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Aim: To investigate the effectiveness of choline alphoscerate in patients with chronic ocular ischemic syndrome (OIS) and coexisting cerebrovascular disease., Material and Methods: We performed a comprehensive examination of 51 patients aged 46--72 years (57.8±6.82 years on average) and diagnosed with OIS. Patients were divided into two groups. In group 1 (main group, 26 patients) the standard therapy was supplemented with choline alphoscerate. Group 2 (controls, 25 patients) received the standard therapy only., Results: Clinical and functional examinations revealed a more rapid and stable improvement of visual acuity in the choline alphoscerate group., Conclusion: Development and application of an adequate combination therapy for patients with ocular ischemic syndrome has yielded an increase in visual acuity, visual fields, and the mean light sensitivity of the retina as well as an improvement of ocular hemodynamics.

Anthocyanins are known to have antioxidant, anti-inflammatory, neuroprotective, and anticarcinogenic activity as well as positive effect on the cardiovascular system. Because of bilberry anthocyanosides (Vaccinium myrtillus L.), Mirtilene forte promotes rhodopsin synthesis and regeneration, increases retinal sensitivity to changes in light intensity, improves visual acuity and dark adaptation as well as blood supply of the retina. Studies conducted in Russia are aimed at evaluating the use of Mirtilene forte in age-related macular degeneration, diabetic retinopathy, primary open-angle glaucoma, and other diseases. This article provides an analysis of foreign and Russian publications on the effects of anthocyanins and flavonoids in different diseases.

To study the capacities of ophthalmological application of the photosensitizer Radachlorine (0.35% solution for intravenous injection), the authors carried out a series of in vivo experiments on rabbits. They studied the time parameters of distribution of the agent in the chorioretinal complex and the reaction of newly formed vessels to photodynamic therapy. Radiation of a diode laser at a wavelength of 0.662 microm was used to stimulate the photosensitizer. A video micro-camera adapted to the ocular of a split lamp was applied to fluorescence fixation. Superficial corneal vascularization was used as a model of the neovascular membrane in response to the application of a non-penetrating silk suture. The findings suggest that photodynamic therapy using Radachlorine is safe and effective in treating ocular tissue neovascularization.

The method of local express-autocytocinetherapy (LEACCT) consists in using an experimentally tested autologous complex of cytokines (alpha- beta- gamma-interferons, interleukins 2.8, tumor necrosis factor gamma etc.), which is produced by joining the autoblood of patients with immune-modulator poludan (complex poly A:poly U). The external LEACCT and the intrachamber LEACCT are distinguished. The former presupposes the administration (subconjunctivally and in installations) of the autoblood-poludan mixture. This method is used in herpes- and adenovirus keratoconjunctivitis, slow re-epithelization after laser keratectomy and in eye burns (178 patients). The latter comprises, apart from the external LEACCT procedures, a 1-4-time introduction of the mentioned mixture into patient's anterior chamber. It was used in endothelial herpetic keratoiridocyclitis, initial bullous keratopathy, severe keratoconus and in injuries of the anterior lens capsule (117 patients). The clinical-study results (main group--295 patients) show that the designed method based on poludan has pronounced anti-inflammatory and regenerative effects in different viral and virus-free lesions of the eye tissues; it is simple and can be applied in clinical settings. An increased visual acuity ranging from 0.05 to 1.0 was registered in 85% of cases. The action of the complex of cytokines is as close as possible to the physiological mechanism, which provides for avoiding the side-effects and for applying the treatment scheme in situations when the administration of other drugs is limited or their efficiency is not sufficient.

The article deals with the use of photodynamic therapy with regard for the modern choice of photosensitizing preparations and with regard for new-generation lasers, which reveal, to a full extent, the possibilities of the above treatment method. Examples of using the photodynamic therapy in the treatment of some oncology pathologies of various localizations, including the ocular pathologies, are depicted in the article. The use of photodynamic therapy at retinal diseases, caused by the onset of new-vascular membranes due to the age-related degeneration of the macular, is under discussion. The application of photodynamic therapy in the treatment of cystic filtration cushions, involving the technique offered by the authors, is described.

Theoretical validation for local express autocytokine therapy (LEACKT), used in recent years with good results for the treatment of viral and nonviral diseases of the eyes, is provided. In vitro experiments showed that autologous cytokine complex appearing after stimulation of patient's peripheral whole blood with poludan (polyA:polyY complex, 200 micrograms) includes all three interferon types (alpha, beta, and gamma) and interleukin-8 (IL-8) and tumor necrosis factor (TNF). It was shown for the first time that poludan stimulated the production of IL-8, the main chemotactic cytokine inducing chemotaxis, neutrophil activation, angiogenesis stimulation, and regeneration. This was not paralleled by an increase in the production of TNF, the key mediator of inflammation, whose level in whole blood did not increase. Addition of poludan to cell culture led to a 2-fold decrease of lymphocyte apoptosis in comparison with that after treatment with dexamethasone alone. The results of experiments indicate that LEACKT with poludan is characterized by pronounced antiinflammatory, interferonogenic, regeneratory, and antiapoptosis effects in various diseases of the anterior segment of the eye and is a simple and safe method.

An original method for treating degenerative processes in the eye by means of Meturakol irrigation system is described. Studies were performed in 95 patients aged 60-70 years. Use of Meturakol irrigation system ruled out pain associated with frequent administration of drugs, ensured high concentrations of drugs in the posterior segment of the eye, and improved the efficiency of drug therapy in patients with degenerative diseases of the eyes. Good remote results are due to potent drug supply to ocular tissues and to the use of hemostatic sponge Meturakol, containing methyluracil. The method is offered for wide clinical use.

The antioxidative activity (AOA) of histochrome (2,3,5,6,8-pentahydroxy-7-ethyl-1,4-naphthoquinone) and some other drugs with antioxidant properties used in ophthalmology has been studied in the hemoglobin--hydrogen peroxide--luminol system. The AOA of histochrome, ascorbate, dicinon, rutin, quercetin, and dihydroquercetin is comparable to that of trolox, the reference antioxidant in our studies. The drugs (in physiological concentrations) listed above are characterized by a high AOA. Cerebrolysin was 300 times less active than trolox, and emoxipin showed no antioxidant properties. Lacrimal AOA increased after a parabulbar injection of histochrome. Histochrome is believed to be a perspective antioxidant for the treatment of ocular diseases.

The efficacy of a new bioantioxidant histochrome is studied in 92 patients (98 eyes). The drug was injected subconjunctivally or parabulbarly in a dose of 0.5 ml 0.02% solution daily, 7-10 injections per course. The clinical effect of histochrome is determined by the localization, duration, and extent of the process. The drug was the most effective in the treatment of intraocular hemorrhages which occurred no more than 7 days before. Electroretinography demonstrated pronounced retinoprotective properties of the drug which improved the electrophysiological parameters in degenerative processes in the retina and optic nerve. Hence, histochrome is characterized by hemoresorption, retinoprotective, and antioxidant properties and is recommended for the treatment of ocular diseases involving metabolic disorders in the retina, vascular membrane, and cornea.

Physiotherapy was administered to 84 patients aged 59-78 years with toxic allergic reaction in the eye after extracapsular cataract extraction with implantation of intraocular lenses (IOL). The patients were divided into 4 groups. Group 1 (n = 15) were treated by fibrinolysin magnetophoresis, group 2 (n = 17) lidase magnetophoresis, group 3 (n = 28) lecozyme magnetophoresis, and group 4 (n = 24) collalysin magnetophoresis. Treatment started on days 3-5 after surgery. Magnetophoresis was carried out using Russian Gradient-1 device, generating a low-frequency magnetic field of 10-12 mT, 10-12 min exposure. For patients with pronounced iridocyclitis and uveitis, enzyme magnetophoresis was supplemented with atropine, adrenalin, and calcium chloride electrophoresis (with monitoring the pupil size). Comprehensive treatment resulted in complete resolution of exudation in the anterior and posterior segments of the eye, hypopyon, loosening and resorption of anterior and posterior synechiae, the vitreous body grew more transparent, visual acuity improved in 91.1% patients (coarse dystrophic changes in the central zone of the fundus oculi were detected in 8.9%). Magnetophoresis with fibrinolysin and lidase is most effective in patients with toxic allergic reaction during the early periods after cataract extraction with IOL implantation, while in later periods magnetophoresis with lecozyme and collalysin should be preferred. The efficacy of collalysin is not inferior to that of lecozyme, but its effect is more mild and the drug causes no allergic reactions. Magnetophoresis with mydriatics (with monitoring the pupil size) and calcium chloride is recommended for all cases.

Describes the main features of an inflammatory process and the contribution of inflammation mediators to its development. Antiinflammatory drugs may be divided into two groups: corticosteroids and nonsteroid antiinflammatory agents. The advantages and drawbacks of corticosteroid therapy of ocular diseases are discussed and indications for and contraindications against the use of some drugs are enumerated. The main dosage forms of nonsteroid antiinflammatory drugs for the eyes are presented and indications for their use listed.

Anatomical variants of the direction and diameter of the supraorbital artery revealed by the authors and the clinical variants of the intensity and direction of periorbital bloodstream shown by doppler studies helped optimize the selection of a facial artery for inserting an infusion system for drug delivery to the vascular system of the eye. The advantages of intraarterial infusion of drugs in the system of ocular blood supply using an automated thermo-infusion dispenser vs. the traditional methods are demonstrated: no side effects on the intraocular and regional hemodynamics, purposeful delivery of drugs to the site of ocular blood supply with a simple and convenient device. This method for the choice of a collector for intraarterial infusions and the method of drug infusion were clinically tried in 2 groups of patients: with retrobulbar intoxication neuritis and partial atrophy of the optic nerve (a total of 21 patients, 23 operations for implantation of infusion system; control group consisted of 11 patients). 120-Hour infusion therapy with, alternately, trental and actovegin resulted in improvement of the vision acuity from 0.03-0.06 to 0.3-0.8 in virtually all group 1 patients. Moreover, central scotomas disappeared and the conductivity of the axial bundle of the optic nerve recovered from 28-32 to 38-40 Hz. In group 2 defects in the visual field disappeared and its peripheral borders widened. In controls no improvement of the visual function was observed.

Immobilized collagenase (collapor) applied as ophthalmic medicinal films has been developed and clinically tried. A new long-acting base (aubasidan, a mucopolysaccharide of a bacterial origin), similar as the main medicinal component, collagenase, exerts a therapeutic effect. Collapor is characterized by a pronounced resolving and proteolytic action causing no appreciable side effects. Altogether 134 patients with various inflammatory and vascular diseases of the eyes were observed. An instruction for collapor application in ophthalmology is offered.

Basing on clinical data (12 patients) and experimental results (42 rabbits), the authors defined the pharmacokinetic characteristics of drugs administered by endo-ocular phonoelectrophoresis technique developed by them. Formation of the drugs' depot in the parabulbar space was demonstrated. Concentrations of the administered drugs in various segments of the eyeball were assessed. The values obtained during parabulbar injection of drugs were used as reference ones.

The results of comprehensive examinations and therapy of 67 patients with autoimmune ophthalmopathy are presented. In 80% of the patients the disease coursed along with thyrotoxicosis, in 10% thyroid function was reduced because of autoimmune thyroiditis, and in the rest autoimmune ophthalmopathy was an individual entity. A staged therapeutic complex for the treatment of this condition is suggested, aimed at correction of thyroid function (stage 1), followed by pathogenetic therapy including antiinflammatory measures, glucocorticoids and nonsteroid antiinflammatory drugs to arrest aseptic inflammation in the orbit, and immunosuppressive therapy to correct the immunity shifts. After clinical and immunologic remission was achieved, courses of maintenance therapy (nonsteroid antiinflammatory drugs) were carried out for 3-5 months monitored by blood analyses and ophthalmologic examinations, immunity status tests, CT clinical data. Choice of the treatment strategy was governed by the morphologic variant of ophthalmopathy, immunologic activity of the process, disease severity and pattern. Such an approach helped achieve positive results and clinico-immunologic remission, as well as timely prevent the progress of the disease.

Fifteen such films created at two Moscow Institutes were allowed for use after clinical trials by the Pharmacologic Committee of the USSR Ministry of Health. Two principal advantages of ocular medicinal films as against ocular drops and ointments are prolonged action of the drugs and accurate dosage of the drug. Application of films may replace subconjunctival instillations in a number of cases. The film completely dissolves in the conjunctival sac, thus providing the daily dose of the drug. Therefore the film may be applied once a day and only in grave cases twice. A packed film retains its activity and sterility for 12-14 months. Unfortunately commercial films do not always meet the medicinal requirements. Noteworthy that individual intolerance of some film brands varies within 0.1 to 8.03%, and that there are certain contraindications against the use of these films. Ocular medicinal films is an intensive care dosage form that may be manipulated only by specially trained personnel. Of course the films cannot absolutely replace other forms of drug administration. Further research is necessary, aimed at improvement of the tolerance of films, creation of films for children, and commercial manufacture of the drugs that were found the most effective and were best of all tolerated, as well at training of personnel.

The immune status and the time course of ophthalmological indices were studied in 54 patients with endocrine ophthalmopathy during bromocriptine therapy. Twelve weeks after the onset of therapy indices of the immune status returned to normal in parallel with the regression of ophthalmological symptoms. In the control group (20 patients with endocrine ophthalmopathy who did not receive bromocriptine) significant improvement of the clinicoimmunological status was unnoticed. An increase in the number of T-lymphocytes, a decrease in the number of B-lymphocytes, an increase in the level of IgG, and a decrease in the levels of IgA and IgM were observed during bromocriptine therapy. The time of the immunity indices could serve as a criterion of bromocriptine therapeutic efficacy in patients with endocrine ophthalmopathy.