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Anti-vascular endothelial growth factor (anti-VEGF) therapies that inhibit choroidal angiogenesis and reduce vascular permeability have revolutionized clinical practices for neovascular eye diseases. Ranibizumab (Lucentis) is a Fab-antibody with high affinity for VEGF, and has a potential to bind to all VEGF isoforms. Diseases of retinal and choroidal vasculature are the most prevalent causes of vision loss in developed countries. Among them diabetic macular edema (DME) is the most common sight threatening complication of diabetes. VEGF plays a critical role in the pathogenesis of DME. Due to modest outcomes with macular photocoagulation, other treatment modalities for DME have been evaluated. The results of the pilot studies and preliminary results of multicenter randomized, controlled studies showed that intraocular injections of ranibizumab decrease the mean retinal thickness and improve the BCVA (best corrected visual acuity) in patients with DME.

The majority of authors as a cause of formation of a leakage in central serous choroidopathy considers the disturbances of function of the pigmentary layer. According to Spitznas it is based on transformation of these cells from absorbing to extracting towards the choroid and retina under the influence of unknown factors (immunological processes, circulatory, inflammatory factors or stress). Marmor sees the lesion of the pigmentary epithelium as a disturbance of a cyclic action of the AMP neeth the neurosensory layer of the retina. There exist contemporary 2 methods of treatment of the central serous retinopathy. One part of the authors thinks that one should wait till the spontaneous remission, the other one--that in cases with the leakage situated beyond the risk area laser therapy can be applied.

Examined were 91 eyes with non-proliferative and proliferative retinopathy with coexisting maculopathy in 51 patients in whom segmental or retinal pan-photocoagulation were performed. The period of observation--3 to 4.5 years. Stabilization of the pathological process was observed in 37.3 p.c. of cases, 54.9 p.c. of patients showed further deterioration and 7.6 p.c. loss of vision. The most frequent cause of deterioration was the progression of the macular lesions (72 p.c.), a smaller number of cases (28 p.c.) was due to other changes.

The authors present a method of treatment of diffuse diabetic macular oedema by means of photocoagulation of scatter grid type. Discussed are observations in the period of 6 months to 1 year after intervention. The technique of surgery, indications and all other factors which could have an influence on the final functional results are discussed in detail. Small risk of this surgical intervention and a good efficacy of this method is evaluated as a stabilization of the visual acuity, they allow to suggest that this method may play an important role in the treatment of diffuse diabetic macular oedema.

Presented are the results of treatment of diabetic changes at the posterior pole by argon laser. Among 26 eyes in which the "macular grid" technique was used an improvement or stabilization of vision was attained in 14 eyes, 12 remaining eyes showing deterioration. The anatomical condition improved or it was stabilized in 24 eyes. Focused laser therapy after fluoresceine angiography was used in 15 eyes; improvement or stabilization of the visual acuity was achieved in 12 eyes, deterioration was observed in 3 eyes. The anatomical condition improved or was stabilized in all the 15 eyes. The period of observation amounted 6 months.

From 1980-1986 46 unselected aphakic patients suffering from persisting cystoid macular edema and vitreous incarceration to the surgical wound were treated by closed vitrectomy and removal of displaced vitreous through a limbal incision. In 30 eyes visual acuity improved averaging 0.35 if the revision was done within one year. In 12 eyes, treated usually after intervals of more than 1 year, vision remained unchanged and in 4 eyes visual acuity decreased, in two of them due to retinal detachment and in other two because of advance macular changes. When medical therapy fails the decision to undertake surgical revision should not be delayed. This releases also the coexisting traction to the retinal periphery.