Currently, there is a wide range of antiglaucoma drugs. Ophthalmologists are faced with the task of choosing certain drugs and their combinations for specific patients. In this regard, studies aimed at studying the effectiveness of treatment, not only in terms of IOP indicators and instrumental research methods, but also in terms of the choice of a particular type of therapy by ophthalmologists, are of great interest. Purpose: to analyze the data obtained in the course of the study of the Russian multicenter scientific program: “Analysis of the assortability of ophthalmologists when choosing therapy within the framework of routine medical care in patients with primary open-angle glaucoma (POAG)”. The large-scale statistical study carried out was based on the study of 197 medical questionnaires from 61 cities of Russia, containing information on 6851 clinical cases. Doctors were asked to fill out a questionnaire based on the results of treatment (at least 2 months), taking into account the following criteria: satisfaction with treatment, adherence to treatment, accessibility, tolerability and ease of use of drugs. Evaluated the use of 5 antiglaucoma drugs of the company Sentiss Russ, belonging to different pharmacological groups: Prolatan (latanoprost), Bimatan (bimatoprost), Brinex-M (brinzolamide); Tisoptan (bimatoprost / timolol maleate), Brinarga (brinzolamide / timolol maleate). During the study, patients were divided into 6 groups depending on the drug used, and also into 3 groups depending on the stage of primary POAG. The data obtained indicate a statically high level of average values when using the point system of all the above criteria when using these drugs. When analyzing the degree of convenience and the level of tolerance of drugs, a tendency towards a decrease in the average scores of these indicators in patients with advanced stage of glaucoma was noted, which may be due to the long-term use of antiglaucoma therapy in this category of patients with changes in the ocular surface. 98.25% of doctors expressed their intention to continue prescribing antiglaucoma drugs from Sentiss Russ.

Corneal injury due to ocular trauma or infection is one of the most challenging vision impairing pathologies. The aim of the work was to study the effect of biodegradable silk fibroin-based scaffolds containing GDNF on the corneal regeneration process. During cultivate the highest keratocytes proliferative activity was registered with scaffolds containing 250 ng/ml and 500 ng/ml GDNF. In mice with an experimental model of epithelial-stromal damage to the cornea, silk fibroin-based scaffolds containing GDNF in various concentrations were used (in groups 1, 2 and 3 silk fibroin-based scaffolds containing GDNF in a concentration of 50 ng/ml, 250 ng/ml and 500 ng/ml, respectively; in group 4 - silk fibroin-based scaffolds without GDNF; in group 5 - a solution of GDNF with concentration of 500 ng/ml; group 6- control). The area of the corneal epithelial defect in groups 2, 3, and 5 was less than in the other groups. The most pronounced positive immunohistochemical reaction with antibodies to Bcl2, Bax, phosphoERK1/2 and phospho-JNK1/2, Ki67, Gap43 was observed in groups 2 and 3. Thus, silk fibroin-based scaffolds with GDNF stimulate the epithelialization process, proliferative activity of epithelial cells and keratocytes, accelerate the formation of the stromal nerve plexus and exhibit anti-apoptotic activity.

Recovery and preservation of visual functions during compression in the chiasm-sellar region is possible in the case of early diagnosis of pathology and timely surgical decompression. Today optical coherence tomography (OCT) of the retina is one of the most informative methods for diagnosing pathology of the retina and optic nerve. It can, due to the presence of early diagnostic criteria, promptly detect the compression in the chiasm-sellar region and expand the indications for surgical treatment. The literature review presents the results of optical coherent tomography (OCT) of the retina during compression in the chiasm-sellar region. An analysis of literature data revealed that in patients with chiasmatic compression, the thickness of the nerve fiber layer in the peripapillary and macular areas decreases, the thickness of the macular complex, consisting of the retinal ganglion cell layer and the inner plexiform layer, decreases. Also, there is a change in the value of asymmetry between the GCC thickness indices in the nasal and temporal halves of the macular region. It has been established that a decrease in the thickness index of a macular complex may precede changes in the visual field. According to the results of single studies, a correlation was found between the parameters of the peripapillary RNFL thickness and the the internal capillary retinal plexus density in the same areas. The results of literature sources’s analysis are summarized in the table by the parameters studied, the OCT model; etiology, treating methods and the results of the OCT study. Despite the results obtained, the early specific and sensitive OCT diagnostic criteria for chiasmatic compression have not yet been developed. In addition, a change in the thickness of GCC and RNFL can also be observed in the absence of chiasmatic compression in certain types of tumors and in the presence of comorbidities (arterial hypertension). In this regard, it is necessary to conduct further studies that will reveal the informative OСT-diagnostic criteria for compression in the chiasm-sellar region, develop diagnostic algorithms taking into account the type of tumor, the presence of concomitant pathology. Early diagnostic criteria for chiasmatic compression will expand the indications and improve the result of surgical treatment of patients.

The literature review presents the results of a static perimetry for the study of the visual field in patients with compression in the chiasm-sellar region on the Humphrey Visual Field Analyzer (HFA) and Octopus. These models of perimeters are recognized as the “gold standard” and are most widely used in the global ophthalmic practice. The analysis of research results using traditional and function-specific perimetry with selective stimulation of the magnocellular and koniocellular (frequency-doubling technology perimetry, FDT; short-wavelength automated perimetry, SWAP) visual pathways was performed. The literature data analysis allows us to conclude that the static perimetry for the study of the visual field in patients with chiasmatic compression is carried out quite widely and is informative. But despite this, there are no generally accepted recommendations on the use of certain testing strategies and programs for the diagnosis and further dynamic observation of changes in the visual field in patients with this pathology. In this regard, it is advisable to conduct further studies that will allow the formation of standard perimetric protocols for diagnosing and monitoring visual field defects in patients with compression in the chiasm-sellar region based on a comparative analysis of the diagnostic informativity of various strategies and programs.

Preservation of visual functions in patients with chiasmo-sellar region compression (CSRC) is possible with early diagnosis and surgical decompression. PURPOSE To analyze the parameters of optical coherence tomography (OCT) and optical coherence tomography-angiography (OCTA) in patients with CSRC. MATERIAL AND METHODS The study included 10 patients (20 eyes) with CSRC, 15 healthy volunteers (30 eyes). OCT, OCTA was performed on Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, U.S.A.) with AngioVue system. RESULTS Patients with CSRC were revealed to have decreased thickness of ILM-RPE in the nasal sector of outer circle (p<0.001) and average mGCIPL - total and for all six sectors (p<0.001), decreased RNFL in the inferior sector (p=0.017); decreased superficial vessel density (SVD) and perfusion density in the inner and outer circle areas and in all sectors of the ETDRS grid (p<0.001) except temporal; in the peripapillary area, decreased vessel perfusion density (VPD) in the inferior sector (p=0.025), capillary flux index (CFI) in all sectors (p<0.001; p=0.025 in the inferior sector). Informative diagnostic criteria included ILM-RPE in nasal sector of the outer circle (AUC=0.896); mGCIPL in the inferonasal sector (AUC=0.914), average (AUC=0.846), superior (AUC=0.829) and superonasal (AUC=0.846) sectors; average SVD (AUC=0.805) and SVD in the inner circle area (AUC=0.810); CFI in the inferior sector (AUC=0.806) with p<0.001. CONCLUSION In CSRC, changes can be seen in OCT and OCTA parameters recorded in the macular and peripapillary regions before the changes in the central visual field. Informative diagnostic OCT and OCTA criteria can help diagnose the pathology early, expand the indications for decompression, and preserve the visual funcitons.

Актуальность. Сохранение зрительных функций у пациентов с аденомой гипофиза (АГ) возможно при ранней диагностике компрессионной оптической нейропатии и своевременном проведении декомпрессии. Цель. Анализ ОКТ-А параметров у пациентов с АГ. Материал и методы. Обследован 21 пациент (42 глаза) с АГ и 10 здоровых человек (20 глаз), сопоставимых по полу и возрасту. Пациенты были разделены по результатам тестирования центрального поля зрения (ЦПЗ) на периметре Galaxypro(MS WestfaliaGmbH, Германия) с использованием стандартного протокола 30-2 на группы – без нарушений в ЦПЗ на обоих глазах (группа 1 – 22 глаза) и с нарушениями в ЦПЗ (преимущественно темпоральные дефекты) на одном или обоих глазах (группа 2 – 20 глаз). ОКТ-А проведена на спектральном томографе REVO nx/SOCT Copernicus REVO (OptopolTechnologyLtd., Польша). Результаты. В 1-й группе выявлено снижение: плотности сосудов (VD) радиального перипапиллярного капиллярного сплетения (RPC) в верхней перипапиллярной зоне (p=0,002), в верхнем (p=0,005) и верхневисочном (p=0,004) секторах; снижение показателя капиллярной перфузии (VP) поверхностного капиллярного сплетения (SRCP) в нижнем секторе наружного кольца по сетке ETDRS (p=0,009); VP глубокого капиллярного сплетения (DRCP) общего внутреннего кольца (p=0,003). Во 2-й группе выявлено снижение: VDRPC по сравнению с 1-й группой – в верхневисочном секторе (p=0,003), по сравнению с контрольной группой – во всех секторах (p <0,0001); VPSRCP по сравнению с 1-й и контрольной группой в нижнем секторе наружного кольца (p=0,003 и p <0,0001 соответственно). Выявлена корреляционная зависимость между толщиной слоя нервных волокон сетчатки (RNFL) и VDRPC у пациентов обеих групп (в нижнем и назальном секторах, соответственно), толщиной RNFL и VPRPC в нижнем секторе в 1-й группе; у пациентов 2-й группы – толщиной RNFL и VDRPC в верхнем секторе; между толщиной макулярного комплекса (mGCC) и VDSRCP общей; между показателем толщины сетчатки в макулярной области (ILM-RPE) и VPSRCP в верхнем секторе наружного кольца и VDDRCP в нижнем и VPDRCP в назальном секторе внутреннего кольца. Выводы. Результаты исследования позволяют предположить, что хиазмальная компрессия, вызванная АГ, приводит к прогрессированию микроциркуляторных нарушений в перипапиллярной и макулярной областях, диагностирование которых возможно до формирования изменений ЦПЗ.

Keratoplasty in patients with recurrent destructive processes in the cornea nowadays remains one of the most serious problems in ophthalmic surgery.Purpose. The analysis of results of penetrating keratoplasty (PK) in patients with destructive processes of the cornea or the corneal graft depending on the initial level of GDNF and the activity of the MAP kinase cascade of the signaling pathways.Material and methods. The analysis of the results of PK was performed in 23 patients (34 eyes) with acute destructive processes of cornea or the corneal graft in different etiologies. The follow-up period was from 6 months to 2 years. The analysis of the results of treatment was carried out depending on the condition of the corneal graft at various times after PK.The immunohistochemical examination of the biological material (corneal disks of the recipient) was performed using antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2, Ki67, GAP43, Bcl2 and Bax.Results. The time of epithelialization of the graft after PK in destructive processes of the cornea was increased in 79% of cases. When the epithelialization of the corneal graft was completed more than 6 and 10 days after PK in the postoperative period persistent erosions of the graft (PEG) with ulceration were formed in 22% and 89% of cases, respectively.The intensity of immunohistochemical reactions with antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2 in corneal disks at the epithelialization time of up to 5, 10 days and more eythan 10 days after PK was reduced from moderately positive to weakly positive and negative, respectively.When the time of epithelialization was completed in 6-10 days and there was not PECG, the intensity of reactions with antibodies to GDNF remains moderately positive, phospho-ERK1 / 2, phospho-JNK1 / 2 was lightly positive; when there was PEG the intensity of all reactions was weakly positive.Conclusion. The severity of the destructive pathological process in the cornea and postoperative complications after PK in patients with destructive corneal processes depend on the degree of GDNF deficiency, the decrease in the activity of the MAP kinase cascade of signaling pathways; the density of nerve plexuses in the own corneal tissue or corneal graft, and the activity of apoptosis processes.

Keratoplasty in patients with recurrent destructive processes in the cornea nowadays remains one of the most serious problems in ophthalmic surgery. Purpose. The analysis of results of penetrating keratoplasty (PK) in patients with destructive processes of the cornea or the corneal graft depending on the initial level of GDNF and the activity of the MAP kinase cascade of the signaling pathways. Material  and  methods. The  analysis  of  the  results  of  PK  was performed in 23 patients (34 eyes) with acute destructive processes of cornea or the corneal graft in different etiologies. The follow-up period was from 6 months to 2 years. The analysis of the results of treatment was carried out depending on the condition of the corneal graft at various times after PK. The  immunohistochemical  examination  of  the  biological  material (corneal disks of the recipient) was performed using antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2, Ki67, GAP43, Bcl2 and Bax. Results. The  time  of  epithelialization  of  the  graft  after  PK  in destructive processes of the cornea was increased in 79% of cases. When the epithelialization of the corneal graft was completed more than 6 and 10 days after PK in the postoperative period persistent erosions of the graft (PEG) with ulceration were formed in 22% and 89% of cases, respectively. The intensity of immunohistochemical reactions with antibodies to GDNF, phospho-ERK1 / 2, phospho-JNK1 / 2 in corneal disks at the epithelialization time of up to 5, 10 days and more eythan 10 days after PK was reduced from moderately positive to weakly positive and negative, respectively. When the time of epithelialization was completed in 6-10 days and there was not PECG, the intensity of reactions with antibodies to GDNF remains moderately positive, phospho-ERK1 / 2, phospho-JNK1 / 2 was lightly positive; when there was PEG the intensity of all reactions was weakly positive. Conclusion. The severity of the destructive pathological process in the cornea and postoperative complications after PK in patients with destructive corneal processes depend on the degree of GDNF deficiency, the decrease in the activity of the MAP kinase cascade of signaling pathways; the density of nerve plexuses in the own corneal tissue or corneal graft, and the activity of apoptosis processes.

Aim. To study effect of sulodexide (Vessel Due F) on the functional state of endothelium in patients with diabetic retinopathy.Materials and methods. A total of 37 patients with DR were divided in 2 groups and treated with sulodexide. Group 1 comprised 16 patients with non-proliferative DR, group 2 included 21 patients with preproliferative DR. The functional state of endothelium was estimated from the plasma and serum levels of endothelial factors (sVCAM, endothelin, nitric oxide, t-PA, Willebrand factor).Results. The measurement of the initial levels of endothelial factors in both groups revealed significant changes in endothelin, nitric oxide, and sVCAM suggesting disturbances of endothelial function due to DR. Sulodexide therapy normalized it regardless of DR stage and thereby improved functional activity of retina.Conclusion. This study has demonstrated beneficial effect of sulodexide on endothelial function in patients with DR due to correction of the production of vasoactive factors (endothelin, nitric oxide) and stimulation of fibrinolytic activity of the vascular wall (t-PA).