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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">10.18008/1816-5095-2015-2-4-12</article-id><article-id custom-type="elpub" pub-id-type="custom">ophthalmology-234</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>СИНДРОМ РЕЦИДИВИРУЮЩЕЙ ЭРОЗИИ РОГОВИЦЫ (обзор)</article-title><trans-title-group xml:lang="en"><trans-title>RECURRENT CORNEAL EROSION SYNDROME (a review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Труфанов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Trufanov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Контактная информация: труфанов Сергей Владимирович, trufanov05@mail.ru</p></bio><email xlink:type="simple">trufanov05@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маложен</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Malozhen</surname><given-names>S. A.</given-names></name></name-alternatives><email xlink:type="simple">trufanov05@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Полунина</surname><given-names>Е. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Polunina</surname><given-names>E. G.</given-names></name></name-alternatives><email xlink:type="simple">trufanov05@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пивин</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pivin</surname><given-names>E. A.</given-names></name></name-alternatives><email xlink:type="simple">trufanov05@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Текеева</surname><given-names>Л. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Tekeeva</surname><given-names>L. Yu.</given-names></name></name-alternatives><email xlink:type="simple">trufanov05@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт глазных болезней, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute of Eye Diseases, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт повышения квалификации Федерального медико-биологического агентства, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Postgraduate Education, Federal Medical Biological Agency, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>04</day><month>07</month><year>2015</year></pub-date><volume>12</volume><issue>2</issue><fpage>4</fpage><lpage>12</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Труфанов С.В., Маложен С.А., Полунина Е.Г., Пивин Е.А., Текеева Л.Ю., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Труфанов С.В., Маложен С.А., Полунина Е.Г., Пивин Е.А., Текеева Л.Ю.</copyright-holder><copyright-holder xml:lang="en">Trufanov S.V., Malozhen S.A., Polunina E.G., Pivin E.A., Tekeeva L.Y.</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/234">https://www.ophthalmojournal.com/opht/article/view/234</self-uri><abstract><p>Синдром рецидивирующей эрозии роговицы (РЭР)  — заболевание, для  которого характерны эпизоды периодически повторяющихся спонтанных дефектов эпителия роговицы. Основные клинические симптомы заболевания (боль, покраснение, светобоязнь, слезотечение), как правило, появляются ночью. Поражения роговицы при РЭР, визуализируемые биомикроскопически, варьируют в зависимости от наличия приподнятости эпителия, эпителиальных микрокист или роговичной эпителиальной эрозии, стромальных инфильтратов и помутнений. Причиной заболевания могут быть микротравмы, дистрофии передних слоев роговицы, вирус герпеса. Другими частыми причинами РЭР либо факторами, повышающими вероятность развития синдрома, считаются дисфункция мейбомиевых желез, сухой кератоконъюнктивит, диабет, состояние после LASIK. В  патогенезе РЭР ключевую роль играет неполноценность базальной мембраны и  нестабильность эпителиальной адгезии к строме. Ультраструктурные изменения, обнаруженные при РЭР, включают аномалии слоя базальных эпителиальных клеток, эпителиальной базальной мембраны, отсутствие или неполноценность полудесмосом, утрату якорных фибрилл. При этом определяется повышенная концентрация матриксных металлопротеиназ и коллагеназ, способствующих разрушению базальной мембраны, что приводит к формированию постоянных циклов повторяющихся эрозий и дальнейшему образованию аномальной базальной мембраны. Помимо купирования болевых ощущений в острой фазе, основная цель лечения РЭР — стимуляция реэпителизации и восстановление полноценного «комплекса адгезии» базальной мембраны. Большинство случаев поддается простому консервативному лечению, включающему любриканты, препараты, стимулирующие эпителизацию, «заклейки» глаза. РЭР, устойчивые к простым методам лечения, требуют более сложных подходов. Неинвазивные варианты включают в себя использование контактных линз длительного ношения, аутологичной сыворотки в виде глазных капель, ботулотоксина, индуцирующего птоз, противовирусное лечение, прием ингибиторов металлопротеиназ внутрь. Подходы к терапии должны включать препараты, стабилизирующие клеточные мембраны, в частности, антиоксиданты. Антиоксидантное действие препаратов, например, Эмоксипина, позволяет усилить репаративные процессы в тканях за счёт препятствия перекисному окислению липидов клеточных мембран, а также за счет антигипоксического, ангиопротекторного и антиагрегантного действия. При неэффективности консервативного лечения применяют хирургические методы — полировка боуменовой мембраны алмазным бором, передняя стромальная пункция, эксимер-лазерная фототерапевтическая кератэктомия. Выбор метода лечения РЭР должен учитывать характер и степень выраженности синдрома, наличие сопутствующей патологии, опыт лечащего врача и, при необходимости, доступность хирургического оборудования. </p></abstract><trans-abstract xml:lang="en"><p>Recurrent corneal erosion (RCE) syndrome is characterized by episodes of recurrent spontaneous epithelial defects. Main clinical symptoms (pain, redness, photophobia, lacrimation) occurred at night. Corneal lesions revealed by slit lamp exam vary depending on the presence of corneal epithelium raise, epithelial microcysts or epithelial erosions, stromal infiltrates and opacities. Microtraumas, anterior corneal dystrophies, and herpesvirus give rise to RCE. Other causes or factors which increase the risk of RCE syndrome include meibomian gland dysfunction, keratoconjunctivitis sicca, diabetes, and post-LASIK conditions. Basal membrane abnormalities and instability of epithelial adhesion to stroma play a key role in RCE pathogenesis. Ultrastructural changes in RCE include abnormalities of basal epithelial cells and epithelial basal membrane, absence or deficiency of semi-desmosomes, loss of anchor fibrils. Increase in matrix metalloproteinases and collagenases which contribute to basal membrane destruction results in recurrent erosions and further development of abnormal basal membrane. The goals of RCE therapy are to reduce pain (in acute stage), to stimulate re-epithelization, and to restore «adhesion complex» of basal membrane. In most cases, RCE responds to simple conservative treatment that includes lubricants, healing agents, and eye patches. RCEs that are resistant to simple treatment, require complex approach. Non-invasive methods include long-term contact lens use, instillations of autologous serum (eye drops), injections of botulinum toxin (induces ptosis), antiviral agent use or oral intake of metalloproteinase inhibitors. Cell membrane stabilizers, i.e., antioxidants, should be included into treatment approaches as well. Antioxidant effect of Emoxipine promotes tissue reparation due to the prevention of cell membrane lipid peroxidation as well as due to its anti-hypoxic, angioprotective, and antiplatelet effects. If conservative therapy is ineffective, surgical procedures (Bowman’s membrane polishing with diamond drill, anterior stromal puncture, excimer laser phototherapeutic keratectomy) are required. RCE therapy decision making should consider disease severity, the presence of concurrent pathology, medical experience and surgical instrument availability if needed. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>синдром рецидивирующей эрозии роговицы</kwd><kwd>дисфункция мейбомиевых желез</kwd><kwd>сухой кератоконъюнктивит</kwd><kwd>диабет</kwd><kwd>состояние после LASIK</kwd></kwd-group><kwd-group xml:lang="en"><kwd>: recurrent corneal erosion</kwd><kwd>meibomian gland dysfunction</kwd><kwd>keratoconjunctivitis sicca</kwd><kwd>diabetes</kwd><kwd>post-LASIK</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">Letko E., Foster S. Recurrent erosion syndrome. 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