№2, 2019, volume 15

Purpose: to evaluate the stability of the electric sensitivity threshold (EST) parameter in a series of fve measurements in patients with the vision pathology. Material and Methods. 66 patients (129 eyes) took part in the investigation with the age ranging from 12 to 82 with diferent ophthalmic pathologies and without them. In each case a series of fve measurements (EST) was performed using ESOM-Komet devise according to the standard program. Results. Five typological groups were revealed which difered reliably as per the tendencies of EST level changes in the course of fve successive measurements. In 80 % of the cases the successive EST values turned out to be practically stable. In 20 % of the cases there was observed a high EST variability with the signifcant trend towards a gradual growth of EST level. The nature interrelation analysis of EST successive charges depending on the diagnosis, age, sex, initial EST level didn»t reveal signifcant relations. Conclusion. The performed series of measurements can be regarded as a highly simplifed model of monitoring the visual system condition in dynamics. The absence of stability / instability interrelation with the clinical data points to the necessity to investigate the criteria and strategy of taking the decision in patients in the course of the diagnostic procedures.

Purpose: to assess the diagnostic capabilities of optical coherence tomography (OCT) in En Face mode for planning and conducting surgical navigation using Navilas 577s laser system in patients with central serous chorioretinopa-thy (CSC). Material and Methods. 12 patients (12 eyes) with CSC underwent high-resolution OCT in En Face mode showing morphological changes in the retinal pigment epithelium (RPE). The treatment was performed on Navilas 577s laser device with an individual selection of the necessary energy parameters in the micropulse mode. The follow-up was performed at 1, 3 and 6 months. Results. According to the OCT data in the En Face mode, all patients had morphological changes in RPE, which made it possible to plan and perform computer-assisted laser surgery. 1, 3 and 6 months after treatment, positive dynamics was observed in all cases. Conclusion. The OCT method in En Face mode allows detailed study of architectonics and identifes pathological changes in RPE, which play an important role in the manifestation of CSC, as it enables planning and implementation of topographic-oriented treatment using the Navilas 577s navigation laser system in the areas of RPE detachments.

Purpose: to improve the efcacy of surgical treatment of primary progressing pterygium by developing a new method of amnioplasty. Material and Methods. 85 patients were divided into two groups based on topographical features of amnioplasty site. The main group included 42 subjects who underwent amnioplasty using a technique which was proposed by us (after surgical removal of primary progressive pterygium at the initial site); the control group included 43 subjects in whom amnioplasty at the zone of limbus was performed after removing the pterygium. The criteria for evaluating treatment efcacy were time to disappearance of symptoms of postoperative infammation, time to complete corneal epithelialization and vitalization of the amnion, visual acuity in the frst year after surgery, reduction of corneal astigmatism, recurrence rate. Results. Amnioplasty technique proposed by us showed high efcacy: time of postoperative ocular surface infammation decreased, which led to an increase in corneal epithelization rate by 1.7 times and in amnion vitalization rate by 1.2 times; reduction of astigmatism by 3 times and an increase in visual acuity by 3.9 times when compared to the control group. Conclusion.

Purpose: development of a method for computer analysis of corneal aberrations as applied to the tasks of laser surgery of the anterior segment of the eye. Material and Methods. As a result of mathematical modeling, an algorithm has been developed that is implemented as a computer program for selecting individual parameters of laser radiation depending on the optical characteristics of the cornea. Results. For astigmatism, it has been proposed to consider the topographic zones of the optical center of the cornea, 3.5 mm in diameter, and peripheral meridional zones. Aberrations at the periphery of the cornea increase by 10 %. At 1 and 2 stages of keratoconus, the rate of aberrations rises 2–3 times. In the third stage of keratoconus, in some cases keratometry and keratotopography is technically impossible. With pterygium 2 and 3 degrees, laser surgery in the peripheral zone of the cornea is impossible. Conclusion. Improving the efciency of laser operations is provided primarily by optimizing the impact parameters on the tissues of the anterior segment of the eye. The data on the types of corneal aberrations for various diseases, which indicate the need to change the parameters of laser exposure. The developed diagnostic algorithms are implemented as a computer program and allow you to optimize the parameters of laser irradiation of eye tissue.

Purpose: to evaluate the efectiveness of surgical treatment of rhegmatogenous retinal detachment with central, paracentral and peripheral tears using autologous conditioned platelet rich plasma (ACP), without endolaser photoco- agulation and silicone oil tamponade. Material and Methods. The operative technique consists of carrying out 25 & 27 Ga vitrectomy, removing the posterior hyaloid membrane, the inner limiting membrane in the presence of a macular hole, pneumoretinopexy. ACP, devoid of leukocytes and containing 1.5–3 times more platelets that found in whole blood is then instilled into the central, paracentral and / or peripheral retinal tears in 2–3 layers including retina around the tear. 59 patients with visual acuity from the correct visual projection to 0.9 were treated. Results. The retina was reattached in 96.6 % of patients and the retinal tears were blocked; two patients with multiple peripheral tears underwent operation. Over a 1–12 months follow up period, 4 recurrent retinal detachments were recorded, which also required repeat surgery. In 93.2 % of patients complete retinal reattachment and blocking of the retinal defect was achieved. The visual acuity of the operated patients was 0.03–0.9. Conclusion. 25 & 27 Ga vitrectomy of retinal detachment with central, paracentral and peripheral tears and blocking of retinal defects with ACP without endolaser photocoagulation of the retina and silicone tamponade is a method that enables total retinal reattachment and better functioning of the operated eye to be achieved in most cases.

Purpose: to study the efects of combined treatment for non-infectious uveitis with macular edema using platelet autoplasmin to estimate the cytokine content in lacrimal fuid. Material and Methods. 120 people aged 18 to 50 years with non-infectious uveitis and macular edema were examined: 46 men, 74 women. The patients were divided into 2 groups: main group (anti-infammatory treatment and the administration of platelet autoplasma); comparison group (anti-infammatory treatment). Patients underwent standard ophthalmological examination. To assess the activity of local infammatory process a study of cytokine content in the lacrimal fuid before and after treatment was conducted. Results. In patients with non- infectious uveitis the use of platelet autoplasma in the treatment of patients assigned to the main group lead to a statistically signifcant increase in the concentrations of IL-4, IL-6, IL-8, IL-17A in the lacrimal fuid. A statistically signifcant decrease in the concentrations of proinfammatory cytokines was observed when auto-plasma was used. Conclusion. The use of platelet autoplasma in the treatment of patients with non-infectious uveitis with macular edema is pathogenetically justifed, as it is associated with a pronounced decrease in the activity of the immuno-infammatory process, which is confrmed by the

Marburg disease afects young people and is characterized by an acute onset with a fulminant course. The disease leads to death within 1 year from the onset of symptoms. In Academician S. N. Fedorov «Eye Microsurgery» Center (Moscow) a patient with Marburg multiple sclerosis was followed up for seven years. Standard treatment in combination with physiotherapy treatment slowed the development of an irreversible decrease in visual function due to atrophy of the optic nerves.

Aim: to determine the preparation of amniotic membrane (AM) necessary for its use as a scafold for cultured cells to create bioengineered constructions (BEC). Material and Methods. Native AM was placed in a special clamping device and subjected to additional mechanical, thermal and enzymatic treatment: removal of mucus residues from its surface and cryoconservation of AM scafolds was performed at –80°C, — 20°C with subsequent decellularization with a 0.25 % Tripsin-EDTA mixture. The lifetime assessment of the morphology of cells cultivated on AM scafolds was performed using a Nikon Eclipse TS100 inverted microscope equipped with camera. The viability and metabolic activity of AM cells was determined by means of an MTT test using a UNIFLAN AIFR-01 tablet spectrophotometer (Picon, Russia) at a wavelength of 570 nm and a reference wavelength of 620 nm. Results. It has been established that the presence of mucous residueson the surface of native AM, which are not removed during standard mechanical processing, negatively afect the survival of the cell test system. The efects of cryoconservation of AM scafolds revealed the positive efects of this process together with enzymatic decellularization for improving the viability of cells cultured on scafolds. Conclusion. Standard mechanical processing of native AM does not guarantee complete cleaning of its surface from mucus residues that interfere with adhesion and even distribution of cultured cells. It is necessary to reliably control the removal of AM surface mucus before immobilization and further manipulations. Cryopreservation and subsequent decellularization of AM scafolds contributes to the increased viability of the cell test system. AM scafolds, purifed from amniotic mucus, cryopreserved at –80 ° C in a mixture of DMEM-F12 and DMSO (1:1) and enzymatic decellularization after thawing, turned out to be the best of the studied substrates for cell cultivation.

The article provides the data on the activity of the Saratov doctors at the front and in the rear during the Great Patriotic War and their contribution to the development of medicine, devotion of a profession and the sense of responsibility for people»s lives.

The present work highlights the facts about two scientists who in diferent years worked as chairs of the department of general biology at the Saratov Medical Institute and who participated in the Great Patriotic War — professor Alexander Stepanovich Konstantinov, doctor of biological sciences, and associate professor Alexander Evgenievich Sholpo.