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  Тип елементу:Документ,

  Патогенез вторинної неоваскулярної глаукоми: роль ішемії, системного запалення та мікроциркуляції

  Гузун, Ольга Володимирівна

  ;

  Задорожний, Олег Сергійович

  (2026)

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  Актуальність. Висока клінічна гетерогенність перебігу неоваскулярної глаукоми та недостатня ефективність оцінки її прогресування лише за традиційними клінічними критеріями зумовлюють необхідність комплексного аналізу ішемічних, запальних і мікроциркуляторних механізмів патогенезу. Мета. Узагальнити сучасні уявлення про патогенез неоваскулярної глаукоми та обґрунтувати інтегральну ішемічно-запально-мікроциркуляторну модель її розвитку на основі аналізу літературних джерел і результатів власних клінічних досліджень. Матеріали та методи. Проведено наративний огляд сучасної наукової літератури відповідно до підходів PRISMA 2020 щодо ролі ішемії, ангіогенезу, системного запалення та мікроциркуляції в патогенезі неоваскулярної глаукоми. Додатково проаналізовано результати власних клінічних досліджень із оцінкою внутрішньоочного тиску, максимально коригованої гостроти зору, ступеня неоваскуляризації за Weiss, інтегральних запальних індексів (SII, SIRI, AISI), маркера ендотеліальної активації (ICAM-1/CD54), маркера апоптозу (CD95/Fas) та показника мікроциркуляції (RQ). Результати. Показано, що неоваскулярна глаукома формується внаслідок взаємодії ретинальної ішемії, патологічного ангіогенезу, системного запалення та мікроциркуляторних порушень. Встановлено асоціацію інтегральних запальних індексів, маркера ендотеліальної активації та апоптоз-асоційованої сигналізації з тяжкістю перебігу захворювання. Виявлено гетерогенність мікроциркуляторних змін і нелінійний (U-подібний) зв’язок між показником RQ та клінічними результатами, що відображає різні варіанти порушень перфузії. Продемонстровано, що інтеграція клінічних, біомаркерних і гемодинамічних показників забезпечує більш точну оцінку тяжкості захворювання порівняно з традиційними критеріями. Висновки. Неоваскулярна глаукома є гетерогенним захворюванням, у патогенезі якого ключову роль відіграє ішемічно-запально-мікроциркуляторна модель. Інтегральний підхід до оцінки пацієнтів створює підґрунтя для клініко-біологічної стратифікації ризику та впровадження персоналізованих, патогенетично орієнтованих стратегій лікування. Практична цінність. Інтеграція клінічних, запальних і гемодинамічних показників може підвищити точність оцінки біологічної активності вторинної неоваскулярної глаукоми, стратифікації ризику та обґрунтування персоналізованої лікувальної тактики. Relevance. The high clinical heterogeneity of the course of neovascular glaucoma and insufficient effectiveness of assessing its progression only according to conventional clinical criteria necessitate a comprehensive analysis of the ischaemic, inflammatory, and microcirculatory mechanisms of pathogenesis. Aim. To summarise current ideas about the pathogenesis of neovascular glaucoma and substantiate the integral ischaemic-inflammatory-microcirculatory model of its development based on the analysis of literature sources and the results of clinical studies. Materials and methods. A narrative review of current scientific literature was conducted in accordance with PRISMA 2020 approaches on the role of ischaemia, angiogenesis, systemic inflammation, and microcirculation in the pathogenesis of neovascular glaucoma. In addition, clinical data were analysed, including intraocular pressure, best-corrected visual acuity, the degree of neovascularisation according to the Weiss classification, integral inflammatory indices (SII, SIRI, AISI), a marker of endothelial activation (ICAM-1/CD54), an apoptosis marker (CD95/Fas), and a microcirculatory parameter (RQ). Results. It has been shown that neovascular glaucoma develops as a result of the interaction between retinal ischaemia, pathological angiogenesis, systemic inflammation, and microcirculatory disturbances. The association of integral inflammatory indices, a marker of endothelial activation, and apoptosis-associated signalling with the severity of the disease was established. Heterogeneity of microcirculatory changes and a nonlinear (U-shaped) relationship between RQ score and clinical outcomes were found, reflecting different variants of perfusion disorders. It has been demonstrated that the integration of clinical, biomarker, and haemodynamic parameters provides a more accurate assessment of disease severity compared to conventional criteria. Conclusions. Neovascular glaucoma is a heterogeneous disease in the pathogenesis of which the ischaemic-inflammatory-microcirculatory model plays a key role. An integrated approach to patient assessment sets the stage for clinical and biological risk stratification and the introduction of personalised pathogenetically oriented treatment strategies. Practical significance. Integration of clinical, inflammatory, and haemodynamic parameters can improve the accuracy of assessing the biological activity of secondary neovascular glaucoma, risk stratification, and rationale for personalised treatment tactics.

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  Тип елементу:Документ,

  Short-term outcomes of faricimab treatment for aflibercept-refractory choroidal neovascularization secondary to chronic central serous chorioretinopathy.

  Кустрин, Тарас Богданович

  ;

  Насінник, Ілля Олегович

  ;

  Щербакова, Валерія Володимирівна

  ;

  Трояновська, Ксенія Володимирівна

  ;

  Задорожний, Олег Сергійович

  (2026)

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  Purpose: To evaluate the short-term results of faricimab treatment in patients with aflibercept-refractory choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSC). Material and methods: The present study was a prospective, single-center interventional study including 25 patients (25 eyes) with aflibercept-resistant type 1 (occult) CNV associated with chronic CSC. After switching, all patients received four consecutive intravitreal injections of faricimab (6 mg/0.05 mL) administered at 4-week intervals. The main endpoint was best-corrected visual acuity (BCVA) at SIMonth 6. Results: The mean age of the patients was 57±7 years. The study population included 15 men (60 %) and 10 women (40 %). The mean BCVA signifiantly improved from 0.56±0.29 at baseline to 0.72±0.32 at 6 months (p<0.001). Complete resorption of subretinal fluid (SRF) was observed in 64 % (16 patients). The mean central retinal thickness (CRT) signifiantly decreased from 270±79 μm to 203±84 μm (p=0.005). After four consecutive intravitreal injections of 6 mg faricimab, the treatment interval was extended in 14 patients (56 %). Conclusion: Switching to faricimab in the treatment of patients with aflibercept-resistant type 1 CNV secondary to chronic CSC led to improved BCVA, anatomical outcomes and extended treatment interval in 56 % of patients at 6 months follow-up period. Further investigations into long-term outcomes are necessary to evaluate the sustained effiacy and safety of intravitreal faricimab.

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  Тип елементу:Документ,

  AI-Powered Detection of Diabetic Retinopathy in Ukraine

  Король, Андрій Ростиславович

  ;

  Невська, Алла Олександрівна

  ;

  Задорожний, Олег Сергійович

  ;

  Щербакова, Валерія Володимирівна

  ;

  Погосян, Ольга Атомівна

  (2026)

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  Purpose: To evaluate the potential of artifiial intelligence in real-world population screening to detect stages of diabetic retinopathy, identify patients with previously undiagnosed diabetes, and establish and optimise patient pathways. Materials and methods: This prospective, multicentre, open-label observational study evaluated the feasibility of automated analysis of colour fundus images to identify individuals with suspected undiagnosed diabetes mellitus (DM) by detecting signs of diabetic retinopathy in a real-world screening program. It was conducted at primary healthcare facilities in collaboration with The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine and Oftacentro SA, Lugano-Paradiso, Switzerland. Patients were not preselected based on diabetes status, allowing assessment of fundus examination as a tool for opportunistic detection of systemic metabolic disease. Results: A total of 14,882 patients were included in the population-based screening and divided into two groups: 3 256 patients with established diabetes mellitus (used to assess detection of diabetic retinopathy in a confimed population), 11626 individuals without diagnosed diabetes but with risk factors (the key group for evaluating opportunistic detection). Fundus image analysis identifid signs of diabetic retinopathy in 622 patients (19.1 %) in DM group and 654 (5.6 %) in risk of DM group. In DM group disease staging showed: mild non-proliferative retinopathy in 58.5 % patients, moderate in 18.5 %, severe in 10 %, and proliferative retinopathy in 13 % of patients with DM. In risk of DM group disease staging showed: mild non-proliferative retinopathy in 87 % patients, moderate in 9 %, severe in 3 %, and proliferative retinopathy in 1 % of patients. Conclusions: Artifiial intelligence demonstrated high effiacy in populationbased screening for diabetic retinopathy. The screening revealed a signifiant prevalence of diabetic retinopathy among the population. Among the screened individuals with risk of DM, signs of diabetic retinopathy were detected in 5.6 % of patients. These fidings highlight the importance of early detection and large-scale screening programs. AI algorithms enable effective identifiation of at-risk patients, including those without a confimed diabetes diagnosis, creating new opportunities for early diagnosis and prevention of severe complications.

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  Тип елементу:Документ,

  27 Filatov’s school of corneal preservation yesterday, today, tomorrow

  Макарова, Марія Борисівна

  ;

  Дрожжина, Галина Іванівна

  ;

  Барканов, Андрій

  ;

  Кацан , Сергій Володимирович

  (2026)

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  Objective To trace the history of the establishment of the first corneal harvesting and preservation laboratory in Ukraine and the process of its transformation into an eye bank during wartime. Materials and Methods Archival materials from the Filatov Institute covering a 100-year period were analyzed. Statistical analysis of the data obtained was performed using the ANOVA method repeated measures. Results In 1936, the first corneal harvesting and preservation laboratory in Ukraine was established at the Ukra-inian Institute of Experimental Ophthalmology (now the V.P. Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine), headed by Academician Volodymyr Petrovych Filatov. For 70 years, this laboratory conducted fundamental scientific research into methods of corneal preservation. For the first time, biomicroscopic, biochemical, and morphological changes in the cornea under different temperature preservation regimes were described, and the optimal condi-tions were identified. The world’s first method of cold corneal preservation developed by V.P. Filatov was further advanced through the development of preservation media and new cold storage methods, which are currently used in eye banks across Europe. At present, due to military operations on the territory of Ukraine and the large number of shrapnel-related ocular injuries among both military personnel and civilians, the demand for donor corneas has increased sharply. This required urgent modernization and reorganization of the corneal preservation laboratory at the V.P. Filatov Institute and its transformation into an eye bank in accordance with European standards in order to ensure timely provision of donor corneal tissue to all patients in need. Collaboration was established with the Lublin Eye Bank (Poland), where colleagues generously shared their experience. Subsequently, a training course was completed at the Monza Eye Bank (Italy); participation took place in the annual EEBA 2025 scientific conference ‘The Bridge’ in Rome (Italy); the necessary equipment was acquired; and the comprehensive course ‘Cornea Evaluation in Eye Banking’ was attended in Venice (Italy). After acquiring the required knowledge and practical skills, their implementation into clinical practice began. Since February 2025, the eye bank has been operating using European cold corneal preservation technology, which has reduced waiting times for donor tissue and, over the course of 2025, enabled a 16.7% increase in the number of keratoplasties performed in the trauma and corneal pathology departments of the V.P. Filatov Institute of Eye Diseases and Tissue Therapy compared with 2024. Conclusions The establishment of an eye bank at the V.P. Filatov Institute of Eye Diseases and Tissue Therapy has significantly improved the timeliness and quality of surgical care for patients requiring keratoplasty.

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  Тип елементу:Документ,

  Staging of diabetic retinopathy using an artificial intelligence-based software platform

  Щербакова, Валерія Володимирівна

  ;

  Король, Андрій Ростиславович

  ;

  Невська, Алла Олександрівна

  ;

  Задорожний, Олег Сергійович

  ;

  Погосян, Ольга Атомівна

  (2026)

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  Objective: The aim of our study was to evaluate the potential of artificial intelligence in real-world population screening to detect stages of diabetic retinopathy, identify patients with previously undiagnosed diabetes, and establish and optimise patient pathways. Materials and methods: This prospective, multicentre, open-label observational study evaluated the feasibility of automated analysis of colour fundus images to identify individuals with suspected undiagnosed diabetes mellitus by detecting signs of diabetic retinopathy in a real-world screening programme. It was conducted at primary healthcare facilities in collaboration with The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine. Patients were not preselected based on diabetes status, allowing assessment of fundus examination as a tool for opportunistic detection of systemic metabolic disease. Results: A total of 12,922 patients were included in the population-based screening and divided into three groups: 2,940 patients with established diabetes mellitus (used to assess detection of diabetic retinopathy in a confirmed population), 7,411 individuals without diagnosed diabetes but with risk factors (the key group for evaluating opportunistic detection), and 2,571 controls without diabetes or significant risk factors. Fundus image analysis identified signs of diabetic retinopathy in 1,308 patients (10.1%), while no retinal pathology was detected in 9,005 individuals (69.7%). Disease staging showed: mild non-proliferative retinopathy in 835 patients (6.5%), moderate in 256 (2.0%), severe in 65 (0.5%), and proliferative retinopathy in 152 (1.2%). Conclusions: Artificial intelligence demonstrated high efficacy in population-based screening for diabetic retinopathy. The screening revealed a significant prevalence of diabetic retinopathy among the population. Among the 12,922 individuals screened, signs of diabetic retinopathy were detected in 10.1% of patients. These findings highlight the importance of early detection and large-scale screening programmes. AI algorithms enable effective identification of at-risk patients, including those without a confirmed diabetes diagnosis, creating new opportunities for early diagnosis and prevention of severe complications. Automated disease staging supports clinical decision-making, while AI-based screening improves access to care, reduces the risk of vision loss, and optimises ophthalmology services, especially in resource-limited settings.

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