В обзоре литературы представлен анализ зарубежных эпидемиологических исследований, касающихся изучения распространенности различных типов глаукомы в зависимости от расовой и этнической принадлежности.

Purpose: To analyze the efficacy of novel technique of primary open-angle glaucoma (POAG) and complicated cataract surgery that combines phacoemulsification and modified stainless steel Glaucoma Filtration Device implantation.

Methods: 34 patients (38 eyes) with POAG and complicated cataract were included in the study. Phacoemulsification with Glaucoma Filtration Device implantation using improved technique (i.e., with additional collagen glaucoma drainage implantation and posterior scleral implantation) was performed.

Results: Following phacoemulsification with Glaucoma Filtration Device implantation using modified technique, IOP was decreased by 43 % in a month and remains stable in a year while visual acuity improved almost 5 times in a year.

Conclusion: Phacoemulsification with Glaucoma Filtration Device implantation using modified technique provides adequate IOP reduction and highest possible functional results in early and late post-op period.

The technology of the cultivation of mesenchymal stem cells with magnetic particles for the subretinal injection was developed in this work. The estimation of the effect of magnetic particles on the proliferation and functional activity of mesenchymal stem cells has been done. We studied the induction of apoptosis and viability of stem cells with magnetic particles. The efficiency of the labeling of MSCs by magnetic particles for this technology is about 90 %, the viability of stem cells is about 95 %.

Methods: Following a standard ophthalmologic examination of 50 patients, among which are the two groups are similar in age and
sex. The main group (n = 37) with Cd 2, DR and DR I and II hypertension II, III stage, the average age was 62,2±1,2 years, antihypertensive therapy — an ACE inhibitor Prestarium (5 mg). Patients of the group were divided into two subgroups: the first subgroup (n = 19)
who underwent parabulbarnom Mildronate (10 injections), the second subgroup (n = 18), which the drug was administered intranasally Semaks (20 days). The control group (n = 13) healthy (n = 6), and patients with type 2 diabetes without DR and GB (n = 7). Quantitative determination of the stable NO metabolites was determined in biochemical method samples of serum and lacrimal fluid.

Results: After completing a course of therapy for patients of the first subgroup marked decrease in retinal thickness (p ≤ 0,05) in f.centralis, temporal lobe, the upper and lower bands parafovea and temporal area perifovea, while in the second group — in 9 areas of the macular area (p ≤ 0.05). It is also noted a significant increase in sensitivity to light in the macular area in patients of both subgroups (MAIA). On the background of the treatment observed reduction of NOx in the lacrimal fluid and serum of patients in both clinical groups. Thus, reduction of NOx in the lacrimal fluid was statistically significant in the subgroup of patients receiving anti-ischemic therapy semaks (p <0,05). In both clinical subgroups after treatment revealed correlation between systolic blood pressure and the level of NOx in the serum (r = 0,4; p <0,05).

Conclusion: The positive effect (p <0,05) antioxidant (Mildronat) and ischemic (Semaks) therapy on clinical and functional and morphological parameters of the retina in patients with retinopathy in type 2 diabetes in combination with GB. NOx reduction in the tear fluid and serum was associated with decreased severity of clinical symptoms DR I and II, the resulting vascular endothelial dysfunction. This allows us to consider this as an effective therapeutic intervention aimed at preventing the onset and progression of retinopathy in the combined course of type 2 diabetes and hypertension.

Purpose: To explore the role of thyroid hormone’ receptors in the development of the autoimmune process in orbita.

Methods: The intraoperative biopsy material of the lacrimal gland obtained from orbital decompression in patients with autoimmune orbitopathy (AOP) was studied and compared with biopsy material of normal lacrimal gland.

Results: The expression of isoforms of thyroid hormone’ receptors in various cellular elements of the lacrimal gland is improved in normal, as well as change their expression when the AOP. This process is associated with change of structure of the lacrimal gland and organ infiltration cells.

Conclusion: The findings support the assumption that the lacrimal gland is the target organ, along with orbital and muscles for autoimmune aggression in the AOP.

Purpose: To investigate the influence of carbohydrate metabolism on the structure and mechanical properties of the lens capsule and nucleus.

Methods: Human lens pathology was studied in different forms of cataract. 220 patients with a cataract (220 eyes) were included in this study. Morphological, immunohystological and immunocytochemical investigations of lens substance (antibodies to a- (a-А and a-В), b-, g- crystallines), spectroscopic analyses of smears and morphometric analyses of slices, investigation of lens morphology and mechanical caracteristics of lens capsule and lens nucleus were performed.

Results: The capsule of the lens in patients with senile cataract contains more Na+, Cl-. The capsule of the lens in patients with senile cataract contains more Ca2+, O. Mechanical strength of the capsule in the case of diabetes mellitus was lower comparatively with senile cataract in the same age groups. More significant expression of a-В and b-crystallines was found in patients with diabetes mellitus comparatively with patients with age-related cataract. Morphological features were founded in patients with cortical and nuclear forms of senile cataract and the diabetic cataract.

Conclusion: During surgery (ultrasonic microcoaxial phacoemulsification) the equivalent of ultrasound was recorded. Lower density of the lens nucleus of patients with diabetes mellitus made it possible to use lower energy parameters. Using the torsion ultrasound in those cases allowed us to decrease the influence of ultrasound on eye tissues and reduce the time of achieving the maximum BCVA in the postsurgical period.

Purpose: To define diagnostic morphometric parameters for temporal and nasal arcades in fundus central zone, 2nd order vessels and peripheral vessels beyond avascular retina for each type of ROP active stages.

Methods: 155 premature children (310 eyes) with I, II, III stages of ROP. The patients were divided according to types of ROP active stages (type 1 — with low risk of ROP progressing, type 2 — with high risk of ROP progressing). Morphometric analysis of digital «RetCam 120» and «RetCam 3» fundus photos was made by means of original soft «ROP-MORPHOMETRY».

Results: Renal vessels diameter, and tortuosity index increasing at type 2 (unfavorable) as compared with type 1 (favorable) (p<0.05) was determined at all active ROP stages both in central fundus zone and at periphery. A tendency to retinal vessels diameters decreasing as distance from central zone increasing was shown in the direction of temporal and nasal arcades at all active ROP stages.

Conclusion: The given retinal vessels quantitative morphometric parameters might be the precise criteria for high and low risk of ROP progressing determination within each ROP stage.

Purpose: То assess the values of the top five topographic parameters of optic nerve head (ONH) obtained by Heidelberg retina tomograph (HRT) II in volunteers and primary open angle glaucoma (POAG) patients with different stage of perimetric changes.

Methods: 73 eyes (38 volunteers at the age of 56 years ±13, 11 men and 27 women) and 170 eyes (90 patients at the age of 66 years ±12, 33 men and 57 women) were examined. We performed the comprehensive ophthalmic examination, standard automated perimetry and measurement of the top five topographic parameters of ONH — rim area, rim volume, cup shape measure, height variation contour и mean RNFL thickness. For the purpose of this study we used HRT II.

Results: We determine the values of the investigated topographic parameters of the ONH for healthy volunteers (rim area = 1.68±0.22 mm2, rim volume = 0.44±0.07 mm3, cup shape measure = –0.2±0.06, height variation contour = 0.38±0.08 mm and mean RNFL thickness = 0.24±0.03 mm) and for the patients in different perimetric glaucoma stages (early stage: rim area = 1.52±0.47 mm2, rim volume = 0.38±0.17 mm3, cup shape measure = –0.14±0.1, height variation contour = 0.36±0.09 mm and mean RNFL thickness = 0.22±0.11 mm; moderate stage: rim area = 1.21±0.46 mm2, rim volume = 0.27±0.17 mm3, cup shape measure = –0.09±0.1, height variation contour = 0.36±0.17 mm and mean RNFL thickness = 0.16±0.12 mm; severe stage: rim area = 0.97±0.01 mm2, rim volume = 0.18±0.17 mm3, cup shape measure = –0.06±0.1, height variation contour = 0.28±0.11 mm and mean RNFL thickness = 0.17±0.11 mm). Hodapp-Parrish-Anderson (H-P-A) ’s staging system includes three separate levels (early, moderate and severe) of glaucoma according to visual field defects. Each stage is additionally characterized by the values of the top five topographic parameters of the ONH.

Conclusion: Early diagnosis, staging and follow-up of POAG are based on both function and structure assessment. The created value intervals for the top five topographic parameters of the ONH for healthy volunteers and patients in different perimetric stages of glaucoma help and support their right classification. Patients with different level changes require different kind of treatment at different price. In this respect the acquired data is an initial step at the development of POAG staging system based on the topographic parameters of ONH obtained by HRT II.

Purpose: Identification of proliferative diabetic retinopathy complicated by vitreomacular traction syndrome and performance evaluation of 23 gauge (G) pars plana vitrectomy using a spectral optical tomography (OCT).

Material and methods: 18 eyes of 15 patients underwent 23 G pars plana vitrectomy for complications of proliferative diabetic retinopathy in 2009‑2012. Vitreomacular interface examination was performed by OCT with Spectral Cirrus HD (Carl Zeiss Meditec, Germany). Follow-up was 6 months to 3 years.

Results: Mean visual acuity in operated eyes was 1,34±0,30 in LogMAR units, after surgery improved to 0,75±0,34. OCT showed normalization of macular anatomy with reduction of macular thickness.

Conclusion: OCT remains a valuable tool as for anatomical localization of vitreomacular interface pathology, as well for surgical planning and changes after surgery in patients with proliferative diabetic retinopathy complicated by vitreomacular traction syndrome. 23 G vitrectomy allows to obtain satisfactory anatomical and functional results in different types of vitreomacular traction in patients with proliferative diabetic retinopathy.

It was conducted the comparison of the middle duration of coming life associated with disablement owing to the different groups of eye disease in work. The difference between the duration of coming life of country population and the patient’ age were used as the gauge of life duration associated with disablement at the moment of the primary recognition by an invalid. It was determined that the middle duration of coming life associated with disablement changed and shook in the groups from 11,31 to 36,37 years for men and from 17,58 to 42,37 years for women subject to the reason of disablement. It is considered that the middle duration of coming life associated with disablement is integral criterion for an estimation of the medico-social burden of disease. It is differed 3 degrees of heaviness of the medico-social burden. The moderate heaviness of the medico-social burden (the middle duration of coming lif associated with disablement less than 20 years) is characteristic for diabetic retinopathy, glaucoma and uveitis and the high degree of heaviness (the middle duration of coming life associated with disablement more than 30 years) for disease of eyeball, visual nerve, eye traumas, myopia and anophthalmia.

Purpose: to study the change of adaptation mechanisms in children of junior classes during working on close distance depending on their psychoemotional state.

Methods: 52 children of the second classes of grammar school were included into the study. There were allocated 30 emotional labile schoolchildren with choleric temperament. The children were examined by pediatrician, neurologist and in laboratory. Standard ophthalmic examination was performed. Accommodation was examined by subjective (reserve of relative accommodation) and objective (familiar tone of accommodation) methods.

Results: All children had low reserve of relative accommodation (RRA) and high familiar tone of accommodation (FTA) in the end of educational week especially in emotional labile children. After course of treatment (hygiene of visual activity; restoration of accommodation and therapy of visual tiredness; gymnastics for cervical spine; preparations with microelements, vitamins C,E, B-carotene; fenibute) RRA was increased and FTA was decreased even in emotional labile children.

Conclusion: There is correlation between refractive-accommodative apparatus and psychoemotional state in schoolchildren of
junior classes.

Purpose. To reveal microcirculation changes in nasal part of bulbar conjunctiva at various stages of primary pterygium formation using fluorescent angiography.

Methods. 10 eyes (10 patients) with pinguecula, 15 eyes (14 patients) with primary pterygium were investigated. As a control group 10 eyes (10 patients) without pathological changes in nasal part of conjunctiva were investigated. Biomicroscopy and anterior segment fluorescent angiography were performed for all patients.

Results. Severe changes of microcirculation in nasal part of conjunctiva in patients with pinguecula and pterygium were revealed in comparison with a control group. The defect of terminal limbal arcades confirmed by fluorescent angiography can be a sign of transformation of pinguecula into pterygium. Primary pterygium gets blood supply from posterior conjunctival arteries, capillary network of a semilunar fold and also from returnable branches of anterior ciliary arteries. Neovascularization going from a semilunar fold to a body of pterygium is one of possible components in pathogenesis of pterygium.

Conclusion. The obtained data testify about sign of transformation of pinguecula into pterygium, blood supply sources of pterygium and a role of neogenic vessels from a capillary network of a semilunar fold in pathogenesis of this disease.

Purpose: Study the peculiarities of the course of ocular ischemic syndrome on the background of cerebrovascular disease.

Methods: The material for this study was the results of complex examinations of 37 patients (49 eyes) with OIS in combination with CCI. In order to study peculiarities of the course of OIS with CCI, in addition to a comprehensive ophthalmologic examination, used UC DM extracranial and intracranial segments of the great vessels of the brain, oftalmodopplerografy, MRI tractography. Quantitative characteristics of blood flow in the vessels of the eye and the brain were maximal systolic, end diastolic velocity, resistance index, carotid-ophthalmic ratio.

Results: Analysis of the results of the study revealed a change in visual function in all patients to varying degrees, depending on the ratio of the
degree of destruction of MCA and ACA, OphAr, CRA and PSCA and maturities to experts. The data obtained Doppler examination of extracranial and intracranial segments of the great vessels and MR tractography correlated with changes oftalmodopplerografy, breach of visual acuity, and defects in the VF.

Conclusion: Pathological changes of the extracranial and intracranial segments of arteries have a negative impact not only on the parameters
of cerebral vascular circulation, but also exacerbate the violation of the parameters of blood circulation vessels of the eye, leading to the progression of OIS. Important in the development CCI and progression of OIS holds the consistency of collateral circulation. So, good consistency of collateral hemodynamics eliminates ischemia of brain and eyes tissue, and suffer less visual function.

Purpose: Evaluate the diagnostic value of specific methods of investigation for the early diagnosis of patients with optic neuritis (ON).

Methods: 75 patients with ON were included into the study. Everyone were examined using static perimetry, optical coherence tomography of the optic nerve and thickness of peripapillary nerve fiber layer, visual evoked potentials to flash and pattern types.

Results. In the early stage of defining the method was static perimetry (sensitivity 94 %), followed in descending order VEP and OCT (sensitivity 87 % and 84 %) and MRI of the brain and orbits (sensitivity 82 %).

Conclusion: VEP, static perimetry, MRI of the brain and orbits, as well as OCT allow establishing inflammation of the optic nerve at the early stages of the disease. Complex application of these methods revealed ON to 97 % of cases.

Purpose: To evaluate the effectiveness of complex treatment included the eyelid hygiene in non-infectious chronic blepharitis patients.

Methods: 50 non-infectious chronic blepharitis, meibomian gland dysfunction and dry eye patients (18‑46 years) were examined before and after the treatment (eyelid hygiene using Blepharoshampoo, Blepharolotion or Blepharosalfetka, Blepharogel-1; anti-inflammatory therapy; artificial tears). Traditional ophthalmological examination, consideration of subjective discomfort level, evaluation of meibomian gland function (compression test) and severity of eyelid epitheliopaty (lyssamine green staining), lipid-interferential test, Schirmer’s test, tear film break up time, optical coherent meniscometry, computer evaluation of xerosis indicator (lyssamine green staining) and ocular surface microbiological examination were performed in all the patients.

Results: Positive therapeutic effect was noted in all of the observed. It included the following significant changes: reducing the level of subjective discomfort; decreasing of sins of eyelid inflammation; increasing of meibomian gland function; improvement of tear film and ocular surface tissues.

Conclusion: Complex treatment, including eyelid hygiene (using Blepharoshampoo, Blepharolotion or Blepharosalfetka, Blepharogel-1), antiinflammatory therapy and artificial tears, allows achieving significant reduction of subjective symptoms and both functional and objective signs of the disease in non-infectious chronic blepharitis patients.

Purpose: clinical case of intraocular electrochemical lysis technique at the stage of endoresection for large choroidal melanoma.

Methods: Endoresection with intraoperational intraocular electrochemical lysis (ECL) was performed in one patients (1 eyes) with large choroidal melanoma T3N0M0 (tumor thickness — 10 mm, base diameter — 13,7 x 15,4 mm, juxtapapillary localization). The original method of two platinum electrodes (extrascleral anode and intraocular cathode) combined positioning was used for ECL during endoresection. Removed material was examined morphologically.

Results: The tumor was removed completely. The anatomical retinal reattachment was reached. Morphological examinations testified ECL efficacy for both tumor and tumor cells destruction. Material removed during endoresection corresponded to tumor fragments in pathomorphism. There were different necrosis extensive fields: acellular detritus with tumor parenchyma complete destruction, tumor parenchyma lixiviation; coagulation necrosis with destroyed parenchyma and compacted tumor stroma. An absence of viable tumor cells and tumor fragmentation did not allow to verify histologic tumor structure.

Conclusion: New vitreoretinal technologies and new intraocular methods that destroyed tumor tissue could make the endoresection perspective and reassuring organ-safe treatment mode.