VITAMIN D LEVEL AND ITS LINK WITH VISUAL ACUITY AND CONTRAST SENSITIVITY IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION.

OBJECTIVE: The aim: Determination of vitamin D level and its connection with visual functions in patients with age-related macular degeneration, dry form. PATIENTS AND METHODS: Materials and methods: We analyzed the data of studies (25(OH)D3 levels (nmol/l), LogMAR visual acuity and Logarithmic contrast sensitivity) of 2 groups of women of postmenopausal age: 1 group (58 people - 58 eyes) - patients with age-related macular degeneration (dry form) - study group; 2 group (29 people - 29 eyes) - people without ophthalmic pathology - control group. RESULTS: Results: In the study group, 37 patients (63,8%) had vitamin D deficiency, 21 people (36,2%) had vitamin D insufficiency. In the control group, these figures were 69% and 31%, respectively. These indicators were defined as low (the normal supply of vitamin D is considered to be 100 nmol/l and more). Visual acuity due to ETDRS chart in the study group was 0,22±0,04 (in patients with vitamin D deficiency) and 0,12±0,03 (in patients with vitamin D insuffi¬ciency), in the control group - 0,13±0,04 and 0,05±0,04 respectively. In the control group, the logarithmic values of contrast sensitivity (log CS) were 1,58±0,04 log CS (in patients with vitamin D deficiency) and 1,62±0,02 log CS (in patients with vitamin D insufficiency). For patients from the study group, these figures were reduced to 0,98±0,1 log CS and 1,10±0,06 log CS respectively. CONCLUSION: Conclusions: Patients with age-related macular degeneration, dry form, have low levels of vitamin D, with a predominance of its deficiency. It has been determined that with age-related macular degeneration, functional losses are observed when perceiving objects of low contrast.

Management of inflammation in dry eye disease: Recommendations from a European panel of experts.

INTRODUCTION: Early initiation of anti-inflammatory therapies is recommended for dry eye disease (DED) to break the vicious cycle of pathophysiology. However, there is limited guidance on how to implement topical ciclosporin (CsA) and corticosteroid treatment into clinical practice. This expert-led consensus provides practical guidance on the management of DED, including when and how to use topical CsA. METHODS: A steering committee (SC) of seven European DED experts developed a questionnaire to gain information on the unmet needs and management of DED in clinical practice. Consensus statements on four key areas (disease severity and progression; patient management; efficacy, safety and tolerability of CsA; and patient education) were generated based on the responses. The SC and an expanded expert panel of 22 members used a nine-point scale (1 = strongly disagree; 9 = strongly agree) to rate statements; a consensus was reached if ≥75% of experts scored a statement ≥7. RESULTS: A stepwise approach to DED management is required in patients presenting with moderate corneal staining. Early topical CsA initiation, alone or with corticosteroids, should be considered in patients with clinical risk factors for severe DED. Patient education is required before and during treatment to manage expectations regarding efficacy and tolerability in order to optimise adherence. Follow-up visits are required, ideally at Month 1 and every 3 months thereafter. Topical CsA may be continued indefinitely, especially when surgery is required. CONCLUSION: This consensus fills some of the knowledge gaps in previous recommendations regarding the use of topical corticosteroids and CsA in patients with DED.

AGE-RELATED MACULAR DEGENERATION - CURRENT STATE OF THE PROBLEM AND PROPHYLAXIS METHODS.

OBJECTIVE: The aim: Analyze the ophthalmic studies on diagnostics and treatment of patients with age-related macular degeneration to optimize diagnostics and management tactics. PATIENTS AND METHODS: Materials and methods: The analysis of scientific papers due to age-related macular degeneration, vitamin D and its functions from scientometric databases: PubMed, Scopus, Web of Science. The methods were next: systematic approach, analysis, summarization and comparison. CONCLUSION: Conclusions: Age-related macular degeneration is a chronic, progressive disease among people older than 50 years. Late diagnostics and inappropriate treatment may lead to irreversible central vision loss and social disadaptation. Modern studies on the pathogenesis and treatment of this pathology (that are due to the role of the immune system, antioxidants and microelements) demonstrate the effectiveness and prospects for further development around the world to find new ways to solve this problem.

Sturge-Weber syndrome-associated glaucoma and intraocular osseous metaplasia: a unique complicated case.

A 30-year-old European man was admitted to our centre complaining about severe pain of the right eye (OD) and right part of the face, redness and no vision of the OD. He had an 18-year history of secondary to Sturge-Weber syndrome glaucoma, 6-month history of red eye and 1-week history of pain in OD. The best-corrected visual acuity was no light perception OD and 20/20 OS. Intraocular pressure was 36 mm Hg OD. Examination revealed endophthalmitis, Sturge-Weber syndrome-associated glaucoma and complicated cataract of OD.Unfortunately, no prescribed treatment helped this patient, so evisceration of OD was performed. During the evisceration, a subretinal 20 mm in width and 22 mm in length osseous tissue, partially vascularised, was removed surgically and was sent to the histological laboratory. Histopathologically, there were data of active inflammatory process, retinal detachment due to huge subretinal osseous metaplasia, gliosis and retinal pigment epithelial hyperplasia, and druses with ossification.

Health of ophthalmologists as a prerequisite of quality medical services.

OBJECTIVE: Introduction: The effectiveness and efficiency of the medical sector workforce directly depend on health of medical professionals. Scientific literature pays considerable attention to the health of surgeons, physicians, obstetricians, gynecologists, infectionists and dentists paying very little, if any, attention to health problems of ophthalmologists. This study is intended to bridge this gap. The aim at revealing the current situation and characteristics of health status of ophthalmologists using the results of sociological research and identifying health problems of the respondents in order to determine reliable preventive measures. PATIENTS AND METHODS: Materials and methods: The authors used bibliographic, medical-statistical, sociological and informational-analytical methods as well as analyzed questionnaires of the sociological survey conducted among ophthalmologists from various regions of Ukraine. RESULTS: Results: The results of the sociological survey allowed determining the main medical-demographic and occupational characteristics of the ophthalmologists working at health facilities. It was found that11,1±2,1 per 100 respondents assess their health condition as very good and 34,3±3,2 per 100 respondents - as good. At the same time every third respondent reports own health condition as satisfactory, 18,5±2,6 per 100 respondents report their health condition as bad and 2,8±1,2 per 100 respondents - as very bad. Chronic diseases in the history were confirmed by 52,8±3,4 per 100 ophthalmologists, recurrent acute diseases were reported by 48,6±3,4 per 100 respondents. Some ophthalmologists reported their low medical activity due to a number of reasons. The main factors that adversely affect the health of ophthalmologists include considerable workload, the need to work part-time for subsistence, neuro-emotional stress, insufficiently equipped medical and diagnostic process lacking modern technologies, poor team atmosphere, lack of comfort at the workplace and others. CONCLUSION: Conclusions: Own health condition assessed by ophthalmologists, the prevalence of chronic and acute pathology, factors of the working environment affecting health serve as the ground for improving prophylaxis activities among ophthalmologists and strengthening their health as a prerequisite for the quality medical services.