Retinal pathology is a common cause of an irreversible decrease of central vision commonly found amongst senior population. Detection of the earliest signs of retinal diseases can be facilitated by viewing retinal images available from the telemedicine networks. To facilitate the process of retinal images, screening software applications based on image recognition technology are currently on the various stages of development.

Purpose: To develop and implement computerized image recognition software that can be used as a decision support technology
for retinal image screening for various types of retinopathies.

Methods: The software application for the retina image recognition has been developed using C++ language. It was tested on dataset of 70 images with various types of pathological features (age related macular degeneration, chorioretinitis, central serous chorioretinopathy and diabetic retinopathy).

Results: It was shown that the system can achieve a sensitivity of 73 % and specificity of 72 %.

Conclusion: Automated detection of macular lesions using proposed software can significantly reduce manual grading workflow. In addition, automated detection of retinal lesions can be implemented as a clinical decision support system for telemedicine screening. It is anticipated that further development of this technology can become a part of diagnostic image analysis system for the electronic health records.

Purpose: To show the basic regulations of the complex retinopathy of prematurity (ROP) treatment with use of retinal pattern scanning laser coagulation and early vitrectomy.

Methods: Pascal pattern scanning lasercoagulation is performed for stage 2 ROP type 2, stage 3 ROP type 2 and subclinical stage
and early clinical stage of aggressive posterior ROP (S. N. Fyodorov Federal State Institution «IRTC «Eye Microsurgery» Kaluga Branch
classification). Early 3‑ports 25G vitrectomy is performed if ROP progressing 2‑4 weeks after the laser treatment.

Results: In 2003‑2011 823 different interventions for infants with active ROP was performed: 737 retinal lasercoagulations, 3‑ports vitrectomy — 72, 3‑ports lensvitrectomy — 14. Treatment efficacy was 98.6 % for stage 2 and stage 3 ROP (regress of the disease occurred in 557 of 565 eyes), and 74.4 % for aggressive posterior ROP (regress of the disease occurred in 128 of 172 eyes). The total efficacy of the complex treatment was 92.9 % (regress of the disease occurred in 685 of 737 eyes).

Conclusion: The basic regulations of the complex ROP treatment are early, within first 6 weeks of chronologic age, photocoagulation
to delay progression of the retinal detachment and to stabilize vascularity, and early vitrectomy if ROP progressing after the laser
treatment.

Purpose: To research of frequency and structure of the complicated myopia among patients with myopia refraction.

Methods: The myopia share was studied among all patients who have addressed in clinic in 2011. Profound survey of all cases of the complicated myopia was conducted, its structure and frequency of separate stages was analyzed.

Results: In total in 2011, 1516 patients with myopia refraction (3028 eyes) addressed in clinic — 16 % of all patients. Signs of myopia
changes of eyeground were noted in 2225 eyes (73.4 %). Age: from 18 to 82 years (men — 463, women — 660). The I stage took place in 57.1 % of the cases, II and the III stages — in 7.2 % and 11 % of cases respectively. The IV stage is noted in 4.1 % of eyes, the V stage — in 3.3 % of eyes. Morphological implications of the expressed visual acuity decrease were extensive myopia staphylomas, macular neovascularization and its outcomes.

Conclusion: Frequency of myopia made 16 % among all patients. 73.4 % of them had signs of various clinical implications of the complicated myopia, including 7.4 % with grave changes of an eyeground (the IV‑V stage).

Purpose: To investigate the frequency and structure of a subepithelial fibroplasia of a cornea after photorefractive keratectomy concerning myopia correction.
Methods: 170 patients (337 eyes) with the following refraction anomalies: stationary myopia from 1.5 to 13.0 D with astigmatism from 0.75 to 4.25 D. Frequency of survey in the postoperative period — in 1, 3, 6, 12 months. To all patients Dexamethasone instillation according to the decreasing scheme was carried out. Existence of biomicroscopic signs of any degrees of subepithelial fibroplasias of a cornea, existence and extent of loss of uncorrected visual acuity in comparison with initial, regress of refractive effect of operation were taped. Subjective estimation of quality of vision was made by patients in 1 year after operations.

Results: Subepithelial fibroplasias with intensity 1.0‑2.5 points stopped in whole or in part after additional treatment, were surveyed as clinically significant and made 4,75 % (16 eyes, 9 patients). Terms of their emergence: from 1 to 10 months after operation. At 3 patients (6 eyes) intensity of fibroplasias made 2.0‑2.5 points before treatment and 1.0‑2.5 points after it. To the observation extremity 7 patients from this group had visual complaints, a discomfort in an eye. Indicators of Subjective estimation of quality of vision in patients with clinically significant fibroplasias of a cornea varied from 5 to 2.9 points.

Conclusion: Frequency of clinically significant fibroplasias after photorefractive keratectomy made 4.75 %. After treatment their
intensity made 1.5‑2.5 points only in 4 eyes (2 patients).

Purpose: To study complications at carrying out posterior capsulorhexis during phacoemulsification, clinical and ultrastructural features of a posterior len’s capsule.

Methods: 82 patients (82 eyes) with an age cataract underwent phacoemulsification, IOL implantation and posterior capsulorhexis
in the Ufa Scientific Research Institute of Eye Diseases. The technique of operation was traditional. The research of a capsular bag by electron microscopy was carried out on 8 cadaver eyes of the person of different ages (range 24 to 83 years).

Results: The operational and postoperative complications, the received functional results in supervision terms till 3.5 years are described. Development of a secondary cataract and retina detachment was not registered. Laser interventions on a len’s bag was not required. High visual acuity was received. Researches of cadaver eyes of the person of different ages by electron microscopy revealed thinning and destruction of a len’s capsule at persons at senile age (after 75 years).

Conclusion: Stable visual functions in the remote period allows to recommend posterior capsulorhexis during phacoemulsification. The fibrosis of posterior len’s capsule should be a compulsory procedure of phacoemulsification.

Purpose: To study the influence of venous blood flow on the ganglion cell complex (GCC) in patients with preperimetric and perimetric open angle glaucoma.

Methods: 74 patients were included in the research. 59 eyes and 62 eyes were diagnosed with preperimetric and perimetric open angle glaucoma respectively. The mean age was 56.5±10.5 years. 22 (12 female and 10 male) healthy individuals constituted the control group. The ganglion cell complex and retinal nerve fibre layer were evaluated with the help of optical coherence tomography (RTVue-100 OCT, Optovue, Inc., Fremont, CA). Ocular blood flow was measured by Color Doppler Imaging (multifunctional VOLUSON 730 ProSystem). The statistical analysis included correlation between GCC and RNFL thickness in both glaucoma groups.

Results: The results showed a statistically significant reduction of venous blood flow velocity in both glaucoma groups compared to the control group. No difference in venous blood flow parameters between two glaucoma groups was found, except resistance index, which was higher in perimetric group in comparison to preperimetric group. A correlation was also obtained between venous blood flow parameters and GCC and RNFL thickness in both glaucoma groups.

Conclusion: Early GCC damage in glaucoma might occur due to venous blood flow reduction. This fact may be of great value in understanding glaucoma pathogenesis and search for novel treatment options.

Purpose: To study the optic nerve vascular hemodynamics in patients with anterior ischemic optic neuropathy (AION) before and after application of the Alloplant biomaterial.

Methods: The ultrasound diagnostic system General Electric Ultrasound Logic 7 (U. S.) was used to study hemodynamics. The study was initially conducted before the intervention and after the insertion of the Alloplant biomaterial in subtenon space in a retrobulbar way in the period from 3 to 6 months. The qualitative and quantitative parameters were determined: peak systolic flow velocity (Vmax), final diastolic velocity (Vmin), the index of peripheral resistance to blood flow (resistance index — RI), pulsation index (PI). According to cluster analysis there were four typological groups of cases, characterized by originality of RI changes in all six vessels in general.

Results: The diagrams show that significant intergroup differences in postoperative RI changes occurred in the medial and lateral branches of short posterior ciliary artery. The most apparent RI decrease in these two arteries in the first typological group: in short posterior ciliary artery medial branch (–0.542±0.080) and in lateral branch reducing RI (–0.415±0.185). However, a comparable (–0.323±0.099) and not significantly different (p>0.09) level of RI reduction occurred in the second typological group. In the fourth typological group (20 cases), the maximum RI drop in medial branch of short posterior ciliary artery was –0.228±0.071.

Conclusion: The results of this study suggest that the use of the Alloplant biomaterial in treating patients with AION consequences
improves blood flow in vessels of the optic nerve (in the central retinal artery and more in short posterior ciliary artery with its branches) and can be recommended as a fairly effective AION treatment.

Purpose: To compare the effect of selective laser trabeculoplasty (SLT) in phacic and pseudophacic patients with glaucoma.

Methods: A retrospective chart review was performed on 148 eyes of 139 patients with moderate primary open angle glaucoma (POAG). In the first group (pseudophacic group) 50 patients (50 eyes) underwent SLT at the period of 6 months and more after uneventful phacoemulsification cataract surgery, in the second (phacic group: 9 patients, 98 eyes) — 2‑3 months prior it. The post-laser follow up examinations were carried out at 1 day, 1 week, 1 month, 6 months and 12 months of follow-up. Average intraocular pressure (IOP), its decrease, and MD — mean deviation perimetric index — for phakic and pseudophakic eyes were compared statistically at each time period. A t-test was used to compare the IOP reduction between the phakic and pseudophakic groups.

Results: IOP reduction in the pseudophakic group was statistically significant in the 1 month of follow up (from 28.3 mm Hg to 18.6
mm Hg, p = 0.02), while in the phacic group its reduction was statistically significant in all steps of observation. The statistically significant
difference of IOP decrease level between groups was obtained in 1 week and 1 year after SLT. The MD perimetric index decreased by 3.89 dB (from –7.63 to –11.52) in the pseudophakic group and increased by 0.65 dB (from –4.31 to –3.66) in the phakic group.

Conclusion: SLT is a safe and effective means of IOP reduction in pseudophakic glaucoma patients. However it seems to be more effective in lowering IOP if performed prior to cataract surgery: effect of SLT in pseudophakic eyes reduced through 6 months. SLT performed on phakic eyes might play a role in visual field improvement.

Purpose: To identify predictors of NHL of the vision associated with treatment choice for prognosis of primary non-Hodgkin’s lymphoma eye and adnexa.

Methods: A retrospective and prospective study characteristics of the disease in 94 patients with primary lymphoma of the vision. Orbital lymphoma diagnosed in 35 patients (36 %), conjunctival — in 48 patients (52 %), the least damage observed age — 11 patients (12 %). Among the various types of malignant lymphomas morphologic immunological dominated B-cell lymphoma or marginal zone MALT-lymphoma, which were diagnosed in 70 (75 %). Patients were treated with radiation, chemotherapy and combined chemoradiotherapy.

Results: During the follow-up period of 1 year to 26 years (median follow-up 5 years) of the 94 patients the primary lymphoma of the vision in 22 cases (23 %) relapses occurred in a period of 6 months to 10 years (median 2 years). In analyzing the data we found that the 5‑year disease-free survival with radiation therapy, chemotherapy, and combination therapy is the same and is equal to — 70 %.

Conclusion: The treatment and monitoring of patients with primary non-Hodgkin’s lymphoma eye and adnexa should be implemented jointly ophthalmologist and oncology. The choice of treatment, with adequate treatment is prescribed, can not be associated with the weather and can not be a predictor of the primary non-Hodgkin’s lymphoma eye and adnexa.

Purpose: Developing a method to improve the accuracy of the measuring of critical flicker frequency (CFF).

Methods: When measuring CFF the light pulses with LEDs yellow 5 mm in diameter with a force of light 3 mcd placed in an area near point of clear vision. Formation of light pulses and measuring CFF was performed using PC Pentium III by the method of successive approximation. Measured CFF value was noted on the plane in the coordinates «CFF value — the number of measurement», a graph of CFF values was drawn as a function F = f (Ni), where Ni — number of i-th measurement, i = 1, 2,…, k, k — number of measurements to obtain a quasi-stationary mode when the transition process is completed. In the quasi-stationary mode we were performed a specified number of measurements and then calculated the CFF estimate as the mean value of test results obtained in the quasi-stationary mode.

Results: Reducing the random component of the CFF measurement error of study group of 10 pre-trained subjects was received in 8 of them and varies from 31.3 to 78.6 %.

Conclusion: Analyzing the dynamics of CFF values obtained during its measurement and performing a statistical analysis of the measurements obtained in the quasi-stationary mode, we can improve the accuracy of CFF estimate.

Purpose: To evaluate of retinal morphology and function progress in patients with diabetes type 2 and DME consistent with the level of pathogenetic factor in tear fluid.

Methods: The progress of visual acuity, retinal thickness and photosensitivity after ranibizumab intravitreal injection has been assessed.

Results: Statistically significant increase in visual acuity, retinal photosensitivity, decrease of retinal thickness and VEGF A level was found in the tear fluid after injection. The correlation of VEGF level in tear fluid with visual acuity after procedure was found to be negative. 

Conclusion: Ranibizumab intravitreal injection is a pathogenic treatment leading to morphological and functional retinal state improvement.

Purpose: To study the efficiency of tear substitutes based on hyaluronic acid at the patients after phacoemulsification for prophylaxis and postoperative therapy of dry eye syndrome.

Methods: 168 patients (168 eyes) were examined before cataract surgery. The average age was 69.2±5.7 years old. Patients were divided into four groups according to the presence of eye dry syndrome and following tear substitutive therapy. 55 patients with a mild case of DES (the first group) were treated with Vismed® eye drops 1 drop given 3 times a day for 1 week before surgery and postoperatively. 10 patients with a moderate case of DES (second group) were treated with Vismed gel® to use with the same periodicity. Patients without DES were divided into two groups: 50 of them (third group) were treated to use Vismed® 1 drop 3 times a day postoperatively, the rest 53 didn’t undergo the course of treatment — «checkout group». The observation period was 45 days after operation. The study of tear secretion and osmolarity of tear fluid was performed before and after operative period.

Results: 65 patients were first diagnosed a mild or moderate case of DES. On the third day after operation every group showed the increase of tear osmolarity, it was especially noticable among the patients of «checkout group» from 294 to 314 mOsm / l at the average. On the seventh day after operation all groups showed further negative dynamics, and in the «checkout» group comparing to initial indices was registered noticable worsening of the studied parameters (р≤0.05). By the 14th day after phacoemulsification patients from the 1st and the 3rd groups displayed the tendency to restoration of indices to the preoperative values. Indices of osmolarity and tear secretion restored among the patients from the 1st and the 2nd groups by the 21st day and even improved in comparison to the preoperative values of group 3. Meanwhile, «checkout» group’s indices fell to a level even lower than before the operation. By the end of the experiment (45th day after operation) decrease of osmolarity and increase of functional tests was registered among all the groups, however, the results were more evident among the groups who underwent tear substitutive treatment.

Conclusion: Performed experiment confirmed that tear substitutive therapy conducted in the postoperatively speeds up recovery and restores indices of tear secretion and osmolarity.

Purpose: To compare tear substitutive properties of Systane® Ultra and Visine® Clear Tears in dry eye therapy.

Methods: 20 patients with dry eye due to chronic blepharoconjunctivitis and 20 patients with neurotrophic dry eye following corneal refractive surgery were examined. Treatment schedule was the following: in the first 7 days, Systane® Ultra was instilled in the right eye and Visine® Clear Tears was instilled in the left eye, while from day 8 to day 30, only one medicine selected by the patient was applied. Their efficacy was measured by tear film stability and patients’ subjective sensations.

Results: Norn test results improved to day 7 in patients with dry eye following corneal refractive surgery and to day 30 in patients with dry eye due to blepharoconjunctivitis regardless of eye drops used. As to patients’ comfort, Systane® Ultra is preferable to Visine® Clear Tears.

Conclusion: Systane® Ultra is therapeutically similar to but preferable to Visine® Clear Tears due to good tolerability.

The actual problem of the modern ophthalmology is prevention of postoperative infectious complications. The efficacy of the drug Okomistin ® was studied in 500 patients after cataract surgery. A scheme for the use of the Okomistin in pre- and postoperative period is proposed. The results of the study showed that Okomistin was effective in the prevention of postoperative infection, including patients with local or systemic allergic reaction in their past history.

To evaluate the efficiency of Molteno 3 transciliary drainage in the case of diabetic secondary glaucoma. The patient with diabetic secondary glaucoma after vitrectomy and phacik eye. Was made transciliary implantation Molteno 3 drainage with delayed technic. At first day after surgery OD 17‑18 mm Hg of IOP, visual acuity improved to 0.02. Observed a sharp decrease in the caliber of neovascular iris vessels. After 2.5 years follow-up period IOP was 20 Hg of IOP. Specific lens opacities were not observed. Preliminary results of Molteno 3 transciliary drainage show long-term efficiency of this method. Further study of this technique need it to determine the
indications and contraindications for this technique.

Anticoagulant therapy is often used to treat various conditions. This often can deviate in the hemostatic system in the direction of hypocoagulation and increase risk of hemostatic complications. The article describes suprachoroidal hemorrhage in the eye of a patient with AMD who received anticoagulants.

The clinical case of a toxocariasis chorioretinitis which is of interest for ophthalmologists is described. Insufficient knowledge of clinic and diagnostics of a lesion of eyes by Toxocara canis, their infrequent occurrence, similarity of the ophthalmologic picture with inflammatory diseases and eye neoplasms can be at the bottom of gross diagnostic mistake and wrong choice of treatment tactics.