[Fixed combination of latanoprost and timolol in the long-term treatment of patients with normal-tension glaucoma]. / Fiksirovannaya kombinatsiya latanoprost/timolol v dolgosrochnom lechenii patsientov s glaukomoi normal'nogo davleniya.

The most well-studied and widely prescribed fixed-combination drug for open-angle glaucoma is latanoprost/timolol. Its significant hypotensive effect is especially important in challenging cases, among which are patients with normal-tension glaucoma. With long life expectancy and the constant need for treatment, requirements are high for both the effectiveness of the drug and its tolerability. This paper presents a follow-up of 7 patients with normal-tension glaucoma who have been using the fixed combination of latanoprost/timolol for 10 years. All patients showed very good tolerability to the drug and their quality of life was preserved. A moderate rate of disease progression according to static perimetry was noted in one case. A mild degree of dry eye syndrome according to the OSDI questionnaire and an objective assessment of the state of the ocular surface was observed in one patient. The latanoprost/timolol fixed combination is a well-tolerated, highly effective and safe long-term treatment choice for normal-tension glaucoma.

[Medicated prevention of scarring after glaucoma surgery]. / Medikamentoznaya profilaktika posleoperatsionnogo rubtsevaniya v khirurgicheskom lechenii glaukomy.

Modulation of wound healing is one of the main challenges in glaucoma surgery. Modern antiproliferative agents used to reduce postoperative scarring are either insufficiently effective or inadequate in terms of safety. In the search for novel agents devoid of such drawbacks, specialists directed their attention to selective inhibitors of proinflammatory cytokines and growth factors. The article reviews pathophysiologic basis of wound healing, characteristics of inflammatory mediators affecting fibroblast proliferation and scarring, and provides description of the currently used and new, potentially promising antiproliferative agents.

[Influence of treatment adherence on the progression of primary open-angle glaucoma in clinical setting]. / Vliianie priverzhennosti k lecheniiu na progressirovanie pervichnoi otkrytougol'noi glaukomy u patsientov v usloviiakh klinicheskoi praktiki.

According to various studies, treatment adherence of patients with primary open-angle glaucoma ranges from 5% to 80% and significantly influences the effectiveness of the therapy. Some authors report higher levels of adherence in patients receiving preservative-free medications. PURPOSE: To study the influence of treatment adherence in patients receiving preservative-free and preserved medications on the progression of primary open-angle glaucoma (POAG). MATERIAL AND METHODS: This prospective multicenter non-interventional study was conducted in clinical setting and included 504 patients with primary open-angle glaucoma receiving drug therapy; 51 ophthalmologist was involved in the management of patients' diaries. RESULTS: The percentage of patients who did not reach target IOP was three times lower in the group with high adherence, in comparison to patients with medium and low adherence (7% against 22%, respectively). Development of side effects was one of the factors influencing treatment adherence, their rates and expressiveness were much lower in the preservative-free group compared with the group receiving preserved medication (13.9% against 35.4%). The rate of patients who did not reach target IOP was two times lower in the group of preservative-free medication (10% against 21%). CONCLUSION: The study confirms that preservative-free glaucoma medication promotes higher adherence to treatment in clinical setting predominantly due to the reduction of quantity and severity of side effects leading to treatment gaps, which results in increased effectiveness and better stabilization of glaucoma.

[Economic aspects of diabetic macular edema treatment at regional level in Russian Federation]. / Ékonomicheskie aspekty lecheniia diabeticheskogo makuliarnogo oteka na regional'nom urovne v Rossiiskoi Federatsii.

An assessment of economic burden of Diabetic Macular Edema (DME) in Russian Federation was conducted on the example of four pilot regions including Samara Region, Republic of Bashkortostan, Chuvash Republic and Yaroslavl Region. The assessment involved a newly developed interactive pharmacoeconomic model that uses data from questionnaire surveys of leading DME experts residing in the regions. In the course of the study, direct and indirect costs associated with DME were calculated. The highest direct costs of DME treatment were seen in the Republic of Bashkortostan - 302 482 RUB/year per patient. Direct cost of treating a single DME patient in the Samara Region was 34 271 RUB/year, in the Yaroslavl Region - 32 308 RUB/year and in the Chuvash Republic - 12 243 RUB/year. Indirect costs per DME patient in the Samara Region amounted to 67 530 RUB/year, in the Yaroslavl Region - 75 177 RUB/year, in the Republic of Bashkortostan - 102 884 RUB/year and in the Chuvash Republic - 81 082 RUB/year. Total annual costs per DME patient in the Samara Region was 101 801 RUB/year, in the Yaroslavl Region - 107 485 RUB/year, in the Republic of Bashkortostan - 405 366 RUB/year and in the Chuvash Republic - 93 325 RUB/year.

[Medication assisted activation of unveoscleral outflow of intraocular fluid in glaucoma: pathogenic aspects].

The article provides an overview of the main groups of IOP-lowering drugs which activate uveoscleral outflow in glaucoma and this activation is a key component of mechanism of action of these drugs. The issues related to the change of tone of ciliary muscle and its participation in uveoscleral outflow, and also relationship of accommodation and aqueous flow in glaucoma pathogenesis and possible pharmacological effects of these processes are being discussed.

[Surgical treatment for recurrent pterygium with plastic repair by means of silicone-dried amniotic membrane].

By taking into account the pathogenesis of the pterygium, the treatment of choice is surgical removal of the latter with plastic repair of the conjunctiva with allogenic tissues. The authors used the allogenic silicone-dried amniotic membrane "Flexamer" to replace the formed defect in order to create conditions for regeneration of the mucosal membrane of the eyeball. The conclusions of the study are based on the analysis of the results of surgical treatment in 106 patients with primary and recurrent pterygium. The unique properties of the implant "Flexamer" made formed from the silicone-dried amniotic membrane promote a rapid corneal epithelial regeneration and create conditions for making the eyeball mucosa good at the site of the excised abnormal conjunctiva, reducing the likelihood of a recurrent. Thus, the use of the silicone-dried amniotic membrane "Flexamer" is safe and effective and the findings allow the implant "Flexamer" to be recommended for use in the removal of both primary and recurrent pterygium.

[Photodynamic visudyne therapy for subretinal neovascularization].

A total of 199 sessions of photodynamic therapy (PDT) with visudine were performed in 119 patients (227 eyes) at the Laser Center, T. I. Yeroshevsky Samara eye diseases hospital. Analysis of the changes occurring in visual function in the presence of the subretinal neovascular membrane developing in age-related macular dystrophy and high complicated myopia showed an increase in visual functions in the first 3-6 months after PDT, which is, in the authors' opinion, associated with the diminution of macular edema and the resolution of hemorrhage. In the subsequent months, visual acuity tended to slightly lower. The late follow-up periods (after 1.5 years) saw visual function stabilization. Visudine PDT for subretinal neovascularization is an effective, safe, technically simple, well-tolerable procedure that makes it possible not only to stabilize, but, in many cases, to improve visual functions. A follow-up of patients for as long as 18 months demonstrated that stable visual functions were retained with a slight tendency for their reduction during continued PDT sessions.

[The risk factors for the development of the multiple organ failure syndrome in destructive pancreatitis]. / Faktory riska razvitiia sindroma poliorgannoi nedostatochnosti pri destruktivnom pankreatite.

The role of neutrophil leukocytes in the development of the polyorgan failure syndrome during an unfavorable course of destructive pancreatitis is discussed. The examinations of 52 patients demonstrated a high correlation of neutrophil functional activity tests (nitroblue tetrazolium reduction test and leukocyte-platelet aggregation) and disorders of microcirculation and hepatorenal involvement (detected clinically and by laboratory tests). The "critical mass" of leukocytosis has been estimated: at least 18 . 10(9)/liter, at which the risk of polyorgan failure appreciably increases. The authors discuss the advisability of selective cytopheresis in a complex of intensive care for critical states involving endogenous poisoning and leukocytosis.