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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]

Diabetic retinopathy (DR) have been taking a leading position among retinal disorders, causing a persistent and significant decrease in visual functions. The base of the disease is a retinal vascular microangiopathy, which induces a tissue ischemia and excessive production of vascular endothelial growth factors. The main method of treatment for this pathology is a laser photocoagulation. However, it is not always possible to perform appropriate laser photocoagulation, by that limiting its efficacy (cases of hard cataract and hemophthalmos). In addition, this type of treatment might have a number of serious complications, such as macular oedema, recurrent vitreous hemorrhages, the occurrence of fibrosis, atrophic changes in the retina, which leads to a decline in visual acuity and contrast sensitivity, worsening the visual field. Over the past 10 years, vascular endothelial growth factor inhibitors have been introduced into clinical practice, and showed their benefits in the treatment of disorders leading to a pathological angiogenesis. But due to the limited number of systematic observations, assessing the impact of these drugs, is necessary to investigate their efficacy and safety in patients with proliferative DR, in order to develop indications for their use. The purpose of the review is evaluation of the effect of vascular endothelial growth factor inhibitors on active neovascularization in patients with proliferative diabetic retinopathy. There is a literature of international clinical guidelines, randomized clinical trials with a varying level of evidence, articles and publications by groups of authors in the article.

Toxacariasis is a parasitic disease from the group of nematodoses, the causative agents of which are toxocaras of dogs and cats (Toxocara canis and Toxocara mystax). Most often, the source of human invasion is dog — the main host of the parasite. Invasion occurs when helminth's eggs are ingested by means contaminated food, water, accidental geophagy, and direct contact with a dog. In the human gut, the larva releases from the egg and migrates, causing a general parasitic infestation known as “visceral migrating larvae” (Visceral larval migrans). Toxocara settles in various organs (lungs, spleen, liver, eyes, brain), which causes the local inflammatory and allergic reactions. The incidence of toxocariasis is a serious problem in recent years, especially in large cities. Each year, relatively low rates of toxocariasis and sporadic ocular infestations are recorded. This situation does not indicate stability of the situation, but rather may be due to insufficient alertness of ophthalmologists in relation to the toxacarous etiology of the inflammatory process in the eye, which leads to incomplete examination of patients and diagnostic errors. An ocular form of toxocariasis may manifest as granulomatous choroiditis, chorioretinitis and parsplanitis with the formation of peripheral granulomas and vasculitis. Complications of these inflammatory diseases are traction retinal detachment, and with a long course, chronic endophthalmitis which develops with the outcome in subatrophy and atrophy of the eye-globe, leading to its death. The disease occurs in children and adult patients. The ophthalmologists should be on the alert to the toxacariasis etiology of the inflammatory process in the choroid and retina. The article cites two case reports of toxacarous chorioretinitis (females of 53 and 57 y.o.) with development of posterior vitreous detachment and hemophthalmos. The dynamics of the pathological process, diagnostic approaches and treatment tactics are described.

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.