[Adequacy of prescribing the disaggregants in vascular pathology of the eye fundus and in primary open-angle glaucoma]. / Ob adekvatnosti naznacheniia dezagregantov pri sosudistykh zabolevaniiakh glaznogo dna i pervichnoi otkrytougol'noi glaukome.

The functional activity of blood platelets was studied in 936 patients with vascular pathology of the eye fundus (central chorioretinal dystrophy--CCRD; preproliferative diabetic retinopathy--PPDR; proliferative diabetic retinopathy--PDR; hypertensive retinopathy--HP; thrombosis of retinal veins--TRV; and primary open angle glaucoma--POAG) by using 2 methods: the routine one, which does not expose the real process of platelets' aggregation in the blood bed, and a method, which is closer to the conditions in vivo. The non-physiological ("tube"-based) methods of determination of platelets' aggregation overstate almost 3-fold the share (%) of patients needing disaggregants. The disaggregation therapy is indicated in 28% of cases; it is more often prescribed for patients with TRV (52.2%), HP (40%), PPDR (35.5%), POAG (29%), PDR (21.5%) and CCRD (15.3%). An acute decrease of the aggregation ability of platelets was registered in 22.5% of the examinees: drugs intensifying the functional activity of platelets were used. The conclusion is that iatrogenic hemorrhages can be reduced by using adequate methods for the determination of the functional activity of platelets and by prescribing an adequate medicamental therapy.

[The content of D-dimer in peripheral blood as observed studied in thrombohemorrhagic lesions of the retina]. / Izuchenie soderzhaniia d-dimera v perifericheskoi krovi pri trombogemorragicheskikh zabolevaniiakh setchatki.

The content of D-dimer in peripheral blood was studied in thrombohemorrhagic lesions of the retina. 60 patients with retinal pathology of the retina, i.e. thrombosis of retinal veins, exudative-hemorrhagic stage of central chorioretinal dystrophy and preproliferative diaichbetic retinopathy with pronounced exudative hemorrhagic maculopathy, were examined. A higher concentration of D-dimer in peripheral blood was shown to be indicative of affected general hemostasis. The below main parameters, which matter in progression of thrombohemorrhagic conditions should be determined, apart from D-dimer, for choosing an adequate medicamental therapy: aggregation ability of platelets, activated partial thromboplastin time, antithrombin-III, protein-C, prothrombin time, soluble complexes of fibrinmonomer, thrombin time, plasma fibrinogen and fibrinolytic plasma activity.

[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.

[Thrombocytopathies and their role in the development of hemorrhagic syndrome in vascular diseases of the fundus oculi]. / Trombotsitopatii i ikh rol' v razvitii gemorragicheskogo sindroma pri sosudistykh zabolevaniiakh glaznogo dna.

Examinations of 407 patients with angiological disorders of the fundus oculi (diabetic retinopathy, retinal vein thrombosis, central chorioretinal dystrophy, retinal angiitis) revealed relapsing hemorrhagic syndrome in 40% (170) patients. No thrombocytopenia was revealed in any of the patients, which suggests qualitative impairment of platelets in such patients. Evaluation of the platelet aggregation coefficient (PAC) using thrombin aggregation inducers and adenosine diphosphate disodium revealed a statistically significant decrease of PAC for one or both aggregants in all 170 patients with the hemorrhagic syndrome, which indicated platelet dysfunction. A course of intramuscular injections of 1% adenosine triphosphate sodium normalized platelet function and stimulated resorption of hemorrhages.

[Effect of therapy with blood component (activated autoplasma) on blood glutathione level in patients with vascular abnormalities on the fundus oculi]. / Vliianie gemokomponentnoi terapii (aktivirovannoi autoplazmy) na uroven' glutationa v krovi u bol'nykh s sosudistoi patologiei glaznogo dna.

Thirty-three patients with central chorioretinal dystrophy, 18 with proliferative diabetic retinopathy, and 15 controls without ocular diseases were examined. All patients were treated by blood components. The treatment started with activation of blood plasma platelets. Glutathione was measured in two portions of plasma: intact and containing platelet activation products. The content of glutathione was higher in activated autoplasma of 21 patients with central chorioretinal dystrophy and 6 patients with diabetic retinopathy than in intact plasma by 107 and 72%, respectively. A decrease in glutathione level in activated autoplasma was observed in 1 patient with central chorioretinal dystrophy and in 9 with diabetic retinopathy. Hence, antioxidant defense is decreased in diabetic retinopathy, since glutathione is involved in reduction of organic hydroperoxides.

[Effects of activated autoplasma on platelet aggregation in patients with vascular diseases of the fundus oculi]. / Vliianie aktivirovannoi autoplazmy na agregatsiiu trombotsitov u bol'nykh s sosudistymi zabolevaniiami glaznogo dna.

Activated autoplasma (AAP) was used in the treatment of patients with central chorioretinal dystrophy and diabetic retinopathy. The therapeutic effect of AAP injected intrabulbarly and its effect on platelet aggregation in the peripheral blood after intramuscular and intravenous injections were assessed. Intravenous AAP was found to exert a manifest disaggregating effect, whereas intramuscular injections did not affect platelet aggregation.

[Hemocomponent therapy of central involution chorioretinal dystrophy]. / Gemokomponentnaia terapiia tsentral'noi involiutsionnoi khorioretinal'noi distrofii.

Hemocomponent therapy was used in 181 patients (347 eyes) with central chorioretinal dystrophy. Activated autoplasma possessing a marked resorptive effect, consisting in resorption of hemorrhages and exudations on the fundus oculi, was used. Vision acuity improved in 75% of examined eyes by an average of 0.2 diopters.

[Results of the use of vasoactive preparation pikamilon in pigmented retinal abiotrophy]. / Rezul'taty primeneniia vazoaktivnogo preparata pikamilona pri pigmentnoi abiotrofii setchatki.

Eighty patients with pigmented retinal abiotrophy (PRA) and 20 controls were examined. The perfusion pressure and arteriovenous coefficient are markedly reduced in patients with stages 1-2 PRA, in comparison with controls. Deterioration of the visual function in patients with stages 3-4 PRA vs. that in stages 1-2 was associated with a more marked reduction of the hemodynamic parameters and the status of ocular vessels. Pikamilon therapy in a dose of 2 ml of 10% solution once a day intramuscularly for 10 days led to improvement of the visual function and ocular hemodynamics in patients with PRA. Treatment efficacy was higher in patients with disease stages 1-2. Pikamilon is recommended for the treatment of patients with PRA.

[Perfusion pressure in ocular vessels of patients with open-angle glaucoma]. / Perfuzionnoe davlenie v sosudakh glaz u bol'nykh otkrytougol'noi glaukomoi.

Perfusion pressure in ophthalmic vessels was measured by computer-aided ophthalmodynamography in health, stenoses of the internal carotid artery, and open-angle glaucoma. A total of 70 subjects were examined. Stenoses of the internal carotid artery are associated with a noticeable reduction of perfusion pressure on the side of stenosis. Some patients develop optic nerve atrophy (without excavation). Secondary neovascular glaucoma was diagnosed in 1 patient. Primary open-angle glaucoma was revealed in none of the patients. Increase of intraocular pressure in patients with open-angle glaucoma was associated with a reduction of perfusion pressure. However, in more than 50% of patients a higher pressure was observed in the orbital artery corresponding to the eye with a higher ophthalmic tone than in the contralateral eye. This was conducive to a certain leveling of perfusion pressure. Such a reaction is regarded as a manifestation of autoregulation of ocular vessels, important for blood delivery to the eyes.

[Clinical significance of the determination of several hemostatic parameters in the lacrimal fluid of patients with vascular diseases of the retina]. / O klinicheskom znachenii opredeleniia nekotorykh gemostaticheskikh pokazatelei v sleznoi zhidkosti bol'nykh s sosudistymi zabolevaniiami setchatki.

Clinicolaboratory studies of 92 patients with vascular diseases of the retina (retinal vein thrombosis, central chorioretinal dystrophy, retinal hypertensive angiosclerosis) were carried out to assess hemorheologic parameters (platelet and red cell aggregation coefficients, blood viscosity). In parallel with this, lacrimal fluid was analyzed for hemostatic parameters, plasminogen and antithrombin III. A marked increase of plasminogen and antithrombin III levels was found in the lacrimal fluid of patients with retinal vein thrombosis, this increase correlating with pathologic shifts in the studied rheologic characteristics. Central chorioretinal dystrophy and retinal hypertensive angiosclerosis were associated with shifts in some rheologic characteristics. Hence, measurements of lacrimal fluid hemostatic parameters plasminogen and antithrombin III in patients with retinal vascular diseases help assess blood rheology.

[Results of the use of ticlid in the treatment of patients with post-thrombotic retinopathy]. / Rezul'taty primeneniia tiklida dlia lecheniia bol'nykh posttromboticheskoi retinopatiei.

Presents 22 case histories of patients with postthrombotic retinopathy (n = 20) and fresh thrombosis (n = 2), treated with ticlid, a new drug. Demonstrates the disaggregating and antithrombotic effects of the drug, a positive time course of microcirculatory changes in the fundus oculi and improvement of blood rheology.

[Results of phlebo-destruction surgery and blood rheology indicators in patients with central chorioretinal dystrophy]. / Rezul'taty operatsii flebodestruktsii i gemoreologicheskie pokazateli u bol'nykh s tsentral'noi khorioretinal'noi distrofiei.

Hemorheologic parameters were analyzed in 34 patients with central chorioretinal dystrophy and the effects of these parameters on the outcome of phlebodestruction studied. Blood viscosity and red cell aggregation coefficient were found increased in such patients. Phlebodestruction was found ineffective in the patients with significant disturbances of blood rheology. The authors come to a conclusion on the usefulness of using blood rheologic parameters for the prediction of phlebodestruction surgery outcome in patients with central chorioretinal dystrophy.

[Effects of phosphaden on hemodynamics of the eye in patients with post-thrombotic retinopathy]. / Vliianie fosfadena na gemodinamiku glaz u bol'nykh s posttromboticheskoi retinopatiei.

A course of treatment with phosphaden, a rheologic agent, has been administered to 33 patients with postthrombotic retinopathy. The treatment resulted in improvement of the fundus oculi status and of vision acuity in the majority of patients. Rheo-ophthalmography data indicate an improvement of blood supply to the eyes after such treatment. The authors claim that ocular hemodynamics improvement is related to correction of impaired blood rheology. The findings evidence the efficacy of phosphaden in the management of postthrombotic retinopathy.

[Study of rheologic properties of the blood in patients with open-angle glaucoma]. / Issledovanie reologicheskikh svoistv krovi u bol'nykh otkrytougol'noi glaukomoi.

Studies of platelet aggregation coefficient and blood viscosity in 53 patients with open-angle glaucoma have revealed a statistically significant elevation of this coefficient value in the patients vs. the normal subjects. Possible mechanisms of this shift are discussed. The authors consider it useful that studies on the efficacies of drugs used in the treatment of open-angle glaucoma be carried out.

[Pathogenetic factors in thrombosis of the central retinal vein]. / Patogeneticheskie faktory tromboza tsentral'noi veny setchatki.

Studies of the hemorheologic parameters and the hemostasis system components in the blood and lacrimal fluid of 130 patients with thrombosis of a branch of the central retinal vein (CRV) and calibrometry of the CRV have lead the authors to a conclusion that the major factors contributing to the pathogenesis of CRV thrombosis are (1) disordered blood rheology; (2) changes in the local hemostatic potential; (3) impaired blood stream in the corresponding CRV branches. Rationale for the use of drugs normalizing the blood rheology in CRV thrombosis is given.