[Activities of trypsin-like serine proteases and their inhibitors in blood and subretinal fluid of patients with different stages of proliferative vitreoretinopathy in rhegmatogenous retinal detachment]. / Izuchenie aktivnosti serinovykh proteinaz tipa tripsina i ikh ingibitorov v krovi i subretinal'noi zhidkosti u bol'nykh s razlichnymi stadiiami proliferativnoi vitreoretinopatii pri regmatogennoi otsloike setchatoi obolochki.

Concentrations of protein, trypsin-like and antitryptic activities, and the level of alpha 2-macroglobulin were measured in the subretinal fluid (SRF) and blood of patients with different stages of proliferative vitreoretinopathy (PVR). The content of protein in SRF of patients with retinal detachment with PVR was by an order of magnitude higher than in the vitreous body and increased from stage B to stage D1, which indicates increased permeability of the blood-eye barrier. Trypsin-like proteolytic enzymes and their main inhibitors are present in the SRF, and changes in their activity indicate augmentation of the inflammatory component of PVR from stage B to stage C3 and transition to a process similar to tissue cicatrization during stage D1. Changes in the proteinase-inhibitor balance in the peripheral blood in PVR are characteristic of a sluggish inflammatory process which activates from stage B to stage C and eventuates in stage D1. Increase in the blood level of alpha 2-macroglobulin during stages C3 and D1 seems to indicate the development of total autoimmune reaction. Antiinflammatory steroid therapy before surgery had a favorable impact on the course of the postoperative period.

[Time course of bioelectrical activity of retina in patients with pigmented abiotrophy treated by deoxinate]. / Dinamika bioélektricheskoi aktivnosti setchatki u bol'nykh s pigmentnoi abiotrofiei pri lechenii preparatom "dezoksinat".

Bioelectrical retinal activity was assessed before and after a course of deoxinate therapy and in a blind placebo test in order to assess the efficacy of this new drug in the treatment of patients with pigmented retinal abiotrophy. Time course of electroretinograms during deoxinate therapy indicated a significant positive effect of the drug on retinal function as regards a variety of electrophysiological parameters in 80-94% patients. Improvement of electroretinography data was paralleled by improvement of visual acuity, extension of visual fields, and decrease of scotomas. Good effect was attained in patients with early and far advanced stages of pigmented retinal abiotrophy. Analysis of bioelectrical activity of the retina after a course of therapy with deoxinate and enkad showed a higher efficacy of the former drug in patients with pigmented retinal abiotrophy.

[Fibrinolytic activity of the lacrimal fluid in disordered choroid circulation in patients with arterial hypertension]. / Fibrinoliticheskaia aktivnost' sleznoi zhidkosti pri narusheniiakh khoroidal'nogo krovoobrashcheniia u bol'nykh s arterial'noi gipertoniei.

Fluorescent angiographic examination of the choroid and retinal circulation in 43 patients with arterial hypertension of different origin without signs of hypertensive retinopathy with low and normal values of the fibrinolytic activity of the lacrimal fluid (FALF) revealed a correlation between disorders of the choroid circulation (ischemic zones, delayed time of contrast staining of the choroid) and reduction of FALF. The results indicate that a reduction of FALF may be regarded as a prerequisite for the development of circulatory disorders in the choroid.

[Clinical-immunological disorders in uveitis in patients with Behçet's syndrome]. / Kliniko-immunologicheskie narusheniia pri uveitakh u bol'nykh s sindromom Bekhcheta.

The results of comprehensive clinicoimmunologic examinations of 38 uveitis patients with Behçet's disease indicate that uveitis in the presence of Behçet's disease should be referred to multifactorial diseases to whose pathogenesis immunopathologic reactions in various combinations and genetic predisposition contribute much. Generalization of the process in the eye predominated in the clinical picture with involvement of the anterior and posterior segments, retinal vessels, this being combined with general somatic symptoms (aphthae on the buccal mucosa, genitals, arthritides, urethritis/cystitis symptoms, positive 'pricking' test). Study of the immunity status revealed depressed lymphocyte proliferative response to mitogen in 58.8% of patients, hyperimmunoglobulinemia of the A and M classes in 63.3%, impaired complex formation (increased levels of circulating immune complexes in 78.3% and cryoglobulin presence in 57.1%), and various combinations of these immunologic signs. The results indicated patients' infection with herpes virus, streptococcus, toxoplasma. An associative connection of Behçet's disease with A (II) red cell phenotype in 54.8% of patients (p < 0.05) suggests a relationship between genetic factors and the conditions of a specific geographic region. A variety of immunologic changes necessitated the use of corticosteroids, hemoperfusion, cytostatics, and immunity stimulants in the treatment of uveitis in Behçet's disease patients.

[Local fibrinolytic activity of the lacrimal fluid in patients with arterial hypertension]. / Issledovanie lokal'noi fibrinoliticheskoi aktivnosti sleznoi zhidkosti u bol'nykh arterial'noi gipertoniei.

Lacrimal fluid local fibrinolytic activity was measured in 101 patients with different variants of arterial hypertension. The studied parameter was found reduced in patients developing hypertensive retinopathy on the respective eye. A correlation was revealed between progress of hypertensive changes in the fundus oculi and reduction of lacrimal fluid local fibrinolytic activity. The results indicate that reduction of this parameter may be regarded as one of the prerequisites for the development of hypertensive retinopathy.

[Immunologic disorders in patients with idiopathic subretinal neovascular membrane]. / Immunologicheskie narusheniia u bol'nykh idiopaticheskoi subretinal'noi neovaskuliarnoi membranoi.

The authors analyze the results of comprehensive clinical and immunologic examinations of 52 patients with this condition (SNVM) in its active and inactive phases, angiographically confirmed, aged 19 to 46; 32 of these were women (61.5%), 20 (38.4%) men. A complex of immunologic methods was employed to reveal the etiology of the condition and the immune status of SNMV patients. The origin of the condition was identified in 44.2% of patients; it was toxoplasmic in 19.2, autoimmune in 15.4, tuberculous in 7.7, and mixed toxoplasmic and tuberculous in 1.9% of cases. T lymphocyte functional activity was inhibited in 37.5% of patients with the exudative hemorrhagic phase of SNMV and in 16.7% of those in the cicatrization phase. Changes in the humoral immunity presenting as gammapathies were detected in 34% of patients, those manifesting by hyperconcentrations of circulating immune complexes in 66.7%, and of cryoglobulins in 37.8% of patients. Krypton laser coagulation was employed in multiple-modality treatment of patients with SNMV. The remissions persisted for 3-5 years.

[Fluorescein iridography in post-thrombotic retinopathy]. / Fliuorestsentnaia iridografiia pri posttromboticheskoi retinopatii.

Fluorescent iridography evidenced that postthrombotic retinopathy is associated with pathologic changes in the iridal vessels, increase of the circulation time, impaired angioarchitectonics, development of shunts and collaterals, in some cases of new vessels. The degree of the pathologic changes in the iris correlates with the severity of the underlying condition. Extravasal release of fluorescein from the iridal and ciliary vessels evidences an impairment of the permeability of the anterior section of the ++hemato-ophthalmic barrier in postthrombotic retinopathy.

[Immunologic disorders in young patients with retinal vein thrombosis]. / Immunologicheskie narusheniia pri trombozakh ven setchatki v molodom vozraste.

Immunologic shifts in 53 patients with retinal vein thrombosis, aged 20 to 41, were under study. Present-day immunologic methods were employed to investigate the status of the humoral and cellular immunity and define the infection rate. The results were assessed functionally and immunologically. The authors have revealed the contribution of infection to the development of retinal vein thrombosis in young patients, analyzed for the first time the immunity status of such patients, detected the signs of humoral immunodeficiency are senting as gammapathies and impaired complex formation, showed the relationship between thromboses and genetic predisposition and the role of the erythrocytic phenotype in the development of a cyst-like edema; this permitted them develop recommendations on the disease source and outcome prediction and on the choice of drugs.

[Hemosorption in multimodal treatment of endogenous uveitis]. / Gemosorbtsiia v kompleksnom lechenii éndogennykh uveitov.

Hemoperfusion was used in multiple modality treatment of 92 patients with chronic recurrent endogenic uveitis and uveitis associated with syndromic conditions. The treatment included systemic and local steroids, and antiinflammatory therapy. Clinical improvement was achieved in 75 percent of patients; it was paralleled by improvement of the vision acuity. In the rest patients vision acuity was unchanged because of irreversible impairment of the retina and optic nerve, but uveitis ceased. Addition of hemoperfusion of multiple-modality treatment of uveitis patients resulted in shortening of hospital stay by 6-7 days, in prolongation of remission periods to 10-15 months after a single course of hemoperfusion in 71 percent of patients and after two courses in the rest. A dynamic immunologic analysis has shown normalization of T lymphocyte functional activity, and of blood serum immunoglobulin and circulating immune complexes levels.

[Pathological changes in the eyeball in tapetoretinal abiotrophy]. / Patologicheskie izmeneniia glaznogo iabloka pri tapetoretinal'noi abiotrofii.

The authors sum up the results of comprehensive examination of all the principal structures of the eyeball in patients with tapetoretinal abiotrophy. Present-day methods of investigation were employed, that helped reveal a generalized pattern of the pathologic process in this condition. The detected shifts should be borne in mind when choosing a method for cataract extraction in such patients.

[Trans-scleral cryopexy in hemophthalmos of diabetic etiology]. / Transskleral'naia kriopeksiia pri gemoftal'makh diabeticheskogo geneza.

Trans-scleral cryopexy (TSC) was carried out in 81 eyes with recurrent hemophthalmos of diabetic genesis. 73 patients were followed up after surgery for a period of 3 months to 5 years. Hemophthalmos resolved in 80 percent of eyes (completely in 60, partially in 20 percent). The condition recurred in 10 percent of eyes, detachment of the retina developed in 13, neovascular glaucoma in 4 percent, and cataract progressed in 10 percent of eyes. Vision acuity improved in 36 percent of eyes; the best results were observed in type II diabetes mellitus. TSC proved to be an effective method for the management of hemophthalmos of diabetic nature.

[Idiopathic parafoveal telangiectasias]. / Idiopaticheskie parafoveal'nye teleangiéktazii.

The authors describe the clinical and angiographic picture of idiopathic parafoveal telangiectasis in 6 patients (10 eyes). Three forms of the condition were distinguished: edematous, occlusive, and with subretinal shifts. A natural course of the process is traced, the criteria and terms of laser coagulation are defined.

[Surgical destruction of varicose veins in involutional central chorioretinal dystrophy]. / Operatsiia destruktsii vortikoznykh ven pri involiutsionnoi tsentral'noi khorioretinal'noi distrofii.

The authors analyze the results of this surgery. The treatment efficacy has been monitored by traditional ophthalmological methods: rheo-ophthalmography, fluorescent angiography, examination of the central visual field, rhythmic and macular electroretinography. The vision acuity has improved in 70% of the cases. Remote results evidence a high stability of the results in the majority of cases.

[Ophthamologic pathology in non-specific aortoarteritis]. / Oftal'mopatologiia pri nespetsificheskom aortoarterite.

Nonspecific aortoarteritis is a systemic autoimmune disease eventuating in gradual stenosis of the aorta and the main vessels with ischemia of the respective organs. Ophthalmologic symptoms have been examined in 54 patients with nonspecific aortoarteritis. Subjective disorders of vision (short-term binocular blindness, metamorphopsia, pain behind the eye, amaurosis fugax) have been detected in 52% of the examinees. Organic lesions of the eye have been diagnosed in 60% of the patients: hypertensive angiopathy (22%), venous stasis retinopathy (17%), occlusion of the central retinal artery (1%), etc. Three possible mechanisms of the development of ocular symptoms have been established: (1) a result of symptomatic hypertension, (2) chronic ocular ischemia, (3) acute hemodynamic ocular circulation insufficiency.

[Involvement of the eyes in yersiniosis]. / Porazhenia glaz pri iersiniosise.

The results of clinical examinations of 15 patients with yersiniasis are analyzed. Besides the involvement of the anterior segment of the eye, known before, the authors have detected for the first time 3 cases of the fundus oculi involvement; the impairments resemble multiplaquoid epitheliopathy. The clinical description is supplied with fluorescent angiograms. Yersiniasis is regarded as a possible etiologic factor responsible for multiplaquoid epitheliopathy; this extends the scope of our knowledge on the etiological structure of the fundus oculi impairments.