[Visualization of retinal blood flow disturbances in acute retinal ischemia syndrome]. / Vizualizatsiya narushenii retinal'nogo krovotoka pri sindrome ostroi ishemii setchatki.

Vascular disorders account for a significant proportion of acute loss of vision. In recent years, scientific and technical progress in ophthalmology has provided new opportunities in the study of vascular pathology, significantly expanding the understanding of their pathogenesis. The article presents a clinical case of a patient with acute retinal ischemia syndrome who had retinal blood flow disturbances studied using optical coherence tomography (OCT) imaging. It demonstrates extensive possibilities of diagnostics of ischemic retinal lesions using OCT angiography that make this method the most informative in terms of evaluating the blood flow at different levels, independently in each vascular plexus.

[Complex assessment of retinal ischemic damage in patients with retinal vein occlusion]. / Kompleksnaia otsenka ishemicheskogo povrezhdeniia setchatki pri okkliuzii retinal'nykh ven.

PURPOSE: To evaluate the effectiveness of treatment and the possibility of restoring visual functions in patients with retinal vein occlusion (RVO) depending on the initial degree of macular ischemia. MATERIAL AND METHODS: The study included 84 patients with RVO. The main inclusion criteria were the presence of macular edema in the setting of RVO with the duration of no more than 3 months and without any previous treatment. All patients underwent intravitreal injections of an angiogenesis inhibitor, followed by laser treatment when necessary. A comparative analysis of the results was carried out in groups that were opposite in terms of the clinical effect - before the start of the therapy, after 1 month, and after 12 months. All patients and the control group members underwent standard ophthalmological examination as well as electroretinography, fluorescence angiography, optical coherence tomography (OCT), and OCT angiography. RESULTS: Based on data obtained during 12 months of the follow-up, the comparative analysis of the initial ophthalmic status of patients with RVO with opposite clinical effect resulted in derivation of 3 clinical groups that correspond to the degrees of macular ischemia - mild, moderate and severe. CONCLUSION: Determination of the degree of macular ischemia at the stage of primary diagnosis can improve the treatment effectiveness and inform the patients about the sequence and duration of anti-VEGF therapy. Intravitreal injections of ranibizumab in retinal vein occlusion are carried out before the elimination of macular edema and further in the on-demand mode, while the number of injections can vary from one to monthly injections during the year.

[Intraocular cytokines imbalance in retinal vein occlusion and its impact on the efficacy of anti-angiogenic therapy].

AIM: To study the concentrations of intraocular cytokines in patients with retinal vein occlusion (RVO) before and after intravitreal ranibizumab injection and to compare the results with clinical activity of the disease and treatment efficacy. MATERIAL AND METHODS: A comprehensive ophthalmological examination of 44 patients with RVO and macular edema was performed. Intraocular fluid was first collected before the intravitreal injection. Cytokines concentrations were measured using Bio-Plex Pro Human Cytokine 27-plex Panel (Bio-Rad Laboratories, USA) for flow cytometry. The test was repeated 1 month after the injection. RESULTS: A total of 11 cytokines were reliably detected. After ranibizumab injections certain angiogenic (VEGF) and proinflammatory (IL-6, IL-8, IL-13, IL-15, MCP-1) factors appeared to be significantly suppressed. Clinical efficacy of the therapy correlated with the degree of cytokines suppression, which in turn depended on the severity of ocular involvement at baseline. CONCLUSIONS: Retinal vein occlusion pathogenesis involves a cascade of immune and inflammatory processes, including activation of not only VEGF but also quite a few inflammatory and chemotactic factors, whose activity depends on the extent of ischemic damage in the retina.

[Comprehensive assessment of risk factors for retinal vein occlusion and derivation of classification criteria for retinal ischemia].

OBJECTIVE: to perform a complex ophthalmological and general examination of patients with retinal vein occlusion (RVO) and to derive classification criteria for retinal ischemia. MATERIALS AND METHODS: A total of 44 patients with RVO and macular edema and 20 controls were enrolled. All patients underwent a thorough ophthalmological and general examination and clinical laboratory testing. RESULTS: Cardinal risk factors of RVO development were derived from among somatic illnesses and laboratory results. Regional hemodynamics assessment helped identify the most significant systolic and diastolic blood flow disturbances in the central retinal vein and central retinal artery circulation systems. Profound changes in electrophysiological parameters were found. Statistical analysis of the collected data allowed to identify 3 stages of retinal ischemia. CONCLUSION: The established risk factors of RVO development, regional blood flow impairment and original classification criteria for retinal ischemia make it possible to predict the course of the disease and treatment effect.

[Changes of intraocular cytokine level in patients with vascular and neovascular retinal pathology depending on pathologic process activity].

Cytokine and growth factors levels were estimated in anterior chamber humor of patients with different diseases manifesting with vascular and neovascular retinal changes and various pathologic process activity. 40 patients with macula edema, retinal and choroid neovascularization were examined. Process activity was determined based on data obtained using high-resolution optical coherence tomography and fluorescent angiography. Quantitative concentration of interleukine 6, 8, vascular endothelium growth factor and monocyte chemoattractive protein-1 in anterior chamber aqueous humor was measured using enzyme immunoassay. Increased level of cytokines studied was found in all forms of the diseases.

[Intravitreal ranibizumab for diabetic macula edema].

25 patients with diabetic macula edema (DME) treated with 0,5 mg intravitreal ranibizumab (Lucentis) were studied. Mean number of intravitreal injections was 1.7 (1-5 injections). Visual acuity improved from 0.29 +/- 0.03 to 0.36 +/- 0.04 after the 1st injection and to 0.38 +/- 0.04 after the last one (p < 0.001). Central retinal thickness reduced from 469 +/- 36.3 to 353 +/- 31.5 microm in a month after the 1st injection and was 346 +/- 30.3 microm after the last one (p < 0.05). No systemic or ocular adverse effects were observed. Intravitreal ranibitumab (Lucentis) leads to stabilization and improvement of visual acuity and reduction of DME. The procedure is a safe treatment option for DME.