Цель-оценить эффективность лечения и возможность восстановления зрительных функций у больных с окклюзией вен сетчатки (ОВС) в зависимости от степени исходной макулярной ишемии. Материал и методы. Обследовано 84 пациента с перенесенной ОВС. Основными критериями включения в исследование были наличие макулярного отека на фоне ОВС, не превышающей по длительности 3 мес, и отсутствие какого-либо предшествующего лечения. Всем пациентам выполнялись интравитреальные инъекции ингибитора ангиогенеза с последующим лазерным лечением при необходимости. Сравнительный анализ результатов проводился в оппозитных по клиническому эффекту группах до начала терапии, через 1 мес и 12 мес. Всем пациентам и лицам контрольной группы проводились офтальмологическое обследование, включавшее стандартные методы, а также электроретинография, флюоресцентная ангиография, оптическая когерентная томография (ОКТ) и ОКТангиография. Результаты. При сравнительном анализе исходного офтальмологического статуса пациентов с ОВС с оппозитным клиническим эффектом и данных, полученных в течение 12 мес наблюдения, были выделены 3 клинические группы, соответствующие 3 степеням макулярной ишемии-легкой, средней и тяжелой. Заключение. Определение на этапе первичной диагностики степени ишемии макулярной зоны позволяет повысить эффективность лечения, а также ориентировать пациентов в отношении последовательности и длительности анти-VEGF-терапии. Интравитреальные инъекции Ранибизумаба при окклюзии ретинальных вен проводятся до ликвидации макулярного отека и далее в режиме «по потребности», при этом количество введений может варьировать от одной до ежемесячных инъекций в течение года.

Background. The most common chronic cerebrovascular pathology is dyscirculatory encephalopathy, in which a decrease in blood supply due to damage to brachiocephalic vessels leads to damage to brain substances and analyzers, including visual, with the possible development of severe damage in the form of ischemic optic neuropathy. Many studies have been devoted to the relationship between atherosclerotic damage to the neck vessels and ischemic damage to the visual organ, but little attention has been paid to the study of the functional activity of the altered visual analyzer in patients with dyscirculatory encephalopathy, and the results are scattered. Aim. To conduct a comparative analysis of changes in neurophysiological parameters of the brain and visual analyzer in patients with dyscirculatory encephalopathy and patients with a combination of dyscirculatory encephalopathy and ischemic optic neuropathy. Materials and methods. 34 patients with the 2nd stage of dyscirculatory encephalopathy were examined and divided into two groups based on the presence/absence of ischemic optic neuropathy of various prescription periods. All patients underwent ultrasound scanning of neck vessels, visual fields determination, electroretinography, visual evoked potentials, and electroencephalogram. Results. The results revealed changes in a number of indicators in the group of patients with a combination of two diseases: more pronounced atherosclerotic lesion of brachiocephalic vessels, a decrease in the amplitude and the alpharhythm prevalence index, a decrease in oscillatory potentials, a change in latency and amplitudes the visual analyzer according, lengthening of time indicators with a simultaneous decrease in amplitudes and depression of retinal sensitivity. Conclusion. Patients with dyscirculatory encephalopathy complicated by ischemic optic neuropathy have a combined lesion of the brain and visual analyzer, which determines the severity of the detected changes and requires a comprehensive multidisciplinary approach to the treatment of these patients.

Degenerative changes in the retina of primary open-angle glaucoma (POAG) patients are developing as response to ischemia and chronic hypoxia accompanied by intolerant IOP. For this reason, the analysis of ocular blood flow changes in glaucoma monitoring, as well as the basic tests, should be considered an integral part of comprehensive examination of such patients.The purpose is to identify the most informative markers of the disease and to assess the effectiveness of its antihypertensive therapy by the fixed combination Dorzolamide / Timolol (Dorzopt Plus). Material and methods. 34 patients aged 68.44 ± 4.26 years with an advanced POAG stage and sub- or decompensated IOP were examined. The examination included optical coherence tomography in the angiography mode.Results. A stable average reduction in IOP by 35.1 % (by 8.6 ± 0.7 mm Hg, p < 0.05) as compared with the baseline was achieved. IOP normalization was accompanied by a stable increase in corneal hysteresis and perfusion pressure, a decrease in the average depth of the perimetric defect, and changes in chorioretinal blood flow.Conclusion. Changes in the choroid thickness and capillary density of the retinal peripapillary layer may be considered as the most informative biomarkers in the diagnosis of glaucoma and the evaluation of antihypertensive therapy effectiveness.

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The aim: to evaluate the restoration features of the structural relationships of the retina and chorioretinal blood fl ow after surgical treatment of large-diameter macular hole (MH) using a modifi ed technology.Material and methods. A prospective study of 14 patients (14 eyes), 13 women and 1 man, with medium-and large-diameter MH was conducted. The mean age of the patients was 67.7 ± 5.38 (55–80) years. The study included patients with endto-end MH of the 3rd–4th stage according to the classifi cation of J. Gass. All patients underwent surgical treatment of macular rupture according to the proposed method of inverted fl ap of the internal limiting membrane (ILM) and fi lling it into a “pocket” formed between the retina and the ILM.Optical coherence tomography (OCT) was performed along with traditional research methods. The obtained images were used to measure manually the parameters of retinal MH, the thickness of the choroid in the projection of the rupture and the fovea zone before the operation and 1, 3 and 6 months after the operation. In the angio-mode, the foveal avascular zone (FAZ) was evaluated, as well as the density of capillaries of the superfi cial and deep retinal plexus in four quadrants, with the exception of the central zone.Results. In all patients, it was possible to achieve MH blocking. Visual acuity in the eyes with MH varied from 0.02 to 0.3, while in the comparison group, the best corrected visual acuity was from 0.3 to 1.0 (p = 0.002). An increase in the diameter of large choroidal vessels, as well as a pronounced decrease in the diameter of the posterior short ciliary artery, attracted attention. However, despite the improvement in visual acuity, patients retained a signifi cant expansion of the FAZ, which by 6 months exceeded the FAZ area of the paired eye by 25.8 % (p = 0.01).Conclusion. The results obtained indicate that the achievement of an anatomicalreconstructive effect and even a moderate improvement in visual acuity during surgical treatment of macular holes by the modifi ed inverted flap technology of the internal limiting membrane does not determine the restoration of retinal perfusion in full.