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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ophthalmology</journal-id><journal-title-group><journal-title xml:lang="ru">Офтальмология</journal-title><trans-title-group xml:lang="en"><trans-title>Ophthalmology in Russia</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1816-5095</issn><issn pub-type="epub">2500-0845</issn><publisher><publisher-name>Ophthalmology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18008/1816-5095-2023-2-208-214</article-id><article-id custom-type="elpub" pub-id-type="custom">ophthalmology-2098</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Эффективность современных методов лечения неинфекционных увеитов. Обзор</article-title><trans-title-group xml:lang="en"><trans-title>Review of the Effectiveness of Modern Treatment of Non-Infectious Uveitis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8111-0919</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Медведев</surname><given-names>И. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Medvedev</surname><given-names>I. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Медведев Игорь Борисович - доктор медицинских наук, профессор, заведующий кафедрой  офтальмологии ФДПО</p><p>ул. Островитянова, 1, Москва, 117997, Российская Федерация</p></bio><bio xml:lang="en"><p>Medvedev Igor B. - MD, Professor, head of the Ophthalmology department, Faculty of Continuing Proffesional Education </p><p> Ostrovityanova str., 1, Moscow, 117997, Russian Federation </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9145-7687</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Самодурова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Samodurova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Самодурова Елизавета Владиславовна - студентка 5‑го курса</p><p>ул. Островитянова, 1, Москва, 117997, Российская Федерация</p></bio><bio xml:lang="en"><p>Samodurova Elizaveta V. - 5th year student </p><p>Ostrovityanova str., 1, Moscow, 117997, Russian Federation </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Светличная</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Svetlichnaya</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Светличная Светлана Владимировна - студентка 5‑го курса</p><p>ул. Островитянова, 1, Москва, 117997, Российская Федерация </p></bio><bio xml:lang="en"><p> Svetlana Vladimirovna Svetlichnaya, 5th year student </p><p> Ostrovityanova str., 1, Moscow, 117997, Russian Federation </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3741-6056</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баталина</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Batalina</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баталина Лариса Владимировна - кандидат медицинских наук, ассистент кафедры  офтальмологии ФДПО </p><p>ул. Островитянова, 1, Москва, 117997, Российская Федерация</p></bio><bio xml:lang="en"><p>Batalina Larisa V. - PhD, assistant department of the Ophthalmology department, Faculty of Continuing Proffesional Education </p><p> Ostrovityanova str., 1, Moscow, 117997, Russian Federation </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3441-9072</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дергачёва</surname><given-names>Н. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Dergacheva</surname><given-names>N. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дергачева Надежда Николаевна - ассистент кафедры офтальмологии ФДПО</p><p>ул. Островитянова, 1, Москва, 117997, Российская Федерация</p></bio><bio xml:lang="en"><p>Dergacheva Nadezhda N. - assistant department of the Ophthalmology department, Faculty of Continuing Proffesional Education </p><p> Ostrovityanova str., 1, Moscow, 117997, Russian Federation </p></bio><email xlink:type="simple">deb20052005@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>29</day><month>06</month><year>2023</year></pub-date><volume>20</volume><issue>2</issue><fpage>208</fpage><lpage>214</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Медведев И.Б., Самодурова Е.В., Светличная С.В., Баталина Л.В., Дергачёва Н.Н., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Медведев И.Б., Самодурова Е.В., Светличная С.В., Баталина Л.В., Дергачёва Н.Н.</copyright-holder><copyright-holder xml:lang="en">Medvedev I.B., Samodurova E.V., Svetlichnaya S.V., Batalina L.V., Dergacheva N.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.ophthalmojournal.com/opht/article/view/2098">https://www.ophthalmojournal.com/opht/article/view/2098</self-uri><abstract><p>Увеиты — термин, объединяющий достаточно обширную группу заболеваний, в основе которых лежит воспаление сосудистой оболочки глазного яблока. Особое место отводится неинфекционным увеитам. Данная группа заболеваний имеет аутоиммунное происхождение, и наибольшая доля заболеваемости приходится именно на них. В настоящее время по-прежнему остаются актуальными проблемы своевременной диагностики, а также эффективного лечения заболеваний сосудистой оболочки глаза. Значительное снижение остроты зрения, наличие грозных осложнений и ранняя инвалидизация пациентов с увеитом и снижение качества жизни определяют социальную значимость данной патологии. Результаты ряда исследований подтверждают наличие прямой связи между сроками начала терапии увеита и вероятностью значительного снижения зрения. Согласно общепринятым рекомендациям, схема терапии неинфекционного увеита может включать местное лечение (инстилляции кортикостероидов, нестероидных противовоспалительных препаратов и мидриатиков) и системную иммуносупрессию с применением кортикостероидов, алкилирующих агентов (циклофосфамид, хлорамбуцил), антиметаболитов (азатиоприн, метотрексат, микофенолат мофетил), ингибиторов Т-клеток (циклоспорин и такролимус). Длительное применение стероидных препаратов в высоких дозах у пациентов с увеитом вызывает частичную ремиссию и достаточно часто сопровождается побочными эффектами. Комбинированная терапия, включающая в себя стероиды с цитостатиками, показала достаточно высокую эффективность, однако ее длительное использование может привести к негативным последствиям в виде гепато- и нефротоксичности, мутагенности, канцерогенности, стерилизации, а также подавлению деятельности костного мозга (тромбоцитопения, кровотечения, инфекции). В случае промежуточного, заднего и панувеита тяжелого и среднетяжелого течения, не поддающегося иммуносупрессивной терапии метотрексатом и циклоспорином А, осуществляют перевод пациентов на терапию генно-инженерными биологическими препаратами (ГИБП). К препаратам биологической терапии относят селективные регуляторы уровня цитокинов. Механизм их действия основан на избирательном связывании цитокинов с помощью моноклональных антител или растворимых рецепторов к цитокинам. Настоящая статья посвящена оценке эффективности биологической терапии как терапии выбора.</p></abstract><trans-abstract xml:lang="en"><p>Uveitis is a term that combines an extensive group of diseases, which are based on inflammation of the choroid of the eyeball. A special place is given to non-infectious uveitis. This group of diseases has an autoimmune origin and the largest proportion of the incidence falls on them. The largest share of morbidity is from this group of uveitis. Despite the successes in modern approaches to the treatment of uveitis, the issue of timely diagnosis and treatment of diseases of the vascular eye membrane does not lose its relevance. The social significance of this pathology is determined by the growing rate of visual acuity decline, the development of complications and early disability. Many studies have revealed a relationship between the untimely late start of treatment and the likelihood of vision loss leading to a deterioration in the quality of life. The therapy of non-infectious uveitis is based on the suppression of the local immune response. Depending on the activity of the inflammatory process, it may include local treatment (instillation of corticosteroids, nonsteroidal anti-inflammatory drugs and mydriatics) and systemic immunosuppression using corticosteroids, alkylating agents (cyclophosphamide, chlorambucil), antimetabolites (azathioprine, methotrexate, mycophenolate mofetil), T-cell inhibitors (cyclosporine and tacrolimus). According to the experience of clinicians, the therapeutic efficacy of steroids even in high doses in treatment of the chronic uveitis provides only partial remission and is associated with the development of serious side effects. Positive results were found when using a combination of steroids with cytostatics, however, with their prolonged use, it is possible to manifest properties such as hepatotoxicity and nephrotoxicity, mutagenicity, carcinogenicity, sterilization, as well as bone marrow suppression, and, as a consequence, the occurrence of severe thrombocytopenic bleeding and granulocytopenic infections. In the case of intermediate, posterior and severe and moderate panuveitis that does not respond to immunosuppressive therapy with methotrexate and cyclosporine A, patients are transferred to therapy with genetically engineered biological drugs (GIBP). The drugs of biological therapy include selective regulators of cytokine levels. The mechanism of their action is based on the selective cytokines’ binding using monoclonal antibodies or soluble cytokine receptors. This article is devoted to evaluating the effectiveness of biological therapy as the drugs of choice.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>неинфекционный увеит</kwd><kwd>иммуновоспалительные заболевания</kwd><kwd>генно-инженерные биологические препараты</kwd><kwd>иммуносупрессанты</kwd><kwd>кортикостероиды</kwd><kwd>биологические модуляторы иммунного ответа</kwd><kwd>фактор некроза опухоли-α</kwd><kwd>ИЛ-6</kwd><kwd>ИЛ-17</kwd><kwd>ИЛ-23</kwd></kwd-group><kwd-group xml:lang="en"><kwd>non-infectious uveitis</kwd><kwd>immuno-inflammatory diseases</kwd><kwd>genetically engineered biological drugs</kwd><kwd>immunosuppressants</kwd><kwd>corticosteroids</kwd><kwd>biological modulators of the immune response</kwd><kwd>tumor necrosis factor-α</kwd><kwd>IL-6</kwd><kwd>IL-17</kwd><kwd>IL-23</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Foster CS, Vitale AT. 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