Purpose: to study the antioxidant system and lipid status of serum and evaluate the effect of Cytoflavin on these characteristics in patients with progressive and stable primary open angle glaucoma (POAG).Patients and methods. 67 patients with advanced stage POAG were observed. The average age was 66.3 ± 1.5 years. According to the course of the glaucoma process all patients were randomized into 2 groups: the 1st group with the stable glaucoma (31 patients) and the 2nd group with rapidly progressive glaucoma (36 patients). The progression criteria of POAG were global ganglion cell loss volume (GLV) and perimetric index (mean deviation-MD). For assessment of the reactivity of the vascular endothelium, a test with reactive hyperemia was performed using ultrasound method. The assessment of oxidative stress (OS) including peroxides, malonyldialdehyde (MDA) and the total antioxidant capacity of serum (AOS) were evaluated. The investigations of lipid metabolism included the level of cholesterol total (CT), cholesterol of low-density lipoproteins cholesterol (LDL-C), high-density lipoproteins cholesterol (HDL-C), triglycerides (TG) and atherogenic index (AI).Results. In the 2nd group there was the significant decrease of the mean GLV indices compared to those in the 1st group (7.16 ± 2.5 и 1.06 ± 0.2, respectively, р < 0.001). The mild degree of endothelial dysfunction (ED) predominantly was detected in patients of the 1st group (69 % of cases). The moderate and marked ED were found in patients with progressive POAG (68 and 25 %, respectively). The high level of OS in serum was determined in 43 % of patients of the 1st group and in 69 % of patients of the 2nd group (significant increase of peroxides and MDA). In patients with progressive POAG the mean indices of lipid metabolism (CT, LDL-C, HDL-C, TG, AI) were significantly higher than in healthy subjects (р < 0.001). Cytoflavin had a positive effect on the vascular endothelium function, normalization of lipid metabolism and decrease of OS in serum with increasing AOS in patients with progressive POAG.Conclusion. The assessment of the indices of OS, AOS and lipid metabolism enable us to determine the risk of progression of POAG and evaluate of the effectiveness of treatment.
The literature review presents information about ultrasound use in diagnosis, therapeutic and surgical treatment of eye diseases. Due to experimental studies it was proved that ultrasound of different power, intensity and exposure causes thermal, mechanical and biological effect on the eye tissue. Thermal effect caused by ultrasonic energy absorption by biological tissues, which is converted from acoustic energy into thermal energy. The mechanical effect is determined by the amplitude of ultrasonic pressure acting on the eye structures during the examination. For the safety of ultrasound scanning, such concepts as thermal (TI) and mechanical (MI) indices have been introduced, which allows to control the level of acoustic impact on tissues. Ultrasound diagnosis in ophthalmology went a long way from one-dimensional echography (A-mode) to the complex scanning in real time, which allows to visualize different structural elements of the eye. Ultrasound eye examination is non-invasive and highly informative and thereby one of the main instrumental diagnosis methods in ophthalmology. Combination of images in gray scale, highly sensitive color and energy Doppler, 3D and sonoelastography to date greatly increased the diagnostic capabilities of ultrasound for simultaneous qualitative and quantitative assessment the eye and orbit in normal and pathological conditions. Therefore general ultrasonic diagnostic systems are widely used in clinical practice, with obligatory correction of TI and MI values. Recommendations of the international professional organizations such as Food and Drug Adminisration (FDA) and American Institute of Ultrasound in Medicine (AIUM))are widely used for the ultrasonic examination of eye pathology, according to which the lowest levels of exposure and intensity of the output acoustic signal (TI and MI) should be set to get a high-quality image. There are still a lot of clinical and experimental studies to determine the optimal modes of ultrasound eye and orbit examination. However, the safety of ultrasound and its effect on eye structures are still need to be studied.
ä-ð ìåä. íàóê, ïðîôåññîð, íà÷àëüíèê îòäåëà óëüòðàçâóêîâûõ èññëåäîâàíèé Ì.Ñ. Çàéöåâ-ìëàäøèé íàó÷íûé ñîòðóäíèê îòäåëà óëüòðàçâóêîâûõ èññëåäîâàíèé Ê.À. Ðàìàçàíîâà-êàíä. ìåä. íàóê, çàâ åäóþùàÿ îòäåëåíèåì óëüòðàçâóêîâîé äèàãíîñòèêè Ê.Â. Ëóãîâêèíà-êàíä. ìåä. íàóê, íàó÷íûé ñîòðóäíèê îòäåëà óëüòðàçâóêîâûõ èññëåäîâàíèé
The literature review presents information on positive effects of anthocyanins on functional indices of cardiovascular system, vascular reactivity of main arteries, microcirculation and retrobulbar blood flow. The positive effect of anthocyanins on the reactivity of main arteries was detected using non-invasive ultrasound method for assessment of flow-mediated dilation andendothelial function. Numerous randomised-controlled trials showed the effectiveness of the long-term supplementation with anthocyanins (during 6–24 months) in correction of microcirculation impairment and functional indices of visual system. The increase of plasma endothelin-1 (ET-1) level and the pathological vascular reactivity have been noted in ocular ischemic diseases such as diabetic retinopathy, occlusion of retinal veins and arteries. We registered the normalization of the plasma ET-1 level, significant improvement of blood flow in neuroretinal rim area and peripapillary area of retina without changes in mean indices of intraocular pressure and ocular perfusion pressure in patients with open-angle glaucoma after anthocyanins administration. There was no progression of visual fields defects. The resulting effect of anthocyanins supplementation consists of metabolic regulation of blood flow and flow-dependent vasodilatation due to the influence on vascular endothelium.Anthocyanins also increase the expression of endothelial nitric oxide (NO) synthase, an enzyme that generates powerful endogenous vasodilator NO. Anthocyanins regulate a number of complex immune and inflammatory signaling pathways involved in maintaining vascular functional activity. Positive dynamic of blood flow velocities and normalization of resistance indices in ocular vessels were detected in patients with dry age-related macular degeneration after 2 months anthocyanins supplementation. That indicates the improvement of ocular blood flow circulation and favorable prognosis for retinal dystrophies. The instrumental examination of blood flow in different vascular systems including microcirculation and main arteries are very useful for assessment of the effectiveness of anthocyanin supplementation.
÷ëåí-êîðð. ÐÀÍ, ä-ð ìåä. íàóê, ïðîô åññîð, äèðåêòîð Ò.Í. Êèñåëåâà-ä-ð ìåä. íàóê, ïðîôåññîð, íà÷àëüíèê îòäåëà óëüòðàçâóêîâûõ èññëåäîâàíèé Ì.Ñ. Çàéöåâ-ìëàäøèé íàó÷íûé ñîòðóäíèê îòäåëà óëüòðàçâóêîâûõ èññëåäîâàíèé
Purpose: to study the impact of diagnostic ultrasound of high acoustic power on animal eye tissues in the experiment.Material and methods. 46 Chinchilla rabbits (92 eyes) were divided into the main group of 38 rabbits (76 eyes) and the control group of 8 rabbits (16 intact eyes). Animals of the main group were exposed for 30 minutes, through closed eyes, to high-intensity ultrasound (MI 0.9–1.0, TI 1.5–2.0, Ispta.3 50 mW/cm2) by colour Doppler imaging and pulsed Doppler. All animals of this group had corneal thickness measured by optical coherence tomography (OCT) before and immediately after exposure to ultrasound (20 rabbits) and also 2 weeks later (18 rabbits). During the same time span, the content of heat shock proteins HSP27 (HSPB1), HSP60 (HSPD1) and inflammatory mediators: monocytic chemotactic protein-1 (MCP-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) in blood serum and vitreous was determined. Histopathological examinations of the enucleated eyes of rabbits with morphological and morphometric assessment of retinal tissues were performed on the 1st day and 2 weeks after exposure to ultrasound.Results. Immediately after ultrasound exposure and 2 weeks later OCT data reflected no structural changes in the cornea. Quantitative assessment of the levels of HSPD1, HSPB1, MCP-1, IL-6 and IL-8 in blood serum and vitreous did not reveal statistically significant changes after ultrasound exposure. A morphological study including an assessment of morphometric characteristics revealed the absence of apoptotic changes in the layers of the retina at different times after exposure to high-intensity ultrasound.Conclusions. We established no immediate or delayed bioeffects of high acoustic power diagnostic ultrasound exposure lasting up to 30 minutes on the biological media and ocular tissues of animals.
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