zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2024_3_100zabmedvestnik-300Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSПАТОГЕНЕТИЧЕСКИЕ МЕХАНИЗМЫ РАЗВИТИЯ ОТЕКА ДИСКА ЗРИТЕЛЬНОГО НЕРВА НА ФОНЕ ПРЕЭКЛАМПСИИPATHOGENETIC MECHANISMS OF PAPILLEDEMA DEVELOPMENT ON PREECLAMPSIAhttps://orcid.org/0000-0002-6223-8888ТаскинаЕ. С.TaskinaE. S.

Таскина Елизавета Сергеевна – к.м.н., доцент кафедры офтальмологии

672000, г. Чита, ул. Горького, 39а

39a Gorky Street, Chita, 672000

taskins@yandex.ruhttps://orcid.org/0000-0003-4390-183XКибалинаИ. В.KibalinaI. V.

Кибалина Ирина Владимировна – д.м.н., доцент, заведующая кафедрой нормальной физиологии имени профессора Б.И. Кузника, директор НИИ Молекулярной медицины

672000, г. Чита, ул. Горького, 39а

39a Gorky Street, Chita, 672000

physiology_chgma@mail.ruhttps://orcid.org/0000-0002-5961-5400МудровВ. А.MudrovV. A.

Мудров Виктор Андреевич – д.м.н., доцент кафедры акушерства и гинекологии педиатрического факультета и факультета ДПО

672000, г. Чита, ул. Горького, 39а

39a Gorky Street, Chita, 672000

mudrov_viktor@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Читинская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияChita State Medical AcademyRussian Federation20240412202403100111Copyright © Таскина Е.С., Кибалина И.В., Мудров В.А., 20242024Таскина Е.С., Кибалина И.В., Мудров В.А.Taskina E.S., Kibalina I.V., Mudrov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/300

Преэклампсия представляет собой мультисистемное заболевание, которое может включать сердечно-сосудистые изменения, гематологические нарушения, печеночную и почечную недостаточность, церебральные и зрительные симптомы. В настоящее время наличие отека диска зрительного нерва при преэклампсии характезирует заболевание как тяжелое. Наличие отека диска зрительного нерва не всегда характеризует вазогенный отек головного мозга с повышением внутричерепного давления. Формирование стушеванности границ и отека диска зрительного нерва может быть связано с нарушением ауторегуляции в головке диска зрительного нерва вследствие повышения артериального давления и наличия эндотелиальной дисфункции при преэклампсии. Поэтому следует дифференцировать истинный отек диска зрительного нерва от псевдоотека. Проведен детальный систематический анализ современной отечественной и зарубежной литературы, посвященный описанию патогенетических механизмов развития отека диска зрительного нерва при преэклампсии. В исследовании использовались информационные базы: eLibrary, PubMed, Scopus, Cochrane Library, MEDLINE за период с 2015 г. до мая 2024 г. В данном литературном обзоре представлены возможные патогенетические механизмы развития отека диска зрительного нерва на фоне преэклампсии, а также современные подходы к дифференциальной диагностике отека диска зрительного нерва от псевдоотека. Необходимо дальнейшее изучение патогенетических механизмов развития отека диска зрительного нерва при гипертензивных расстройствах беременности для выявления пациенток группы риска и оптимизации тактики их ведения и лечения.

Preeclampsia is a multisystem disease that can include cardiovascular changes, hematological disorders, liver and kidney failure, cerebral and visual symptoms. Currently, the presence of papilledema in preeclampsia characterizes the disease as severe. However, it is likely that the presence of papilledema does not always characterize vasogenic cerebral edema with increased intracranial pressure. The formation of blurred borders and papilledema may also be associated with impaired autoregulation in the head of the optic disc due to increased blood pressure and the presence of endothelial dysfunction in preeclampsia. It is also important to differentiate the true papilledema from the pseudopapilledema. The study carried out a detailed systematic analysis of modern domestic and foreign literature, devoted to the pathogenetic mechanisms of papilledema development in preeclampsia. The study used such information databases as: eLibrary, PubMed, Scopus, Cochrane Library, MEDLINE for the period from 2015 to May 2024. This literature review presents possible pathogenetic mechanisms of the development of papilledema against on preeclampsia, as well as modern approaches to the differential diagnosis of papilledema from pseudopapilledema. Further study of the pathogenetic mechanisms of papilledema development in hypertensive pregnancy disorders is necessary to identify high-risk patients and optimize their management and treatment tactics.

преэклампсиягипертензивные расстройства беременностипатогенезотек диска зрительного нервапсевдоотек зрительного нерваповышение внутричерепного давленияpreeclampsiahypertensive disorders of pregnancypathogenesispapilledemapseudopapilledemaincreased intracranial pressureReferencesWu P., Green M., Myers J.E. Hypertensive disorders of pregnancy. BMJ. 2023. 381. e071653. doi: 10.1136/bmj-2022-071653.Wu P., Green M., Myers J.E. Hypertensive disorders of pregnancy. BMJ. 2023. 381. e071653. doi: 10.1136/bmj-2022-071653.Chiang Y.T., Seow K.M., Chen K.H. The Pathophysiological, Genetic, and Hormonal Changes in Preeclampsia: A Systematic Review of the Molecular Mechanisms. Int J Mol Sci. 2024. 25 (8). 4532. doi: 10.3390/ijms25084532.Chiang Y.T., Seow K.M., Chen K.H. The Pathophysiological, Genetic, and Hormonal Changes in Preeclampsia: A Systematic Review of the Molecular Mechanisms. Int J Mol Sci. 2024. 25 (8). 4532. doi: 10.3390/ijms25084532.Mahendra V., Clark S.L., Suresh M.S. Neuropathophysiology of preeclampsia and eclampsia: A review of cerebral hemodynamic principles in hypertensive disorders of pregnancy. Pregnancy Hypertens. 2021. 104–111. doi: 10.1016/j.preghy.2020.10.013.Mahendra V., Clark S.L., Suresh M.S. Neuropathophysiology of preeclampsia and eclampsia: A review of cerebral hemodynamic principles in hypertensive disorders of pregnancy. Pregnancy Hypertens. 2021. 104–111. doi: 10.1016/j.preghy.2020.10.013.Клинические рекомендации «Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройства во время беременности, в родах и послеродовом периоде» – ID:637 – (05.09.2024) : [утверждены Министерством здравоохранения Российской Федерации].Clinical recommendations "Preeclampsia. Eclampsia. Edema, proteinuria and hypertensive disorders during pregnancy, childbirth and the postpartum period" – ID:637 – (09/05/2024) : [approved by the Ministry of Health of the Russian Federation]. in Russian.Kornacki J., Olejniczak O., Sibiak R., Gutaj P., Wender-Ożegowska E. Pathophysiology of PreEclampsia-Two Theories of the Development of the Disease. Int J Mol Sci. 2023. 25 (1). 307. doi: 10.3390/ijms25010307.Kornacki J., Olejniczak O., Sibiak R., Gutaj P., Wender-Ożegowska E. Pathophysiology of PreEclampsia-Two Theories of the Development of the Disease. Int J Mol Sci. 2023. 25 (1). 307. doi: 10.3390/ijms25010307.Kornacki J., Wirstlein P., Wender-Ożegowska E. Markers of Endothelial Injury and Dysfunction in Early- and Late-Onset Preeclampsia. Life. 2020. 10. 239. doi: 10.3390/life10100239.Kornacki J., Wirstlein P., Wender-Ożegowska E. Markers of Endothelial Injury and Dysfunction in Early- and Late-Onset Preeclampsia. Life. 2020. 10. 239. doi: 10.3390/life10100239.Marchesi N., Fahmideh F., Boschi F., Pascale A., Barbieri A. Ocular Neurodegenerative Diseases: Interconnection between Retina and Cortical Areas. Cells. 2021. 10 (9). 2394. doi: 10.3390/cells10092394.Marchesi N., Fahmideh F., Boschi F., Pascale A., Barbieri A. Ocular Neurodegenerative Diseases: Interconnection between Retina and Cortical Areas. Cells. 2021. 10 (9). 2394. doi: 10.3390/cells10092394.Серова Н.К., Елисеева Н.М. Застойный диск зрительного нерва как признак внутричерепной гипертензии. Вестник офтальмологии. 2022. 138 (4). 87 93. doi:10.17116/oftalma202213804187.Serova N.K., Eliseeva N.M. Stagnant optic disc as a sign of intracranial hypertension. Bulletin of Ophthalmology. 2022. 138 (4). 87 93. doi:10.17116/oftalma202213804187. in Russian.Pichamuthu K. Optic Nerve Sheath Ultrasound: Where do We Go from Here? Indian J Crit Care Med. 2021. 25 (4). 360–361. doi: 10.5005/jp-journals-10071-23795.Pichamuthu K. Optic Nerve Sheath Ultrasound: Where do We Go from Here? Indian J Crit Care Med. 2021. 25 (4). 360–361. doi: 10.5005/jp-journals-10071-23795.Urfalioglu S., Bakacak M., Ozdemir G., et al. Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography. Pregnancy Hypertens. 2019. 17. 203–208. doi: 10.1016/j.preghy.2019.07.001.Urfalioglu S., Bakacak M., Ozdemir G., et al. Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography. Pregnancy Hypertens. 2019. 17. 203–208. doi: 10.1016/j.preghy.2019.07.001.Shim K.Y., Bae J.G., Lee J.K., Kim Y.C. Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia. PLoS One. 2021 May 20. 16 (5). e0251933. doi: 10.1371/journal.pone.0251933.Shim K.Y., Bae J.G., Lee J.K., Kim Y.C. Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia. PLoS One. 2021. 16 (5). e0251933. doi: 10.1371/journal.pone.0251933.Fayed A.E., Thabet M.M., Salama M.M., El Shazly M. Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography. 2023. 18 (5). e0285884. doi: 10.1371/journal.pone.0285884.Fayed A.E., Thabet M.M., Salama M.M., El Shazly M. Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography. 2023. 18 (5). e0285884. doi: 10.1371/journal.pone.0285884.Курышева Н.И. Окт-ангиография и ее роль в исследовании ретинальной микроциркуляции при глаукоме (часть первая). Российский офтальмологический журнал. 2018. 11 (2). 82–86. doi: 10.21516/2072-0076-2018-11-2-82-86.Kurysheva N.I. Oct angiography and its role in the study of retinal microcirculation in glaucoma (part one). Russian Ophthalmological Journal. 2018. 11(2). 82–86. Dpi: 10.21516/2072-0076-2018-11-2-82-86. in Russian.Hayreh S.S. Pathogenesis of optic disc edema in raised intracranial pressure. Prog Retin Eye Res. 2016. 50. 108–44. doi: 10.1016/j.preteyeres.2015.10.001.Hayreh S.S. Pathogenesis of optic disc edema in raised intracranial pressure. Prog Retin Eye Res. 2016. 50. 108-44. doi: 10.1016/j.preteyeres.2015.10.001.El-Gendy R.S., El-Hamid A.S.A., Galhom A.E.A., Hassan N.A., Ghoneim E.M. Diagnostic dilemma of papilledema and pseudopapilledema. Int Ophthalmol. 2024. 44 (1). 272. doi: 10.1007/s10792-024-032155.El-Gendy R.S., El-Hamid A.S.A., Galhom A.E.A., Hassan N.A., Ghoneim E.M. Diagnostic dilemma of papilledema and pseudopapilledema. Int Ophthalmol. 2024. 44 (1). 272. doi: 10.1007/s10792-024-032155.McElwain C.J., Tuboly E., McCarthy F.P., McCarthy C.M. Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows into Future Cardiometabolic Health? Front. Endocrinol. 2020. 11. 655. doi: 10.3389/fendo.2020.00655.McElwain C.J., Tuboly E., McCarthy F.P., McCarthy C.M. Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows into Future Cardiometabolic Health? Front. Endocrinol. 2020. 11. 655. doi: 10.3389/fendo.2020.00655.Tada M. Reversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES). No Shinkei Geka. 2021. 49 (2). 342–348. doi: 10.11477/mf.1436204396.Tada M. Reversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES). No Shinkei Geka. 2021. 49 (2). 342–348. doi: 10.11477/mf.1436204396.Xie J.S., Donaldson L., Margolin E. Papilledema: A review of etiology, pathophysiology, diagnosis, and management. Surv Ophthalmol. 2022. 67 (4). 1135–1159. doi: 10.1016/j.survophthal.2021.11.007.Xie J.S., Donaldson L., Margolin E. Papilledema: A review of etiology, pathophysiology, diagnosis, and management. Surv Ophthalmol. 2022. 67 (4). 1135–1159. doi: 10.1016/j.survophthal.2021.11.007.Minckler D., Lin K. Papilledema: An Inaccurate Term in Our Medical Vocabulary. Ophthalmology. 2023. 130 (2). 137–138. doi: 10.1016/j.ophtha.2022.12.009.Minckler D., Lin K. Papilledema: An Inaccurate Term in Our Medical Vocabulary. Ophthalmology. 2023. 130 (2). 137–138. doi: 10.1016/j.ophtha.2022.12.009.Dziedziak J., Zaleska-Żmijewska A., Szaflik J.P., Cudnoch-Jędrzejewska A. Impact of Arterial Hypertension on the Eye: A Review of the Pathogenesis, Diagnostic Methods, and Treatment of Hypertensive Retinopathy. Med Sci Monit. 2022. 28. e935135. doi: 10.12659/MSM.935135.Dziedziak J., Zaleska-Żmijewska A., Szaflik J.P., Cudnoch-Jędrzejewska A. Impact of Arterial Hypertension on the Eye: A Review of the Pathogenesis, Diagnostic Methods, and Treatment of Hypertensive Retinopathy. Med Sci Monit. 2022. 28. e935135. doi: 10.12659/MSM.935135.Серегина Т.В., Кабанова Е.А., Иойлева Е.Э., Гаврилова Н.А., Хабазова М.Р. Этиология и патогенез застойного диска зрительного нерва. Медицинский вестник Башкортостана. 2020. 15 (4). 113–118.Seregina T.V., Kabanova E.A., Ioyleva E.E., Gavrilova N.A., Khabazova M.R. Etiology and pathogenesis of congestive optic disc. Medical Bulletin of Bashkortostan. 2020. 15 (4). 113–118. in Russian.Lifson N., Pasquale A., Salloum G. Ophthalmic manifestations of posterior reversible encephalopathy syndrome. Neuroophthalmology. 2019. 43. 180–184. doi: 10.1080/01658107.2018.1506938.Lifson N., Pasquale A., Salloum G. Ophthalmic manifestations of posterior reversible encephalopathy syndrome. Neuroophthalmology. 2019. 43. 180–184. doi: 10.1080/01658107.2018.1506938.Ramírez-Montero C., Lima-Gómez V., Anguiano-Robledo L., et al. Preeclampsia as predisposing factor for hypertensive retinopathy: Participation by the RAAS and angiogenic factors. Exp Eye Res. 2020. 193. 107981. doi: 10.1016/j.exer.2020.107981.Ramírez-Montero C., Lima-Gómez V., Anguiano-Robledo L., et al. Preeclampsia as predisposing factor for hypertensive retinopathy: Participation by the RAAS and angiogenic factors. Exp Eye Res. 2020. 193. 107981. doi: 10.1016/j.exer.2020.107981.Jena M.K., Sharma N.R., Petitt M., Maulik D., Nayak N.R. Pathogenesis of Preeclampsia and Therapeutic Approaches Targeting the Placenta. Biomolecules. 2020. 10. 953. doi: 10.3390/biom10060953.Jena M.K., Sharma N.R., Petitt M., Maulik D., Nayak N.R. Pathogenesis of Preeclampsia and Therapeutic Approaches Targeting the Placenta. Biomolecules. 2020. 10. 953. doi: 10.3390/biom10060953.Qu H., Khalil R.A. Vascular mechanisms and molecular targets in hypertensive pregnancy and preeclampsia. Am J Physiol Heart Circ Physiol. 2020. 319 (3). H661-H681. doi: 10.1152/ajpheart.00202.2020.Qu H., Khalil R.A. Vascular mechanisms and molecular targets in hypertensive pregnancy and preeclampsia. Am J Physiol Heart Circ Physiol. 2020. 319 (3). H661-H681. doi: 10.1152/ajpheart.00202.2020.Bueno-Pereira T.O., Bertozzi-Matheus M., Zampieri G.M., et al. Markers of Endothelial Dysfunction Are Attenuated by Resveratrol in Preeclampsia. Antioxidants. 2022. 11. 2111. doi: 10.3390/antiox11112111.Bueno-Pereira T.O., Bertozzi-Matheus M., Zampieri G.M., et al. Markers of Endothelial Dysfunction Are Attenuated by Resveratrol in Preeclampsia. Antioxidants. 2022. 11. 2111. doi: 10.3390/antiox11112111.Cabral T., Mello L.G.M., Lima L.H., et al. Retinal and choroidal angiogenesis: a review of new targets. Int J Retina Vitreous. 2017. 3. 31. doi: 10.1186/s40942-017-0084-9.Cabral T., Mello L.G.M., Lima L.H., et al. Retinal and choroidal angiogenesis: a review of new targets. Int J Retina Vitreous. 2017. 3. 31. doi: 10.1186/s40942-017-0084-9.Matsubara K., Higaki T., Matsubara Y., Nawa A. Nitric oxide and reactive oxygen species in the pathogenesis of preeclampsia. Int J Mol Sci. 2015. 16. 4600-4614. doi 10.3390/ijms16034600.Matsubara K., Higaki T., Matsubara Y., Nawa A. Nitric oxide and reactive oxygen species in the pathogenesis of preeclampsia. Int J Mol Sci. 2015. 16. 4600-4614. doi 10.3390/ijms16034600.Flammer J., Konieczka K. Retinal venous pressure: the role of endothelin. EPMA J. 2015. 6. 21. doi: 10.1186/s13167-015-0043-1.Flammer J., Konieczka K. Retinal venous pressure: the role of endothelin. EPMA J. 2015. 6. 21. doi: 10.1186/s13167-015-0043-1.Caldeira-Dias M., Viana-Mattioli S., de Souza Rangel Machado J., et al. Resveratrol and grape juice: Effects on redox status and nitric oxide production of endothelial cells in in vitro preeclampsia model. Pregnancy Hypertens. 2021. 23. 205–210. doi: 10.1016/j.preghy.2021.01.001.Caldeira-Dias M., Viana-Mattioli S., de Souza Rangel Machado J., et al. Resveratrol and grape juice: Effects on redox status and nitric oxide production of endothelial cells in in vitro preeclampsia model. Pregnancy Hypertens. 2021. 23. 205–210. doi: 10.1016/j.preghy.2021.01.001.Akhter T., Wikström A.K., Larsson M., et al. Association between angiogenic factors and signs of arterial aging in women with pre-eclampsia. Ultrasound Obstet. Gynecol. 2017. 50. 93-99. doi: 10.1002/uog.15981.Akhter T., Wikström A.K., Larsson M., et al. Association between angiogenic factors and signs of arterial aging in women with pre-eclampsia. Ultrasound Obstet. Gynecol. 2017. 50. 93–99. doi: 10.1002/uog.15981.Garzon-Martinez M., Perretta-Tejedor N., Garcia-Ortiz L., et al. Association of Alk1 and Endoglin Polymorphisms with Cardiovascular Damage. Sci Rep. 2020. 10 (1). 93-83. doi: 10.1038/s41598-02066238-9.Garzon-Martinez M., Perretta-Tejedor N., Garcia-Ortiz L., et al. Association of Alk1 and Endoglin Polymorphisms with Cardiovascular Damage. Sci Rep. 2020. 10 (1). 93–83. doi: 10.1038/s41598-02066238-9.Zhang Y., Zhao H.J., Xia X.R., et al. Hypoxia-induced and HIF1α-VEGF-mediated tight junction dysfunction in choriocarcinoma cells: Implications for preeclampsia. Clin Chim Acta. 2019. 489. 203–211. doi 10.1016/j.cca.2017.12.010.Zhang Y., Zhao H.J., Xia X.R., et al. Hypoxia-induced and HIF1α-VEGF-mediated tight junction dysfunction in choriocarcinoma cells: Implications for preeclampsia. Clin Chim Acta. 2019. 489. 203–211. doi 10.1016/j.cca.2017.12.010.Sriyanti R., Mose J.C., Masrul M., Suharti N. The difference in Maternal serum hypoxia-inducible factors1α levels between early onset and late-onset preeclampsia. Open Access Maced J Med Sci. 2019. 7 (13). 2133-2137. doi: 10.3889/oamjms.2019.601.Sriyanti R., Mose J.C., Masrul M., Suharti N. The difference in Maternal serum hypoxia-inducible factors1α levels between early onset and late-onset preeclampsia. Open Access Maced J Med Sci. 2019. 7 (13). 2133-2137. doi: 10.3889/oamjms.2019.601.Казанцева В.Д., Айларова И.М., Мельников А.П. Маркеры преэклампсии. Российский вестник акушера-гинеколога. 2022. 22 (4). 31–38.Kazantseva V.D., Aylarova I.M., Melnikov A.P. Markers of preeclampsia. Russian bulletin of the obstetrician-gynecologist. 2022. 22(4). 31-38. in Russian.He X., Cheng R., Benyajati S., Ma J.X. PEDF and its roles in physiological and pathological conditions: implication in diabetic and hypoxia-induced angiogenic diseases. Clin Sci. 2015. 128. 805-823. doi: 10.1042/CS20130463.He X., Cheng R., Benyajati S., Ma J.X. PEDF and its roles in physiological and pathological conditions: implication in diabetic and hypoxia-induced angiogenic diseases. Clin Sci. 2015. 128. 805–823. doi: 10.1042/CS20130463.Benlghazi A., Bouhtouri Y., Belouad M., et al. Bilateral serous retinal detachment in pre-eclampsia a rare but favorable complication: case report. Oxf Med Case Reports. 2023. 23. 2023 (10). omad109. doi: 10.1093/omcr/omad109.Benlghazi A., Bouhtouri Y., Belouad M., et al. Bilateral serous retinal detachment in pre-eclampsia a rare but favorable complication: case report. Oxf Med Case Reports. 2023. 23. 2023 (10). omad109. doi: 10.1093/omcr/omad109.Зиганшина М.М., Шилова Н.В., Хасбиуллина Н.Р., и др. Аутоантитела к антигенам эндотелия при преэклампсии. Акушерство и гинекология. 2016. 3. 24-31. doi:10.18565/aig.2016.3.24-31.Ziganshina M.M., Shilova N.V., Khabibullina N.R., et al. Autoantibodies to endothelial antigens in preeclampsia. Obstetrics and gynecology. 2016. 3. 24-31. doi:10.18565/aig.2016.3.24–31. in Russian.Han C., Huang P., Lyu M., Dong J. Oxidative Stress and Preeclampsia-Associated Prothrombotic State. Antioxidants. 2020. 9. 1139. doi: 10.3390/antiox9111139.Han C., Huang P., Lyu M., Dong J. Oxidative Stress and Preeclampsia-Associated Prothrombotic State. Antioxidants. 2020. 9. 1139. doi: 10.3390/antiox9111139.Tong N., Zhang Z., Zhang W., et al. Diosmin alleviates retinal edema by protecting the blood-retinal barrier and reducing retinal vascular permeability during ischemia/reperfusion injury. PLoS One. 2013. 8 (4). e61794. doi: 10.1371/journal.pone.0061794.Tong N., Zhang Z., Zhang W., et al. Diosmin alleviates retinal edema by protecting the blood-retinal barrier and reducing retinal vascular permeability during ischemia/reperfusion injury. PLoS One. 2013. 8 (4). e61794. doi: 10.1371/journal.pone.0061794.

The authors declare that there are no conflicts of interest present.