The role of elevated intraocular pressure (IOP) in the progression of glaucoma optical neuropathy has emphasized repeatedly. The question about the role of elevated IOP as the underlying cause of glaucoma arose in the early 1960s. However, epidemiological studies have questioned the role of IOP as a diagnostic criterion for glaucoma, due to the relatively rare detection the disease among those with ocular hypertension and frequent detection of glaucoma with normal IOP. Multicenter studies determining the role of antihypertensive therapy in the treatment of glaucoma, have shown the importance of reducing IOP: decricing IOP at 1 mm Hg reduced the risk of developing glaucoma on 10-19%. In addition, it was found that the rate of glaucoma progression is very variable. It depends not only on the form of glaucoma, but also on other factors such as the stage of disease and therapy. Swedish study shown normal-tension glaucoma often progressed among the patients with more aggressive treatment such as argon laser trabeculoplasty or trabeculectomies. According to the study’s data, age is the most important risk factor for the progression of normal-tension glaucoma. Such questions as fluctuations in IOP, reduction of retrobulbar blood flow, antihypertensive treatment on the progression of glaucoma are still discussed. Despite the fact that the latter UKGTS multicenter study (2014) showed a decrease in the rate of progression of glaucoma in patients treated with latanoprost, a high percentage of non-treated patients didn’t have disease’s progression. In this regard, the role of IOP as main starting factor in glaucoma pathogenesis is still open.

To develop a device with broad functionality for treatment amblyopia. methods. Analysis of functionality and technical characteristics of devices for amblyopia treatment and the development of multifunctional apparatus. results. The full-color light transmitters (i.e., LEDs) are used in device. It provides the radiation withfull color spectrum. There are several directions of movement of stimuli which are presented on the display: horizontally from left to right or from right to left, vertically bottom-up or top-down, multidirectionally from the center of the display to the periphery or from the periphery of the display to the center, in a circumferential or helical pattern clockwise or counterclockwise. The period of motion of the stimuli varies from 0.25 to 4 seconds in increments of 0.25 seconds. Pulse modulation is 0-20 Hz. Light intensity is 0.1-3.0 cd. The duration of one treatment session is 1-7 min. The characteristic property of the device is multiprogram operating, i.e., several modes are switched consistently in the course of one session. Operating modes are customized for each patient. Computer control provides reprogramming of the device when assigning new tasks. Light-emitting display can be placed in the cone or be made as external component (rectangular-, quadratic-, or round-shaped). Conclusions. Stimulation of visual analyzer is performed with full-color light stimuli which move in various directions or rotate. Adjustment of modulation frequency and movement rate of the stimuli allows to change stimulation mode temporally and spatially. The device can be used in clinical and domestic settings to treat amblyopia, myopia and computer vision syndrome as well as to prevent eye fatigue.

Puspose: to develop a method for the prevention of scarring of filter pads in patients with glaucoma using Ahmed Glaucoma Valve. patients and methods: We developed modification of the techniques Ahmed drainage implantation using a PTFE membrane. We covered Ahmed drainage with PTFE membrane and implanted it according to standard method, recommended by manufacturer. There were 149 patients with the different forms of refractive glaucoma in the study (93 (59%) — men, 64 (41%) — women. Average age was 64 years (from 22 to 88 years old). Patients were divided in two groups. 54 patents (59 eyes) were in the first group, 95 (98 eyes) in the second. Ahmed drainage with PTFE membrane was implanted according to proposed method in the first group; traditional method was used in the control group. Results and discussion: visual acuity was higher and intraocular pressure was lower during all follow-up period in patients received modificated surgical treatment. 3 patients (5%) from the main group and 11 (11%) from the control group were operated repeatedly. Conclusion: Offered method of Ahmed drainage’s implantation using a PTFE membrane is more effective than standard method and reduces complications associated with excessive scarring of the filter pads, that requires the repeated of the surgical treatment. The results of the study allow to recommend this method for ophthalmological practice.

Aim. To improve the treatment of early infectious corneal ulcers by combining microdiathermocoagulation (MDC), external autocytokinotherapy, and antiviral and/or antibacterial therapy. patients and methods. The study enrolled 2 groups of outpatients (a total of 112 patients, 112 eyes) who either showed no improvement or deteriorated under 7-day to 1.5-month therapeutic treatment. Group I included 70 patients (70 eyes) with superficial corneal ulcers due to herpes virus infection under antiviral therapy (instillations and periocular injections of Poludan (PolyA:PoliU) as well as Zovirax 3% ophthalmic ointment), group II — 42 patients (42 eyes) with early-stage purulent corneal ulcers under instillations of modern antibiotics (current-generation fluoroquinolones). results and discussion. The combination of MDC and external autocytokinotherapy is the most effective treatment for torpid herpetic ulcerative keratitis that allows a reliable reduction in the recovery period: from 24.1±2.2 days (therapeutic treatment only) down to 9.2±1.3 days (both methods plus antiviral therapy). Moreover, MDC is the treatment of choice in outpatients with purulent corneal ulcer in its early stage. The healing period in this case can be also reliably reduced (р<0.05) from 18.6±1.9 days (MDC plus antibacterial therapy). Hence, MDC is a highly effective urgent method of treatment available to ambulatory care patients with herpetic keratitis and early-stage purulent corneal ulcers. External autocytokinotherapy shows a pronounced anti-inflammatory and regenerative effect. When applied together, MDC and external autocytokinotherapy act synergistically and provide twice as short treatment periods. MDC as well as its combination with external autocytokinotherapy, if started early, allow to avoid keratoplasty in most patients with herpetic keratitis and early-stage purulent corneal ulcers.

Age-related macular degeneration (AMD) is a chronic, progressive, degenerative eye disease affecting the central retina. It is the leading cause of blindness among individuals of 65 years and older. In the early stage patients have drusen and/or alterations of pigmentation in the macular region. This disease can progress to geographic atrophy and/or choroidal neovascularization. It has been shown that oxidative stress and hypoxia are important in the pathogenesis of AMD. Patients may gain some visual improvement with inhibitors of vascular endothelial growth factor, but complete restoration of visual function is achieved only in small cases. No effective therapies are known for atrophic AMD. Many large observational studies have shown that dietary antioxidant supplementation is beneficial in preventing the progression of AMD from early to late stages. The Age-Related Eye Disease Study (AREDS) demonstrated that daily oral supplementation with vitamins C (500 mg) and E (400 IU), beta carotene (15 mg), zinc (80 mg) and copper (2 mg) reduced the risk of progression to advanced AMD by 25% at 5 years. In primary analyses AREDS II failed to show further reduce of this risk by addition of lutein (10 mg) and zeaxanthin (2mg), or/and omega-3 long-chain polyunsaturated fatty acids [docosahexaenoic acid (350 mg DHA) and eicosapentaenoic acid 650 mg (EPA)] to the AREDS formulation. But there was no true placebo group. The simultaneous administration of beta carotene, lutein and zeaxanthin may suppress tissue level of the both laters because of competitive absorption of carotenoids. Subgroup analyses revealed that dietary supplementation with lutein, zeaxanthin and AREDS formulation without beta carotene may reduce the risk of progression to advanced AMD.The LUNA (Lutein nutrition effects measured by autofluorescence) study demonstrated that supplementation with lutein (12 mg), zeaxanthin (1 mg), vitamin C (120 mg), vitamin E (17,6 mg), zinc (10 mg), selenium (40 mg) resulted in a significant augmentation of macular pigment optical density (MPOD). This effect was more prominent in cases with initial low level of MPOD. The CARMA (Carotenoids in Age-Related Maculopathy) Study has shown that lutein (6 mg), zeaxanthin (0,3 mg), vitamin C (75 mg), vitamin E (7,5 mg), zinc (10 mg) and copper (0,2 mg) prevented progression from early to late stages of AMD. Early intervention is more effective in maintaining visual function.

background. Hypoxic keratopathy (HK) is the most common cause of dysregenerative conditions after corneal refractive surgery in case of long-term contact lenses wears. purpose: to study the correlation between the tears osmolarity, OSDI index and in vivo histo-morphological lesions in the corneas in patients with long-term contact lenses use. patients and methods. 3 groups of patients with mild (34 people), moderate (32 people) and severe (29 people) degrees of HK were examined. Control group consisted with 34 healthy volunteers. In all patients we performed the confocal microscopy of the cornea, the tears osmolarity assess and the calculation of the OSDI index. results and discussion. According to the confocal microscopy the intact corneas were visualized in the controls as well as the mean OSDI index was 5.1±0.9 points, and the tears osmolarity was 291,3 of ±9.8 mOsm/l, which corresponded to the norm. In the mild degree of HK the moderate pseudo-keratinization of the corneal epithelium was noted, the OSDI index was 20.8±4.4 points, which corresponded to the initial lesion of the ocular surface, and the tears osmolarity was 308.9±23 (most patients were within the limits of the norm values). In the moderate degree of HK cornea showed the changes in all layers with a prevalence of noninfectious inflammation signs; mean OSDI index was 22.9±7.2 points that was not significantly different from the mild HK, and osmolality greatly exceeded the mild HK (332,3±14,2, p<0.05). Severe HK was characterized by the significant changes in all corneal layers with a prevalence of autoimmune inflammatory and degenerative processes; mean OSDI index was significantly higher than in moderate degree of the HK (62,5±9,7, p<0.001), and the value of the tears osmolarity (364,9±26,7 mOsm/l) corresponds to the moderate or severe dry eye syndrome. Conclusion. The screening methods for the HK evaluation in refractive surgery will provide a rapid assessment of the ocular surface during contact lens wear and by conducting the preventive and corrective measures will reduce the frequency of the postoperative dysregenerative conditions.

Aim was to study the effectiveness of neuromedin in the treatment of patients with primary glaucoma with compensated intraocular pressure (IOP). patients and methods. There were 40 patients (80 eyes): 10 eyes with early stage, 36 — advanced, 33 — advanced and 1 eye with end-stage glaucoma. IOP was offset by drops in the history of the 26 eyes underwent surgical treatment. Neuromedin was administered at 20 mg 2 times a day, 25 days. Efficacy was evaluated by visual status, fluid dynamics and morphometric parameters of the disk. results. Under the influence of neuromedin reduced the number of cattle and increased the number of zones with normal retinal sensitivity in the initial stage of 14.9%. In the advanced stage, the acuity improved to 66.6 per cent, in 33.3% of cases has not changed. In advanced stage, the visual acuity increased to 51.5% and 48.5% had not changed. In advanced stage, the effect is less pronounced: the number of livestock type 1 and 2 declined by 3.0±0.6 to 2.9±0.8% respectively, while the absolute number of livestock has not changed, the number of zones with normal sensitivity increased by 7.4±2,0%. Field of view is increased at all seeing eyes. Decreased true IOP, activation of the outflow chamber moisture. In initial and advanced stages significantly decreased the area of excavation, increased the area of the neuroretinal belt and the thickness of the retinal nerve fibers. In advanced stages it only changes the thickness of the retinal nerve fibers. More pronounced than in traditional therapy, the visual acuity improvement, the expansion of the field of view, the effect on retinal sensitivity and indicators HRT, probably due to a central action of neuromedin and activation of ganglion cells in a state of parabiosis. In recent years, in the literature there have been reports about the possible generality of the pathogenetic mechanisms of primary glaucoma and neurodegenerative diseases due to mitochondrial dysfunction, therefore, the positive dynamics of visual functions on the background of treatment with neuromedin can be explained by the ability of the drug to affect the energy potential of cells, to have a positive impact on cognitive function. Conclusion. Neuromedin has a positive impact on the state of visual functions, hydrodynamics and morphometric parameters of the disk.

Purpose. Morphological and functional evaluation of results of intravitreal injections of ranibizumab in treatment of choroidal neovascularization (CNV) caused by degenerative myopia (DM). patients and methods. The study included 32 patients (32 eyes) aged from 29 to 55 years with the CNV, developed due to the DM. They received 0.5 mg (0.05 ml) ranibizumab according to the standard. Indications for repeat intravitreal injections of ranibizumab were retention of the CNV activity or its recurrence. In addition to the standard ophthalmologic examination all patients were examined with fluorescein angiography (FAG) with photodetection of fundus picture and optical coherence tomography (OCT) of the retina (sizing subretinal neovascular membrane (SNM), evaluation of retinal foveal thickness (FCS). The study was conducted before the introduction of ranibizumab, monthly during the first 6 months after surgery, and then, in the absence of symptoms of CNV activity, every 2-3 months. The total follow-up was 12 months. results. the transition the CNV in inactive form according to FAG was observed in 25 people (78.1%) was observed after 1 month (single injection of ranibizumab). The angiographic signs of CNV activity remained after the first injection in 7 patients (21/9%). They received second intravitreal injection of ranibizumab. After 3 months from the beginning of observation according to FAG and OCT data relapse of activity of myopic CNV occurred in 5 patients (15.6%) after a single injection, and in 2 patients (6.3%) — after a double injection of ranibizumab. After 6 months according to FAG disappearance of pathological leakage of the dye was diagnosed in 87.5% of patients (28 eyes). After 12 months follow-up all 32 patients had remission of the pathological process with no evidence of CNV activity with formation of local subretinal fibrosis with choriocapillaries atrophy. Conclusions. It took from 1 to 3 (average 1.58) injections of ranibizumab to transfer the active phase of the CNV in inactive. Complete inhibition of the growth and activity of myopic CNV was accompanied by positive morphological and functional results, which led to a significant improvement in visual acuity in 2 times at the observation period of 12 months.

Purpose. To comparatively evaluate the antihypertensive efficacy and tolerability of preservative-free Tafluprost 0,0015% and Latanoprost 0,005% with preservative (0.02% BACH) in patients with initial and advanced stages of POAG. patients and methods. 63 patients (83 eyes) with primary open-angle glaucoma, aged from 56 to 75 years. 21 Men, 42 women. Patients were randomized intwo groups. The first group consisted of 32 patients (38 eyes), they received Latanoprost 0,005% (Prolatan®, “Sentiss Pharma”,) 1 drop once daily in the evening. The second group consisted of 31 (45 eyes) of patients treated with Tafluprost 0,0015% (Taflotan® JSC, “Santen”, Finland) 1 drop once daily in the evening. The follow-up period was 3 months. results. All patients had received reliable decrease in the true IOP: on monotherapy with Prolatan® on average by 27.8% (from 22.5±0,14 to 17.6±0,14 mm Hg.St.) in the first month, 26.4% (22,5±0,14 to 17.8±0,14 mm Hg.St) in third. In patients treated with Taflotan, reduction of IOP was approximately on the same level: 29.7 % in a month, 26.8 % in three months. The study of perimetry showed significant improvement of the MD index by 17.4% in the first group and 20% in the second, index, PSD, respectively, 10.7% and 11.9%. Improved parameters as a result of reduction IOP of optic nerve head were in both groups. But a significant decrease in the volume and area of excavation, respectively, 8.4% and 24.4% as well asincreasing the area of the disc rim band by 20.8% were observed only in the first group (instillation Prolatan®). Side effects were registered in 6 patients from the first group and 7 patients from the second group. One patient had several side effects. A mild hyperemia was identified in 3 patients of the first group and 2 from the second group at 4 week, in 5 out of first and 4 from second 8 week. Flushing medium degree was observed in 2 patients of the first group and 3 of the second group at 4 week. Conclusion. Thus, a comparative study has shown that the antihypertensive efficacy of the drug Prolatan comparable with the value of the drug Taflotan. According to optical coherence tomography as a result of treatment significantly decreased the volume, the area of excavation and the increased area of the disc rim of the shoulder in patients of the first group and was not observed in patients of the second group, which may indirectly indicate possible neuroprotective properties of the drug Prolatan. Side effects were registered in both groups, mostly of local character in the form of hyperemia of mild and moderate, increased pigmentation and growth of eyelashes. Patients in both groups noted the complete absence of burning, discomfort, foreign body in the administration of the drugs for a long period of time, with no cases of general disorder.

Objective: to assess the efficacy, safety and tolerability of the new combined medication Allergoferon® beta in patients with moderate-to-severe hay fever (seasonal allergic rhinitis and conjunctivitis) during periods of exacerbation. patients and methods: the object of our study was medication Allergoferon® beta (recombinant human interferon alpha-2b, not less than 5000 IU/ml + betamethasone sodium phosphate, 1.0 mg/ml) in the form of eye and nasal drops. Total of 120 patients aged 18-65 years with hay fever for at least two years were enrolled in the clinical trial, including 76 women and 44 men. All patients had a clinical picture of moderate-to-severe hay fever during periods of exacerbation. Patients were divided into two equal groups. The main group received Allergoferon® beta, the control group was treated with Oftan® Dexamethasone and Nasobek medications. This trial used a randomized, open-label, multicenter, parallel, comparative, controlled study design. results: we found that new combined medication Allergoferon® beta had a significant therapeutic effect in relieving main clinical manifestations of acute hay fever and showed a higher efficacy, than the comparison remedies. By comparing similar symptoms in both groups, we observed that in patients treated with Allergoferon® beta clinical symptoms of acute hay fever were relieved earlier (on the 5th day of treatment), than in the control group (on the 10th day of treatment) and the disease itself proceeded milder. Therapeutic efficacy of Allergoferon® beta was 85,96% (in the control group — 74,73%, p<0.05). During clinical trial we have not observed any adverse effects; general or local toxic and allergic reactions were also not discovered. The medication tolerability was rated as “good” for patients. Conclusion: according to the clinical study results, the medication Allergoferon® beta (eye and nasal drops) is recommended for the state registration and can be used by medical professionals in the treatment of moderate-to-severe hay fever (seasonal allergic rhinitis and conjunctivitis), including periods of exacerbation.

The second part of the article is focused on the issue of prevention and treatment of the most common clinical situations in which applicable therapeutic hygiene: seborrheic blepharitis; Staphylococcal blepharitis; Allergic blepharitis; barley and chalazion; prevention keratoconjunctival xerosis (during the preoperative and postoperative period, while wearing contact lenses, in computer vision syndrome, in remission after acute inflammation of the conjunctiva and cornea). There is an algorithm for the therapeutic care of eyelids and the basic mechanisms of action of this procedure. Until recently, the treatment of dry eye syndrome involves the use tearsubstitude therapy. Ten or fifteen years ago, 2–3 tearsubstitudes were presented at the domestic market. Currently, there are doses of different forms of artificial tears, while there are hundreds of them on the western pharmaceutical market. The rapid development in the search for new forms tearsubstitudes is not accident. This is due to the increasing number of patients suffering from disorders of the tear membrane stability, which achieves, according to different sources, up to 40–60% of the adult population. It should be noted that the primary cause of dry eye syndrome in 85–95% of patients is meibomian gland’s dysfunction, thus applying tearsubstitudes symptomatic therapy is treatment that does not solve the problem on the pathogenic level. For this reason, conducting therapeutic hygiene century (warm compresses + self-massage) is an important component of the treatment of this group of patients. Objective evidence of relevance and effectiveness of therapeutic care age, in our opinion, is the rapid development of the pharmaceutical market in this area. There is a large number of new gels, lotions, wipes and other products for hygiene century every year. Clear algorithms that include therapeutic hygiene century (dates, the indications for the use of certain hygiene products) is an actual problem of modern ophthalmology.

Part 1 — Trubilin VN, Poluninа EG, Kurenkov VV, Kapkova SG, Markova EY, Therapeutic eyelids hygiene in the algorithms of prevention and treatment of ocular surface diseases. Ophthalmology in Russia. 2016;13(2):122–127 doi: 10.18008/1816–5095– 2016–2–122–127

Purpose: to evaluate the tregalose based eye drops effectiveness in patients who underwent PRK or TransPRK surgery. patients and methods: 50 patients with moderate myopia were examined before, 7 days and 1 month after PRK or TransPRK surgery made by SCHWIND Amaris excimer laser by the same surgeon. In addition to conventional diagnostics, Schirmer test and tear break up time were performed as well as ODSI questionare and Oxford index of ocular surface disorders were investigated. Patients were divided in two groups, Study group — “Thealos” group and “Control” group. In both groups patients have started using non preservative eye drops based on tregalosa and hyaluronic acid 4-th day after surgery respectively. results: The tear film breakup time was significantly better in “Thealos” group (7,22±3,61 sec 7 days postop and 9,36±3,68 sec 1 month postop in comparison to «Control” group 5,21±0,25 (р<0,01) sec and 7,21±2,85 sec respectively (р<0,05)) as well as ocular surface index score in “Thealos” group post surgery was less (0,26±0,38 и 0,85±0,31 marks 7 days postop (р<0,05) and 0,09±0,19 and 0,21±0,4 (р<0,05) 1 month postop respectively). There were no other statistically significant differences found in analysed data. Conclusion: Using of “Thealoz” non-preservative eye drops leads to faster recovery after surface excimer laser ablations in terms of dry eye manifestation, those as tearfilm stability and ocular surface index score, measured using “Oxford” scale. Moistening properties of tregaloze solution could be compared with those of hyaluronic acid solution.