. MATERIAL AND METHODS: The study included 84 patients (165 eyes) with a genetically confirmed LHON or ARON diagnosis. The patients underwent best-corrected visual acuity (VA) test, color vision (CV) examination, computerized perimetry using the program for low vision assessment, optical coherence tomography (OCT). RESULTS: Over the course of the follow-up (60 months or longer) HON patients were revealed to have higher VA in c.152A>G and m.14484T>C mutations compared to mutations m.11778G>A and m.3460G>A. The final VA 0.5 or higher in patients with c.152A>G and m.14484T>C mutations in 54 and 71% of cases, and only in 6 and 13% of cases - with m.11778G>A and m.3460G>A mutations. Direct correlation was determined between minimal VA in the first year after disease onset and the final VA (K=0.67; p<0.001). In all patients with the investigated mutations CV recovered slightly quicker than VA. CONCLUSION: HON associated with c.152A>G and m.14484T>C mutations have better prognosis compared to LHON caused by m.11778G>A and m.3460G>A mutations. Vision recovery prognosis is worse in patients who had significant decrease of visual acuity at the disease onset. OCT findings reveal preservation of visual functions in all mutations.

[Rare pathogenic nucleotide variants of mitochondrial DNA associated with Leber's hereditary optic neuropathy]. / Redkie patogennye nukleotidnye varianty mitokhondrial'noi DNK, assotsiirovannye s nasledstvennoi opticheskoi neiropatiei Lebera.

Patients with Leber Hereditary Optic Neuropathy (LHON) in most cases have one of the three most common mutations: m.11778G>A in the ND4 gene, m.3460G>A in the ND1 gene, or m.14484T>C in the ND6 gene. According to the international Mitomap database, in addition to these three most common mutations, there are 16 other primary mutations that are even more rare. There are nucleotide substitutions that are classified as candidate or conditionally pathogenic mutations. Their involvement in the disease development is not proven due to insufficient research. Moreover, in many publications, the authors describe new primary and potential mitochondrial DNA mutations associated with LHON, which are not yet included in the genetic data bases. This makes it possible to expand the diagnostic spectrum during genetic testing in the future. The advancements in genetic diagnostic technologies allow confirmation of the clinical diagnosis of LHON. The importance of genetic verification of the disease is determined by the existing problem of differential diagnosis of hereditary optic neuropathies with optic neuropathies of a different origin.

[Leber's hereditary optic neuropathy clinical features in patients with mitochondrial DNA m.13513G>A candidate mutation]. / Klinicheskie osobennosti nasledstvennoi opticheskoi neiropatii Lebera u patsientov s kandidatnoi mutatsiei m.13513G>A v mitokhondrial'noi DNK.

Leber's hereditary optic neuropathy (LHON) is caused by primary mtDNA by both primary mtDNA mutations and new mtDNA mutations. The last ones, when detected in several independent LHON families, receive candidate status. The description of new LHON-associated mtDNA mutation is relevant. PURPOSE: To determine the LHON clinical features in patients with the m.13513G>A mutation and to estimate the patients' proportion with this pathogenic variant in the LHON patients' sample. MATERIAL AND METHODS: The study included 5 LHON patients, associated with m.13513G>A mutation in the ND5 gene in the heteroplasmic state. A standard examination was performed, including color blindness test, visual fields test, spectral optical coherence tomography. RESULTS: LHON, associated with m.13513G>A in the heteroplasmic state in the range of 25-60%, is characterized by visual impairment without additional neurological or other extraocular symptoms. Visual recovery to 0.3-1.0 presents in all patients; the visual recovery onset occurs between 12 and 20 months from the disease manifestation. The decrease of the central scotoma size and its density and the color vision improvement are also observed as well as the average retinal nerve fibers layer and ganglion cell complex thickness decrease. The m.13513G>A mutation frequency is 5% in 100 LHON patients' sample and 22.5% in 22 LHON patients with rare and candidate mtDNA mutations. CONCLUSION: The m.13513G>A mutation can be considered as primary LHON mutation. The list of pathogenic variants recommended for testing LHON can include this mutation. The m.13513 G>A mutation determines the mild LHON course and good visual functions prognosis in these patients.

[Bilateral vision loss on programmed hemodialysis (clinical observation)]. / Dvustoronnyaya poterya zreniya na fone programmnogo gemodializa (klinicheskoe nablyudenie).

The most common complication of hemodialysis is blood pressure decrease, which is an ischemic optic neuropathy risk factor. The article presents a case study of sequential bilateral ischemic optic neuropathy with the development of amaurosis as a result of arterial hypotension against the background of programmed hemodialysis. Differential diagnosis in bilateral visual impairment is discussed.

[Modern prerequisites for creating a collagen-based artificial analogue of the corneal stroma]. / Sovremennye predposylki sozdaniya iskusstvennogo analoga stromy rogovitsy na osnove kollagenovogo materiala.

Despite the fact that various collagen biomaterials have been actively used in ophthalmology for more than 30 years, the problem of creating a material that could replace the donor cornea have not been solved. Recent advances in the field of tissue engineering and regenerative medicine have shifted the focus of approaches to solving the problem of creating an artificial cornea towards laying conditions for the restoration of its specific layers through mechanisms of its own cellular regeneration. In this regard, extracellular matrices based on collagen are gaining popularity. This review discusses general limitations and advantages of collagen for creating an artificial cornea.

[Metabolic disorders in hereditary optic neuropathies]. / Metabolicheskie narusheniya pri nasledstvennykh opticheskikh neiropatiyakh.

Folate metabolism disorders are known to have a potential involvement in the pathophysiology of mitochondrial diseases. Many researchers suggest that profound systemic folate deficiency may contribute to mitochondrial folate deficiency. Folic acid metabolism is closely related to vitamin B12 and homocysteine. Considering that hereditary optic neuropathies (HON) are mitochondrial diseases, it is important to study the folate status, the content of vitamin B12 and homocysteine in patients with this pathology. OBJECTIVE: To compare the content of folic acid, vitamin B12 and homocysteine in the blood serum of patients with Leber's hereditary optic neuropathy (LHON) and autosomal recessive optic neuropathy (ARON), optic neuropathy of other genesis, and the comparison group. MATERIAL AND METHODS: The study involved 58 patients with LHON and ARON, the control group of 49 patients with ischemic, inflammatory, traumatic and compressive optic neuropathies, and the comparison group of 20 healthy volunteers. RESULTS: A decrease in blood folic acid levels was revealed (4.0±1.6 ng/mL) in patients with HON compared to the control group (p=1.3·10-8) and the comparison group (p=1·10-17). The content of vitamin B12 in patients with HON was 380.8±168.1 pg/mL, which was significantly lower than in the comparison group (p=0.0001). The homocysteine content was 14.1±5.6 µmol/L in patients with HON, which was significantly higher than in the control group (p=0.0007) and the comparison group (p=0.000003). At the same time, an increase in homocysteine level of more than 10 µmol/L was revealed in 75% of patients with HON. Similar metabolic disorders were found in groups with various mutations in mitochondrial and nuclear DNA. CONCLUSION: Patients with HON showed marked decrease in the levels of folic acid and vitamin B12, as well as hyperhomocysteinemia. It is very important to identify the causes of metabolic disorders in order to determine the role of folate deficiency in the development of HON, as well as the possibility of its pharmacological treatment.

[Electrophysiological and psychophysical studies in assessment of visual functions in patients with hereditary optic neuropathy]. / Elektrofiziologicheskie i psikhofizicheskie issledovaniya v otsenke zritel'nykh funktsii pri nasledstvennoi opticheskoi neiropatii.

PURPOSE: To study the capabilities of electrophysiological and psychophysical examination methods for assessment of the functional state of ganglion cells, retina and optic nerve in patients with hereditary optic neuropathy (HON). MATERIAL AND METHODS: The study included 60 patients (118 eyes) with a genetically confirmed diagnosis of HON. All study patients underwent visual field test (VFT), spectral optical coherence tomography (OCT), flash and pattern visual evoked potentials (VEP) (Flash-VEP, FVEP; Pattern-VEP, PVEP), photopic electroretinography with photonegative response (PhNR) registration and the color vision test. In 24 patients (46 eyes), these parameters were assessed before the start of treatment and one year later. The treatment involved the mitochondria-targeted antioxidant SkQ1 - plastoquinonyl-decyl-triphenylphosphonium bromide (PDTP) in the form of eye drops. RESULTS: The main PVEP components for 1.0° and 0.3° were registered in 20% and in 14% of patient eyes with HON and high visual functions, respectively. After one year of PDTP use, a significant decrease in P100 peak latency was found only in the group with disease duration of ≤1.5 years as of the time of treatment start (p<0.05). Significant differences were observed in the PhNR amplitude (p<0.004) between patients of the main and the control groups, as well as in the PhNR amplitude between patients with visual acuity of ≤0.1 and ≥0.13 (p<0.01). Patients with high visual functions were found to have a correlation between the PhNR amplitude, GCC thickness and the global loss index (GLV). CONCLUSION: Along with VFT, OCT and color vision tests, electrophysiological studies are one of the main methods of examining patients with HON. After one year of PDTP use, there was a significant decrease in the FVEP P2 peak latency in the group with a disease duration of ≤1.5 years as of the time of treatment start. The PhNR amplitude in patients with high visual functions was found to correlate with structural changes in the ganglion cell layer and the retinal nerve fiber layer.

[Possibilities of an experimental damaging effect on the retinal pigment epithelium]. / Vozmozhnosti eksperimental'nogo modelirovaniya povrezhdayushchego vozdeistviya na pigmentnyi epitelii setchatki.

PURPOSE: To simulate the damaging effect on retinal pigment epithelium (RPE) in an experiment studying the effect of human neuronal precursors (NPs). MATERIAL AND METHODS: The study was carried out on 31 rabbits (31 eyes) of the Chinchilla breed, which were divided into 3 groups: the 1st group received a subretinal injection of balanced saline solution (BSS); the 2nd group - subretinal injection of BSS with vitrectomy, displacement of the injection bladder away from the injection site using a perfluororganic compound (PFOC) and laser coagulation; the 3rd group - subretinal injection of a culture of NPs using the same method as in the group 2. All rabbits were observed for 21 days using ophthalmoscopy, optical coherence tomography (OCT) and autofluorescence (AF). RESULTS: In the 1st group, 4 out of 5 rabbits were observed to have total retinal detachment and vitreoretinal proliferative processes in the early postoperative period after subretinal injection of the BSS. In the 2nd group, OCT and AF revealed atrophy of the outer and inner layers of the retina as well as disorganization of the photoreceptors-RPE-Bruch's membrane complex in the area of injection on the 21 day after the operation. In the 3rd group, the OCT data obtained during the 21 days of observation showed that a hyperreflective zone at the level of the RPE-Bruch's membrane complex corresponding to the NPs injection site was preserved, while there was a partial loss of the outer retinal layers - but of a smaller volume compared to the BSS injection. The suggested method of subretinal injection led to a reduced number of complications: in the 1st group, postoperative complications amounted to 80%, while in the 2nd and 3rd groups - 45%. CONCLUSION: The study proposes a new method for retinal injection of BSS, which can help reduce RPE degeneration patterns and possible postoperative complications, thus increasing research efficiency. Subretinal injection of a culture of neuronal precursors derived from human induced pluripotent stem cells (iPSCs) in an experiment can serve as a universal model for studying the survival and integration of stem cells.

[Characteristics of changes in retinal and optic nerve microvascularisature in Leber hereditary optic neuropathy patients seen with optical coherence tomography angiography]. / Osobennosti mikrososudistykh izmenenii setchatki i zritel'nogo nerva u patsientov s nasledstvennoi opticheskoi neiropatiei po dannym opticheskoi kogerentnoi tomografii-angiografii.

PURPOSE: To investigate the features of various parameters of the density of retinal blood vessels, optic nerve head (ONH) and peripapillary region in hereditary optic neuropathy (HON) patients revealed with optical coherence tomography angiography (OCTA). MATERIAL AND METHODS: The study included 29 HON patients divided into three groups based on symptoms duration (less than 1 year; 1-5 years, more than 5 years) and visual acuity (0.5-1.0; 0.04-0.4; 0.03 and lower). Relative macular, optic disc and peripapillary vessel density (VD, %) was assessed by OCTA (xR Avanti, Optovue Inc., USA). RESULTS: Significant progressive VD reduction in superficial capillary plexus (SCP) was detected in all parafovea sectors and in the temporal sector of perifovea over the course of disease progression. No significant differences of these parameters were found in correlation with visual acuity. Patients with VA of 0.5-1.0 turned out to have greater VD in deep capillary plexus (DCP), whereas no differences were found in relation to the duration of HON. A strong significant correlation between the SCP and DCP VD only in central foveal area was revealed in all groups depending on the VA and symptoms duration. Over the course of HON progression, VD in the temporal sector and in temporal segments of superior and inferior sectors has gradually reduced. In patients with VA of 0.5-1.0, the retinal nerve fibers layer (RNFL) thickness in the temporal sector and optic nerve VD was notably greater compared to patients with lower VA. The most significant correlation was established between VA and structural changes (K=0.75, p<0.001) and VD in the temporal sector (K=0.57-0.61, p<0.001). CONCLUSION: The obtained data suggest that derivative microvascular changes play an active role in the clinical progression of the disease.

[Dysthyroid optic neuropathy: surgical treatment potential]. / Opticheskaya neiropatiya pri endokrinnoi oftal'mopatii: vozmozhnosti khirurgicheskogo lecheniya.

PURPOSE: To evaluate the effectiveness of bony orbital decompression in patients with dysthyroid optic neuropathy (DON). MATERIAL AND METHODS: The study analyzed 255 patients with thyroid eye disease (TED) and bony orbital decompression. Those among them who had DON as an indication for surgery were investigated further. Patients underwent standard ophthalmological examination, computer perimetry, color vision assessment using Ishihara tables, relative afferent pupillary defect (RAPD), computed tomography (CT) of the orbit, and in some cases optical coherence tomography (OCT) of the optic nerve. RESULTS: Final analysis included 31 patients (52 eyes). On 13 orbits, only lateral wall decompression was performed, and medial wall decompression was the only intervention in 7 orbits. In other cases, these techniques were performed either simultaneously - in 14 orbits, or alternately - in 18 orbits. In the postoperative period, all patients showed significant positive dynamics in terms of visual acuity, visual field, and proptosis. In all cases, decrease of the amount of orbital inflammation was observed. Exophthalmos significantly decreased after surgery and averaged 20.5±3.1 mm, which is 4.7 mm less than the initial one. All changes were statistically significant (p<0.01). CONCLUSION: Bony orbital decompression is an effective and safe treatment option for DON resistant to high doses of glucocorticoids. In the vast majority of cases, this intervention is the only way to improve and stabilize visual function in this severe category of patients.

[Structural and functional changes in the retina and optic nerve in patients with toxic optic neuropathy caused by acute methanol poisoning]. / Osobennosti strukturnykh i funktsional'nykh izmenenii setchatki i zritel'nogo nerva u patsientov s toksicheskoi opticheskoi neiropatiei na fone otravleniya metanolom.

PURPOSE: To identify the specifics of structural and functional changes in patients with toxic optical neuropathy caused by acute methanol poisoning. MATERIAL AND METHODS: One female patient with toxic optic neuropathy (TON), 2 male patients with partial optic atrophy caused by methanol poisoning, and 1 male patient with methanol intoxication after ethanol containing alcohol use were examined with kinetic perimetry and optical coherence tomography. RESULTS: Patients with TON caused by acute methanol poisoning were observed to have decreasing visual acuity to the extent of complete blindness. OCT follow-up studies revealed thinning of the retinal nerve fiber layer (RNFL) as well as formation of microcysts in the inner retinal layers, destruction of ellipsoid zone and outer segments of photoreceptors. The patient with methanol intoxication after use of ethanol containing alcohol had retained his visual functions; he was found to have microcysts and RNFL thinning during the first few months after the intoxication, but they were within normal range of OCT parameters. CONCLUSION: Patients with TON caused by acute methanol poisoning are common to have optic atrophy with either residual visual functions or complete blindness as well as microcysts formation, structural changes and destruction of the ellipsoid zone and outer segments of photoreceptors. In patient with methanol intoxication after use of ethanol, which is known to be an antidote, complete visual recovery was observed, although some microcystic changes and ganglion cells layer thinning were noted.

Inorganic Polyphosphate and Physiological Properties of Saccharomyces cerevisiae Yeast Overexpressing Ppn2.

The effect of the yeast endopolyphosphatase Ppn2 overproduction on the metabolism of inorganic polyphosphates in Saccharomyces cerevisiae yeast was studied. Expression of the PPN2 gene under control of the strong constitutive promoter of glyceraldehyde 3-phosphate dehydrogenase gene (PKG1) led to a significant increase in the endopolyphosphatase activity stimulated by cobalt/zinc ions. This activity was present in both soluble and membrane subcellular fractions; it was higher toward long-chain polyphosphates and could be stimulated by ADP. The content of short-chain polyphosphates in the cells of the overexpressing strain was ~2.5 times higher compared to the parent strain. The cells overexpressing Ppn2 were more resistant to peroxide and alkali. The role of short-chain polyphosphates in the adaptation to these stress factors is discussed.

[Mitochondrial biogenesis in hereditary optic neuropathies]. / Mitokhondrial'nyi biogenez pri nasledstvennykh opticheskikh neiropatiiakh.

The article offers a review of mitochondrial biogenesis in hereditary optic neuropathies. It covers the mechanisms of mitochondrial biogenesis, factors affecting it and tools for mitochondrial turnover assessment.

Polyphosphates and Polyphosphatase Activity in the Yeast Saccharomyces cerevisiae during Overexpression of the DDP1 Gene.

The effects of overexpression of yeast diphosphoinositol polyphosphate phosphohydrolase (DDP1) having endopolyphosphatase activity on inorganic polyphosphate metabolism in Saccharomyces cerevisiae were studied. The endopolyphosphatase activity in the transformed strain significantly increased compared to the parent strain. This activity was observed with polyphosphates of different chain length, being suppressed by 2 mM tripolyphosphate or ATP. The content of acid-soluble and acid-insoluble polyphosphates under DDP1 overexpression decreased by 9 and 28%, respectively. The average chain length of salt-soluble and alkali-soluble fractions did not change in the overexpressing strain, and that of acid-soluble polyphosphate increased under phosphate excess. At the initial stage of polyphosphate recovery after phosphorus starvation, the chain length of the acid-soluble fraction in transformed cells was lower compared to the recipient strain. This observation suggests the complex nature of DDP1 involvement in the regulation of polyphosphate content and chain length in yeasts.

Polyphosphates and exopolyphosphatase activities in the yeast Saccharomyces cerevisiae under overexpression of homologous and heterologous PPN1 genes.

The role of exopolyphosphatase PPN1 in polyphosphate metabolism in fungi has been studied in strains of Saccharomyces cerevisiae transformed by the yeast PPN1 gene and its ortholog of the fungus Acremonium chrysogenum producing cephalosporin C. The PPN1 genes were expressed under a strong constitutive promoter of the gene of glycerol aldehyde-triphosphate dehydrogenase of S. cerevisiae in the vector pMB1. The yeast strain with inactivated PPN1 gene was transformed by the above vectors containing the PPN1 genes of S. cerevisiae and A. chrysogenum. Exopolyphosphatase activity in the transformant with the yeast PPN1 increased 28- and 11-fold compared to the mutant and parent PPN1 strains. The amount of polyphosphate in this transformant decreased threefold. Neither the increase in exopolyphosphatase activity nor the decrease in polyphosphate content was observed in the transformant with the orthologous PPN1 gene of A. chrysogenum, suggesting the absence of the active form of PPN1 in this transformant.

Polyphosphates and exopolyphosphatases in cytosol and mitochondria of Saccharomyces cerevisiae during growth on glucose or ethanol under phosphate surplus.

Content and chain lengths of inorganic polyphosphates (polyP) as well as exopolyphosphatase activities were compared in cytosol and mitochondria of the yeast Saccharomyces cerevisiae during growth on glucose or ethanol under phosphate surplus. PolyP metabolism in cytosol and mitochondria was substantially dependent upon the carbon source. Acid-soluble polyP accumulated mainly in cytosol using either glucose or ethanol. The level of the accumulation was lower during growth on ethanol compared to that on glucose. Increase in polyP content in mitochondria was observed during growth on glucose, but not on ethanol. In cytosol the activity of exopolyphosphatase PPN1 was increased and the activity of exopolyphosphatase PPX1 was decreased independently of the carbon source under phosphate surplus conditions. Growth on ethanol caused exopolyphosphatase PPN1 to appear in the soluble mitochondrial fraction, while during growth on glucose only exopolyphosphatase PPX1 was present in this fraction.

High molecular mass exopolyphosphatase from the cytosol of the yeast Saccharomyces cerevisiae is encoded by the PPN1 gene.

It has been shown that the high molecular mass exopolyphosphatase localized in cytosol of the yeast Saccharomyces cerevisiae is encoded by the PPN1 gene. This enzyme is expressed under special culture conditions when stationary phase cells are passing on to new budding on glucose addition and phosphate excess. The enzyme under study releases orthophosphate from the very beginning of polyphosphate hydrolysis.

Accumulation of polyphosphates and expression of high molecular weight exopolyphosphatase in the yeast Saccharomyces cerevisiae.

The effect of cultivation time and concentration of inorganic phosphate (P(i)) in the culture medium on the accumulation of polyphosphates (polyP) and the activity of two cytosolic exopolyphosphatases of the yeast Saccharomyces cerevisiae was studied: an exopolyphosphatase of 40 kD encoded by PPX1 and a high molecular weight exopolyphosphatase encoded by another gene. Depletion of polyP in the cells on P(i) starvation is a signal factor for the accumulation of polyP after the subsequent addition of 5-20 mM P(i) and glucose to the cells or spheroplasts. A high activity of both exopolyphosphatases does not prevent the accumulation of polyP. The expression of the high molecular weight exopolyphosphatase is due to the acceleration of metabolism in cells that have reached the stage of growth deceleration on the addition of P(i) and glucose or complete culture medium. This process may occur independently from the accumulation of polyP. The activity of exopolyphosphatase PPX1 depends less on the mentioned factors, decreasing 10-fold only under conditions of phosphate surplus at the stationary growth stage.

[Peculiarities of metabolism and functions of high-molecular inorganic polyphosphates in yeasts as representatives of lower eukaryotes].

The review presents the recent data demonstrating the important role high-molecular inorganic polyphosphates in regulatory processes in a yeast cell. It has been shown that polyphosphates are localized in different cell compartments, where they are metabolized by a special set of enzymes. The review presents the evidence in favor of the concept of multiple functions of these biopolymers in a cell, as well as the data on the pleiotropic effects of mutations in the genes encoding the enzymes of polyphosphate metabolism.