[Macular and multifocal electroretinography in the evaluation of the retinal macular region function in age-related macular degeneration].

The electrogenesis of the retinal macular region versus optic coherent tomographic data was studied in different forms of age-related macular degeneration (ARMD). A macular electroretinogram (M-ERG) and mixed ERG, multifocal ERG (mf-ERG), and optical coherent tomograms were recorded in 60 patients (112 eyes) aged 57 to 82 years who had ARMD. A significant moderate correlation was established between the averaged N1 amplitude of mf-ERG in the central rings and the M-ERG a-wave to a red stimulus, as well as between the averaged latency of an mfERG P1-component and the latency of the latency of b-wave and between the amplitudes of respective components. There was a significant reduction in the amplitude of the retinal macular region in confluent druzen. In focal atrophy of the retinal pigment epithelium (RPE), the amplitude decrease rate and extent varied from a significant reduction in M-ERG b-wave amplitude and a P1 decrease in the central hexagon to the significant reduction in the amplitude of M-ERG a- and b-wave components and mfERG N1 and P1 components in the foveal and parafoveal rings. M-ERG and mfERG changes in exudative ARMD were different in neuroepithelial and RPE detachments, retinal cystic changes and in varying activity of choroidal neovascularization.

[Macular and multifocal electroretinography in the diagnosis of Stargardt's dystrophy].

Retinal bioelectrical activity was studied in Stargardt's dystrophy from the data of multifocal and macular electroretinography (M-ERG) and retinal morphometry was carried out. The group of 11 patients (22 eyes) with the central form of Stargardt's dystrophy showed reductions in the retinal density of a bioelectric response of a P1 component, the amplitude of N1 and P1 components in the area of 0 to 16 degrees, as well as decreases in the amplitude of M-ERG a- and b-waves and in the retinal thickness in the macular region. The mixed Stargardt's dystrophy group was characterized by reductions in the retinal density of an electrical response of a P1 component, in the amplitude of N1 and P1 components in the entire posterior pole in the area of 0 to 32 degrees, as well as decreases in the a- and b-waves of M-ERG, photopic, scotopic, and mixed ERG; the lowered retinal thickness was found in the foveal and parafoveal regions. A statistically significant relationship was established between the morphometric indices of the volume of the central retina, the amplitude of M-ERG b-wave, and the moderate retinal density of P1 component bioelectrical activity in the central regions.

[Electroretinography in the evaluation of vitreoretinal proliferative changes due to penetrating shell injury to the eye].

The influence of vitreoretinal proliferative changes on retinal electrogenesis and glioneuronal relationships was studied in 41 patients with penetrating shell injury to the eye. The early data of studies indicated that there is a reduction in the hanz-feldt amplitude on an electroretinogram (ERG). According to the data of optic coherent tomography (OCT), this corresponds to an exudative reactive response and to the development of vitreoretinal tractional changes in the retina in the central zone and at the site of a foreign body. Retinal electrogenetic changes were most pronounced at months 1 to 6 of a follow-up. The integral glial index was decreased and the central index of Müller's cells was drastically increased in the injured eyes. In this period, there was a reduction in an exudative response to injury and an increase in vitreoretinal proliferative changes, as evidenced by OCT. In late posttraumatic period, the injured eyes were characterized by a slow increase in the amplitude of biopotentials that did not achieve the lower normal range just 1 year or more after injuring. Late posttraumatic inhibition is likely to be caused by vitreoretinal complications of mainly dystrophic nature in the central retinal zone and at the site of fragment bedding or removed foreign body.

[Clinical peculiarities of optic neuritis and alterations of local immune response in patients with multiple sclerosis]. / Klinicheskie osobennosti techeniia opticheskogo nevrita i izmeneniia lokal'nogo immunnogo otveta u bol'nykh rasseiannym sklerozom.

Multiple sclerosis (MS) is a severe organic disease of the central nervous system (CNS) affecting mostly young people. Optic neuritis (ON) is one of the first manifestations of the disease in approximately 75% of cases. The autoimmune reactions to myelin antigens play a key role in ON pathogenesis of MS. The pro- and anti-inflammatory unbalance is the most important factor of the origin, development and stabilization of CNS changes. Presented are the data on alterations of the levels of pro- and anti-inflammatory cytokines TNF-alpha, IF-gamma and antibodies to MBP and anti DNA in patient's tears. The clinical peculiarities of ON in MS correlating with immunological alterations are established.

[Leber's hereditary optic atrophy: neurological and other non-optic appearances]. / Nasledstvennaia atrofiia zritel'nykh nervov Lebera: nevrologicheskie i drugie vneglaznye proiavleniia.

Comparing to other mitochondrial diseases, multisystemic lesions in Leber's hereditary optic atrophy (LHOA) occur less frequently. However, in some cases there are concomitant manifestations, especially neurological ones. Out of thirteen patients examined in the study, 5 exhibited MRI-detected neurological symptoms and changes, which may have concern to the underlying disease, namely LHOA caused by 11778A mutation. Literature and author's own data on neurological spectrum of LHOA and its possible relation to multiple sclerosis are summarized. A rare combination of LHOA caused by 14484C mutation and diabetes mellitus, described first-ever in the present study, is emphasized.

[Pulse therapy in the treatment of optic neuritis in multiple sclerosis]. / Pul's-terapiia v lechenii opticheskogo nevrita pri rasseiannom skleroze.

Corticosteroids are the preparations in the treatment of optic neuritis at multiple sclerosis. The doses and methods of introduction of corticosteroids are chosen individually for the adults and children. A maximum effect is registered in a majority of cases of optic neuritis, when methylprednisolone is prescribed with the pulse-dose introduction, as compared to parabulbar injections or administration of corticosteroids per os. The recovery of vision at relapsing optic neuritis sets on faster and is of a more prolonged nature as compared to other variants of the introduction of corticosteroids. Therefore, the prescription of methylprednisolone as pulse-doses is more effective in both adults and children.

[Leber's hereditary optic neuropathy: DNA-diagnosis and clinico-genetic comparisons in 12 families]. / Nasledstvennaia atrofiia zritel'nykh nervov Leber: DNK-diagnostika i kliniko-geneticheskie sopostavleniia v 12 sem'iakh.

Leber's hereditary optic neuropathy (LHON) is a worldwide spread neuro-ophthalmologic disease characterized by immediate pronounced visual reduction with a picture of retrobulbar neuritis, following by optic atrophy. The disease is caused by mitochondrial DNA mutations. Molecular genetic structure of 12 families, including 26 LHON patients, 13 of them being examined, is presented. All of the main primary mutations have been found: the most frequent 11778A (in 10 families), 3460A and 14484C (each in 1 family). In 5 families, the disease was clearly hereditary. Men predominated among the patients, that indicated a reduction of the gene penetrance in women. The most frequent age at the disease onset is 18-25 years. Clinico-genealogical LHON mechanisms correlate with mutation type. Molecular genetic mechanisms of the disease and possible environmental factors, influencing the gene penetrance, are discussed.

[Role of ultrasonic B-scanning in differential diagnosis and prognosis of the course of optic neuritis]. / Rol' ul'trazvukovogo B-skanirovaniia v differentsial'noi diagnostike i prognozirovanii techeniia opticheskogo nevrita.

The possibility of using ultrasonic scanning in differential diagnosis of optic neuritis (ON) and anterior ischemic neuropathy (AIN) and the prognostic significance of the results were evaluated. The thickness of retrobulbar part of the optic nerve directly behind the eye was measured by echographic B method in patients with ON and AIN. The thickness of the retrobulbar part of the involved and paired optic nerve was more than 0.7 mm in 90% patients with ON, which can be considered as an additional clinical sign of ON. Thickening of the retrobulbar part of the optic nerve is not characteristic of AIN. In patients with disseminated sclerosis ON is associated with less pronounced thickening of the retrobulbar part of the optic nerve than in idiopathic ON, which agrees with the pathogenesis and pathomorphology of disseminated sclerosis. The degree of optic nerve thickening in ON in patients with disseminated sclerosis is prognostically insignificant, while in idiopathic ON more than 2 mm asymmetry of the retrobulbar part of the involved and paired optic nerve is a sign predicting a long course of the disease and maybe incomplete recovery of vision. Thickening of the involved optic nerve by less than 1.7 mm is associated with a better prognosis as regards the time and completeness of vision restoration.

[Psychophysical symptoms of demyelinating diseases of the optic nerve in multiple sclerosis]. / Psikhofizicheskie simptomy demieliniziruiushchikh porazhenii zritel'nogo nerva pri rasseiannom skleroze.

Visual system channels were examined in 25 patients with multiple sclerosis. A new complex of symptoms was detected, reflecting the acute stage and the chronic demyelinizing process, which includes disorders of contrast, color, and spatial contrast sensitivity and stereoscopic vision. This can be useful in differential diagnosis of optic nerve diseases and evaluation of the visual system function in multiple sclerosis and prediction of the disease course.

[Experience of garasone use in surgical practice]. / Opyt primeneniia preparata "garazon" v khirurgicheskoi praktike.

The efficiency of garasone (Schering-Plau) in preoperative and postoperative treatment was evaluated in 50 patients. Controls (48 pts) were treated by combinations of antibiotics (0.25% levomycetin and 20% sodium sulfacyl solutions) and antiinflammatory drugs (0.1% dexamethasone and maxidex). The postoperative inflammatory reaction ceased much sooner in the patients treated with garasone than in the controls. Conjunctival edema, corneal edema, and descemetitis completely disappeared on days 4-5 after the operation in the study group and only on day 6 in the control. Higher efficiency of garasone can be attributed to the advantages of its components: wide-spectrum gentamicin and its high bioavailability for the eyeball tissues and an effective steroid betamethasone. One more advantage of garasone is that it is convenient to use (a single flask, no need in repeated instillations). The results recommend garasone for wide use for prevention and treatment of postoperative inflammatory diseases of the eyes.

[Spatial contrast sensitivity in the differential diagnosis of optic neuritis]. / Prostranstvennaia kontrastnaia chuvstvitelnost v differentsialnoi diagnostike opticheskikh nevritov.

Contrast sensitivity was examined in patients with optic neurites of different etiology. Achromatic and chromatic (red-black, green-black, and blue-black) sinusoidal patterns were presented in succession against the black background at a frequency of 1-22 cycles/degree on the monitor of an IBM computer. Contrast sensitivity was found altered during exacerbation of optic neuritis on both involved and intact eyes, this indicating a possible involvement of the chiasmal region. The authors discuss a new approach to investigation of the mechanisms of impairment of the optic nerve in optic neuritis in the presence of disseminated sclerosis and neuritis of obscure etiology.