[Patterns of structural and functional changes in the retina and choroid in acute posterior multifocal placoid pigment epitheliopathy]. / Zakonomernosti strukturno-funktsional'nykh izmenenii setchatki i khorioidei pri ostroi zadnei mul'tifokal'noi plakoidnoi pigmentnoi epiteliopatii.

PURPOSE: The study analyzes the patterns of pathological changes in the retina and choroid in acute posterior multifocal placoid pigmented epitheliopathy (APMPPE). MATERIAL AND METHODS: The results of the examination of two patients with bilateral APMPPE were analyzed retrospectively. The examination had included visometry, tonometry, static perimetry, autofluorescence, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). RESULTS: The analysis revealed signs of the inflammatory nature of the choriocapillary vascular wall lesion with the development of their local obstruction and, consequently, local ischemia of the retinal pigment epithelium (RPE) and the outer layers of the retina in the acute period. At the same time, partial destruction of the ellipsoid zone, uneven hyperreflectivity of the RPE with local areas of its elevation and impaired connection with photoreceptors were revealed. The subsequent restoration of choriocapillaris perfusion was accompanied by significant restoration of the functional and structural state of the RPE over a larger area, as well as partial restoration of the ellipsoid zone of the retina. Two years after the onset of the disease, separate areas of defects of the RPE and the outer retina were observed, coinciding in localization with zones of severe circulatory deficiency at the level of choriocapillaris in the acute stage. CONCLUSION: According to the results of multimodal imaging, choriocapillaritis is the initial link in the pathogenesis of APMPPE. The change in RPE and the outer retina is secondary to the local ischemic zones due to choriocapillaris nonperfusion. The nature of RPE change over a larger area manifests as a functional structural disorder, with the potential for recovery in case of choriocapillaris reperfusion.

[Regularities of structural and functional visual system changes in patients with myopic refraction and presbyopia].

Two age groups of 57 patients with noncomplicated low or moderate myopia were examined to reveal the regularities of structural and functional visual system changes in patients with myopic refraction and presbyopia. Characteristics of visual impression, anatomic and physiologic parameters were studied. Presbyopia development in patients with myopic refraction was found to occur on the background of significant changes in anatomic proportions and optic parameters of the eye, decrease of functional capability of visual system and development of abnormal functional system of visual perception. The key mechanisms of presbyopia development in myopia besides the accommodation decrease are pupil dysfunction and binocular interactions disintegration i. e. all the near vision reflex components.

[Regularities and mechanisms of visual perception transformation in presbyopia development].

66 healthy subjects were divided into 2 groups (mean age in the 1st group 18,6+/-0,4 years and 51,7+/-6,5 years in the 2nd group) to study regularities and mechanisms of presbyopia development. Visual pattern characteristics and anatomico-physiological parameters were studied using ultrasound biomicroscopy, electroretinography, ISCEV and visual evoked potentials. The most informative parameters for division of 2 groups are near visual point, fusion capacity in convergence, range of relative accommodation, binocular visual acuity, intraocular pressure, astigmatism, ciliary body thickness, A-wave amplitude on maximal ERG. Presbyopia development is accompanied with significant reorganization of visual analyzer activity, including binocular interaction. Surgical treatment of presbyopia should be supplemented with methods aimed to recover binocular interaction.