Purpose: to study the cytological, immunological and antiviral effects of the HILOPARIN-KOMOD® drug in vitro.Material and methods.We used transplantable cultures of normal cells of the human Chang conjunctiva, and the kidney cells of the Vero monkeys. The cytotoxic effect of the HILOPARIN-KOMOD® was  determined by the effect on the cell viability, and by optical density  (OP) of the monolayer of the Chang conjunctiva cell culture using the enzyme immunoassay (ELISA) with MTT. The effect of the drug on  the functional activity of conjunctival cells was evaluated by the  production of cytokines at the level of their in vitro transcription. The antiviral effect of the drug HILOPARIN-KOMOD® was studied on  the Vero cell line infected with herpes simplex virus type 1 (HSV-1) and HSV type 2 (HSV-2). The viral activity of HSV-1 and HSV-2  and the antiherpetic effect after the drug was evaluated by  polymerase chain reaction (PCR). Results.No significant cytotoxic effect on the metabolism of conjunctival cells of the preparation HILOPARINKOMOD ® in  dilutions from 1/2 to 1/2048 was revealed (in comparison with the  control). The effect of the drug in dilutions of 1/40 and 1/1000 on  the culture of the conjunctival cells resulted in suppression of the  production of interferon λ-1 mRNA (IFNλ-1) and IFNλ-2 mRNA  compared to the control. In the dilution of preparation 1/1000, the  production of mRNA of interleukin-6 (IL-6) was not revealed with  simultaneous presence of IL-10 mRNA. In different dilutions of the  drug, the number of copies of HSV-1 virus DNA decreased in  comparison with the control in all cases, the greatest antiviral effect  was achieved in a 1: 2 dilution. The effect of the preparation  HILOPARIN-KOMOD® on the culture of cells infected with HSV-2 in  dilutions of 1: 2 and 1: 5 led to a decrease in the level of viral replication by 300 and 40 times, respectively.The conclusion.The drug HILOPARIN-KOMOD® has an anti-inflammatory effect that manifests itself in suppressing the synthesis of the mRNA of the acute phase proinflammatory cytokine IL-6 and  stimulating the production of anti-inflammatory IL-10 mRNA, without having a cytotoxic effect on conjunctival cells. The proven antiviral  effect of the drug makes it possible to recommend the inclusion of  HILOPARIN-KOMOD® in the scheme of therapy of patients with viral ophthalmopathology.

The clinical and laboratory picture of acute infectious conjunctivitis has undergone significant changes in the last few years. This circumstance, apparently, is associated with the appearance of a large number of both eye and systemic forms of antibacterial, anti-inflammatory, immunocorrecting drugs and their widespread use, often without establishing an etiological factor of inflammation. The objective of our work was to propose a scheme of rational empirical therapy of acute infectious conjunctivitis, based on the potential of modern ophthalmopharmacology; and to study the etiological spectrum and features of the clinical picture of the above diseases, thereupon correcting the proposed scheme according to the obtained data. Material and methods. A retrospective analysis of over 20,000 outpatient charts of patients with acute inflammation of the conjunctiva and a prospective examination of 275 patients with acute infectious conjunctivitis was carried out. The method of polymerase chain reaction (quantitative and qualitative) was used to identify the genetic material of the pathogen in scrapings from the conjunctiva, the oropharynx and the nasopharynx. Results. The data of the retrospective analysis has shown that when the symptoms indicated acute infectious conjunctivitis, the actual diagnosis of an ophthalmologist was adenoviral conjunctivitis. There were no other nosological forms with the type of pathogen recorded in outpatient charts. The peak incidence was in the winter-spring period, with the highest number of cases in 2011 and 2013 (1509 and 1482 respectively). Results of the prospective study showed the leading role of adenoviruses (20 % of cases), hemophilic rod (18 % of cases) and pneumococcus (12 % of cases) in the development of acute inflammation of the mucous membrane of the eye. As a concomitant infection, the bacteria of the staphylococcus group were found most often. The spectrum of the revealed pathology confirmed the validity of the selected empirical therapy. Conclusion. The results of the study allow us to recommend the prescription of three groups of drugs (antibiotic, antiviral, non-steroidal anti-inflammatory drug) in the treatment of acute infectious conjunctivitis.

The optical properties of the cornea are determined by its ability to refract and transmit light. Keratoconus changes cornea’s shape, the surface of the cornea becomes irregular, which leads to a violation of light refraction and the occurrence of optical aberrations. The progressing course of the disease and its late detection lead to a delayed start of therapeutic measures, which affects the prognosis of the disease progression and reduces the patient’s quality of life. The quality of visual functions depends on the stage of the process. There are 4 stages of keratoconus (according to M. Asler), each of which corresponds to certain changes in refraction and degree of deformation of the cornea. Early biomicroscopic signs are: “dilution” of the stroma (inhomogeneity of the cornea and a grayish tint in the zone of the developing apex), change in the shape of endothelial cells and clearly visible nerve endings due to longitudinal thickening. In the second stage of keratoconus, the biomicroscopic picture is complemented by the appearance of keratoconus lines (Vogt’s striae). The opacities of the Bowman’s membrane indicate the beginning of the scarring process and the transition of the disease to its third stage. The fourth stage of the disease is characterized by further development of stromal opacities and the occurrence of gross changes of the Descemet’s membrane. Advanced medical equipment for topographic mapping and measuring the cornea makes it much easier for ophthalmologists to diagnose keratoconus and choose more effective treatment methods: crosslinking or surgical treatment. Later it allows to stabilize keratoconus, but does not provide high visual acuity due to the induction of optical aberrations, including high order optical aberrations. Contact lens vision correction is the main way to correct the refractive error resulting from keratoconus. However, the use of corneal gas permeable or soft contact lenses cannot provide high quality vision, additionally causing discomfort associated with their excessive mobility. The use of scleral gas permeable contact lenses is the most effective method of optical correction of all stages of keratoconus and after keratoplasty.

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Objective. To determine the characteristics of drug therapy in patients with herpetic keratitis (HK), based on laboratory diagnosis.Material and methods. 49 patients with clinical symptoms of HK were included in the study. The conjunctival cells were used as a material for laboratory diagnosis of adenovirus and enterovirus infection by polymerase chain reaction (PCR) and for microbiological examination. Herpesvirus DNA in tears, saliva, urine and blood was determined using PCR (for varicella-zoster virus (VZV) and human herpesvirus type 7 (HHV-7)) and real-time PCR (for herpes simplex virus types 1 and 2 (HSV-1,2), Epstein-Barr virus (VEB), cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6). Tear and urine were examined for the presence of DNA of obligate intracellular parasites (chlamydia, ureaplasma, and mycoplasma) by PCR.Results. Сlinical picture of HK was presented by superficial (57.1 %, n = 28) and deep forms of corneal inflammation (42.9 %, n = 21). The results of laboratory diagnostics of herpetic infection had showed replication of herpesviruses in all examined patients. Genetic material of herpesviruses in lacrimal fluid was found in half of the examined patients (51 %), in saliva — in 67,3 % of cases. Viruria was observed in 21 patients (42.9 %), viraemia in 6 (12.2 %). DNA of intracellular parasites in lacrimal fluid was detected in 18.4 % of patients and in urine — in 12.2 % of patients. Bacteriological sowing of the conjunctiva scrape was positive in 75.5 % of cases.Conclusion. Instrumental diagnostics (visometry, biomicroscopy) of HK should be supplemented with laboratory research of activity of not only herpesvirus infection, but also bacterial pathogens. Positive results of microbiological sowing of conjunctival scrapers allow to approach reasonably the prescription of antimicrobial drugs in patients with HK.