Polypoidal choroidal vasculopathy (PCV) is a rare subtype of neovascular age-related macular degeneration (AMD), its specific features are abnormal branching vascular network with aneurysmal dilatations (polyps), it can be diagnosed in indocyanine green angiography. PCV differs from typical AMD by some ophthalmoscopic manifestations, multimodal imaging data as angiography, OCT with the ability to visualize the choroid, OCT-angiography and expression of VEGF. Despite the different response to antiangiogenic therapy, the presence of pathological neovascularization requires anti-VEGF treatment for both AMD types. In this review, we summarize the latest literature data on the treatment of polyphoidal choroidal vasculopathy: anti-VEGF monotherapy, photodynamic monotherapy, and their combinations. Special attention is paid to the results of multicenter randomized clinical trials with a large number of patients evaluating efficacy of Ranibizumab and Aflibercept (EVEREST 2 and PLANET). The short-term and long-term results of treatment are presented, taking into account the dosing regimens, the number of required injections and the requirement for a combination of anti-VEGF monotherapy with photodynamic therapy. The results of randomized clinical trial are providing high level evidence to guide clinical specialists in choosing the most appropriate therapy for PCV.

The lamina cribrosa of the sclera is a multilayer structure consisting of layers of connective tissue represented by collagen of various types. The ratio of collagen fibers I, II and IV types, as well as elastin protein provide support and elastic properties of the lamina cribrosa. Increased intraocular pressure on the background of involutional changes in the composition of the connective tissue of the lamina cribrosa leads to deformation of the latter, compression of nerve fibers passing through the holes in the lamina cribrosa and violation of the axoplasmic current. Modern high-resolution optical coherence tomographs allow to visualize the confines of the lamina cribrosa, and the standard software integrated into each device allows to measure the parameters of the lamina cribrosa. The visualization of the lamina cribrosa in the early stages of glaucoma due to the severity of the pre-laminar tissue and the screening of the surface of the lamina cribrosa is still a problem. The presented review contains the results of studies of various ophthalmologists from different countries. The dependence of such parameters of the lamina cribrosa as depth, thickness, angle of inclination and curvature on the increased of intraocular pressure and the stage of glaucoma process was found. These studies confirm the possibility of visualization of the lamina cribrosa, open prospects in the study of the pathogenesis of glaucoma and expand the possibilities in the search for new methods of treatment of glaucoma optical neuropathy based on pathogenetic aspects. However, a small number of articles on this subject, found in the literature, and a small sample of the study groups in most works require further study of the visualization of the lamina cribrosa using optical coherence tomography.

The review presents information concerning the botulinum toxin use in the treatment of children`s strabismus; highlights aspects of the safety and the complications frequency. It contains information about the methods and doses of botulinum toxin injection, and also considers the cases of necessity of further surgery. There are several ways of introducing BTA: the traditional transconjunctival method of administration under the control of electromyography, used by most ophthalmologists, is not acceptable for treating pediatric patients, transconjunctivally into the subtenon space 10 mm from the limbus into the projection zone of the medial rectus muscle using a 1.0 ml tuberculin syringe with 27G needle, introduction to the muscle with the opening of the conjunctiva, which is safer, is carried out under complete visual control and with the release of extraocular muscle. According to the domestic and foreign literature data we can conclude that the injection of botulinum toxin may be an alternative or complement to surgical techniques, injection of botulinum toxin in the treatment of strabismus in children may be an alternative or complement to surgical and pleopto-orthopto-diploptic correction methods, although not in all clinical cases. The treatment approach of such patients should be comprehensive. There are reports that BoNT-A reduces eye deflection in more than 50 % of patients and provides satisfactory long-term results in infants and children. The average safe dose for Botox is 1-3 units for the muscle. The frequency of complications increases with higher doses (especially> 10 units) and with the transconjunctival route of administration without electromyographic control. This clinical example illustrates the effectiveness of botulinum toxin for the non-concomitant strabismus treatment.

Keratoconus is one of the topical problems in modern ophthalmology. Among the currently used treatment methods is intralamellar keratoplasty that utilizes allomaterials or homotransplants. The surgery technique has obvious advantages over penetrating and deep anterior lamellar keratoplasty. There is no risk of tissue incompatibility, the recovery period is shorter, and prolonged use of corticosteroids is not necessary. In recent years, technological development has made the application of femtosecond laser a standard procedure for various surgical interventions on the cornea, particularly for creation of intrastromal tunnels and corneal bags. This article presents an analysis of the modern literature data about different intralamellar keratoplasty techniques for treatment of keratoconus. The described techniques show its great clinical possibilities, especially the intrastromal keratoplasty variant with implantation of biological tissues. One of such techniques was developed and tried by a group of specialists at Research Institute of Eye Diseases in 2014. It involves recovery of corneal thickness in the ectatic area by intralamellar transplantation of a layered transplant of adequate size, which acts as a bandage. The surgery simultaneously affects the stabilization action, corrects refractive errors and eliminates the structural changes; it was accordingly named bandage therapeutic-optical keratoplasty (BTOK). The indication for its usage is progressing keratoconus in stage II–III patients. Among the described outcomes are cease of the disease progression in long-term follow-up, improvement of corrected and uncorrected visual acuity. The foreign analogue of the technique is Corneal Allogenic Intrastromal Ring Segments (CAIRS) by Jacob S. et al. His study included 20 patients with stages I to IV keratoconus; all patients undergone corneal cross-linking as the first stage, then they had CAIRS implanted into the intrastromal tunnels prepared with femtosecond laser. In both methods, the authors point at the improvement of corrected and uncorrected visual acuity. None of the patients had implant dislocation or keratoconus progression during the follow-up period.

Eye trauma is one of the leading causes of blindness and low vision in young working age people. It gives this particular group of diseases a special social significance. The absence of a universal surgical treating tactic is explained by the variety of traumatic agents and the various types of injuries. Penetrating wounds with the introduction of a foreign body, accompanied by detachment of the retina, vascular membrane, hemorrhagic and infectious complications are the most difficult in the clinical plan.

Material and methods: 103 with penetrating eye injuries were operated during the period from 2015 to 2017. 29 of them were involving the introduction of foreign bodies, which were removed at different times: 18 eyes (62 %) — at 7–10 days, 8 eyes 27.5 %) — 14–28 days after injury and 3 eyes (10.3 %) — more than 1 month. In all cases, subtotal vitrectomy 25G (68.9 %) was performed, in some cases, 23-hedge vitrectomy was preferred (31 %) due to pronounced fibro-proliferative changes in the vitreous body. In the case of a foreign body impacted into the shells with dimensions greater than 4 mm, the real cavity was tamped with PFOS.

Results. The adherence of the detached retina was achieved in 14 cases, adherence of the choroid — 4 cases. Uveitis was observed in 5 cases, ophthalmic hypertension in 12 patients in the early postoperative period. Hypertension was compensated by using the antihypertensive regimen. 5 patients at the time of hospitalization had a Vis = 0, the operation was of a diaphragm-preserving nature, since a foreign body that was not removed was the cause of the development of subatrophy of the eyeball in 16 % of cases. The remaining patients had stable, positive dynamics of visual functions in the postoperative period.

Conclusion: Surgery tactics for extensive eye injuries are individual, and the amount of intervention depends largely on the parameters of the traumatic agent, so planned surgery is preferable to emergency because it allows for detailed preoperative examination and to get valuable information about the condition of the eye. The exceptions are injuries with symptoms of acute endophthalmitis. Multi-unit operations provide optimal conditions for the preservation of the eye as an organ and contribute to the restoration of visual functions. 

Purpose. To evaluate the effectiveness of cataract extraction in patients with varying degrees of corneal opacity.

Patients and methods. We performed cataract extraction with implantation of the intraocular lenses of 14 eyes (9 patients) with varying degree of corneal opacity. The causes of corneal opacities were: keratitis in anamnesis — 6 cases, the result of wearing soft contact lenses — 2 eyes, eye injury — 2, the outcome of dermatitis of unspecified genesis with eye damage — 3, perforation of the corneal ulcer — 1 case. In 9 eyes, opacity of the cornea occupied the optic part of the cornea, in 5 cases, the opacity of the cornea was in the paraoptic zone. The middle uncorrected visual acuity of all cases is 0.05 ± 0.03, and the middle best corrected visual acuity is 0.14 ± 0.07. The phacoemulsification of the cataract with implantation of the intraocular lens was performed for all the patients.

Results. There were no complications during the operation, in the early and late postoperative periods. As a result of cataract extraction, all patients, regardless of the degree of cornea opacity, noted vision improvement. On the first day after the operation, the middle best corrected visual acuity was 0.06 ± 0.02 in 4 eyes, in 10 cases the middle best corrected visual acuity was 0.09 ± 0.03. The middle best corrected visual acuity 7 days after the surgery was 0.31 ± 0.07. After 6 months of observation of patients with corneal opacity after phacoemulsification of the cataract with implantation of the intraocular lens, the most corrected visual acuity was 0.27 ± 0.19.

Conclusions. All patients with corneal opacity of varying degrees of intensity after cataract extraction noted improved vision. The central location of the opacity of the cornea significantly reduced visual acuity, and paraoptic — influenced the vision to a lesser extent. The degree of cornea turbidity was also affected the initial visual acuity — the more clouding and the depth of the cornea, the lower the vision. The result of the lens extraction also depended on the maturity of the cataract — with a more turbid lens the result was higher in relation to preoperative indices. 

Purpose: To identify and analyze factors contributing to the development of macular edema after cataract phacoemulsification (FEC).

Methods: over 3 years of follow-up, 6218 surgeries were performed in 4608 patients. They were divided into three groups, taking into account the specifics of the surgery: operated on with 2.2 mm access without posterior capsulorhexis (РC), operated on using MICS technology through access 1.6–1.8 mm without РC, patients operated on with MICS technology through access of 1.6–1.8 mm from РC. The study included patients with persistent cystic macular edema (СMЕ), whose treatment required invasive interventions. During the observation period, 28 cases of persistent CME were identified, which were divided into groups corresponding to the time of onset, type of surgery and comorbidities.

Results: a comparative analysis in groups without posterior capsulorhexis with access of 2.2 mm (n = 513) and 1.6–1.8 mm (n = 2588) using the Student’s statistical confidence coefficient (P) showed that a decrease in surgical access was significantly reduces the risk of СМЕ, which confirms its connection with the invasiveness of the intervention.

Conclusion: Identified groups of factors that influence the nature of the macula response to the FEC, in particular, the occurrence of macular edema. All factors were analyzed. It was revealed that such factors as comorbidities (diabetes mellitus, age-related macular degeneration), type of surgical approach, and the presence of the epiretinal membrane directly affected the development and progression of macular edema. All factors were analyzed. It was revealed that such factors as comorbidities (diabetes mellitus, age related macular degeneration), type of surgical approach, and the presence of the epiretinal membrane directly affected the development and progression of macular edema. At the same time, revealed a direct relationship between the time of occurrence of CME and its effectiveness, as well as the volume of its invasive treatment. A significant increase in visual acuity in patients suggests a high efficacy of CME treatment associated with surgery. 

Purpose — to study the morphological changes of the retinal pigment epithelium (RPE) by optical coherence tomography-angiography (OCT-A) in En Face mode before and after selective micropulse laser irradiation in patients with central serous chorioretinopathy (CSC), determine the correspondence between the topographic location of RPE defects and detachment on the OCT-angiogram in En Face mode and points of leakage on the FAG.

Patients and methods. There were 20 patients (21 eyes) with CSC before and after laser treatment under the observation. All patients underwent high-resolution FAG and OCT-A using Angio Retina 2×2 or 3×3 mm protocol and Angio Retina HD 6×6 mm. The treatment was carried out in a selective micropulse mode with individual selection of parameters using the Navilas 577s navigation laser system (OD-OS, Germany) or the IQ 577 laser system (IRIDEX, USA).

Results were evaluated at 2 weeks and 1 month after treatment. Results. In all cases, the leaking points of the subretinal fluid on FAG corresponded to the topographic location of defects and detachments of RPE detachment on OKT-A En Face. According to OCT-A En Face, the following morphological changes were revealed: in 5 cases — single defects of RPE, in 7 cases — multiple defects of RPE, in 9 cases of slit-like detachment of RPE, in 3 patients a combination of slit-like detachment and defect RPE. The sizes of RPE defects varied in the range from 21 to 159 microns, while their rounded shape prevailed. 1 month after the selective micropulse laser effect on OCT-A in the En Face mode, the defects were closed and the RPE detachments fit in all patients, which resulted in resorption of the subretinal fluid and the neurosensory retina attachment.

Findings. OCT-A in En Face mode is a highly informative diagnostic method that allows noninvasive detection of morphological changes in RPE with a clear topographic localization relative to the retinal vascular network, as well as evaluating the effectiveness of selective micropulse laser treatment in patients with CSC. 

Purpose: to estimate the results of the clinical and laboratory survey among patients with uveites for refinement of the disease’s etiology.

Patients and Methods. 107 patients with uveites (114 eyes) were under control. A standard ophthalmologic survey was done with them; a serodiagnosis (immunoassay analysis) towards Toxoplasma gondii, Herpes simplex virus Ist, IInd types, Citomegalovirus, Chlamidia trachomatis; a bacteriological examination of tear fluid, some material from nose and cavity to definite factors of virulence and antibiotic sensitivity of exuded microorganisms. A molecular and genetic survey (PCR) of tear fluid towards Toxoplasma gondii , Herpes simplex virus Ist, IInd types, Citomegalovirus was done among 30 people.

The results. Provocative factors of the disease were detected in 42 % of cases. Concomitant diseases were in 77 %. Diseases of cardiovascular system prevailed in 49 %; ceiling of mouth cavity in 42 %; systemic diseases in 29.3 %. The most widespread were anterior uveites in 60.5 %; recur character prevailed in 51 %; deteriorations progressed in 58.8 % of cases. A chronic infection with herpes viruses was among almost all the patients (HSV I, II — 100 %, CMV — 96.3 %). To Toxoplasma gondii specific IgG were detected in 44.9 %, IgM in 2.8 %; to Clamidia trachomatis specific IgG in 21.5 %. 66 strains of bacteria were selected: from tear fluid — 34, from mouth — 17, from nasal cavity — 15; gram-positive bacteria of Staphylococcus prevailed in 83.3 %. In some cases of revealing S. aureus, which were isolated from all three biotypes, they were close to their phenotypic characteristics, which indicates to their etiologic importance in uveites’ progress. The research of tear fluid in PTSR turned to be less informative. Based on the anamnesis and the results of a complex survey it managed to become possible to decipher the etiology of the disease in 74.6 %. Among them were 67.1 % of infectious and infectious-allergic uveites; 80.7 % of bacterial uveites; 15.8 % of virus uveites and 3.5 % of parasitic uveites. 28.2 % of inflammations occurred on a background of system and syndromic diseases, the majority of diseases were on a background of Behterev’s disease and rheumatoid arthritis, 45.5 % for each. Non-infectious autoimmune and toxical-allergic reasons were set in 4.7 % of cases.

Conclusion. It is more expediently to use a complex diagnostic approach with taking into account clinical and anamnestic information and laboratory information of the survey in the investigation of uveitis etiology. 

Purpose: to study the potential of wide-field imaging with NAVILAS laser system.

Material and methods. In this study we included patients diagnosed with indirect ophthalmoscopy as having one of the follows: diabetic retinopathy (6 eyes), central retinal vein occlusion (5 eyes), choroidal melanoma (3 eyes), rhegmatogenous retinal detachment (4 eyes), and peripheral chorioretinal degeneration (10 eyes). Using NAVILAS 532 laser system and a wide-field contact lens (HR Wide Field (VOLK)) a wide-field central image and a panoramic (consisted of 4 to 6 images) images were obtained in all patients. Fundus images were evaluated according to their diagnostic value versus indirect ophthalmoscopy and wideness of the viewing angle versus standard color fundus photography (55°). In each patient within a single session were obtained: 1) a central fundus image and 2) panoramic image (4-field and in dynamic mode). In a subgroup of patients with central retinal vein occlusion and lattice retinal degeneration, we studied the ability of simultaneous laser photocoagulation wide-field imaging.

Results. A single field images obtained with NAVILAS allows to visualize up to 130.3 ± 9.6° of the eye fundus while four-field and dynamic acquisition up to 150.1 ± 8.9° and 171.3 ± 17.0°, respectively. Representative findings of diabetic retinopathy, central retinal vein occlusion, choroidal melanoma, rhegmatogenous retinal detachment, and peripheral lattice degeneration were identified in all cases. Insufficient visualization was found for “snail track” degeneration because the subtle retina and choroid changes were hardly seen on the low magnified image. In 4 patients with lattice retinal degeneration and 3 patients with central retinal vein occlusion within a single session, both wide-field imaging and laser photocoagulation were performed. Surgical goals were achieved in all cases.

Conclusion. Wide-field imaging with NAVILAS laser system demonstrated high potential in the documentation of the most widely spread eye fundus disease the and represents an adequate alternative for wide-field fundus cameras. Aside from wide-field imaging this approach also allows for simultaneous laser photocoagulation in entire eye fundus including far peripheral retina. 

The optical properties of the cornea are determined by its ability to refract and transmit light. Keratoconus changes cornea’s shape, the surface of the cornea becomes irregular, which leads to a violation of light refraction and the occurrence of optical aberrations. The progressing course of the disease and its late detection lead to a delayed start of therapeutic measures, which affects the prognosis of the disease progression and reduces the patient’s quality of life. The quality of visual functions depends on the stage of the process. There are 4 stages of keratoconus (according to M. Asler), each of which corresponds to certain changes in refraction and degree of deformation of the cornea. Early biomicroscopic signs are: “dilution” of the stroma (inhomogeneity of the cornea and a grayish tint in the zone of the developing apex), change in the shape of endothelial cells and clearly visible nerve endings due to longitudinal thickening. In the second stage of keratoconus, the biomicroscopic picture is complemented by the appearance of keratoconus lines (Vogt’s striae). The opacities of the Bowman’s membrane indicate the beginning of the scarring process and the transition of the disease to its third stage. The fourth stage of the disease is characterized by further development of stromal opacities and the occurrence of gross changes of the Descemet’s membrane. Advanced medical equipment for topographic mapping and measuring the cornea makes it much easier for ophthalmologists to diagnose keratoconus and choose more effective treatment methods: crosslinking or surgical treatment. Later it allows to stabilize keratoconus, but does not provide high visual acuity due to the induction of optical aberrations, including high order optical aberrations. Contact lens vision correction is the main way to correct the refractive error resulting from keratoconus. However, the use of corneal gas permeable or soft contact lenses cannot provide high quality vision, additionally causing discomfort associated with their excessive mobility. The use of scleral gas permeable contact lenses is the most effective method of optical correction of all stages of keratoconus and after keratoplasty.

Purpose. Revealing of the ocular risk factors in the formation of diabetic macular edema (ME) in type 2 diabetes mellitus (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 retrospect 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 % of the 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 % of the 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 with high degree of probability a high risk of the primary formation of diabetic ME in patients with DM2. 

Introduction. In a number of pathological conditions accompanied by the basement membrane defects, such as chemical or thermal burns, mechanical trauma, Sjögren’s syndrome, neurotrophic keratopathy or some corneal dystrophies, in which conditions are created independent epithelialization is weakened or becomes impossible. This condition was named recurrent corneal erosion (RCE). For the experimental study of the regenerative processes and evaluation of the effectiveness of new treatments, a standardized and reproducible RCE model is needed. Several RCE models are known: chemical, bacterial. The disadvantages of such models are the labour intensity of their implementation and a relatively high cost. The proposed method makes it possible to create the necessary conditions for local inflammation and destruction of adhesive molecules using the energy of ultraviolet (UV) irradiation. In this study, an experimental RCE model in rabbits has been proposed.

Purpose. To create a reproducible standardized experimental model of recurrent corneal erosion.

Materials and methods. The studies were conducted in 8 chinchilla rabbits (16 eyes). After local instillation (0.5 % alkaine solution) and retrobulbar anesthesia (2 % lidocaine solution), superficial deepithelialization of the cornea was performed by mechanical removal of its epithelium with a blunt scraper; and the quality of deepithelialization was assessed by staining the surface with 2 % fluorescein solution. In the optical zone with a diameter of 4 mm, local UV irradiation of the cornea was performed with exposures of 30 and 45 minutes.

Results. In case of 30-minute exposures, the epithelialization of the cornea subjected only to mechanical deepithelialization was observed since Day 3 in the form of concentric epithelial growth. On Day 14, a complete epithelialization of the cornea was observed, along with the formation of superficial newly formed vessels along the limbus. On Day 24, the vascular injection significantly decreased; and no erosion was observed. After 45-minute exposure without treatment, the regeneration occurred much slower; and a complete epithelialization had been achieved by Day 34 of the experiment, by the time the newly formed vessels grew to the epithelial defect zone. It was noted that since Day 86, the turbidity in the irradiation area persisted, as well as the inflammatory infiltrate.

Conclusions. The proposed method makes it possible to reproduce RCE, in which there is an alternation of epithelialization and deepithelialization of the irradiated corneal area through 30 days of the experiment and is arrested only after the ingrowth of surface vessels into the affected area. At that, the non-irradiated cornea is epithelialized by Day 7 of the experiment. 

The revolution in understanding the etiology and clinical manifestations of the disruption of the tearing process and the development of dry eye syndrome (CVS) has occurred in last 20–30 years. It has been established that the loss of the tear film homeostasis can occur not only because of a violation of systemic and autoimmune disorders, but also as a result of a blinking disorder and distribution of the tear film over the ocular surface. Therefore, new pathogenetic disease development mechanisms have been identified. The prevalence of diseases of the ocular surface and CVD in recent years has increased significantly. It is mostly caused not only by scientific discoveries in the field of understanding, for example, the etiological and pathophysiological role of the neurosensory mechanism of development of CVS. An important aspect is the emergence of new risk factors that potentiate the development of ocular surface diseases and CVL. These factors include the use of various drugs — antidepressants, antihistamines, hormone therapy, and others; instillation of eye drops — antiglaucoma drugs, etc., as well as the appearance of little-studied factors such as cosmetology procedures (eyelids tattooing, eyelash extensions, botulinum toxin injections for aesthetic purposes, etc.). They are carried out in proximate close to the eye and eyelids, causing multiple pathological reaction. The experience of observing patients, literature data, and the conducted study have showed that various cosmetological effects in the periorbital zone, whose popularity has increased in recent years, may cause the appearance of iatrogenic dry eye syndrome. The following most vivid clinical examples will help, encountered in our practice, to illustrate the data presented. Collecting the anamnesis, it is necessary to identify the presence of risk factors for the development of diseases of the ocular surface and CVD, to eliminate them, if possible, and to carry out adequate pathogenically based therapy.

The artificial tears on the basis hyaluronic acid is primary importance today in dry eye syndrome (DES) treatment. In recent years, they have been supplemented Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) differing concentrations of sodium hyaluronate and viscosity. The study is devoted to assessing the effectiveness of these drugs in the treatment of patients with dry eye syndrome (DES) of various etiology and severities.

There were 73 volunteers with DES of various etiology: 21 — Sjogren’s syndrome, 24 — meibomian blepharitis, and 28 — perimenopause in the study. All patients were divided into 2 groups: 36 patients of the first group received instillations into conjunctival cavity of the Optinol® Express Moisture (0.21 %) and 37 patients of the second group — Optinol® Deep moistening (0.4 %).

Starting from the first days of therapy, all patients had a decrease in the severity of subjective signs of DES, estimated by the value of the ocular surface disease index (OSDI). At the same time, tendency to stop of the degenerative changes in the epithelium of the ocular surface was established. It is characterized by a decrease in the degree of staining. The increasement of the tear film stability and an index of the tear meniscus was found in all patients. The dynamics of the controlled parameters increased, as the instillation of the drugs took place and by the 30th day of therapy. There were significant differences from the baseline values. At the same time, the Optinol® Express Moisture (0.21 %) was more effective (mainly in terms of subjective discomfort and the severity of degenerative changes in the epithelium of the ocular surface) in patients with mild and extremely severe form of the xerosis process.The drug Optinol® Deep Moisture (0.4 %) was more effective in patients with xerosis of moderate severity and severe by the same parameters. In the course of research, we have not observed any side effects of both drugs. It allows us to recommend the drugs Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) to widespread clinical use in treating patients with DES of various etiology. 

Objective. To determine the characteristics of drug therapy in patients with herpetic keratitis (HK), based on laboratory diagnosis.

Material and methods. 49 patients with clinical symptoms of HK were included in the study. The conjunctival cells were used as a material for laboratory diagnosis of adenovirus and enterovirus infection by polymerase chain reaction (PCR) and for microbiological examination. Herpesvirus DNA in tears, saliva, urine and blood was determined using PCR (for varicella-zoster virus (VZV) and human herpesvirus type 7 (HHV-7)) and real-time PCR (for herpes simplex virus types 1 and 2 (HSV-1,2), Epstein-Barr virus (VEB), cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6). Tear and urine were examined for the presence of DNA of obligate intracellular parasites (chlamydia, ureaplasma, and mycoplasma) by PCR.

Results. Сlinical picture of HK was presented by superficial (57.1 %, n = 28) and deep forms of corneal inflammation (42.9 %, n = 21). The results of laboratory diagnostics of herpetic infection had showed replication of herpesviruses in all examined patients. Genetic material of herpesviruses in lacrimal fluid was found in half of the examined patients (51 %), in saliva — in 67,3 % of cases. Viruria was observed in 21 patients (42.9 %), viraemia in 6 (12.2 %). DNA of intracellular parasites in lacrimal fluid was detected in 18.4 % of patients and in urine — in 12.2 % of patients. Bacteriological sowing of the conjunctiva scrape was positive in 75.5 % of cases.

Conclusion. Instrumental diagnostics (visometry, biomicroscopy) of HK should be supplemented with laboratory research of activity of not only herpesvirus infection, but also bacterial pathogens. Positive results of microbiological sowing of conjunctival scrapers allow to approach reasonably the prescription of antimicrobial drugs in patients with HK. 

The lutein-containing vitamin-mineral complex Retinorm, developed on the basis of the formula AREDS 2, with an optimal content of vitamins and minerals involved in antioxidant protection, is a potentially promising ophthalmic geroprotector.

Purpose: to evaluate the effectiveness of vitamin-mineral complex “Retinorm” in patients with the dry form of AMD and accelerated pace of aging.

Patients and Methods. The study involved 40 patients with a dry form of AMD (stage 2.3 according to AREDS classification) with an accelerated rate of aging (biological age of patients was measured by the method of Tokar, 1990). Gender distribution: men — 15 (37.5 %), women — 25 (62.5 %). The mean age of patients was 67.3 ± 6.8 years. Patients were divided into 2 groups. Patients of the study group (n = 20) were assigned “Retinorm” 1 capsule 3 times a day for 16 weeks. Patients of the control group (n = 20) were treated with “Lutein Forte” 1 capsule 2 times a day for 16 weeks. Visometry, perimetry, optical coherence tomography of the macular zone, measurement of biological age at the beginning of the study, at 2 and 4 months of the study, the tolerability of treatment in patients with a dry form of age — related macular degeneration on the background of taking dietary supplements-vitamin and mineral complexes with lutein and zeaxanthin.

Results and discussion. As a result of treatment, there were the positive dynamics in terms of visometry and perimetry in the main and control groups. There were no negative dynamics of the indicators of thickness of the retina (in the area of the fovea), and increased macular volume in the main group. In the control group there was a weak tendency to the growth of these indicators. We found a significant positive effect of Retinol on the biological age of patients to 4 months of therapy. It allows to consider the drug as a promising ophthalmoscopy an agent. The results of the study showed the effectiveness of the inclusion of “Retinorm” in patients with the dry form of AMD. The proven geroprotective effect of “Retinorm” with good tolerability of treatment and the absence of side effects from all organ systems with a long term of administration allows us to recommend it for wide use in patients with a dry form of age-related macular degeneration, including patients with an accelerated rate of aging. 

Radial keratotomy (RK) was widely used at the end of the last century for refractive purposes. However, ophthalmologists are increasingly faced with negative long-term consequences after RK now. A relatively rare complication after RK is subepithelial fibrosis (according to some data, it occurs in 2.7 % of cases), which may be the result of abnormal activation or proliferation of stromal keratocytes (stromal fibroblasts) after surgical or accidental injury of the Bowman membrane. Phototherapeutic keratectomy and manual mechanical removal by the “scraper” are used for the removal of fibrous tissue, as well as a combination of these methods with mitomycin. Since laser energy can provoke a recurrence of fibrosis in the future due to the activation of stromal keratocytes and using “scraper” is not always possible to remove fibrotic tissue and the use of mitomycin is associated with a number of complications, the question of finding new methods for its removal with minimal risk of complications arises. The method of diamond burr polishing of the cornea, which developed by us for treating the syndrome of recurrent cornea erosion, was, in our opinion, the most optimal for this purpose. The method of diamond burr polishing of the cornea in this clinical case made it possible to remove the epithelial fibrosis zone without damaging the Bowman’s layer, thereby avoiding the recurrence of fibrosis in the postoperative period (the follow-up period was 2 years). The depth of the location pathological tissue location was assessed using the OCT of the cornea. The absence of recurrence is also confirmed biomicroscopically and with the OCT of the cornea. So, the method of diamond burr polishing of the Bowman’s layer can be a method of choice for the treatment of subepithelial fibrosis for patients after keratorefractive operations, being highly effective, accessible, easy to perform.

This report is devoted to the problem of absence universal databases of patients with different chronic eye diseases and continuity of these patients between medical organizations. On the basis of MONIKI there has was held a prospective, observational cohort study of patients since 2016, with diagnoses: uveal melanoma — the first group of patients, degenerative States of the optic nerve and retina (multiple sclerosis, glaucoma) — the second group, — and vascular retinal diseases (venous occlusion, diabetic retinopathy) — the third group. There were 114 patients — in the first, 68 — in the second, 92 — in the third. There were developed statistically significant parameters of patients examination, adaptation of registers to application and increase of their efficiency continues to be corrected. All patients underwent standard ophthalmological examination, in addition-gonioscopy, ultrasound (ultrasound) in a and b-scan mode, including ultrasound biomicroscopy (UBM), optical coherence tomography (OCT), fluorescence angiography (FAG), computed tomography (CT) and/or magnetic resonance imaging (MRI) of the orbit. According to the indications, patients were examined by related specialists. For each patient group, prior results were obtained. They were late detection, untimely treatment and referral patients to other medical organizations, which proves the need to systematize patients with various pathologies and the subsequent continuity of medical organizations as for the timely detection of the disease, as for adequate and timely treatment not only at the local, but also at the regional or Federal levels. The integration of patients register with various ophthalmic diseases has a priority course in the development of healthcare in the Moscow region.