For many years in ophthalmology there is a complex intractable problem associated with inflammation of the vascular membrane of the eye, the so-called uveitis. Experts around the world are trying to understand this heterogeneous pathology of the visual organ, in a short time, which can lead to a sharp decrease in visual acuity, the development of severe complications and further disability. The number of patients with inflammation of the vascular tract is growing rapidly every year, the age is younger. The clinical picture of this pathology has changed slightly. Often began to manifest itself in two radically different directions. It proceeds as a sluggish form or vice versa manifests itself more aggressively with the rapid development of clinical manifestations in a short time. Currently, there is evidence of endogenous causes of uveitis.
The article provides a review of the literature summarizing modern views on the problem of autoimmune uveitis. New factors affecting the etiology, pathogenesis of the disease, some aspects of therapy are considered. In addition, the main experimental models of autoimmune diseases of the vascular tract of the eye are analyzed.

The article presents a review of studies on various aspects of vascular theory of primary open-angle glaucoma (POAG) development and progression. The data of foreign and domestic scientists on the influence of hemodynamic disturbances in the glaucoma pathogenesis, including various levels: Central, regional and microcirculatory. Violations of the universal mechanism of vascular tone regulation, namely endothelial dysfunction are described. Vascular endothelium is a barrier between vascular wall and blood plasma. When the endothelium is damaged, its antithrombotic properties are transformed into a powerful prothrombotic potential. This leads to an imbalance between vasoconstrictors (endothelin) and vasodilators (nitric oxide). In addition, the release of biologically active substances with local neurotoxic effects. The authors noted an increase in the concentration of endothelin-1, studied its interaction with nitrogen oxide and considered its role in the occurrence of ischemia and the impact on the death of retinal ganglion cells. Scientists have noticed an increase in the level of Willebrand factor and increased platelet aggregation in patients with progressive glaucoma. As a possible cause of hemodynamic disturbances and glaucoma progression, the authors consider changes in blood rheological properties. In addition, the state of the three closely interacting components: the wall of blood vessels (primarily endothelium and subendothelial structures); cellular elements of blood (primarily platelets) and plasma proteolytic systems ensure the normal functioning of the hemostatic system. Changes in of these components state may affect the hemostatic system. Therefore, further study of various directions of vascular theory will help in understanding the etiopathogenesis of glaucoma.

Purpose. Evaluation of short-term (up to 9 months) results of new one-piece aspherical diffractive trifocal intraocular lens implantation. Patients and Methods. A prospective, open-label study included 65 patients (100 eyes) with presbyopia, who received cataract extraction with the implantation of a new IOL AcrySof PanOptix® trifocal. The average age of the patients was 60.0 ± 12.1 years. 35 patients underwent bilateral correction with multifocal IOLs, and 30 had a monolateral correction. In 21 % (n = 21) cases, femtolaser support of cataract extraction was performed. In 9 eyes (9 %) the primary posterior capsulorhexis was performed. The range of optical power of implanted IOLs was 13 to 30 D. The follow-up period was from 6 to 9 (6.8 ± 0.9) months. Results. On the 1 day after the MIOL implantation, an UCIVA increase was from 0.22 ± 0.19 to 0.76 ± 0.23 (p < 0.05), at follow-up to 6 months up to 0.85 ± 0.22. One day after surgery, the UCIVA increased from 0.23 ± 0.19 to 0.7 ± 0.25 (p < 0.05), with following raise up to 0.84 ± 0.24 in the maximum follow-up period of 6 months. UCFVA in the preoperative period was 0.27 ± 0.23, with an increase to 0.78 ± 0.23 (p < 0.05) for 1 day and 0.93 ± 0.18 at 6 months. The BCNVA increase was from 0.56 ± 0.25 before surgery to 0.8 ± 0.19 on the 1st day after cataract removal (p < 0.05) and 0.98 ± 0.16 at the 6 months follow-up period. Similar data (0.58 ± 0.29, 0.82 ± 0.21, and 0.95 ± 0.14) was noted for BCIVA. An BCFVA increase was from 0.71 ± 0.28 in the preoperative period to 1.0 ± 0.04 (p < 0.05) after 6 months. The primary endpoint of the study (BCFVA = 1.0) in the group was achieved in 83 % of cases (n = 83). The effect of glare was noted in 17 patients (26.1 %), halo in 9 (13.8 %), driving difficulties in 6 (9.2 %). The overwhelming majority of patients (96.9 %) rated the result of the operation as “excellent” (n = 51, 78.5 %) and “good” (n = 14, 21.5 %). Conclusion. Implantation of the examined IOL is associated with a high efficiency for near, intermediate distance and far vision correction. A new trifocal IOL may be recommended for use in clinical practice. Further comparative studies including other multifocal IOLs are needed to determine the indications and contraindications for its implantation.

To present the new method as a variant of minimal invasive strabismus surgery (MISS) technique for less invasive and faster reсtus muscle plication. Extraocular muscle strengthening is common for strabismus treatment. Plication as an alternative for tightening or strengthening muscles appears to be less traumatic, quicker and vascular preserving operation. A new plication variant performed by fixating the edge of muscle with 6-0 vicril sutures and pulling them forward and oversewn at 2–3 mm from external part sclera-tendon joint avoiding the anterior ciliary artereies. The distance of muscles advancement depends on the eye deviation angle and calculated by Kenneth Wright charts. In all patients fornix transconjunctival access was performed. Proposed trapezoidal scleral myopexy (TSM) was performed in 26 patients at the age from 3 to 32 years old (children 3–15 y.o. = 29; adults 20–32 y.o. = 7). 23 consecutive patients underwent TSM combined with antagonist recession at the same eye (15 esotropia, 11 exotropia). Follow up period was 6–26 months. The results were considered satisfactory if the postoperative angle was between 0 ± 3° (92.3 %). Only 2 cases (7.6 %) failed to reach this standart. The obtained results considered as very satisfactory. Patients reported only minimal postoperative discomfort and no complain on cosmetics. Trapezoidal muscle plication was inconspicuous throught the conjunctive. The good results of TSM proposed by the author seems to be very simple and more effective for muscle strengthening comparing to resection of medial and lateral rectus muscles. Placement of sutures at the muscle edge during trapezoidal plication exclude ciliary vassel destruction and anterior segment ischemia. The obtained results demonstrated that TSM was considered to be equivalent to resection of horizontal rectus and especially of vertical rectus muscles. Trapezoid form of plication increases the arc of sclera contact to the muscle, probably, explaining the efficiency of proposed operation for muscle strengthening. Proposed modification of muscle plication is reversible, simple, sparing for ciliary artery procedure and is recommended as minimal invasive strabismus surgery (MISS) for simultaneous operation on multiple rectus muscles.

Currently, there are many studies on the effectiveness of ointment ophthalmological medicines. Ophthalmic ointments are unique because they have a multi-component action mechanism. On the one hand, the action of the medicinal substance itself is prolonged due to the ointment base, and on the other hand, due to the structural features of the conjunctival cavity mucosa, these medicinal substances are very rapidly absorbed. In the treatment of ocular surface pathology, including as meibomiitis, barley and chalazions, local therapy and ointment forms are preferred. The purpose of the study was the investigation the antibacterial eye ointment effectiveness of domestic production Oftocipro — a fluoroquinolone derivative for the treatment of acute and chronic eyelid and conjunctiva diseases. During the study patients were divided into 2 groups with acute and chronic inflammatory diseases of the eyelids and conjunctiva in the acute stage. It is known that chronic pathological processes are often stopped in longer periods. This fact was a prerequisite for assessing the effectiveness of Ontocipro with a comparative analysis of the dynamics of subjective (patient complaints) and objective (biomicroscopy, tear production tests) indicators characterizing the severity of the inflammatory process. The study has showed a high drug efficacy, when it is applied topically 3–4 times a day. The average time to relieve the inflammatory process was 3–7 days. The possibility of using the drug Oftocipro locally, when it is applied to the eyelid area, without affecting the conjunctival cavity, allows to minimize the impact area due to the ointment base and limit the risk of side effects in the form of a violation of the natural conjunctival microflora. Considering high level of tolerance and low allergenicity of the drug Oftotsipro, it can be recommended for widespread use for the treatment of acute and chronic blepharoconjunctivitis, barley and chalazion in the acute stage, as well as meibomiitis.

Purpose: to study the possibilities of complex ultrasound examination in the assessment of hemodynamic and structural features of retinal capillary hemangioma (RCH).
Patients and methods. 26 patients (35 eyes) with RCHs at the age of 11 to 53 years (mean 26.6 ± 9.4 years) were examined. Ultrasound examination was performed using B–mode image, echodensitometry, Color Doppler Imaging (CDI) and pulsed Doppler (PD). The peak systolic velocity (Vsyst), the end-diastolic velocity (Vdiast) of the blood flow, and the resistance index (RI) in the orbital vessels were examined using CDI and PD. Qualitative and quantitative assessment of blood flow in a feeding artery and a draining vein of the RCHs were performed. The follow-up efficiency evaluation of the laser coagulation of RCH was performed in 12 eyes. Results. The elevation of RCH was 1.7 ± 0.7 mm (from 0.5 to 3.3 mm) on average, the base diameter — 5.4 ± 2.1 mm (from 1.8 to 11.5 mm). The acoustic density varied from 42 to 176 (mean 109.6 ± 30.9) in relative units. The indices of Vsyst were from 5.5 to 21.4 cm/s (mean value — 10.6 ± 4.2 cm/s) in the feeding arteries, from 3.06 to 14.3 cm/s — in veins (mean value — 4.9 ± 2.4 cm/s). A significant increase in the blood flow velocity in the central retinal vein (CRV), a decrease in RI in the central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) were determined. In 3 (8.6 %) eyes, in the absence of echographic manifestations of small RCHs of optic nerve head (ONH), there was an increase of the blood flow velocity in the CRV (the mean value was 8.95 ± 1.15 cm/s). After treatment, B-scan ultrasonogram showed no visualization of RCHs in 3 eyes. A significant decrease (31 %) of prominence compared to the baseline values was registered in 9 eyes (66.7 %). A decrease of the tumor base the diameter by an average of 37.7 % was also registered in 7 eyes (58.3 %). A significant decrease (26.3 %) in Vsyst in arterial-type feeding vessels was determined. Conclusion. Significant changes in regional ocular blood flow in RCH were registered. The increase of blood flow in the CRV at the localization of RCH on the ONH can be an additional differential diagnostic criterion of the disease. The hemodynamic instability in the retinal vessels feeding the RCH and the positive dynamics of the blood flow after laser coagulation were determined. 

Purpose. To study the dynamics of electrophysiological parameters of the retina and optic nerve after vitrectomy for a primary fullthickness macular hole. Patients and Methods. Electrophysiological examination was performed in 40 patients (40 eyes) before vitrectomy, on the 1st, 3rd, 7th, 14th, 30th, 60th, 180th day after the operation. Three groups of patients were formed depending on the intraocular tamponade: the first group — air tamponade, the second group — gas (C3F8) tamponade, the third group — silicone oil tamponade. Results. In the first, second and third groups significant decrease in the retinal and optic nerve electrogenesis was revealed on the 1st day (p < 0.001) after vitrectomy. By the end of observation period all electrophysiological indices in the first, second and third groups recover to normal levels, excluding the retinal cone system and optic nerve parameters in the third group. Electrophysiological indices recovered twice as slow in the second group, compared to the first group, due to C3F8 gas tamponade inhibitory effect. In the first and second groups the photoreceptors recovered twice as fast as bipolar cells. Conclusions. Vitrectomy causes significant inhibition of photoreceptors, bipolar and ganglion cells electrogenesis. The duration of vitrectomy is a significant negative factor determining retinal and optic nerve electrogenesis inhibition in the postop. Intraocular C3F8 gas, silicon oil tamponade (compared to air tamponade) is a significant adverse factor affecting retinal and optic nerve electrogenesis inhibition in the postop. The primary full-thickness macular hole diameter is a significant factor in inhibiting electrogenesis of the retinal cone system. Photoreceptors have a greater rehabilitation ability than bipolar cells.

The problems of resistance to modern antibiotics and fluoroquinolones naturally stimulate interest in the development of eye dosage forms based on antiseptics. Today, their list has successfully supplemented the domestic drug Okomistin eye, ear, nasal drops (0.01 % — benzyldimethyl-myristoylamino-propylammonium), the manufacturer of Infamed-K. Numerous clinical studies performed, however, on adult patients, indicate a high therapeutic efficacy of the drug Okomistin®. However, with respect to children, the efficacy of Okomistin® remains unclear, although the drug has been approved for use by children from birth today. Objective. To evaluate the effectiveness of the Okomistin® in the treatment of children with bilateral bacterial conjunctivitis. Patients and Methods. Material research consisted of 30 children aged 3–16 years with bilateral acute bacterial conjunctivitis. 15 of them (26 eyes) received six-time instillations of the Okomistin® and 15 (24) — 0.05 % — Рicloxidin. All were subjected to traditional clinical examination and examination of the microflora of the conjunctival cavity with the determination of its sensitivity to antibiotics using the disk method. Results. In the spectrum of microflora found in the examined children, Staphylococcus Аureus dominated (14 eyes (53.8 %) — in the group of patients receiving Okomistin® and 13 (54.2 %) — Picloxidin), and Еpidermal Staphylococcus — 12 (46, 2 %) and 12 (50.0 %), respectively. Against the background of six-fold instillations of the compared drugs, a pronounced positive dynamics was established in relation to the relief of objective and subjective clinical symptoms of bacterial conjunctivitis already in the first week of treatment. At the same time, on the 7th day of therapy, in both groups of children, a significant decrease in the frequency of detection of microflora in the conjunctival cavity was noted, and on the 10th day, all the examined people underwent the contents of the conjunctival cavity to be sterile. Conclusion. The clinical efficacy of the Okomistin®, in combination with the absence of side effects of the drug and the affordable cost, allows recommending it for widespread practical use in pediatric and adult ophthalmology in the treatment of eye diseases of a bacterial nature. It seems promising to study the effectiveness of the drug in order to reorganize the conjunctival cavity in infants with dacryocystitis.

Purpose. Revealing of the intraocular risk factors in the diabetic macular edema (ME) formatis in diabetes mellitus type II (DM2). Patients and methods. A 3.5-year research of 80 patients (160 eyes) with DM2 without signs of ME at the beginning of the research was performed. The main group consisted of 46 patients with ME symptoms on one or both eyes during the research period, the comparison group included 34 patients without ME symptoms to the end of the research. The initial ocular characteristics were retrospectively compared in groups. Results. The mean value of the axial lengths (AL) in the eyes of the main group was 23.12 ± 0.75 mm compared to 23.82 ± 0.62 mm in the comparison group (significant difference, p < 0.01). AL was less than 23.5 mm in 66 % eyes in the main group and only in 22 % of the eyes in the comparison group (p < 0.01). The mean value of the initial macular retina volume in the main group was significantly higher than in the comparison group — 7.51 ± 0.22 mm3 and 7.21 ± 0.12 mm3, respectively (p < 0.01). Initial background diabetic retinopathy (DR) was noted in 73 % eyes in the main group, which significantly differed from the comparison group, where this index was noted only in 13 % of the eyes (p < 0.01). Conclusion. Significant ocular risk factors for the formation of ME in patients with DM2 are: the initial macular retina volume more than 7.3 mm3, the value of the AL less than 23.5 mm; the initial background DR. The use of the detected morphometric parameters of eye and retina in combination with an adequate assessment of the risk factors in human organism makes it possible to assume a high risk of the primary formation of diabetic ME in patients with DM2 with high degree of probability.

The aim is to evaluate the effectiveness of Stillavit in the treatment of dry eye syndrome (DES) and its effect on the density of conjunctival goblet cells and the functional parameters of tear production. Methods. There were analyzed treatment results of 18 patients (36 eyes) with DES at the age of 48 to 80 years (average 60.6 ± 1.3 years) including 17 women and 1 male before and after 1 and 3 months after Stillavit prescription. In all patients in addition to a standard ophthalmological examination the results of Schirmer I, Norn, as well as the LIPCOF test were evaluated and the density of conjunctival goblet cells was examined. Results. After 1 and 3 months there was a significant improvement in the results of the Norn test: from 5.17 ± 0.22 seconds to 7.18 ± 0.17 seconds which indicated an increase in the stability of the tear film. After 3 months there was a significant increase in the density of conjunctival goblet cells, improvement in the Schirmer sample: from 9.26 ± 0.89 to 11.7 ± 0.6 mm (t = 2.28, p < 0.05) and LIPCOF test (t = 2.18, p < 0.05) which indicated an increase in tear production and a significant decrease in the inflammatory process and edema of the conjunctiva. Conclusion. Treatment of DES with the use of Stillavit leads after 3 months to a significant increase in the density of conjunctival goblet cells, increases tear production and stability of the tear film.

The purpose. To study the clinical efficacy of plasmapheresis in combination with ozone therapy in the prevention of ocular herpes recurrence. Patients and methods. There were 108 patients with relapsing forms of eye herpes (herpes keratitis, keratouveitis, uveitis) under our observation. 56 men and 52 women, aged between 37 and 62 old (47,6 ± 11,5) were involved into the research. The number of patients included into the main group were 54 (54 eyes), and also 54 patients (54 eyes) were in the comparison group. Results. In the main group, the patients undergone a course of anti — relapse therapy with plasmapheresis in combination with therapeutic ozone in combination with traditional treatment from 54 persons — the expressed therapeutic effect was registered in 48-and (88.8 %) patients, the partial therapeutic effect (decrease in the frequency of relapses) was observed in 6 (11.1 %) patients, the absence of effect was not registered in any patient. In the control group, consisting of 54 patients, which undergone anti-relapse therapy with plasmapheresis in combination with traditional treatment, expressed therapeutic effect (no exacerbations) was observed in 31 (57.4 %) patients, a partial therapeutic effect (decrease in the frequency of relapses) was observed in 17 (31.5 %) patients, and the absence of effect — in 6 (11.1 %) patients. Conclusions. For prevention of ophthalmic herpes recurrence and optimal results of anti-relapse therapy of patients with recurrent ophthalmic herpes were shown concurrently with the beginning of the standard antiherpetic treatment courses of plasmapheresis with ozone therapy and spend it as monotherapy at the end of treatment.

Purpose. Analysis of electron microscopic changes in rabbit eyes with intravitreal tamponade of perfluorocarbon liquids (PFCL) (perfluoro-1,3-dimethylcyclohexane and perfluorodecalin). Material and Methods. The study was performed on Chinchilla breed rabbits. 25G vitrectomy with PFCL intravitreal tamponade was performed on 12 eyes of 6 rabbits (perfluorodecalin (Bausch+Lomb «Dk-line», USA) and perfluoro-1,3-dimethylcyclohexane (ZAO “Optimedservis”, Russia). Standard three-port vitrectomy technique was used. After removal of the vitreous body 2.5 ml of PFCL were injected in vitreous cavity. Research studies were performed in 5, 14 and 30 days after surgery by electron microscopy. Eyes were enucleated in 20 minutes after animal was killed by air embolization. Intact eyes were used as a control. All samples were prepared in same conditions. The damage of the retina architectonics and the presence of intracellular inclusions were evaluated. Results. Tamponade of the vitreous cavity by both types of PFCL in 5, 14 and 30 day caused following similar electron microscopic changes at date: swelling ganglion layer and dystrophy of inner and outer nuclear layer. Electron microscopic changes in outer nuclear layer appeared at 30 days. The photoreceptor neurons were characterized by single ultrastructural changes. Retina pigment epithelium cells had a typical ultrastructure. Conclusion. Intravitreal perfluoro-1,3-dimethylcyclohexane tamponade caused similar electron microscopic changes as well as perfluorodecalin in the experiment and it was relatively harmless to rabbit retina for up to 14 days. Irreversible changes in the retinal ultrastructure were not observed.

The authors consider presented in the literature tested new approaches to diagnosis, prevention and correction of symptoms of asthenopia in persons visually-intense work related to theoretical aspects of asthenopia in fact, the selection of spectacle correction and application of a multidisciplinary approach. Determines the pattern of allocation in the traditional classification of asthenopia (accommodative, muscular, sensory) classification criterion is the presence or absence of phenomena of psychological maladjustment. Along with this, it is established that the astigmatic component correction of complex myopic astigmatism, it is advisable to perform in the range of 60–75 % of the required (according to cycloplegics examination of refraction). At the same time, the level of visual performance (in the most difficult conditions of presentation of test information of the type “choice of signal from several — evaluation of the signal — response ratio”) with incomplete (60–75 %) correction by 12.7–20.4 % (p < 0.05) is higher than with partial (75–85 %) and complete, taking into account minor differences in the achieved visual acuity (0.04–0.08, p > 0.05). In addition, the practical expediency of applying a multidisciplinary approach to the correction of asthenopia, based on the complex effects of specific and non-specific methods of stimulation of vision. It was found that the combined use of multidirectional technologies of physical impact (low-energy laser radiation, cranial osteopathic effects and special training of the cervical-thoracic spine) provides effective correction of accommodation disorders, which is confirmed by a pronounced, statistically significant positive dynamics of clinical and functional, ophthalmic-ergonomic and subjective indicators of the visual system after a course of therapeutic and restorative measures.

Aim: To analyze the effectiveness of intravitreal injection of an anti-VEGF agent (ranibizumab) and an dexametazon implant for the intravitreal injection, in real clinical life. Patients and Methods. 137 patients with MO due to retinal venous occlusion were included in the study. Patients were retrospectively divided into groups: patients who received monotherapy with ranibizumab 94 people; and monotherapy with dexamethasone implant — 15 patients; patients who initially were injected with a dexamethasone implant, but due the study transferred to ranibizumab 15 patients; patients who initially received ranibizumab, but then transferred to the dexamethasone implant -13. For the treatment of macular edema were used an anti-VEGF agent — ranibizumab (Lucentis) 0.05 ml (0.5 mg) manufactured by Novartis (Switzerland) or glucocorticosteroid — dexamethasone implant for intravitreal injection of 0.7 mg (Ozurdex) manufactured by Allergan Pharmaceutical Ireland (Ireland). The injections were administered on a pro re nata basis (the presence of macular edema). Standard ophthalmological examination and fluorescent angiography (PAG), optical coherent tomography (OCT), optical coherence tomography angiography (OCT-A) were used. Visual acuity changes (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were analyzed depending on the study group (group 1–4), the duration of treatment and the number of injections. Results: In group 1, from 1 to 8 IVVs were performed in 24 months, an average of 3.77. In group 2, from 1 to 4 intravitreal injections were performed in 24 months, an average of 1.37. In group 3, from 1 to 2 of intravitreal injections Ozurdex and from 1 to 4 intravitreal injections of ranibizumab for 24 months. In group 4, from 1 to 4 intravitreal injections of anti-VEGF drug and from 1 to 4 intravitreal dexamethasone implant were performed in 24 months of follow-up. Monotherapy with the Ozurdex drug (12 months) had the most stable effect, with a relapse of the process, repeated injections were required, conducted only in 3 out of 15 patients. Conclusion: In real clinical practice, the dexamethasone implant showed a good safety profile and high efficacy in the resorption of macular edema in patients with retinal vein occlusion, which corresponds to the clinical trials that was made earlier. 

Combined traumatic injuries of the anterior eye segment are attributed to the severe consequences of the injured organ of vision. Iris defects result in spherical and chromatic aberrations, diplopia, flares, severe photophobia, cosmetic defects, and significantly reduced visual acuity after the injury. The literature describes various methods to restore visual functions impaired as a result of aniridia. Use of an artificial iris together with an intraocular lens pathology results in optimal reconstruction and recovery of normal anterior segment anatomy and topography. In this paper, we provide a report on a patient followed up for 15 years after combined reconstruction eye surgery for an off-the-job penetrating eye injury sustained in 2003. A complex intervention was required due to the involvement of the cornea, iris, and lens. In 2004, the patient underwent a lens-iris diaphragm implantation combined with penetrating keratoplasty. The diaphragm implantation was followed by an improvement in visual acuity and elimination of photophobia and flares. There were no intra- or postoperative complications. Two years later, LASIK refractive surgery was performed on the corneal transplant to eliminate induced ametropia. The patient retained good eye function, with a stable position of the lens-iris diaphragm, for many years after the diaphragm implantation, keratoplasty, and refractive surgery. In 2018, he had an intravitreal implant impregnated with dexamethasone, as changes in the retina had developed. The long-term follow-up in this case demonstrates that the implantation of a lens-iris diaphragm resulted in an elimination of undesirable optical events associated with aniridia and produced an optimal functional result, while also improving the patient’s quality of life with a good aesthetic effect.

Introduction. Giant cell (temporal) arteritis refers to a group of chronic and acute systemic vasculitis mainly affecting the extracranial and intracranial arteries of large and medium caliber. Loss of vision due to anterior ischemic optic neuropathy (AION) or occlusion of the central retinal artery is one of the most severe and most common complications of giant cell arteritis. This case report describes a patient with giant cell arteritis, the outcome of it was a total vision loss in the right eye. The patient repeatedly visited the ophthalmologists in the outpatient clinics with complaints of intermittent episodes of vision loss. Purpose. To present methods of diagnosis and treatment, through which the doctor at the initial reception will be able to suspect the disease and start treatment timely. Conclusions. The anamnestic criteria for the GCA diagnosis in the practice of ophthalmologist are: female, age over 50 years, headaches with paresthesia, intermittent lameness of the mandible, short-term episodes of vision loss. The necessary laboratory methods of research include: clinical blood test with determination of erythrocyte sedimentation rate, determination of C-reactive protein level.

A clinical case of chronic postoperative endophthalmitis treatment after cataract phacoemulsification is described in the article. The patient received vitrectomy with lens posterior capsule discission and tamponade of vitreal cavity by perfluororganic compound (up to 14 days) and 1mg vancomicin +2.25 mg ceftazidim intravitreally, also anterior chamber washing by 0.5 ml saline containing 5 mg vancomicin. Anterior chamber washing by antibiotics and intravitreal injection of antibacterial  medicine combination was repeated on the second and third day after the surgery. This tactics of treatment allowed to save lens capsular bag and intraocular lens. Purpose. To assess efficacy and safety of new treatment method in the patient with chronic postoperative endophthalmitis. Patient B, 65 years old applied to clinic with complaints on the pain in the right eye, visual acuity decrease up to finger counting near face. Symptoms started to disturb in 2 weeks after cataract extraction with IOL implantation. During 6 months courses of antibacterial therapy including vancomicin (antibiotic of reserve) there were no positive dynamics. Cornea edema, multiple precipitates at endothelium and intraocular lens were defined at biomicroscopy; 2.5 mm hypopyon in anterior camera; fibrin in pupil projection; exudation in vitreous cavity. Laser tyndalmetry data (albumen flow in anterior chamber) confirmed inflammation strong enough — 173 f/ms. Surgical treatment according the described method was rendered to the patient. In the postoperative period we saw stable visual functions, uncorrected visual acuity was 0.6, corrected — 0.8. Patient noted the absence of pain and eye’s reddening decrease. At biomicroscopy we observed considerable inflammation decrease, almost total absence of precipitates at cornea endothelium. Laser tyndalmetry data confirmed inflammation decrease, albumen flow in anterior chamber was 17.6 f/ms. Endothelial cells’ loss after surgery was 142 cells/1 mm2 (5.61 %). According to electrophysiologic investigation and ERG there was no deviation from normal values was revealed. This treatment method allows to restore visual functions rather quickly and can be used in  case of inefficient lengthy conservative therapy.

The purpose: to describe clinical cases of choroideremia with mutation in CHM gene with molecular genetic verification of the diagnosis. Methods. Two relatives: a patient aged 33 and his mother’s sibs aged 39 with a rare hereditary retinal disease — choroideremia were examined. Patients’ full ophthalmic examination including autorefractometry, visual acuity testing with full correction, tonometry, biomicroscopy, fundus examination and photo as well as kinetic perimetry were performed. Electrophysiological examination included maximal electroretinogram (ERG), ERG to 30 Hz flicker and macular ERG (MERG) that were registered with electroretinograph MBN (Russia). Family anamnesis was studied. Genetic examination was performed for the verification of the diagnosis and pathologic gene molecular. Results. In 33-year-old patient advanced stage was diagnosed: best corrected visual acuity (BCVA) was OU 0,9, visual field was constricted to 10 degrees in both eyes. High BCVA and subnormal MERG correlated with comparatively preserved foveal structure on OCT. There was the terminal stage of choroideremia: In 39 years old his mother’s sibs BCVA was 0,1 OU, constricted to 5 degrees in both eyes. Maximal ERG and ERG to 30 Hz flicker were nonrecordable. Low BCVA and nonrecordable MERG correlated with defected retinal layers and cystoids macular edema on OCT. In both patients we revealed previously described pathogenic variant of nucleotic sequence in 6 exon of CHM gene (chrX:85213886 G>A), causing nonsense-mutation (p.Arg267*, NM_000390.2) in hemizygous state. Conclusion. Etiopathogenetic approach in choroideremia diagnostics allows providing correct diagnosis, prevention and developing of new treatment methods considering etiological factor.

Purpose: To perform cost-effectiveness analysis of using different types of monofocal intraocular lenses (IOL) for cataract surgery in adults in Russian Federation. Materials and methods. MS Excel based model of medical care patients with cataract has been developed for 1 patient undergoing surgery treatment. “cost-effectiveness” and “budget impact” analyses (BIA) were used to measure the costs associated with cataract treatment with different types of monofocal IOLs for the state budget. Direct medical costs included IOLs cost, treatment of PCO with neodymium-doped uttrium aluminium garnet laser capsulotomy (Nd:YAG), side effects treatment associated with Nd:YAG and were calculated from the Russian healthcare system perspective. Results. Cost-effectiveness analysis among monofocal IOLs demonstrated that the lowest costs for 1 case of successful cataract surgery followed by implantation of the IOL are connected with the use of the AcrySof® Single Piece model — 4,938 rubles, the largest costs — using the Tecnis® One model — 11,753.5 rubles. The use of others hydrophobic IOLs on the AcrySof® platform demonstrated economic feasibility, analyzed models have costs for 1 effective cataract treatment -AcrySof® IQ 9,858 rubles, AcrySof® Natural 6,452 rubles. The conducted BIA has showed that direct medical costs for surgical treatment of cataracts with the implantation of monofocal IOLs from different manufacturers for 100 patients amount to 708,121 rubles. If ua monofocal IOL are used alone on an AcrySof® platform, the cost will be 691,261 rubles, the difference is in favor of monofocal IOL on an AcrySof® platform — 16,860 rubles. Conclusion. Using AcrySof® IOLs for cataract surgery in adult patients is an effective and an economically justified treatment option in Russia Federation.

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