[Role of pentoxifylline retard dosage forms in the correction of hemodynamic disorders in retinal venous occlusion and diabetic retinopathy].

The investigation was undertaken to study the effect of the pentoxifylline retard dosage form Vasonit on ocular hemodynamics in patients with retinal vein occlusions and non-proliferative diabetic retinopathy (DR). Forty-two patients aged 45 to 75 years, including 20 patients (20 eyes) with retinal vein occlusion in the presence of hypertensive disease and atherosclerosis (Group 1) and 22 patients (44 years) with non-proliferative DR (Group 2), were examined. All the patients received the pentoxifylline retard dosage form Vasonit, 600 mg twice a day, for 2 months. After a course of pentoxifylline therapy, the patients were observed to have improved visual functions, positive clinical changes in the fundus of the eye as a reduction in the frequency and extent of retinal hemorrhages, in the degree of manifestations of macular edema, in the number of retinal microaneurysms and ischemic areas. The results of color Doppler mapping of ocular and orbital vessels are indicative of improved hemodynamics as an increase in the values of blood flow velocity and normalization of blood flow resistance and pulsation indices in the arteries supplying blood to the retina and optic nerve.

[Treatment of patients with proliferative diabetic retinopathy and serotonin insufficiency]. / Lechenie bol'nykh proliferativnoi diabeticheskoi retinopatiei s serotoninovoi nedostatochnost'iu.

30 patients (19--female and 11--male) with proliferative diabetic retinopathy (DR) were examined. The age of patients and of the controls ranged from 25 to 72 years. The duration of diabetes mellitus amounted on the average to 16.4 +/- 4.1 years. The cause of diabetes mellitus was evaluated for the moment of examination as of mean severity and in the stage of subcompensation. Ophthalmologically, relapsing hemophthalmias and extensive preretinal hemorrhages in the eye fundus were typical for this group of patients. Standard techniques were used to determine the index of erythrocytes deformability and the concentration of serotonin in the blood plasma. All patients were prescribed intramuscular injections of 1% ATP solution, 2 ml daily during 2 weeks. Pentoxifillin was prescribed perorally, 0.2 g x 3 times per day during 30 days, enterogel--15 g x 3 times per day during 7 days. The simultaneous administration of pentoxifylline and enterogel normalized the erythrocytes elasticity and the concentration of serotonin in the blood plasma. Clinically, it led to an improvement of visual acuity (0.18 +/- 0.008) and to resorption of hemorrhages in the eye fundus. The obtained results are indicative of the advisability to use simultaneously pentoxifylline, enterogel and ATP in a comprehensive medication treatment of proliferative DR with chronic serotonin insufficiency.

[Significance of serotonin in the pathogenesis of diabetic retinopathy and central chorioretinal dystrophy]. / Znachenie serotonina v patogeneze diabeticheskoi retinopatii i tsentral'noi khorioretinal'noi distrofii setchatki.

A total of 147 patients with preproliferative and proliferative diabetic retinopathy (DR), with the exudative hemorrhagic and nonexudative stages (93 females and 54 males), were consulted at Helmholtz Institute of Ophthalmic Diseases in 1997-2001. Control group consisted of 39 healthy subjects aged 25-76 years. The group of patients with preproliferative DR consisted of 27 patients with compensated diabetes mellitus. The course of diabetes in 39 patients with proliferative DR was evaluated as medium severe during the subcompensation stage. The clinical picture of the fundus oculi was characterized by pronounced hemorrhagic activity. Slight retinal hemorrhages were seen in the patients with preproliferative DR. Nodules, defects of pigmented epithelium, atrophic foci were seen in the central zone of the fundus oculi in patients with nonexudative stage of central chorioretinal dystrophy; edema in the central zone, polymorphic hemorrhages, solid exudate were observed in the patients with the exudative hemorrhagic stage; subretinal neovascular membrane was detected in some patients. Erythrocyte deformability coefficient, platelet aggregation coefficient to ADP, and platelet factor were evaluated by common methods. Serotonin was measured by the fluorometric method (B. M. Kogan's method) at clinical biochemical laboratory of urgent methods of examination of N. V. Sklifosovsky Institute of Emergency. The erythrocyte deformability coefficient was notably increased in the patients with proliferative DR and central chorioretinal dystrophy in comparison with the normal value. Plasma serotonin concentration was increased significantly only in the patients with proliferative DR, while in the rest groups this concentration was notably decreased. Study of platelet aggregation gave contradictory results. The values of platelet factor 4 differed from the control negligibly. Serotonin insufficiency in patients with proliferative DR was paralleled by increased plasma serotonin concentration and thrombocytopathy. In patients with preproliferative DR and central chorioretinal dystrophy serotonin insufficiency was associated with decreased concentration of serotonin and thrombocytopathy. Erythrocyte rigidity was similarly increased in patients with proliferative DR and central chorioretinal dystrophy.