Vascular endothelium plays the key role in the control of vascular tone due to release of vasoactive substances. Reduction of retinal, choroidal and optic nerve head blood flow is above all a result of misbalance between endothelium-produced vasoconstrictors and vasodilators mainly ET-1 and NO. NO is involved in the maintenance of choroidal, optic nerve head and retinal basal blood flow. Combination of NO deficiency and overproduction of ET-1 is accompanied by diabetic retinopathy, glaucomatous optic nerve atrophy, retinal vascular occlusion and other ocular disease. In the review, the role of endothelium dysfunction in the pathogenesis of vascular ocular diseases and the advisability of drugs inclusion for correction of endothelium dysfunction in the medical therapies complex are discussed.

This article contains a review of the literature on the issue of migraine and glaucoma interrelation. At the present time, despite the controversial nature of the results of global research, we can talk about an authentic increase of glaucoma risk in patients with a history of migraine. It is assumed a significant role of the primary vascular dysregulation in the pathogenesis of both diseases. Also we considered the issue of increasing the risk of angle-closure glaucoma during a migraine therapy with anticonvulsant called «Topiramate».

In the article, methods of ocular blood flow investigation are discussed, as well as main factors influencing measurement results. Criteria of choice for «ideal» blood flow investigation method are given. Benefits and drawbacks of methods based on ocular pulse registration are presented. The influence of different factors on measurement results, their relation to ocular and systemic diseases are discussed.

Introduction and purpose. Central serous chorioretinopathy - a disease that manifests itself serous detachment of the neurosensory retina and / or retinal pigment epithelium (RPE). Chronic course of pathological process may be complicated by the development of subretinal neovascularization, and is accompanied by a decrease in visual functions. Despite the large number of studies, there are no pathogenetically oriented and effective methods of treatment of central serous chorioretinopathy today, because there is no consensus on the causes of its origin. To evaluate the accuracy of the information content of chorioretinal blood flow changes in patients with central serous chorioretinopathy, to compare the degree of changes of RPE and hemodynamic disorders in different forms of the disease. Materials and Methods. The study involved 26 patients with central serous chorioretinopathy aged 35 to 54 years. To assess chorioretinal blood flow the optical coherence tomography (OCT) in retinal angiography mode was included in the volume of diagnostic examination. Results. It was demonstrated that the choroidal vessels and RPE are an original target in the realization of the pathological process in central serous chorioretinopathy. The changes in the pigment epithelium and the neurosensory retinal detachment, whose height ranged from 53.4 to 513.0 m (238.3 ± 80.4 - in acute and - 215.5 ± 129.9 - in chronic diseases) were revealed in all patients. In 45 % of cases of acute and 67 % in patients with a chronic form of disease the neurosensory retinal detachment combined with RPE detachment, preventing recovery of macular interface on a background of medical actions. Prolonged existence of ischemia and RPE detachment is accompanied by severe progressive degenerative changes in the retina as a whole, causing resistance to treatment. Conclusions. OCT in angiography mode in the diagnosis of various forms of chorioretinal central serous chorioretinopathy allows visualizing blood flow, evaluating the extent and nature of the structural changes of the retina taking into account hemodynamic disorders. The revealed changes of RPE and choroid, as classification and prognostic criteria of the disease, determine the effectiveness of treatment measures and prognosis of disease.

Branch retinal vein occlusion (BRVO) leads to retinal ischemia, releases vascular endothelial growth factor (VEGF) and other cytokines that damage to the blood retinal barrier which causes to macular edema. The aim of the study was to determine the serum and the lacrimal fluid (LF) levels of VEGF-A and IL-6 in their association with clinical parameters in patients with BRVO on the background of ranibizumab treatment. Materials and methods: 32 patients (median age 58.9 years, women - 21) underwent a three month intravitreal ranibizumab injection (IRI) due to macular edema causes BRVO. Ophthalmological examination and spectral domain optical coherence tomography was performed every month. Serum and the LF levels of VEGF-A and IL-6 were measure by ELISA before and after 3 months of treatment with IRI. The control group consist of healthy volunteers in the same age. Results: The visual acuity was improved on the background of the three IRI to 0.3 (±0.1) by Snellen in nonischemic type and 0.15 (±0.04) in ischemic type BRVO. Reduction of the retinal thickness in the macula was obtained in both groups. The serum (714.6±311 pg/ml) and LF level (762.6±432 pg/ml) of VEGF-A were in 2 times higher than in a con-trol and significantly correlated (p=0.0001) with retinal thickness. The serum level of IL-6 was higher than in control in ischemic type BRVO. Ranibizumab treatment resulted to decrease serum and LF level of VEGF-A in all patients in correlation with clinical parameters. LF level of IL-6 was decreased in while non-ischemic type of occlusion. Conclusions: There were determined high serum and lacrimal fluid levels of VEGF-A correlated with retinal thickness in patients with macular edema due to BRVO. Intravitreal ranibizumab injections led to reduced VEGF-A in serum and tear, correlating with improvement in clinical parameters.

Introduction. Approximately 80-90 % of circulating ocular blood is concentrated in the choroid. Pathological changes in choroidal blood vessels could be found in many posterior diseases of the posterior segment of the eye. Purpose. To measure choroidal thickness in healthy subjects in different age and refraction. To assess the correlation between choroidal thickness in macular area and ophthalmoplethysmography, ophthalmoreography, sphygmography indices in normal subjects. Materials and methods. To assess age and refraction influence on the choroidal thickness 149 healthy probands (258 eyes) were examined. To assess correlation between choroidal thickness and ophthalmoplethysmography, ophthalmoreography, sphygmography indices a group of 30 subjects (60 eyes) without any ocular disease were recruited. Choroidal thickness was measured on Spectralis OCT (Heidelberg Engineering, Germany) in enhanced depth imaging regime. Results. Negative correlation between choroidal thickness and age (r = -0.78, p < 0.0001), and degree of myopia (r = -0.75, p < 0.0001) were found. In all examined subjects positive correlations between choroidal thickness in the zone corresponding to the retinal avascular area and systolic increase of pulse volume according to ophthalmoplethysmography, ophthalmoreography, sphygmography data as well as between choroidal thickness at the central line near the optic nerve head (ONH) and amplitudes of ophthalmoreography were found. Conclusions. Significant mild and moderate positive and negative correlations were found between studied haemodynamic indices (investigated by different methods) and choroidal thickness. Ophthalmoplethysmography, ophthalmoreography, sphygmography indices are influenced by biometric eyeball parameters and the choroid. That is why it is necessary to take into account these parameters in consideration when interpreting and calculating measurement results.

The aim of this investigation is to study endothelial dysfunction expressiveness in patients with primary open-angle glaucoma (POUG) and physiologically ageing people. Materials and methods. The main group consisted of 64 men (122 eyes) with POUG at the age of 65.3±1.4 years. The group of control consisted of 56 men (102 eyes) of the same age without glaucoma. The biological age (BA) and a ratio of functional vasotonic bioeffectors in endothelial dysfunction were studied. Level of a stable metabolite of nitrogen oxide - nitrite (NO^2-) and endothelin-1 (ET-1) in a blood plasma were defined. Reactive hyperemia test showed pronounced changes in vascular endothelial function in patients with glaucoma.The method is based on ability of an endothelium to secrete NO in the conditions of a reactive hyperemia. Endothelia dependent vasodilatation after decompression of a humeral artery was counted. Results. Patients with glaucoma grow older early in comparison with clinically healthy volunteers of the same age without glaucoma. It is connected with development of an endothelial dysfunction and vasomotorial answer vascular endothelia. Patients of the main group with the expressed endothelial dysfunction have constrictor reaction of a vessel after elimination of occlusion. It leads to increasing of ischemia and accelerate the progression of glaucoma. Conclusions. The endothelial reaction depends on endothelial dysfunction expressiveness and rates of physiological ageing.

Pseudoexfoliation syndrome (PEX) is a relatively widespread generalized age-related disease, in which abnormal fibrillar extracellular material is produced and accumulates in many tissues. It seems reasonable to evaluate ocular pulse amplitude in patients with PEX. Purpose. To evaluate ocular pulse amplitude in patients with PEX. Methods. 460 eyes of 230 patients were enrolled in the prospective study. We evaluated ocular pulse amplitude and perfusion pressure. Results. Difference in perfusion pressure between groups was not significant. Ocular pulse amplitude was significantly lower in patients with PEX. Conclusion. Ocular pulse amplitude decrease indicates damage of ocular blood flow.

Introduction and the aim of the research. The staff of the faculty therapy department of FESMU for a long time has been studying the microvasculature (MV) by the method of bulbar conjunctiva video biomicroscopy (CAVBM) in smoking young people and the patients with ischemic heart disease. In this research we tried to find the simplified algorithm of the CAVMB and the analysis of the obtained data in current and former young smokers. We used mathematical model of logistic regression for the search of the most informative MV parameters which recovered after smoking cessation. The aim of this study was to find more significant (sensitive) parameters for analysis of the results and assessment of dynamics in the positive microcirculatory changes after smoking cessation. Material and the methods. Using a computer-assisted video biomicroscopy (CAVBM) of the bulbar conjunctiva, microcirculatory parameters were studied in generally healthy young adults who were current or former smokers (n=51). Qualitative and quantitative parameters of MV were processed by a logistic regression method. Results and their discussion. The two most significant MV parameters were identified. These parameters were found to be increased after smoking cessation and therefore can be used to determine, with a probability of 97.7%, whether an individual is a current or former smoker. These two parameters are the arteriole-to-venule ratio (AVR) and the number of capillaries in the left eye. Conclusions. We suggest a new simplified algorithm of the CAVMB with registration and analysis of only two MV quantitative parameters. We appreciate these parameters as the most objectively demonstrating the recovery of microcirculation in young subjects who quitted smoking.

This study examined the factors that determine the recovery of the patient after an acute cerebrovascular accident, and satisfaction with medical care and rehabilitation in the Russian Federation and Republic of China. We interviewed 522 patients in Stroke units in Russian and China. We analyzed personal patient factors, quality of life (EQ-5D), social and economic factors, the characteristics of the treatment and rehabilitation of the patient and staff attitude to the rehabilitation process. Logistic regression with ROC-analysis was used. Results. Quality of life in patients with a stroke depends on the country where the patient is receiving treatment and rehabilitation (higher in Russia than in China). The more time a patient spends in the hospital leads to the low quality of life. Having diabetes reduces the quality of life. In Russia, a good recovery and rehabilitation high potential contributes to the presence of the total family income of patient 40-60 000 rub per month, and the highest value on the Rankin scale, but a high value on NIHSS and RI on admission reduces a good recovery after a stroke. A lot of money for rehabilitation and treatment of patients with stroke lead to good patient recovery. Conclusion. Rehabilitation of stroke patients will be more effective if patient has a significantly limited ability to live, but has not high severity of the stroke and immobility problem then other factors such environment and psychological factors plays key role.