Efficacy of complex treatment of glaucoma optical neuropathy by Cortexin

The comparative analysis of efficacy of intranasal and intramuscular application of cortexin in combination with transcranial magnetotherapy in patients with primary open-angle glaucoma was conducted. 102 patients (182 eyes) took part in research with primary open-angle glaucoma of I, II, III stages. The most considerable improvement of visual functions resulted from intramuscular and endonasal introductions of cortexin in combination with transcranial magnetotherapy; and longer stabilization of functional indicators was marked in this grou

VISUAL DISTURBANCES IN PATIENTS WITH LATENT SYPHILIS

<p><em>Цель</em>: определить характер зрительных нарушений у больных латентным сифилисом, оценить возможности исследования зрительных вызванных потенциалов (ЗВП), оптической когерентной томографии (ОКТ) и лазерной конфокальной томографии (ЛКТ) в диагностике и уточнении формы нейросифилиса. <em>Материал</em> <em>и</em> <em>методы</em><em>. </em>Обследованы 133 больных скрытым сифилисом на предмет выявления признаков поражения нервной системы и органа зрения. <em>Результаты</em><em>. </em>Рутинное офтальмологическое обследование позволяет обнаружить нарушения зрения у 48 % больных латентным сифилисом. При нейросифилисе наиболее часто встречается ангиопатия сетчатки и первичная атрофия дисков зрительных нервов. Исследование ЗВП, использование ОКТ и ЛКТ позволяют выявлять признаки поражения органа зрения в 66 – 79 % случаев латентного сифилиса, нередко — до появления симптомов и признаков заболевания. <em>Заключение</em><em>. </em>Офтальмологическое обследование должно быть обязательным не только при установленном диагнозе «нейросифилис», но и во всех случаях латентного сифилиса.</p&gt

Clinical-and-functional basing of the tactics of complex pharmacophysiothera-py of patients with primary glaucoma simplex

The research goal was to estimate the effectiveness of complex pharmacophysiotherapy of patients with initial glaucoma simplex on the basis of analysis of morphology, visual cortex electrobiological activity and regional blood flow level. 80 patients (149 eyes) aged 60-75 were examined. All of them had an initial glaucoma simplex of II or III stage and normalized intraocular pressure. Depending on the stage of glaucoma there were two groups of patients and each group contained two sub-groups. patients of sub-group A were treated by percutaneous electrostimulation with feedback based on visual evoked biopotentials; and patients of sub-group В were treated by traditional electrostimulation. All patients got complex eye examination before and after the therapeutic course, and in 3 months after it. Method of selection of optimal electrostimulation parameters was worked out for the appropriate retina ganglionary cell effect. Individually selected electrostimulation in combination with nootropics contributes to eye hemodynamics improvement. Addition of magnetotherapy to the complex therapy of patients with eye hemodynamics leads to improvement of functional results. the increase of functional results of complex therapy with magnetotherapy that affects cervical sympathetic ganglia has been determined in patients with eye hemodynamic

Practical application of a nutraceutical in age-related macular degeneration

Kamenskykh T.G., Kolbenev I.O., Veselova E.V., Batischeva Yu.S. Saratov State Medical University named after V.I. Razumovsky Age-related macular degeneration (AMD) occupies one of the leading places among diseases leading to visual impairment and blindness. Aim: to evaluate the results of the use of Retinorm in patients with a «dry» form of AMD based on optical coherence tomography (OCT) and multifocal electroretinography (MF-ERG) data. Patients and Methods: 40 patients (66 eyes) with a «dry» form of AMD (drusen) participated in the study. Group 1 — 20 patients (34 eyes) who received Retinorm 1 capsule 3 per day during meals, group 2 — 20 patients (32 eyes) who received standard conservative therapy for 16 weeks. The standard examination included static perimetry, OCT, OCT-angiography, MF-ERG. Results and Discussion: A statistically significant change in the total perfusion density in the foveal area was observed in patients with small hard drusen in the Retinorm group. The thickness of the retina in patients of group 1 was 258±31 μm before treatment and did not change significantly during the treatment. In group 2, the thickness of the retina in the foveal region was 245±46 μm before the study and 312±28 μm in 6 months. Normalization of the configuration of a three-dimensional image of MF-ERG was observed in 75% of patients in group 1, while in group 2, the electrophysiological parmeters worsened in 60% of patients. Within 6 months, no significant change in visual acuity was detected in both groups, but in group 2 there was a tendency to its decrease. The improvement of well-being and a decrease of complaints was noted in group 1, and in group 2 there were no changes. Conclusions: Retinorm, as a balanced source of substances necessary for the retina, can be recommended for the use in the complex therapy of patients with a «dry» form of AMD. Key words: age-related macular degeneration, drusen, optical coherence tomography, angiography, Retinorm. For citation: Kamenskykh T.G., Kolbenev I.O., Veselova E.V., Batischeva Yu.S. Practical application of a nutraceutical in age-related macular degeneration. RMJ “Clinical ophthalmology”. 2018;2: 107–112.<br

Modern aspects of diagnostics and monitoring of tape-toretinal degeneration

Objective: to evaluate the informativity of clinical and instrumental methods of examining patients with tapetoretinal abiotrophy (TRA). Material and Methods. 45 patients with a diagnosis ofTRA, divided into 3 groups: 1) 8 people (under 18 years); 2) 20 people (19-40 years); 3) 17 people (over 41 years). Performed: standard ophthalmological examination, computer perimetry (kinetic, static perimetry in the "Macula threashold 24-2bs" mode, OCULUS Twinfield device), fundus shots (TOPCON device), EPS* (Neuro-MEP device). Results. The average total value of the visual fields of the first group patients amounted to 394±23°, the second group has 173±26° result and the third group has 86±15° result. Mean deviation of the bacillary component of electroretinogram in the first group has reached 53.8±10.4%, 70.2±4.3% in the second group and 84.7±7.3% in the third group. As for the rhythmic component, the indicators were following: 20.3±4.3%, 41.6±5.2%, 62.3±6.4% in the first, second and the third groups respectively. The data of static perimetry showed a decrease in the average photosensitivity in the central parts with respect to the population's age. According to the data of ophthalmoscopy the bony bodies' remoteness of the location from the center of the fundus corresponds to the degree of narrowing of the field of vision. Conclusion. There is a significant relationship between the total value of the peripheral boundaries of the visual field, electroretinogram data and perimetry.</p

Fluorescent angiography and optical coherence tomography with angiography of the ocular fundus in patients with "the wet" form of an age-related macular degeneration.

Purpose: to investigate the informative value of fluorescent angiography (FA) and optical coherence tomography with fundus angiography (angio-OCT) in the diagnosis of "wet" form of age-related macular degeneration (AMD). Material and methods. The present study included 20 patients (20 eyes) diagnosed with degeneration of macula and posterior pole of the eye, the "wet" form (late stage age-related macular degeneration, AREDS category 4). The study used machines: optical coherence tomography, Spectralis HRA+OCT (Heidelberg Engeneering, Germany), optical со- herence tomography-angiography CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany). Results. When conducting the FA, in 11 patients found the ill-defined zone of small leakage of dye in 7 patients revealed a clearly defined area of hyperfluorescence in the early phase, and marked leakage of dye in the late phase, 2 patients — uncertain indices. In connection with the received data questionable PHAGE in 11 patients, all were held angio-OCT, to clarify the localization of choroidal neovascularization (CNV). When performing angio-OCT in 11 patients revealed that "wet" form of AMD with occult choroidal neovascularization. In 7 patients there had been discovered classic CNV in 2 patients combined. Conclusion. Angio-OCT gives a clearer picture about the presence of a choroidal neovascular membrane that plays a significant role in determining the course of treatment of patients with wet age-related macular degeneration.</p

Clinical and immunological parallels in the diagnosis of primary open-angle glaucoma.

The purpose of study is an assessment of the informative value of various diagnostic parameters in monitoring and prognosis of the state of the visual organ in patients with primary open-angle glaucoma. Material and methods. 216 patients (216 eyes) were examined. 126 patients (126 eyes) with the diagnosis of primary open-angle glaucoma I, II or III stage were included in the main group (I), and 90 patients (90 eyes) without ophthalmologic pathology were included in the control group (II). All patients underwent complex examination. Laser confocal scanning tomography for the analysis of the optic disc morphology was performed using a Heidelberg Retina Tomograph II from Heidelberg Engineering (Germany). Evaluation of the field of view was carried out using the computer static perimeter Oculus twinfield-2 (Germany). Electrophysiological studies (apparatus Roland Consult, Germany) included: the study of visual cortical potentials on the outbreak, the pattern-electroretinogram, photopic negative response. Neurotrophic brain factor, ciliary neurotrophic growth factor and protein NF-200, S-100 protein, monocyte chemoattractant, vascular endothelial growth factor were determined in the serum. Results. An increase in the concentration of the S-100 protein with progression of POAG testifies to the existence of parallels between apoptosis of retinal ganglion cells and systemic neurodegenera-tion affecting the central nervous system as a whole. The importance of electrophysiological research methods, which give information about the third neuron of the visual pathway, has been confirmed. Pattern-electroretinogram, photopic negative response most reflect abnormalities in the work of ganglion cells of the retina, including before the appearance of structural changes in the optic disc and the retina. Conclusion. The interrelation of dynamics of functional, morphological and immunological criteria of progression of POAG is revealed, which allows to predict the further course of the pathological process. Since the study involved patients with IOP target values, it is important not only to maintain IOP on target values, but also to carry out neuroprotection.</p

Comparative analysis of the results of various physical therapy techniques in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia

&lt;p&gt;&lt;em&gt;Aim of the study: &lt;/em&gt;to evaluate the effectiveness of the techniques of dynamic simultaneous transcranial magnetic therapy and resonance, and electrical stimulation, transcranial magnetic therapy and dynamic laser stimulation, magnetic simpatokorrektsii in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia. &lt;em&gt;Techniques. &lt;/em&gt;We observed 184 patients diagnosed with primary open-angle glaucoma who received different physical therapy techniques. &lt;em&gt;Results&lt;/em&gt;. Patients treated with transcranial magnetic therapy and electrical stimulation or laser stimulation, in addition to improving visual function and improve the bioelectrical activity of the visual cortex, more pronounced than in other groups also observed the activation of the intraocular blood fow. Application of magnetic simpatokorrektsii allows for improvement of basic functional, electrophysiological and hemodynamic performance by reducing the activity of the sympathetic nervous system and reduce the vasopressor effect. &lt;em&gt;Conclusion&lt;/em&gt;. Transcranial magnetic therapy in combination with electrical stimulation or laser stimulation is effective in the treatment of patients with POAG. In patients with primary open-angle glaucoma with chronic cerebral ischemia technique of magnetic sim-patokorrektsii compared with traditional methods of vasoactive therapy is more effective, which is manifested not only increase the visual functions, but also a decrease in cognitive impairment.&lt;/p&gt

Experience of antiangiogenic and corticosteroid therapy of a diabetic macular edema

Diabetic macular edema (DME) is a leading cause of blindness in patients with diabetes. The purpose of the research is to evaluate the effectiveness of treatment of patients with DMOs resistant to the administration of ranibi-zumab, using the intrauritreal implant "Ozurdex". Material and Methods. 66 patients (98 eyes) are examined. All of the patients were divided, into three groups, depending on a stage of a diabetic retinopathy. The patients underwent a complex of examinations: along with traditional methods, optical coherence tomography, fluorescence angiography of the fundus, multifocal electroretinography, determination of the content of VEGF-Aand cytokines in serum were used. Results. According to ОСТ of a retina and a visometry there are differences in efficiency of treatment depending on a condition balance of cytokine. Conclusion. The use of the intrauretic implant "Ozurdex" was more effective in patients with DMO in the stage of p re-pro I iterative diabetic retinopathy and in patients resistant to anti-VEGF therapy.</p

Computer analysis of epiretinal membrane parameters

Objective: to develop algorithms of processing of video images of optical slices of the eye retina to quantify the degree of folding of the epiretinal membranes and of the central fossa. Material and methods. The object of the study was the video image of the retina obtained by optical coherence tomography. To develop methods of determining the degree of folding epiretinal membrane was formed mathematical model of the profile consisting of a base profile (low frequency component) and folding (high frequency part). Results. There had been developed two alternative methods of estimation of folding epiretinal membrane: retinal-averaging method and the method using the wavelet transform. The algorithm of geometrical parameters of the central fossa: the height, width and line shape. These algorithms are implemented in a software system. Conclusion. The practical application of the developed system showed its adequacy, as well as an introduction into medical practice the use of quantitative estimates of some parameters of the retina condition.</p