Elevated Electron Temperature Coincident with Observed Fusion Reactions in a Sheared-Flow-Stabilized Z Pinch.

The sheared-flow-stabilized Z pinch concept has been studied extensively and is able to produce fusion-relevant plasma parameters along with neutron production over several microseconds. We present here elevated electron temperature results spatially and temporally coincident with the plasma neutron source. An optical Thomson scattering apparatus designed for the FuZE device measures temperatures in the range of 1-3 keV on the axis of the device, 20 cm downstream of the nose cone. The 17-fiber system measures the radial profiles of the electron temperature. Scanning the laser time with respect to the neutron pulse time over a series of discharges allows the reconstruction of the T_{e} temporal response, confirming that the electron temperature peaks simultaneously with the neutron output, as well as the pinch current and inductive voltage generated within the plasma. Comparison to spectroscopic ion temperature measurements suggests a plasma in thermal equilibrium. The elevated T_{e} confirms the presence of a plasma assembled on axis, and indicates limited radiative losses, demonstrating a basis for scaling this device toward net gain fusion conditions.

[Physical and mechanical properties of materials used in the technology of computer production of surgical templates]. / Fiziko-mekhanicheskie svoistva materialov, ispol'zuemykh v tekhnologii komp'yuternogo proizvodstva khirurgicheskikh shablonov.

OBJECTIVE: The physical and mechanical properties of samples printed from different materials subjected to post-processing in a clinic were evaluated. MATERIAL AND METHODS: Studied hardness and modulus of elasticity before and after sterilization by autoclaving. Based on the analysis of the literature and monitoring of the dental materials market, our choice fell on the most popular materials for 3D printing of surgical templates for dental implantation, such as: material 1 (FormLabs Dental SG Resin (Formlabs, USA)) and material 2 (NextDent SG (NextDent, Netherlands)). In connection with the events of recent years, we also took into the study a domestically produced polymer - material 3 (HARZLabs Yellow Clear PRO (HARZLabs, Russia)). RESULTS: As a result of the study, it was found that in each of the groups of materials studied, the values of the elastic modulus of sterilized samples are higher than the elastic modulus of samples that have not undergone sterilization. According to GOST 31572-2012 (ISO 1567:1999 Polymeric materials for denture bases, non-sterilized samples of group 2 are considered not to have passed the test, since all three samples of the studied group have a crack resistance index of less than 1 MN/m1.5. Crack resistance index of sterilized samples of the group of materials 2 is also close to 1. Samples of group 1 (both sterilized and non-sterilized) have the highest crack resistance. This group also has the highest flexural strength. On non-sterilized samples of material 1, there was no crack initiation along the cut and groove. The samples of other groups were mainly destroyed along the axis of the groove. CONCLUSION: Analyzing the obtained data and considering that all studies carried out were in accordance with dental standards, the researchers concluded that the increase in flexural strength after sterilization by autoclaving and the feasibility of using material 1 for the production of surgical templates in accordance with all manufacturer's recommendations.

Implementation of extreme ultraviolet spectroscopy on a sheared-flow-stabilized Z pinch.

A diagnostic for extreme ultraviolet spectroscopy was fielded on the sheared-flow-stabilized (SFS) fusion Z-pinch experiment (FuZE-Q) for the first time. The spectrometer collected time-gated plasma emission spectra in the 5-40 nm wavelength (30-250 eV) range for impurity identification, radiative power studies, and for plasma temperature and density measurements. The unique implementation of the diagnostic included fast (10 ns risetime) pulsed high voltage electronics and a multi-stage differential pumping system that allowed the vacuum-coupled spectrometer to collect three independently timed spectra per FuZE-Q shot while also protecting sensitive internal components. Analysis of line emission identifies oxygen (N-, C-, B-, Be-, Li-, and He-like O), peaking in intensity shortly after maximum current (>500 kA). This work provides a foundation for future high energy spectroscopy experiments on SFS Z-pinch devices.

[Clinical efficiency of occlusive splints in the treatment of patients with temporomandibular joint dysfunction complicated by bruxism]. / Klinicheskaya effektivnost' okklyuzionnykh shin v lechenii patsientov s disfunktsiei visochno-nizhnechelyustnogo sustava, oslozhnennoi bruksizmom.

OBJECTIVE: Improving the effectiveness of treatment of patients with temporomandibular joint (TMJ) dysfunction complicated by bruxism. MATERIAL AND METHODS: 70 patients with signs of parafunction of the masticatory muscles were selected for the clinical study. The patients were divided into 2 groups of 35 people. Splints were made for patients from the groups using 2 different 3D printing methods. The treatment was monitored using clinical and instrumental studies, electromyography of the muscles themselves and computed tomography of the TMJ after 3, 6 and 12 months. RESULTS: The severity of hypertonicity of the masticatory muscles decreased by the end of 3 months of treatment with the help of repositioning occlusal splints. After 6 months of treatment, the mean BEA decreased in both study groups, but to a lesser extent than in the first 3 months. After wearing a splint after 12 months, the decrease in muscle tone was insignificant. CONCLUSION: The clinical use of positioning splints plays a crucial role in the stabilization of occlusion and is a mandatory stage of complex treatment of patients with pathology of the occlusal-musculoskeletal complex.

Protein Tyrosine Phosphatase CD45 As an Immunity Regulator and a Potential Effector of CAR-T therapy.

The leukocyte common antigen CD45 is a receptor tyrosine phosphatase and one of the most prevalent antigens found on the surface of blood cells. CD45 plays a crucial role in the initial stages of signal transmission from receptors of various immune cell types. Immunodeficiency, autoimmune disorders, and oncological diseases are frequently caused by gene expression disorders and imbalances in CD45 isoforms. Despite extensive research into the structure and functions of CD45, the molecular mechanisms behind its role in transmitting signals from T-cell receptors and chimeric antigen receptors remain not fully understood. It is of utmost importance to comprehend the structural features of CD45 and its function in regulating immune system cell activation to study oncological diseases and the impact of CD45 on lymphocytes and T cells modified by chimeric antigen receptors.

[Modern methods of adhesive fixation of facial epitheses]. / Sovremennye metody adgezivnoi fiksatsii epitezov litsa.

This review presents an analysis of domestic and foreign literature on the issues of fixation of facial epitheses and combined maxillofacial prostheses, such as the use of craniofacial implants installed in the zygomatic bone, brow arches, orbital walls, mastoid process of the temporal bone with beam or magnetic beam fixation systems. The advantages and disadvantages of such fastening systems are described. The analysis and systematization of available data on medical adhesive compositions that can be used in maxillofacial prosthetics to hold facial epitheses has been carried out. Much attention is paid to the chemical composition of pressure-sensitive adhesives, water-based and silicone-based. Examples of such compositions are given. The physicochemical properties of medical adhesive systems that cause adhesive-cohesive interaction are described. This review presents the results of comparative studies to assess the fixing properties of various adhesives, as well as to study the formation of biofilm on the surfaces of prostheses and skin when using different adhesives.

CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.

INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 µm, which is caused by dilatation of the choroidal vessels of the Haller's layer, thinning of the Sattler's layer and the choriocapillaris layer. METHODOLOGY: Literary research focused on the current view of pachychoroid spectrum diseases, including clarification of the pathophysiological theories of the formation of "pachychoroid". RESULTS: It is assumed that "pachychoroid" disease has an autosomal dominant type of heredity. Depending on the further activity of various exogenous and/or endogenous factors, pachychoroid diseases may appear. According to the current knowledge, the spectrum of pachychoroid disease covers six clinical entities: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation and peripapillary pachychoroid syndrome. In this study, we describe the clinical symptoms and objective findings of focal choroidal excavation and peripapillary pachychoroid syndrome. The current pathophysiological theory of pachychoroid diseases is based on impaired venous outflow from the choroid ("venous overload choroidopathy") and thickening of the sclera in the eyes of affected patients. CONCLUSION: Pachychoroid diseases should be included in the differential diagnosis of characteristic features observed during multimodal imaging analysis of choroidal changes.

[Manufacture of facial prosthesis by three-dimensional printing]. / Izgotovlenie litsevykh protezov metodom ob"emnoi pechati.

The objective of the literature review was to study and analyze literature sources on the methods and means of facial prosthesis manufacture by three-dimensional printing. MATERIALS AND METHODS: An analysis of information sources covering the last 15 years was carried out, in search sources as PubMed, Elsiver and eLIBRARY and on the website of the Federal Institute of Industrial Property. RESULTS: The technology of direct production of prostheses by volumetric printing from silicone materials is the object of research for its development. Most of the materials used for the manufacture of facial prostheses using 3D printing need technical improvements, often requiring expensive equipment, which in turn does not allow the method of manufacturing face prostheses by direct method in everyday clinical practice. CONCLUSION: Based on the obtained data there is a need to develop a new structural material for the manufacture of facial prostheses by 3D printing using laser stereolithography and digital LED projection technologies.

CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.

INTRODUCTION: The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 µm, which is caused by dilatation of the choroidal vessels of the Haller's layer, thinning of the Sattler's layer and the choriocapillaris layer. METHODOLOGY: Literary research focused on the current view of pachychoroid spectrum diseases, including clarification of the pathophysiological theories of the formation of "pachychoroid". RESULTS: It is assumed that "pachychoroid" disease has an autosomal dominant type of heredity. Depending on the further activity of various exogenous and/or endogenous factors, pachychoroid diseases may appear. According to the current knowledge, the spectrum of pachychoroid disease covers six clinical entities: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation and peripapillary pachychoroid syndrome. In this study, we describe the clinical symptoms and objective findings of focal choroidal excavation and peripapillary pachychoroid syndrome. The current pathophysiological theory of pachychoroid diseases is based on impaired venous outflow from the choroid ("venous overload choroidopathy") and thickening of the sclera in the eyes of affected patients. CONCLUSION: Pachychoroid diseases should be included in the differential diagnosis of characteristic features observed during multimodal imaging analysis of choroidal changes.

[Development of structural material for the manufacture of facial prosthesis by 3D printing]. / Razrabotka i otsenka fiziko-mekhanicheskikh svoistv konstruktsionnogo materiala, primenyaemogo v tekhnologii proizvodstva epitezov litsa metodom ob"emnoi pechati.

THE AIM OF THE STUDY: Was to develop and evaluate the physical and mechanical properties of a structural material for the manufacture of facial epithesis using photopolymer printing technology. MATERIALS AND METHODS: The study of the physical and mechanical properties of the developed structural material consisted of measuring the Shore hardness; determination of material strength at break, conditional yield strength, relative elongation at break and modulus of elasticity; the study of the characteristics described above, after artificial aging, simulating the daily use of a prosthesis. RESULTS: According to the test results, the samples of the studied material did not have a yield strength, they were torn at a deformation of 40-60%. The values of the conditional yield strength were 0.41±0.01 MPa, regardless of the time of the aging procedure. The values of the modulus of elasticity were 2.96±0.19 MPa and 2.88±0.14 MPa for the samples that underwent the aging procedure at 6 and 12 months, respectively. CONCLUSION: The results obtained were compared with the results of similar studies of structural materials used in 3D printing technology of facial prostheses, which allowed us to recommend the developed material for clinical use after evaluating its toxicological and biological characteristics.

Generation of sub-MV/cm terahertz fields with large-size Cherenkov-type optical-to-terahertz converters.

It is known that a structure comprising a tens of microns thick, and ∼1 × 1 cm2 in size, layer of LiNbO3 attached to a Si prism can serve as an efficient Cherenkov-type converter of tens of microjoules-energy femtosecond laser pulses to broadband terahertz radiation. Here we experimentally demonstrate scaling up the terahertz energy and field strength by extending the width of the converter to several centimeters, expanding appropriately the pump laser beam, and increasing the pump pulse energy to hundreds of microjoules. In particular, chirped Ti:sapphire laser pulses of 450 fs duration and 600 µJ energy were converted to 1.2 µJ terahertz pulses, and 0.5 MV/cm peak terahertz field was obtained when pumping by unchirped laser pulses of 60 fs duration and 200 µJ energy.

CAR-tropic extracellular vesicles carry tumor-associated antigens and modulate CAR T cell functionality.

Tumor-derived extracellular vesicles (EVs) are active contributors in metastasis and immunosuppression in tumor microenvironment. At least some of the EVs carry tumor surface molecules such as tumor-associated antigens (TAAs) and/or checkpoint inhibitors, and potentially could interact with T cells or CAR T cells. Upon contact with T cells, EVs could alter their phenotype and functions by triggering signaling through TCR or CAR reprogramming them to escape immune response. We hypothesize that EVs that possess TAA on the surface will probably interact with CAR T cells which can recognize and bind corresponding TAA. This interaction between EVs and CAR T cells may change the outcome of CAR T-based cancer immunotherapy since it should affect CAR T cells. Also, EVs could serve as adjuvants and antigenic components of antitumor vaccines. Herein, we isolated EVs from B cell precursor leukemia cell line (pre-B ALL) Nalm-6 and demonstrated that recognition and binding of CD19+EVs with CD19-CAR T cells strongly depends on the presence of CD19 antigen. CD19+EVs induce secretion of pro-inflammatory cytokines (IL-2 and IFN-y) and upregulated transcription of activation-related genes (IFNG, IFNGR1, FASLG, IL2) in CD19-CAR T cells. Tumor necrosis factor receptor superfamily (TNFRSF4 and TNFRSF9) and T-cell exhaustion markers (CTLA4, LAG3, TIM3 and PDCD1LG2) were also upregulated in CD19-CAR T cells after incubation with CD19+EVs. Long-term cultivation of CD19+ or PD-L1+EVs with CD19-CAR T cells led to increased terminal differentiation and functional exhaustion according to elevated expression of PD-1, TIGIT, CD57. In summary, our results suggest that chronic exposure of CD19-CAR T cells to CD19+EVs mediates activation and systemic exhaustion in antigen-specific manner, and this negative effect is accompanied by the impaired cytotoxic activity in vitro.

In Vitro Antiviral Activity of a New Indol-3-carboxylic Acid Derivative Against SARS-CoV-2.

The coronavirus disease (COVID-19) pandemic has brought into sharp relief the threat posed by coronaviruses and laid the foundation for a fundamental analysis of this viral family, as well as a search for effective anti-COVID drugs. Work is underway to update existent vaccines against COVID-19, and screening for low-molecular-weight anti-COVID drug candidates for outpatient medicine continues. The opportunities and ways to accelerate the development of antiviral drugs against other pathogens are being discussed in the context of preparing for the next pandemic. In 2012-2015, Tsyshkova et al. synthesized a group of water-soluble low-molecular-weight compounds exhibiting an antiviral activity, whose chemical structure was similar to that of arbidol. Among those, there were a number of water-soluble compounds based on 5-methoxyindole-3-carboxylic acid aminoalkyl esters. Only one member of this rather extensive group of compounds, dihydrochloride of 6-bromo-5-methoxy-1-methyl-2-(1-piperidinomethyl)-3-(2-diethylaminoethoxy) carbonylindole, exhibited a reliable antiviral effect against SARS-CoV-2 in vitro. At a concentration of 52.0 µM, this compound completely inhibited the replication of the SARS-CoV-2 virus with an infectious activity of 106 TCID50/mL. The concentration curves of the analyzed compound indicate the specificity of its action. Interferon-inducing activity, as well as suppression of syncytium formation induced by the spike protein (S-glycoprotein) of SARS-CoV-2 by 89%, were also revealed. In view of its synthetic accessibility - high activity (IC50 = 1.06 µg/mL) and high selectivity index (SI = 78.6) - this compound appears to meets the requirements for the development of antiviral drugs for COVID-19 prevention and treatment.

Scalable optical-to-terahertz converter with a prism-coupled plane-parallel lithium niobate plate.

A nonlinear optical converter of femtosecond laser pulses to terahertz radiation, which combines the tilted-pulse-front pumping and prism coupling techniques, is proposed and experimentally tested. In contrast to the conventional tilted-pulse-front scheme with a prism-shaped LiNbO3 crystal, the converter consists of a plane-parallel LiNbO3 plate sandwiched between two dielectric prisms. One prism is used to couple the pump beam into the LiNbO3 plate, another prism couples the generated terahertz radiation out of the plate. The proposed scheme enables scaling to large-diameter LiNbO3 wafers and large-aperture high-energy pump laser beams resulting in generation of strong terahertz fields. In a proof-of-principle experiment with a 1-mm thick, small size (1 × 2 cm2) LiNbO3 plate pumped by a mJ-class laser, the conversion efficiency comparable to that of the conventional scheme (∼0.1%) was demonstrated.

[Evaluation of the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases]. / Otsenka klinicheskoi effektivnosti primeneniya navigatsionnogo khirurgicheskogo shablona v protokole vestibuloplastiki u patsientov s boleznyami parodonta.

THE AIM OF THE STUDY: Was to evaluate the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases. MATERIALS AND METHODS: There were 48 people selected to participate in the study and randomly divided into 2 equal groups. The patients of the main group underwent vestibuloplasty procedure using a free gingival graft modeled using the developed protocol and a navigational surgical template. Patients in the control group underwent a similar operation using classical technology. The study assessed postoperative pain, the index of early wound healing, Doppler fluometry of the transplanted flap and flap morphometric measurements. RESULTS: The results of all conducted studies confirmed the effectiveness of the developed clinical protocol. CONCLUSION: According to objective and subjective assessments, the use of a surgical navigation template can reduce the time and invasiveness of vestibuloplasty surgery, make it more comfortable for the patient and get a more predictable clinical result.

Development of a Test System to Detect the Omicron Variant of SARS-CoV-2 and the Frequency of Its Detection in Patients.

We developed a new test system to detect the omicron variant of SARS-CoV-2 using allele-specific reverse transcription PCR and estimated the frequency of its detection in patients living in the Novosibirsk Region. Clinical samples were divided into 3 groups: samples collected from December 1 to December 30, 2021 (group 1; n=66), from December 30, 2021 to January 10, 2022 (group 2; n=20), and from January 11 to January 22, 2022 (group 3; n=101). Based on the identification of 5 mutations specific to SARS-CoV-2 (B.1.1.529), two systems of oligonucleotide primers and probes were developed for detecting this coronavirus genotype in clinical samples. Limit of detection (LOD95) was 4×103 genome equivalents per 1 ml of clinical sample for the first test system and 2×103 for the for the second test system. The omicron variant of SARS-CoV-2 was absent in group 1 of studied samples, but was detected in 20% (4/20) of group 2 samples and 88% of group 2 samples collected within less than 2 weeks of January 2022. Using developed test system, we showed that in less than 2 weeks the omicron variant has become dominant in patients, which confirms previously published data on its exceptional contagiousness.

EFFECT OF BASELINE CENTRAL RETINAL THICKNESS ON THE RESULTS OF TREATMENT OF DIABETIC MACULAR EDEMA WITH AFLIBERCEPT: REAL-LIFE EVIDENCE IN THE CZECH REPUBLIC.

AIM: Presentation of the 1-year results of aflibercept treatment in patients suffering from diabetic macular edema (DME) and comparison of the response to treatment of patients with different baseline central retinal thickness (CRT). METHODS: This was a multicentre, retrospective observational study of a series of cases. Patients with DME were treated in a fixed regimen (5 injections at 1-monthly intervals and then injections at 2-monthly intervals). The period of follow-up was 12 months. The development of best corrected visual acuity (BCVA) and CRT was evaluated. Measurements were performed prior to the commencement of treatment and then after 4, 6, 8, 10, and 12 months. RESULTS: The therapeutically naive group consisted of 82 eyes of 79 patients. The total cohort of patients was divided into 3 groups according to the baseline values of CRT. The first group was composed of 28 eyes with baseline CRT < 450 μm (34.1%), the second included 25 eyes with CRT in the range of 450-550 μm (30.5%), and the third group consisted of 29 eyes with baseline CRT > 550 μm (35.4%). The average baseline BCVA and SD in the first group was 66 ±7.1 letters ETDRS optotypes, and then 70 ±7 letters, 69.6 ±7.3 letters, and 71.3 ±7 letters at the follow-ups after 4, 8, and 12 months. The average baseline value of CRT and SD in the first group was 379 ±48.6 μm, and then 337.1 ±76.5 μm, 320.2 ±74.1 μm, and 315.1 ±62.2 μm after 4, 8, and 12 months. The average baseline BCVA and SD in the second group was 64.1 ±9.7 ETDRS letters, and then 66.9 ±10 letters, 70 ±9.9 letters, and 70.5 ±11.5 letters after 4, 8, and 12 months. The average baseline value of CRT and SD in the second group was 497.4 ±76.4 μm, and then 376.5 ±106.1 μm, 360.8 ±70 μm, and 351.3 ±91.3 μm after 4, 8, and 12 months. In the third group, the average baseline value of BCVA and SD was 59.7 ±10.4 ETDRS letters, and then 65 ±10.6 letters, 64.8 ±9.6 letters, and 67 ±10 letters after 4, 8, and 12 months. The average baseline value of CRT and SD in the third group was 639.4 ±79.6 μm, and then 396.7 ±147.1 μm, 416.9 ±139.8 μm, and 368.5 ±109.9 μm after 4, 8, and 12 months. All these changes were statistically significant (p < 0.05). CONCLUSION: Aflibercept treatment in a fixed regimen in patients suffering from DME results in a statistically significant improvement in BCVA and a decrease in CRT in the first year of treatment. Patients with a higher baseline CRT showed the best anatomical and functional results of the 1-year treatment with aflibercept.

[Clinical efficacy of hydroxyapatite and tricalcium phosphate modified with hyaluronic acid in the treatment of patients with periimplantitis]. / Klinicheskaya effektivnost' primeneniya gidroksiapatita i trikal'tsiifosfata, modifitsirovannykh gialuronovoi kislotoi v lechenii patsientov s periimplantitami.

THE AIM OF THE STUDY: Was to assess the effectiveness of the use of hydroxyapatite (HAP) and tricalcium phosphate (TCF) modified with hyaluronic acid in the treatment of patients with periimplantitis. MATERIALS AND METHODS: Clinical studies were conducted in 128 patients (44% male and 56% female) aged up to 55 years, who sought dental care with the main diagnosis of periimplant mucositis and periimplantitis. To compare the features of osseointegration of dental implants under bone remodeling three groups of patients were formed: one control and 2 main ones. In the control group the wound was managed under a blood clot, in the first main group HAP and TCF and in the second main group HAP and TCF modified with hyaluronic acid were used. X-ray examination was performed in various modes. Clinical assessment of implant stability in the operated area was carried out using subjective (percussion and palpation method) and objective method of frequency resonance analysis using the Osstell ISQ device calculating the stability coefficient of the dental implant (SCDI). RESULTS: 12 months after the periimplant zone remodeling procedure the bone resorption rates surrounding the implant were statistically significantly the lowest in the second main group (0.682±0.006 mm, p<0.001) compared with the values in the control and first main groups (1.626±0.022 and 1.025±0.034 mm, respectively). In the former groups bone resorption continued to progress during the observation period. In patients of the second main group, the average values of the SCDI for all study periods were 68.97±1.09 units which turned out to be the highest indicator and significantly differed from the values of other observation groups (p<0.05), which may be due to a tighter fit of the implants to the surface of the newly formed bone tissue. CONCLUSION: The results of the study 12 months after the periimplant zone remodeling operation procedure prove the efficacy of HAP and TCF modified with hyaluronic acid for the treatment of patients with periimplantitis.

LUCENTIS IN THE TREATMENT OF DIABETIC MACULAR EDEMA, TWO-YEAR RESULTS.

AIM: To evaluate, on the basis of two-year observations, the effectiveness of intravitreal treatment with Ranibizumab in patients with diabetic macular edema (DME) unresponsive to the previous laser treatment. Cohort and Methods: A retrospective study evaluates 29 eyes of 29 patients with diffuse DME unresponsive to their previous laser treatment. The group of the patients consisted of 16 males (55.1%) and 13 females (44.8%); their mean age was 71.3. The mean duration of diabetes mellitus was 13 years (3-20). 19 patients (65.5%) were treated with insulin, 10 patients (34.4%) were treated with peroral antidiabetics (PAD); the mean HbA1c value was 52 mmol/l. The treatment was started with 3 initial doses of intravitreal injections of Ranibizumab 0.5 mg. There was a one- -month interval between the applications. Subsequent evaluations and administrations of the following injections were made in the pro re nata (PRN) mode; the check-ups were carried out every month during the first year and on average every 3 months in the second year. The monitored parameters: the best corrected visual acuity (BCVA) measured on ETRDS (Early Treatment Diabetic Retinopathy Study) optotypes, the central retinal thickness (CRT). These parameters were monitored prior to the treatment and then in the 3rd, 6th, 9th, 12th, 18th and 24th months. RESULTS: A statistically significant improvement in the mean value of BCVA was detected. From the initial 65.4 ±10.61 letters it improved by 11.2 letters (p.

RHEOHEMAPHERESIS IN THE TREATMENT OF DRY FORM OF AMD. A CASE REPORT.

AIM: We present a case report of a patient with dry form of age-related macular degeneration (AMD) in whom we monitored the effect of rheohemapheresis (RhF) treatment over 6 years. METHODS: A 67-year-old man was examined in April 2014 at the Department of Ophthalmology at the University Hospital in Hradec Králové for metamorphopsia and decreased visual acuity of the left eye. The patient received general treatment for hypercholesterolemia with Lipfix 10 mg once a day (atorvastatin 10 mg). The cholesterol level in the blood was 3.41 mmol/l, the lipid profile was normal. The patient's previous ocular medical history was unremarkable. The patient reported ocular complaints over the course of the last year, the main symptom of which was image distortion on the Amsler grid on the left eye. Baseline best corrected visual acuity of the left eye was 6/10. Visual acuity in the right eye was 6/6. In both eyes, the findings on the anterior segment corresponded to the patient's age, with the exception of incipient cortical cataract. On the fundus of both eyes, the border of the optic nerve was demarcated, in the macula of the left eye there were a number of soft confluent drusen, in the central periphery there were no pathological changes. On the fundus of the right eye the finding was similar, but to a lesser degree. Optical coherence tomography on the macula of the left eye showed drusoid ablation of the retinal pigment epithelium (RPE), with accumulation of hyperreflectivities below the RPE. Pattern-reversal electroretinography (pERG): showed a slightly prolonged retention of the activity of the central region of the retina (p50 wave) and ganglion cells (N95 wave). Multifocal electroretinography (mfERG) in the central 30° of the retina was within normal limits. Electroretinography (ERG) demonstrated physiological photopic and scotopic rod activity. The patient was treated with 8 RhF procedures, two per week, with a 2-week interval, and the pulse was repeated 4 times. RESULTS: We noted a gradual resorption of soft drusen in the patient, with attachment to the RPE line according to OCT examination at the following sixmonthly check-ups over the next 6 years. Visual acuity of both eyes was maintained at the baseline values at the last check-up in April 2020, the area of soft drusen was significantly reduced. The function of the rod, cone system and the central region of the retina mfERG fluctuated only to an insignificant degree during the entire follow-up period, with a tendency towards a slight increase in activity after RhF treatment. CONCLUSION: We noted an improvement of the anatomical and functional findings in a patient with dry form of AMD during a 6-year follow-up period after RhF treatment. The visual acuity of the affected eye remained at the baseline values.