Alina V. Korneeva

Introduction. Pregnant women are objects of special attention of physicians due to two main reasons. The first one is that the fetal life depends on the health and quality of life of a future mother. The second is associated with increased load on all organs and systems of the female body, including the organ of vision. However, manifestations of dry eye syndrome (DES) in this contingent are often not given due attention and often remain untreated, which has a negative impact on the quality of life of women during this difficult period and can lead to diseases of the anterior segment of the eye. The aim of the study was to evaluate the effectiveness of a drug based on sodium hyaluronate 0.21 % in pregnant women with dry eye syndrome due to dysfunction of the meibomian glands. Рatients and methods. The study included 60 patients (120 eyes) with dry eye syndrome with an average age of 31.45 ± 5.98 years and a follow-up period of 3 months. There were 2 groups of patients: the main group (pregnant women with DES) and the control group (non-pregnant women with DES). Patients of both groups were administered a preservative-free form of 0.21 % sodium hyaluronate three times a day for 3 months. All studied patients underwent standard methods of examination, indicators of DES were assessed along with an objective valuation of tear film parameters and meibomian glands condition by digital biomicroscopy on a MediWorks slit lamp (Precision Instruments Co., Ltd., Shanghai) at the time of first visit and at 1 and 3 months of follow-up. Results and discussion. A comparative analysis of therapy effectiveness in the main and control groups showed that OSDI scores (ocular surface disease index), non-invasive tear breakup time (NITBUT) and meibomian gland function improved after treatment in both groups. Early diagnosis and timely correction of DES manifestations in pregnant women by administration of tear replacement therapy with preservative-free sodium hyaluronate 0.21 %, as well as eyelid hygiene can improve the quality of life of this group of patients and prevent associated with DES complications. Conclusion. The selected preservative-free tear replacement therapy with sodium hyaluronate 0.21 % (Optinol® Express moisturizing) provided a combination of ocular surface moisturizing and reducing the risk of inflammatory lesions with facilitating the release of meibomian gland secretion, contributing to the effectiveness and prolongation of therapy.

This literature review is devoted to one of the most challenging problems of ophthalmology — neuroprotective and neuroregenerative treatment of glaucoma and consists of two parts. The second part of the review deals with the role of glia, inflammation and autoimmunization in the pathogenesis of neuroretinal degeneration in glaucoma optic neuropathy (GON), new treatment strategies based on modern achievements of gene and immunotherapy. Special attention is paid to promising therapeutic approaches based on artificial intelligence application, usage of peptide bioregulators, immunomodulators and mixed-action drugs. Alternative methods of axonal regeneration, including gene therapy and stem cell therapy, are discussed.

Methylethylpyridinol is a frequently used drug in ophthalmology. Many years of experience of its use in clinical practice and a variety of pharmacological effects have caused its wide introduction in the treatment of a wide range of ophthalmopathologies, as well as in various fields of medicine. It is known that methylethylpyridinol has antioxidant activity, neuroprotective effect, ability to stabilize cell membranes and improve microcirculation. These properties open wide possibilities for its application in therapy of eye diseases, in which oxidative stress and deterioration of blood supply play a key role. The broad spectrum of action of methylethylpyridinol is useful in combination therapy with other drugs, which allows to achieve a synergistic and enhanced therapeutic effect. This, in turn, can be applied for treatment of various diseases, including ophthalmologic pathology of the anterior and posterior segment of the eye, as well as ocular manifestations of systemic diseases. A significant advantage of methylethylpyridinol is the presence of the form of eye drops, which has an equivalent effect in comparison with parabulbar administration of the drug. This determines the unique position of the drug in the form of eye drops in ophthalmopharmacotherapy, because to date, the pharmaceutical market has no alternative agents with such a wide range of pharmacological properties in a convenient and safe dosage form, targeting the structures of the eye. This review discusses the therapeutic properties of methylethylpyridinol and the results of preclinical and clinical studies of this drug, which is important for expanding the prospects of its clinical application and ensuring patient safety.

This literature review is devoted to one of the most complex ophthalmology problems — neuroprotective and neuroregenerative treatment of glaucoma and consists of two parts. The first part considers the main mechanisms of neurodegeneration and the main aspects of therapeutic control related to these mechanisms (excitotoxicity, mitochondrial dysfunction, oxidative stress). The main aim of the conducted literature analysis is to provide a comprehensive overview of both existing neuroprotective strategies and promising areas of therapy based on neuroprotective agents in the potential treatment of glaucoma. A wide range of approaches to neuroprotection demonstrates the great potential for effective treatment of neurodegeneration in order to preserve visual functions in patients with glaucoma.

Aminobenzoic acid is a biologically active substance widespread in nature, which has a wide range of therapeutic applications as an antiviral, antibacterial, antioxidant, antimutagenic, anticoagulant, fibrinolytic, immunomodulatory, radioprotective agent. As an interferon inducer it has been used for many years in mono- and complex therapy of viral eye lesions: conjunctivitis, keratoconjunctivitis, keratouveitis, including those caused by the herpes virus (Herpes simplex, Herpes zoster), adenoviruses; keratopathies of infectious, post-traumatic and postoperative origin. Taking into account the available information, a new drug has been registered and introduced into clinical practice, the main active ingredient of which is 0.007% aminobenzoic acid – Exinta. However, a number of studies have also shown the effectiveness of аminobenzoic acid in the treatment of neurodegenerative eye diseases by reducing the intensity of oxidative damage by lipid peroxidation products, as well as increasing the activity of transport adenosine triphosphatases in eye tissues. Based on the results obtained, it is recommended to use a 0.007% aminobenzoic acid solution not only for the treatment of viral eye diseases as an interferon inducer, but also in the treatment of uveitis, burns and eye injuries, retinal dystrophies, retinopathy, after ophthalmological operations, inflammatory and dystrophic diseases of the cornea, for keratopathies of various origins, for accommodation disorders, etc. In the given clinical example, 0.007% aminobenzoic acid showed its effectiveness in the lingering course of chronic conjunctivitis in the background of the low effectiveness of other drugs, where with the help of monotherapy it was possible to achieve clinical recovery.

Introduction. Meibomian gland dysfunction (MGD) is considered as the leading cause of the evaporative dry eye syndrome (DES). At the same time the standard methods of DES treatment often allow to achieve only a short-term effect and the search of alternative methods to achieve remission for a longer period is required.Aim. To evaluate the effectiveness of a combined treatment of DES with MGD using transdermal Intense Pulsed Light (IPL) method combined with preservative-free sodium hyaluronate 0.18% eyedrops.Materials and methods. The study involved 60 patients (120 eyes) after refractive surgery (femtoLASIK) with DES and MGD aged 20 to 40 years with a follow-up period of 3 months. The patients were divided into two groups: main (30 patients) and control (30 patients). Patients of both groups were administered a preservative-free form of 0.18% sodium hyaluronate four times a day for 3 months. All studied patients underwent standard examination methods, indicators of DES were assessed along with an objective valuation of tear film parameters and the meibomian glands condition by mean of digital biomicroscopy using a MediWorks slit lamp before surgery and 7 days, 1, 2 and 3 months after refractive surgery.Results and discussion. A comparative analysis of therapy effectiveness in the main and control groups showed that OSDI scores (ocular surface disease index), non-invasive tear breakup time (NITBUT) and meibomian gland function improved after treatment in both groups, but in the main group (IPL) positive dynamics of indicators were more pronounced with a cumulative increase of effectiveness after subsequent sessions.Conclusion. A course of IPL therapy in combination with a course of sodium hyaluronate 0.18% for dry eye syndrome due to MGD reduces the time, allows for longer-term results of therapy and promotes earlier elimination of discomfort.

Introduction. The Ahmed glaucoma valve (GV) type drainage implantation is characterized by high efficiency and low complication rate, and is finding an increasing application in clinical practice. Although GV provides better intraocular pressure (IOP) control and higher surgical success rates compared to trabeculectomy, the so-called hypertensive phase (HP), typically defined as an IOP elevation more than 21 mmHg, can occur at the period from one to three months postoperatively, related to the fibrous capsule reservoir formation, which does not have the character of persistent hypertension.Aim. To analyze the effectiveness of the Dorzolamide-Optic carbonic anhydrase inhibitor and the Latanoprost-Optic prostaglandin analogue as the drugs of choice in clinical conditions at different periods during postoperative follow-up when antihypertensive therapy after GV implantation is needed.Materials and methods. The study included 80 glaucoma patients who underwent GV implantation in the clinic “Eye Surgery Rascheskov” with a postoperative follow-up period of at least one year. In order to increase the effectiveness of surgical intervention and preserve visual functions, hypotensive therapy was prescribed in studied patients either when IOP exceeded the target pressure, or when there was a tendency to a constant increase between control visits. 180 operated patients with IOP level within the target level during the follow-up period were excluded from the study.Results. The overall incidence rate of the hypertensive phase (GF) was 44.4%. In all studied patients to compliance with the operation technique and early therapy appointment, Dorzolamide-Optic monotherapy was sufficient to achieve stabilization of visual functions for up to 3 months after surgery. During a follow-up period more than 3 month, 15 patients (18.8%) required additional appointment of Latanoprost-Optic to achieve the target IOP level. After 2 months following the implantation, the antihypertensive therapy was discontinued under the IOP control in 17 patients (21.3%).Conclusions. Medical management of HP is crucial for preventing further optic nerve damage and preserving visual functions, as reduction of the incidence and severity of HP are known to be associated with higher operative success rates and a better long-term IOP control.

Introduction. Dry eye syndrome (DES) is a common cause of blurred vision and discomfort in patients after eye surgery, which has a great impact on the on the patients’ mental state. Evaluation of the presence of DES during the preoperative examination is important not only for obtaining a high postoperative result, but also for the timely administration of therapy in order to improve the patient's quality of life.Aim. Thus, the aim of this study was to establish the features of the clinical course of dry eye syndrome and to determine the effectiveness of ultra-high viscosity hyaluronic acid therapy in patients with anxiety and depression after cataract and keratorefractive surgery.Materials and methods. The study involved 100 patients (150 eyes). Preoperative examination included DES diagnostic and psychotesting. DES in all studied subjects was treated with ultra-high viscosity hyaluronic acid 3 times a day for 3 months after surgery in combination with topical combination of glucocorticoids, antibacterial and non-steroidal anti-inflammatory drugs, which were administered within 1 week after surgery. There were no intraoperative complications in all studied cases.Results. It was found that patients with depressive and/or anxiety symptoms (46% of the subjects) had higher OSDI scores, while there were no differences in clinical and functional tests of dry eye syndrome between the studied groups. There was a significant improvement in the results of OCT meniscometry and Norn's test during therapy with ultra-high viscosity hyaluronic acid. The given clinical examples show the importance of timely diagnosis and treatment of DES.Conclusions. The study showed the importance of dry eye syndrome evaluation and timely artificial tear therapy prescribing for both to achieve a high postoperative result and to reduce the patients’ subjective discomfort and improve patients’quality of life.

The literature review discusses the role of vitamins (in particular, B vitamins) in maintaining neuroprotective and antioxidant properties of the retina in glaucomatous optic neuropathy, and presents the data from foreign research papers devoted to studying the positive influence of vitamins of this group on the condition of ganglion cells of the retina and axons of the optic nerve.

Purpose: to analysis the results of microimpulse transscleral diode laser cyclophotocoagulation (DCPC) technique as a method of choice in patients with open-angle subcompensated glaucoma (OAG) with toxic allergic syndrome of the ocular surface (TASOS).Methods. The retrospective analysis of patients’ case reports with subcompensated open-angle glaucoma and TASOS was performed. Transscleral diode laser cyclophotocoagulation (DCPC) in a microimpulse mode was used in their treatment. A total of 19 patients’ case reports were analyzed.Results. In the postoperative period, its course, patient’s complaints, ophthalmological status, visual acuity indicators were determined. The level of intraocular pressure was measured. Almost all patients (84.2 %) reached the target level of IOP. The frequency of side effects was low. In 36.84 % of patients, symptoms of TASOS decreased in response to hypotensive treatment due to reduction of instillation frequency.Conclusion. The use of micro-pulse cyclophotocoagulation in patients with subcompensation form of OAG and toxic-allergic ocular surface syndrome (TASOS) reduces the intensity of the drop regime of antihypertensive drugs. As a result, the manifestations of TASOS are reduced, which increases the patients’ quality of life in the postoperative period. In addition, the use of DCPC in microimpulse mode leads to stabilization of functional and structural indicators, helps to prevent a decrease in visual functions. Thus, the described method is characterized by safety, high efficiency and a wide range of indications for its performance. It allows to compensate the IOP with a minimum percentage of complications and stable postoperative results.