The Effect of Anthocyanins on Microcirculation and Retrobulbar Blood Flow in Ocular Pathology

The literature review presents information on positive effects of anthocyanins on functional indices of cardiovascular system, vascular reactivity of main arteries, microcirculation and retrobulbar blood flow. The positive effect of anthocyanins on the reactivity of main arteries was detected using non-invasive ultrasound method for assessment of flow-mediated dilation andendothelial function. Numerous randomised-controlled trials showed the effectiveness of the long-term supplementation with anthocyanins (during 6–24 months) in correction of microcirculation impairment and functional indices of visual system. The increase of plasma endothelin-1 (ET-1) level and the pathological vascular reactivity have been noted in ocular ischemic diseases such as diabetic retinopathy, occlusion of retinal veins and arteries. We registered the normalization of the plasma ET-1 level, significant improvement of blood flow in neuroretinal rim area and peripapillary area of retina without changes in mean indices of intraocular pressure and ocular perfusion pressure in patients with open-angle glaucoma after anthocyanins administration. There was no progression of visual fields defects. The resulting effect of anthocyanins supplementation consists of metabolic regulation of blood flow and flow-dependent vasodilatation due to the influence on vascular endothelium.Anthocyanins also increase the expression of endothelial nitric oxide (NO) synthase, an enzyme that generates powerful endogenous vasodilator NO. Anthocyanins regulate a number of complex immune and inflammatory signaling pathways involved in maintaining vascular functional activity. Positive dynamic of blood flow velocities and normalization of resistance indices in ocular vessels were detected in patients with dry age-related macular degeneration after 2 months anthocyanins supplementation. That indicates the improvement of ocular blood flow circulation and favorable prognosis for retinal dystrophies. The instrumental examination of blood flow in different vascular systems including microcirculation and main arteries are very useful for assessment of the effectiveness of anthocyanin supplementation

NONINVASIVE METHODS ASSESSMENT BLOOD FLOW IN ANTERIOR SEGMENT AND CLINICAL APPLICATION PERSPECTIVE

The literature review contains information on the anatomical and physiological features of the vessels of the conjunctiva, iris, ciliary body. There are data on the development and application of new non-invasive methods for the study of hemodynamics in the microvessels of anterior eye segment. To study the blood flow of the anterior segment of the eye, biomycroscopy, photography and videobiomicroscopy, television biomicroscopy of vessels, darkfield visualization, application fluorescence angiography, photoacoustic angiography, orthogonal polarization spectroscopy, laser Doppler flowmetry and OCT-angiography were used in recent years. These methods allow to determine the qualitative and quantitative characteristics of conjunctiva, iris, ciliary body microcirculation. They are highly informative for assess of various drugs effect on the vascular eye system. Investigation of hemodynamics in the eye microvessels is necessary for a fundamental approach to the study of the pathophysiology of systemic circulatory pathologies (with arterial hypertension, diabetes, etc.) and changes in regional blood flow in organ of vision disease. Monitoring of anterior segment microcirculation in clinical practice makes possible to monitor the effectiveness of drug and surgical treatment

POSSIBILITIES OF COLOR DUPLEX IMAGING IN THE DIAGNOSIS OF OCULAR VASCULAR PATHOLOGY

The literary review presents the results of domestic and foreign studies of blood flow in the arteries and veins of the eye and orbit using color Doppler Imaging (CDI) and pulsed dopplerography. These methods are used to obtain the data on linear blood flow velocity and vascular resistance in different areas of the ocular vascular system and detect the correlation thereof with the severity of vascular disorders. CDI demonstrates the possibilities of multiple application in order to obtain reliable results in the diagnosis and evaluation of the effectiveness of treatment of the vascular pathology of the eye. For citation: Kiseleva T.N., Zaitsev M.S., Ramazanova K.A., Lugovkina K.V. Possibilities of color Duplex Imaging in the diagnosis of ocular vascular pathology. Russian ophthalmological journal. 2018; 11 (3): 84-94 (In Russian). doi: 10.21516/2072-0076-2018-11-3-84-9

Аntioxidant Status and Lipid Metabolism in Patients with Different Forms of Primary Open-Angle Glaucoma Progression

Purpose: to study the antioxidant system and lipid status of serum and evaluate the effect of Cytoflavin on these characteristics in patients with progressive and stable primary open angle glaucoma (POAG).Patients and methods. 67 patients with advanced stage POAG were observed. The average age was 66.3 ± 1.5 years. According to the course of the glaucoma process all patients were randomized into 2 groups: the 1st group with the stable glaucoma (31 patients) and the 2nd group with rapidly progressive glaucoma (36 patients). The progression criteria of POAG were global ganglion cell loss volume (GLV) and perimetric index (mean deviation-MD). For assessment of the reactivity of the vascular endothelium, a test with reactive hyperemia was performed using ultrasound method. The assessment of oxidative stress (OS) including peroxides, malonyldialdehyde (MDA) and the total antioxidant capacity of serum (AOS) were evaluated. The investigations of lipid metabolism included the level of cholesterol total (CT), cholesterol of low-density lipoproteins cholesterol (LDL-C), high-density lipoproteins cholesterol (HDL-C), triglycerides (TG) and atherogenic index (AI).Results. In the 2nd group there was the significant decrease of the mean GLV indices compared to those in the 1st group (7.16 ± 2.5 и 1.06 ± 0.2, respectively, р < 0.001). The mild degree of endothelial dysfunction (ED) predominantly was detected in patients of the 1st group (69 % of cases). The moderate and marked ED were found in patients with progressive POAG (68 and 25 %, respectively). The high level of OS in serum was determined in 43 % of patients of the 1st group and in 69 % of patients of the 2nd group (significant increase of peroxides and MDA). In patients with progressive POAG the mean indices of lipid metabolism (CT, LDL-C, HDL-C, TG, AI) were significantly higher than in healthy subjects (р < 0.001). Cytoflavin had a positive effect on the vascular endothelium function, normalization of lipid metabolism and decrease of OS in serum with increasing AOS in patients with progressive POAG.Conclusion. The assessment of the indices of OS, AOS and lipid metabolism enable us to determine the risk of progression of POAG and evaluate of the effectiveness of treatment

An experimental study of resveratrol effect on neurotrophic and structural changes in retinal ischemia

Purpose. To investigate the effect of resveratrol antioxidant on neurotrophic and structural changes of retina/choroid tissue complex in experimental ischemia/reperfusion (I/R) injury of retina induced by endothelin-1 (ET-1) injection in rats. Material and methods. 60 male Wistar albino rats were divided into 3 groups. 50 rats underwent I/R (Group 1 [n = 20]; Group 2 [n = 30]) while 10 animals served as controls. Retinal I/R was induced in Group 1 and Group 2 by subconjunctival injection of 0.2 mL 4 x 10-6 М ET-1. The animals in Group 1 received no resveratrol; those in Group 2 received 20 mg/kg resveratrol per os during 1 month before I/R and continued to receive it after I/R up to the moment they were euthanazied. Factors regulating mitochondrial apoptosis (BAX/BCL-2) and external pathways of apoptosis (sFas/FasL), inflammatory marker — monocyte chemoattractant protein-1 (МСР-1) and neurotrophic factors – brain-derived neurotrofic factor (BDNF), nerve growth factor (NGF) were quantified in retinal/choroidal tissue homogenates. In each group, laboratory assessment of retina/choroid complex samples and morphological investigations were performed 3 days (16 eyes), 7 days (16 eyes), 30 days (18 eyes) after ischemia. Results. After 30 days, a statistically significant decrease of apoptotic factors BAX/BCL-2 (p < 0.001) and reduced level of MCP-1 in animals of Group 2 (p < 0.05) as compared to those in Group 1 were noted. The histological examination of the retina on day 3 showed reduced retinal ischemic lesions and signs of inflammation, decrease of the apoptosis of ganglion cells and zones of preserved retina with intact nuclear layers and a layer of photoreceptors in late post-ischemic period (after 30 days). Conclusions. The experimental results demonstrate that resveratrol has neuroprotective properties after retinal I/R injury. This suggests that resveratrol has therapeutic potential in the treatment of diseases of the retina and optic nerve

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

Item does not contain fulltextOBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use