[Modern view on ocular hypertension]. / Sovremennyi vzgliad na problemu oftal'mogipertenzii.

Increased intraocular pressure is the main, and the only modifiable risk factor in the development of glaucoma. This review analyzes studies on differential diagnostics of ocular hypertension and risk factors of its conversion to glaucoma, and gives recommendations based on literature data for the most correct algorithm for management of patients with ocular hypertension.

[Structural retinal and optic nerve changes in patients with post-geniculate visual pathway damage]. / Strukturnye izmeneniia setchatki i zritel'nogo nerva pri porazhenii tsentral'nogo nevrona zritel'nogo puti.

AIM: To establish the possibility of retrograde trans-synaptic neural degeneration following acquired post-geniculate visual pathway damage. MATERIAL AND METHODS: Twenty-two patients with homonymous hemianopia caused by acquired post-geniculate visual pathway damage were examined. Peripapillary retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) measurements were assessed with RTVue-100 Fourier-domain optical coherence tomography (OCT). RESULTS: In 12 out of 22 patients we detected binocular GCC thinning that was ipsilateral to post-geniculate involvement. Nine patients showed a decrease in the RNFL thickness. However, topographic correspondence between the post-geniculate lesion and RNFL thickness was established for 2 of them only. GCC thinning was more common in patients with hemianopsia acquired more than 6 months ago (p<0.0009). CONCLUSION: Having assessed the ganglion cell complex and retinal nerve fiber layer with OCT, we have proved possible that trans-synaptic retrograde degeneration develops in patients with post-geniculate visual pathway damage.

[Diffusion tensor magnetic resonance imaging in the diagnosis of visual pathway neurodegeneration in glaucoma].

AIM: To study the state of visual pathways in patients with glaucoma by means of diffusion tensor magnetic resonance imaging (DT-MRI). MATERIAL AND METHODS: DT-MRI was performed in 16 patients: 12 patients with POAG of different stages and 4 controls. Fractional anisotropy (FA) and its longitudinal variation (FA) determined by an original software (Fractional Anisotropy Analyzer) were used to assess the state of the lateral geniculate body and optic radiation. All patients also underwent optical coherence tomography (OCT) of the retina and optic nerve head, Heindelberg retinal tomography (HRT), and Humphrey standard automated perimetry (SAP). RESULTS: There was a significant decrease in FA values in glaucoma patients as compared with the control group (medians of 0.74 and 0.77 respectively, p < 0.01). Moderate and strong correlations of AFA with glaucoma stage as well as morphometric (GCC Average, GLV, FLV, and RNFL Average provided by OCT, rim area provided by HRT) and functional parameters (MD and PSD provided by SAP) of the retina and optic nerve head were also established. CONCLUSION: Reduced fractional anisotropy of the lateral geniculate body and optic radiation in patients with glaucoma may be considered an indicator of axonal degeneration at the level of the visual centers. DT-MRI in vivo helps to determine whether or not the neurodegenerative process spreads to the central nervous system as glaucoma progresses.

[Dissociation of structural and functional parameters of the retina and optic nerve in a patient with Alzheimer's disease (clinical case)].

Visual impairment is often one of the earliest sings of Alzheimer's disease. This article reports a clinical case of a female patient diagnosed with mild dementia due to Alzheimer's disease. As revealed by a comprehensive examination, her visual fields and visual evoked potentials were markedly changed, while morphometric parameters of the retina and optic nerve appeared normal. Such a significant dissociation of structural and functional parameters may indicate a more proximal involvement of visual pathways in Alzheimer's disease.