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Background. Hypertension is a risk factor for the development of microvascular anomalies and retinal vessel occlusions. Both pathological conditions can be the cause of hemorrhage in the vitreous body in hypertension. Assessment of the influence of the severity of systemic pathology, disease history, age, gender, the presence of previously diagnosed ophthalmological signs, as well as the clinical course and recurrences of hemophthalmos with various mechanisms of development is an urgent task for modern ophthalmology. The purpose of our research was to study the features of development, clinical course and surgical treatment of hemophthalmos in hypertension. Materials and methods. During clinical studies, 100 patients (200 eyes) were examined: 54 women and 46 men aged 30 to 82 years, who were diagnosed with hypertensive retinopathy and hemophthalmos. Duration of dynamic observation was five years. All patients gave informed voluntary consent to participate in the study. According to the Order of the Ministry of Health of Ukraine No. 117 issued on March, 15, 2007, all patients with hemophthalmos against the background of hypertensive retinopathy were initially observed and conservatively treated. In case of treatment failure for 4–5 weeks, surgical intervention was performed. It was carried out in the scope of a closed subtotal vitrectomy 23/27ga with removal of the inner limiting membrane and endotamponade with a gas-air mixture. The frequency of hemophthalmos in hypertensive retinopathy was analyzed taking into account gender, age, history of the general disease, blood pressure, administration of antihypertensive drugs and anticoagulants, a history of hypertensive crises, the degree of severity of hypertensive retinopathy. Visual results and the frequency of complications and recurrences during the entire observation period were also evaluated. Results. Analysis of the results showed that the frequency of hemophthalmos among patients with hypertension was 21 %. An increase in the frequency of hemophthalmos with hypertension was detected with age — the highest level was observed in the age group of 61–70 years, with an increase in blood pressure, the length of the general illness and with a history of hypertensive crises. The frequency of hemophthalmos was statistically significantly higher in the absence of treatment. The severity of hypertensive retinopathy affected the frequency of hemophthalmos. It was found that 71 % of patients required surgical treatment. Surgical treatment was accompanied by postoperative complications in 17 % of patients after 2 weeks, in 7 % after 1 month, and in 34 %, six months after surgery. We recorded 7% recurrence of hemophthalmos 1 month after surgical treatment and 10% after 6 months. Conclusions. Our study demonstrated the influence of the general condition in hypertension on the clinical course, occurrence and frequency of hemophthalmos recurrences. Surgical treatment of hemophthalmos statistically significant improved visual functions and quality of life in this category of patients. The presence of complications and relapses after surgical treatment largely depends on the severity of hypertension in these patients. [ABSTRACT FROM AUTHOR]

Proliferative diabetic retinopathy (PDR) is one of the most common reasons of blindness among working age people. Among patients with diabetes mellitus (DM) the prevalence of diabetic retinopathy is more than 40%, and at present there is a tendency to an increase of its incidence. The main methods of treatment of this disease are a pars plana vitrectomy and retinal laser photocoagulation (RLP). Medication used only in combination with surgery. One of the most common PDR complications is a vitreous hemorrhage. The use of modern methods of primary VE is accompanied by a low surgical risk and causes an improvement of visual and anatomical results. However, in the PDR complicated by vitreous hemorrhage, there can be possible difficulties of preoperative diagnosis. Prior to the removal of the vitreous body a visualization of retinal lesions is hampered as well as planning volume of the retinal endolaser coagulation (RELC). The main diagnostic procedures used in the PRD are direct ophthalmoscopy, fluorescein angiography (FAG) and optical coherence tomography (OCT). In the PDR their implementation is difficult because of a violation of the vitreous transparency. The intra-operative FAG can serve as a solution to the problem. This method is simple to perform. It allows to diagnose retinal vascular abnormalities directly during the surgical intervention, the study of which was impossible in the preoperative period. The intra-operative FAG allows to diagnose macular edema and ischemia, to determine the location of the retinal avascular regions and areas of neovascularization. The identification of areas of bleeding becomes possible. As a result there is a more precise RELC procedure, and, therefore, an improvement of treatment outcomes as well as an reduction in the quantity of complications.