Study of the influence of various types of «intraocular lens – posterior lens capsule» interface on visual acuity and refraction of pseudophakic eyes in the early postoperative period after femtosecond laser-assisted cataract surgery

Purpose. To study the influence of various types of «intraocular lens – posterior lens capsule» (IOL–PLC) interface on visual acuity (VA) and refraction pseudophakic eyes in early postoperative period after femtosecond laser-assisted cataract surgery in patients with senile cataract.Material and methods. The study included 133 pseudophakic eyes of 133 patients after femtosecond laser-assisted cataract surgery. The study did not include patients with uncorrected VA less than 0.8 on the first day after surgery; with eye axial length less than 22 and more than 26 mm; with initial posterior capsule opacification in the central area; with corneal pathology; with corneal astigmatism more than 1 diopters; with pseudoexfoliation, rigid pupil and zonal weakness and with severe somatic pathology and cognitive impairment.On the first day and one month after the surgery, corneal astigmatism, the spherical and cylindrical component of objective refraction, uncorrelated and best corrected VA were studied and the type of IOL– PLC interface was determined.Results. On the first day after the surgery, all studied eyes were divided into 3 groups depending on the type of IOL–PLC interface and dependence of postoperative refraction on relations between IOL and PLC was revealed. The greatest changes in astigmatism during month after surgery were detected in eyes with initial incomplete contact IOL with PLC and presence of folds of the latter. The most stable indexes of VA and refraction in pseudophakic eyes were in presence full contact IOL and PLC.Conclusion. Initial incomplete contact IOL and PLC was exerted greatest negative influence on VA and refraction, which led to deformation PLC in form of residual folds and local sections of fibrosis in the central area in 51 eyes (66.2%) duri ng month after surgery

Prospects of modern pharmacotherapy in postoperative rehabilitation of patients after endovitreal surgery of rhegmatogenous retinal detachment

Purpose. To assess increasing the functional effectiveness of the results of endovitreal surgery in patients with rhegmatogenous retinal detachment (RRD) by using modern pharmacotherapy drug in the postoperative rehabilitation.Material and methods. 108 people (108 eyes) with RRD. All patients underwent standard three-port vitrectomy, after which tamponade of the vitreous cavity with silicone oil with its removal 3 months after operation was performed. Patients were divided into 2 groups: the first – 60 people who received Cytoflavin on the background of standard therapy, and the second – 48 people with postoperative treatment only with standard therapy. Depending on the visual prognosis calculated before the operation, both groups were represented patients with satisfactory (A subgroup) and low (B subgroup) visual prognosis. Laser Doppler fluometry (LDF) was used to study chorioretinal microcirculation: microcirculation index and microcirculation efficiency index were recorded. Using OCT angiography (OCT-A), signs of macular ischemia were investigated: choroidal thickness, area nonperfusion of foveal avascular zone, density in the superficial capillary plexuses and density in the deep capillary plexuses in the macular area.Results. The inclusion of Cytoflavin in the postoperative rehabilitation of patients with RRD increases the possibility of a favorable functional outcome of the operation, affects the positive dynamics in the state of the capillary plexus in the macula. In the aggregate of patients of the 1st group, the increase in visual acuity was 2 times higher than in patients of the 2nd group 6 months after surgery. Also, in patients of the 1st group there was a more significant activation of chorioretinal blood flow according to LDF and OCT-A.Conclusion. The prescription of Cytoflavin in the postoperative treatment of patients underwent endovitreal surgery of RRD, regardless of the visual prognosis, increases the functional outcome of the operation. Improvement in visual functions in patients receiving Cytoflavin therapy is directly related to improved intraocular blood flow and macular perfusion

Features of vascular-platelet and coagulation hemostasis in relation to parameters of macular blood fl ow in women with preeclampsia

Background. Recently, more and more attention has been paid to the development of vascular retinal disorders after suffering preeclampsia. It is noted that the key role in this process is assigned to the systemic endothelial dysfunction that persists for a long time after delivery.Aim: to elucidate the features of vascular-platelet and coagulation hemostasis in relation to the indicators of blood flow in the macular region in women with preeclampsia.Materials and methods. The main group included 45 women with preeclampsia in the third trimester of pregnancy (35–36 weeks). Their age ranged from 19 to 40 years (27 ± 5.2 years). The comparison group was represented by 20 women with physiological pregnancy in the third trimester (35–36 weeks). Their age averaged 26 ± 5.1 years (18–38 years). Somatically healthy non-pregnant women (20 people) were included in the control group. Their age ranged from 19 to 38 years (26 ± 5.4 years). A comparative analysis of the studied parameters of macular blood fl ow, vascular-platelet and coagulation hemostasis between the groups was carried out.Results. When studying the number of platelets in pregnant women, it turned out that in patients with preeclampsia, this indicator was statistically signifi cantly lower compared to the comparison and control groups (p < 0.05). The level of fi brinogen in women with complicated pregnancies was statistically significantly higher than in women with physiological pregnancy and in somatically healthy nonpregnant women (p < 0.05). In addition, retinal microcirculation disorders were observed in women of the main group.Conclusions. The revealed disorders of vascular-platelet and coagulation hemostasis in women during the period of complicated pregnancy were accompanied by disorders of macular blood fl ow in the form of a decrease in the total average density of vessels in the superfi cial vascular plexus, subfoveolar thickness of the choroid and an increase in the area of the avascular zone relative to the group of women with physiological pregnancy and somatically healthy nonpregnant women

Frequency of vitreoretinal adhesion in retinal vessels in patients with axial myopia of different age groups

Purpose. Finding out the frequency and structures posterior vitreous detachment (PVD), the proportion of local vitreoretinal adhesion in topographical zones of large retinal vessels of posterior pole of the eye in patients of different age groups with axial myopia.Material and methods. Clinical material was 82 eyes (41 patients). The age of patients ranged from 18 to 70 years. According to the age category, which is determined by the WHO classification, all patients were divided into 3 groups. The 1st group (18-44 years old) included 12 people (24 eyes); the 2nd group (45–59 years old) included 14 people (28 eyes); the 3rd group (60–74 years old) included 15 people (30 eyes).Results. In the 1st group PVD was not detected in 11 eyes (45.8%); in 13 eyes there were various variants of PVD (54.2%). In the 2nd group PVD was not detected in 9 eyes (32.1%); in 19 eyes there were various variants of PVD (67.9%). In the 3rd group PVD was not detected in 5 eyes (16.7%); in 25 eyes (83.3%) there were various variants of PVD. In this group, there was statistically significant predominance of partial PVD with fixation of the posterior hyaloid membrane to inner limiting membrane (PHM to ILM).Conclusion. In the group of elderly patients with axial myopia (60– 75 years), statistically significant increase in incidence of local adhesion of PHM to ILM in the projection of large retinal vessels was revealed in comparison with young and middle-aged groups (10 cases versus 1 and 2, respectively, p<0.05). This feature must be taken in examination and subsequent management of these patients

Dynamics of cellular immunity indicators in the complex treatment of acute optic neuritis

An increase in the incidence of optic neuritis among the working-age population, as well as an unpromising prognosis for vision due to the development of optic nerve atrophy, determines the high social significance of this problem. The aim of the work is to analyze the effect of Imunofan at the parameters of cellular immunity and clinical symptoms of the disease in the complex treatment of optic neuritis associated with herpes virus infection. The study involved 37 people (37 eyes) with acute optic neuritis associated with herpes infection. The treatment regimen included the appointment of a dexamethasone solution according to a decreasing scheme, a 1% solution of the drug Emoxipin 0.5 mL and a 12.5% solution of the drug Dicynone 0.5 mL through an irrigation system implanted in the retrobulbar space, in combination with the neuroprotection drugs (Pikamilon and Semax) for 10 days. All patients were divided into 2 groups. The main group consisted of 20 patients who received Imunofan to the treatment regimen in addition. The comparison group included 17 patients who were treated only according to the method described above. The course of treatment lasted 10 days. The analysis of the data showed a more significant positive dynamics of cellular immunity parameters in those who received immunotherapy. Our studies showed the effectiveness of this drug in the complex treatment of optic neuritis associated with herpes infection, what is confirmed by the acceleration of inflammation relief, a more significant increase in visual functions of patients treated with Imunofan, and a lower percentage of optic nerve atrophy. In this group of patients, changes in the parameters of the cellular link of immunity occurred earlier and remained stable throughout the entire period of observation. According to our data, an intergroup assessment of the immunoregulatory index showed its faster increase in patients of the comparison group who received Imunofan, and reached normal values already 6 months after treatment. The clinical effectiveness of Imunofan in the complex therapy of optic neuritis associated with herpes infection was characterized by a reduction in the period of relief of signs of inflammation in the optic nerve by 2 times or more, by an increase in the maximum corrected visual acuity by 4.5 times, and by a decrease in the incidence of recurrence of optic neuritis by 2 times over a 12 months observation period

Role of immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

Background. An increase in the incidence of optic neuritis (ON) among the workingage population, the complexity of etiological diagnosis and the choice of adequate etiotropic therapy, as well as a disappointing prognosis for vision due to the development of optic nerve atrophy determines the high social significance of this problem.The aim. Comprehensive clinical, functional, morphometric and laboratory-immunological evaluation of results of using the drug Imunofan® in combined treatment of ON associated with herpesvirus infection (HVI).Materials and methods. The study involved 39 people (39 eyes) with acute ON associated with HVI. The standard treatment regimen for the patients included the appointment of solutions: dexamethasone in a decreasing scheme, a 1 % Emoxypine® preparation 0.5 ml and 12.5 % Dicynone® preparation 0.5 ml through an irrigation system implanted into the retrobulbar space, with subsequent appointment of medicinal means of neuroprotection (Picamilon® and Semax®). All patients were divided into two groups. The main group – 22 patients, whose standard inpatient treatment was supplemented with intramuscular administration of the drug Imunofan®, 50 μg daily for 10 days. The control group consisted of 17 patients, who were treated only according to the standard method.Results. Analysis of obtained data showed that more significant positive dynamics was noted in patients of the main group.Conclusion. The clinical efficacy of the drug Imunofan® in the complex therapy of ON associated with HVI was characterized by relief of signs of inflammation in the optic nerve in the main group immediately after the end of the course of treatment, while in the control group – only after 3 months; an increase in the best corrected visual acuity by 1.3 times, a decrease in the incidence of postneuritic optic nerve atrophy at a follow-up period of 12 months

Intracellular zinc depletion induces caspase activation and p21Waf1/Cip1 cleavage in human epithelial cell lines

To better understand the mechanisms by which zinc deficiency induces epithelial cell death, studies were done of the effects of intracellular zinc depletion induced by the zinc chelator TPEN on apoptosis-related events in human malignant epithelial cell lines LIM1215 (colonic), NCI-H292 (bronchial), and A549 (alveolar type II). In TPEN-treated cells, depletion of zinc was followed by activation of caspase-3 (as demonstrated by enzymatic assay and Western blotting), DNA fragmentation, and morphologic changes. Increase in caspase-3 activity began 1–2 h after addition of TPEN, suggesting that zinc may suppress a step just before the activation of this caspase. Caspase-6, a mediator of caspase-3 processing, also increased, but later than caspase-3. Effects of TPEN on apoptosis were completely prevented by exogenous ZnSO4 and partially prevented by peptide caspase inhibitors. A critical substrate of caspase-3 may be the cell cycle regulator p21Waf1/Cip1, which was rapidly cleaved in TPEN-treated cells to a 15-kDa fragment before further degradation.F. Chai, A. Q. Truong-Tran, A. Evdokiou, G. P. Young and P. D. Zalewsk

Non-NAD-Like poly(ADP-Ribose) Polymerase-1 Inhibitors effectively Eliminate Cancer in vivo

The clinical potential of PARP-1 inhibitors has been recognized N10 years ago, prompting intensive research on their pharmacological application in several branches of medicine, particularly in oncology. However, natural or acquired resistance of tumors to known PARP-1 inhibitors poses a serious problemfor their clinical implementation. Present study aims to reignite clinical interest to PARP-1 inhibitors by introducing a new method of identifying highly potent inhibitors and presenting the largest known collection of structurally diverse inhibitors. The majority of PARP-1 inhibitors known to date have been developed as NAD competitors. NAD is utilized by many enzymes other than PARP-1, resulting in a trade-off trap between their specificity and efficacy. To circumvent this problem, we have developed a new strategy to blindly screen a small molecule library for PARP-1 inhibitors by targeting a highly specific rout of its activation. Based on this screen, we present a collection of PARP-1 inhibitors and provide their structural classification. In addition to compounds that show structural similarity to NAD or known PARP-1 inhibitors, the screen identified structurally newnon-NAD-like inhibitors that block PARP-1 activity in cancer cellswith greater efficacy and potency than classical PARP-1 inhibitors currently used in clinic. These non-NAD-like PARP-1 inhibitors are effective against several types of human cancer xenografts, including kidney, prostate, and breast tumors in vivo. Our pre-clinical testing of these inhibitors using laboratory animals has established a strong foundation for advancing the new inhibitors to clinical trials

Особенности ранней диагностики пигментной глаукомы с псевдонормальным давлением после радиальной кератотомии (клинический случай)

The article describes a clinical case of diagnostics and diagnosis of pigmentary glaucoma with pseudo-normal pressure in a patient who had previously underwent radial keratotomy (RKT).This case is interesting in that the detection of pigmentary glaucoma can be significantly complicated by a falsely low level of intraocular pressure (IOP) in the myopic eye after previous RKT and secondary hypermetropic shift, combined with the difficulty of an in-depth ophthalmoscopic assessment of the state of the optic nerve head in myopia, as well as perimetric study due to keratotomy scars. Tonometric IOP readings in such eyes should be considered carefully and supplemented with examination of other characteristic clinical signs of pigmentary glaucoma. This would help establish the diagnosis early and timely prescribe pathogenetic treatment.В статье описывается клинический случай диагностики и выявления пигментной глаукомы с псевдонормальным давлением у пациента после ранее выполненной радиальной кератотомии (РКТ).Данный случай интересен тем, что ложнозаниженный уровень внутриглазного давления (ВГД) в миопическом глазу после ранее проведенной РКТ и сформировавшегося вторичного гиперметропического сдвига в сочетании с затруднением углубленной офтальмоскопической оценки состояния диска зрительного нерва при миопии, а также периметрического исследования из-за кератотомических рубцов, способен значительно затруднить выявление пигментной глаукомы. Следует относиться с осторожностью к показателям тонометрического уровня ВГД в подобных глазах, выявляя другие характерные для пигментной глаукомы клинические признаки. Это позволит вовремя выставить диагноз и своевременно назначить патогенетическое лечение

Биометрические факторы риска возникновения острого приступа глаукомы

PURPOSE. To assess the prognostic significance of the LAF coefficient (Lens thickness/Axial length factor) as a risk factor for acute glaucoma attack in anatomically short eyes of Europeans.METHODS. Group 1 consisted of 24 patients (48 eyes) with axial hyperopia. Group 2 included 24 patients (48 eyes) with primary closure of the anterior chamber angle. Group 3 — 17 patients (34 eyes) with initial stage of primary angleclosure glaucoma. Group 4 — 35 patients (35 eyes) with an acute attack of glaucoma. The studied groups did not differ in age (p=0.97) and gender (p=0.28). Lens thickness and axial length (AL) were measured by A-scan with calculation of the LAF coefficient.RESULTS. The LAF coefficient in group 4 (acute attack) was statistically significantly higher than in the other three groups. The best separation of groups 1 and 4 was seen in LAF coefficient compared to lens thickness and AL with sensitivity, specificity and the area under the curve (AUC) of 89%, 83% and 0.9, respectively. LAF coefficient values greater than 2.332 in patients with short AL are objectively associated with high risk of acute attack of glaucoma. The average value of the LAF coefficient (2.528) observed in group 4 (acute attack of glaucoma) significantly exceeds these parameters in works of other authors, which may be associated with morphometric structural features of the eyes of Europeans compared to the eyes of Asians.CONCLUSION. The LAF coefficient provides better separation of group 1 and 4 in comparison with lens thickness and, especially, axial length. LAF coefficient values greater than 2.332 in eyes with short AL objectively indicate high risk of acute attack of glaucoma, as evidenced by high sensitivity, specificity, and AUC.ЦЕЛЬ. Оценить прогностическую значимость коэффициента LAF (Lens thickness/Axial length factor; фактор толщины хрусталика/осевой длины) в качестве фактора риска возникновения острого приступа глаукомы в анатомически коротких глазах европейцев.МЕТОДЫ. В группу 1 вошли 24 пациента (48 глаз) с осевой гиперметропией. В группу 2 — 24 пациента (48 глаз) с первичным закрытием угла передней камеры. В группу 3 — 17 пациентов (34 глаза) с начальной стадией первичной закрытоугольной глаукомы. В группу 4 — 35 пациентов (35 глаз) с острым приступом глаукомы. Исследуемые группы не отличались по возрасту (p=0,97) и полу (p=0,28). Толщина хрусталика (ТХ) и переднезадняя ось (ПЗО) измерялись с помощью А-сканирования с расчетом коэффициента LAF.РЕЗУЛЬТАТЫ. Коэффициент LAF в группе с острым приступом глаукомы был статистически значимо выше, чем в первых 3-х группах. Наилучшее разделение 1-й и 4-й групп обеспечивает показатель LAF по сравнению с показателями ТХ и ПЗО с чувствительностью, специфичностью и площадью под ROC-кривыми 89%, 83% и 90%, соответственно. Значения коэффициента LAF более 2,332 у пациентов с короткой ПЗО объективно ассоциировано с высоким риском возникновения острого приступа глаукомы. Полученное нами среднее значение коэффициента LAF в группе с острым приступом глаукомы (2,528) значительно превышает данные показатели в работах других авторов, что может быть обусловлено морфометрическими особенностями строения глаз европейцев по сравнению с глазами азиатов.ЗАКЛЮЧЕНИЕ. Коэффициент LAF обеспечивает лучшее разделение 1-й и 4-й групп по сравнению с показателями ТХ и, особенно, ПЗО. Значения коэффициента LAF более 2,332 в глазах с короткой ПЗО объективно свидетельствуют о высоком риске возникновения острого приступа глаукомы, что подтверждается высокой чувствительностью, специфичностью и данными ROC-анализа