[Xalacom: possibilities and advantages of the drug in the treatment of patients with glaucoma]. / Ksalakom: vozmozhnosti i preimushchestva preparata v terapii glaukomy.

The strategy of glaucoma therapy is aimed at preserving visual functions and ensuring an acceptable quality of life for patients. To achieve this strategic goal, clinicians in their practice use drugs that affect the main factor in the progression of the disease - intraocular pressure (IOP), aiming to reduce it to an individual target level. It is not always possible to achieve optimal IOP values with monotherapy. Many patients require a combination of drugs from different pharmacological groups. Xalacom is a fixed drug with good tolerability and t hypotensive effect. This review focuses on the benefits of this drug for the treatment of glaucoma.

[Dry eye syndrome in patients with primary open-angle glaucoma].

AIM: to determine the frequency and severity of dry eye syndrome (DES) in primary open-angle glaucoma (POAG) patients that are newly diagnosed or already receiving beta blocker instillation therapy. MATERIAL AND METHODS: A total of 127 patients (190 eyes) with POAG were divided into two groups. Group 1 included 55 newly diagnosed patients (88 eyes), group 2-72 POAG patients (102 eyes) instilling timolol 0.5% twice daily into the affected eye. The control group included 20 patients (40 eyes) aged 60-88 years (73.6 ± 9.2 years on average) with early age-related cataract. RESULTS: DES was found in 69 POAG patients (79%) who was just starting their topical hypotensive therapy and 85 of those (84%) under treatment (p = 0.39). CONCLUSIONS: One should take into account when prescribing ocular hypotensive therapy that newly diagnosed POAG patients usually already suffer from a dry eye. The use of topical beta blockers that contain preservatives exacerbates dry eye signs and symptoms in these patients.

[Results of the use of antioxidant and angioprotective agents in type 2 diabetes patients with diabetic retinopathy and age-related macular degeneration].

AIM: to investigate changes in clinical, functional, and morphological parameters of the retina in type 2 diabetes patients with diabetic retinopathy (DR) and those with combined fundus pathology (DR plus age-related macular degeneration (AMD)) before and after a course of antioxidants and angioprotectors in the form of mono- or combination therapy. MATERIAL AND METHODS: The study included 180 patients (180 eyes) with type 2 diabetes divided into 6 groups of 30 each. DR was graded according to E. Kohner and M. Porta classification, AMD--AREDS classification. Thus, group 1 consisted of patients with DRO,; group 2--DR1 without DM, group 3--DR1 with DM, group 4--DRO and "dry" AMD (AREDS 1-3), group 5--DR1 with no DM but with AMD (AREDS 1-3), and group 6--DR1 with DM and AMD (AREDS 1-3). A drug containing lutein 6 mg, zeaxanthin 0.5 mg, vitamin C 60 mg, vitamin E 7 mg, vitamin A 1.5 mg, vitamin B2 1.2 mg, rutin 25 mg, zinc 5 mg, selenium 25 mcg, and bilberry extract 60 mg was used for antioxidative therapy. Ginkgo biloba leaf extract 60 mg was chosen as the angioprotector. In all patients visual acuity, macular thickness and morphology (OCT) as well as light sensitivity (microperimetry) were assessed before and after the treatment course. RESULTS: Analysis of baseline measurements demonstrated a significant decrease in best corrected visual acuity (p < 0.05) in study groups 2-6 as compared with group 1. Macular thickness was increased in all groups, however, the changes were statistically significant only in groups 3 and 6 (p<0.05). Light sensitivity of the macula showed a reduction, which was statistically significant in groups 4-6 (p < 0.05). After the course of antioxidant and angioprotective therapy, these parameters improved in all groups. The greatest effect was achieved with simultaneous antioxidant and double-dose angioprotective therapy (240 mg per day): visual acuity increased significantly (p < 0.05) in all groups except group 1; macular thickness decreased in all groups, however, the changes were statistically significant (p < 0.05) only in groups 1-3 and 5; light sensitivity also improved in all groups, significantly (p < 0.05) in groups 1-3 and 4. CONCLUSIONS: Extended analysis of clinical, functional and morphological changes in the retina at the onset of DR in type 2 diabetes patients with concomitant "dry" AMD enables timely diagnosis, prognosis, prevention, and early treatment. Conservative treatment with antioxidant and angioprotective agents has been proved effective in type 2 diabetes patients with preclinical (DRO) and early (DR1) diabetic retinopathy and those with DR and "dry" AMD (AREDS 1-3) in terms of functional and morphological parameters of the retina. From all the regimens, a combined antioxidant and double-dose angioprotective (240 mg) therapy appeared to be the most effective and can be considered not only a preventive, but also a therapeutic measure in type 2 diabetes patients with initial stages of DR (DRO, DR1) or those with DR and DM or combined DR and AMD (AREDS 1-3).

[On some pathogenic features of diabetic retinopathy in type II diabetes mellitus and the role of antioxidants and ginkgo biloba].

Diabetic retinopathy is a microvascular complication of diabetes and has complex and multifactorial pathogenesis. Cascade of biochemical changes characteristic to other diabetes vascular complications leads to structural changes of retinal capillaries some of which are unique. As a result of all processes at different pathogenesis levels there is an increase of free radicals concentration and decrease of antioxidant protection thus provoking an oxidative stress in retina and endothelial dysfunction with subsequent hypoxia and activation of growth factors and promotion of neovascularization leading to loss of vision in patients with type II diabetes mellitus. Consideration of oxidative stress reduction and restoration of retinal antioxidant system using exogenous antioxidants is a promising issue for further research.

[Results of antioxidant therapy for non-proliferative diabetic retinopathy in patients with type 2 diabetes mellitus].

Diabetes mellitus is associated with dangerous vascular complications, including diabetic retinopathy (DR), which can lead to complete visionloss. Modern diagnostic methods, such as optical coherent tomography, help accurately and objectively verify the stage of DR, thus providing an opportunity to choose a treatment algorithm able to prevent further progression of the disease. The aim of the study was to investigate the efficacy of antioxidant therapy (Vitrum Vision Forte and Vitrum Memory) as the initial phase of treatment of non-proliferative DR in type 2 diabetes, what is pathogenically reasonable due to involved oxidative stress.

[Retrospective analysis of causes of enucleations after anti-glaucomatous surgery].

Proximate causes of intraocular pressure (IOP) decompensation accompanied with persistent pain syndrome were determined based on results of morphological examination of 59 eyes enucleated due to terminal previously operated glaucoma and medical history analysis. Excessive scarring, formation of solid hyalinized membrane in the site of filter pad, closure of anterior chamber angle with synechia as an outcome of chronic iridocyclitis and inappropriate surgical approach lead to increase in the resistance of the aqueous humor outflow and result in glaucoma decompensation causing complications that necessitate enucleation. The most common complications are the following: bacterial corneal ulcer with potential perforation and endophthalmitis, hemorrhagic choroidal detachment, vitreous hemorrhage, persistent pain syndrome and phthisis bulbi.

[Contusions of the eye, their clinical picture and outcomes]. / Kontuzii glaza, klinicheskaia kartina i iskhody.

Clinical observations of 426 patients with blunt injuries to the eye (records of Moscow Ophthalmological Clinical Hospital) showed that eyeball contusions were responsible for 40.57% of hospital injuries, 364 cases (85.54%) were communal traumas and 22.77% criminal. The most frequent complication of blunt injury to the eye was hemorrhage to the anterior chamber (57.57%). Total or almost total hyphemas were observed in 5.83% cases, in 0.7% with repeated hemorrhages. Hemorrhages into the vitreous body were observed in 36.6% patients. Postcontusion opacities and retinal edemas were diagnosed in 25.87% cases. The most severe contusions of the eyeball with ruptures of fibrous membrane were observed in 19.11% cases, 6.29% of these along the postoperative cicatrix. Subdislocation or dislocation of the lens took place in 13.75% cases. Blunt injury to the eye resulted in alteration of ophthalmic tone presenting as reactive hypertension (22.33%), reactive hypotone (11.19%), secondary hypertension (17.01%), and stable hypotone (5.59%). By discharge from hospital visual functions improved in 72.73%, visual acuity of 0-0.03 diopters was observed in 14.92% and 0.4-1.0 in 63.87% cases. Secondary hypertension persisted in 1.86% and stable hypotone of the injured eye in 5.13% cases.

[Contusion changes in ophthalmic tonus: clinical observations and pathogenesis]. / Kontuzionnye izmeneniia oftal'motonusa, klinicheskie nabliudeniia i aspekty patogeneza.

Contusions of the eyeball involve reactive or secondary changes in intraocular pressure. Clinical examinations of 151 patients with contusion disorders in ophthalmic tone revealed reactive hypertension in 6.62%, reactive hypotone in 31.79%, secondary hypertension in 48.34%, and stable hypotone of the injured eye in 15.89% cases. Secondary changes in intraocular pressure were caused by massive intraocular hemorrhages and structural injuries to the eyeball. The main cause of reactive hypotone resulting from blunt injury to the eye was exfusion, detachment of the vascular membrane diagnosed at that period by ultrasonic examination in 76.92% cases. The main factors responsible for the postcontusion reactive syndrome are changes occurring within a very short period of time, intraocular pressure differences, and "loss" of the threshold volume of the anterior chamber humor because of its discharge during the shock, and activation of the kallikrein-kinin system with release of kinins causing capillary dilatation and increasing capillary wall permeability in the presence of low activity of angiotensin-converting enzyme which destroys bradykinin.

[Role of kallikrein-kinin system in pathogenesis of eye contusions]. / Rol' kallikrein-kininovoi sistemy v patogeneze kontuzii glaza.

Studies of the plasma components of the kallikrein-kinin system (KKS) in the lacrimal fluid (LF) of damaged eyeball of 32 patients hospitalized for contusion for the eyeball showed an appreciable increase of KKS activity during the first three days and its less expressed increase on days 10-19 after the injury. The content of prekallikrein in the damaged eye LF depends on the severity of eye contusion and plasma KKS status, and the levels of LF prekallikrein in the damaged and intact eye correlate. Serum kallikrein activity depends on the severity of injury.

[Corneal astigmatism after refraction keratotomy]. / Rogovichnyi astigmatizm posle operatsii refraktsionnoi keratotomii.

Refraction keratotomy, by changing corneal refraction, may cause postoperative astigmatism, including its reverse form. The author suggests to assess astigmatism using astigmatic coefficient (K alpha), which is expressed as the cosine of the angle between the vertical and the direction of the stronger main meridian. Intra-and postoperative use of fibronectin solution is proposed to lower the K alpha and improve the efficacy of surgery.

[Indications for keratotomy]. / O pokazaniiakh k keratotomii.

The paper analyses indication to anterior radial keratotomy. Results of the study carried out concerning the influence of uncorrected myopia on successful fulfillment of different tasks (aiming from a sporting gun, operation of a bridge crane, take off and landing on the airplane trainer, etc.) have shown that myopia of 2. OD doesn't influence the fulfillment of work not only with objects situated at near distance from the eyes but at far distance as well. Thus the mentioned myopia cannot serve as a professional indication to keratotomy. The analysis of typical complaints of patients after keratotomy allowed to distinguish 8 main complaints and to assess their incidence and causes as well as causes their of appearance. It is established that even uncomplicated keratotomy can lead to functional changes in vision lowering visual capacity for work. On the basis of all mentioned above a scheme of indications and contraindications to keratotomy is proposed.