Central serous chorioretinopathy (CSCR) is a chorioretinal pathology characterized by the development of serous detachment of the neurosensory retina, local or multifocal areas of fluid filtration at the level of retinal pigment epithelium with predominant damage to the macular region. The epidemiology of CSCR in the Russian Federation has not been studied. Some authors believe that there is a tendency for increasement the incidence of CSCR.
This article presents the studies results of the influence of various factors on the disease occurrence. CSCR may be associated with various factors, the their contribution to the etiopathogenesis of the disease may be influenced by national and geographical features. All risk factors of CSCR were conditionally divided into chemical (taking different groups of medicines, smoking, alcohol consumption), biological (the presence of somatic or infectious diseases), psychosomatic (stress, sleep disturbance), socio-demographic (gender, age, race, level of education and income). Currently only an increase in the level of corticosteroids in the blood can be considered as a proven risk factor.
Numerous epidemiological studies from around the world show different, often conflicting, data. This makes it difficult to develop methods for the prevention of this disease, and dictates the need for descriptive and  analytical epidemiological studies in this direction.

The authors present the problem of differential diagnosis of primary corneal keratectasias: pellucid marginal degeneration (PMD) and keratoconus. Some cases of differential diagnosis can be very challenging and choice of rational treatment for these patients is actual. Despite multiple publications concerning keratoconus and extensive knowledge of this disease, articles about PMD are rare. Results of surgical treatment for PMD are usually worse than for keratoconus. The authors show the value of confocal microscopy, keratotopography, and high-resolution optical tomography of the anterior segment of the eye based on a two-channel Scheimpflug camera and give clinical examples of differential diagnosis that present certain complexity. Recommendations on treatment of patients with PMD are given, including such severe complication of progressive far-advanced corneal ectatic diseases as acute corneal hydrops. The important role of modern scleral gas-permeable contact lenses in visual correction of PMD and keratoconus is summarized. The authors believe that in cases of PMD without critical thinning of the cornea, if patients are satisfied with contact correction, the surgical treatment should be avoided or postponed.

Objective. Improving the efficiency of the operation of orbit decompression in patients with endocrine ophthalmopathy through the development of a new method for calculating an excess volume of soft tissues of the orbit.

Patients and methods. A total of 16 patients with edematous exophthalmos were examined, 7 of them were men and 9 women were aged 28 to 62 years (mean age 39 ± 8 years). All patients underwent surgery — simultaneous internal decompression of the orbit for bilateral exophthalmos with endocrine ophthalmopathy (EO). Before surgery and after 6 months. after surgery, patients were performed MSCT control. According to the method developed by us with the help of standard software MSCT, before the operation, calculations were made and the magnitude of the postoperative standing of the eyeballs was planned.

Results. As a result of the operations performed, we removed the estimated amount of adipose tissue and achieved the predicted result. Error in the calculations amounted to 0,1(+/-0,1) mm, which may be due to inaccurate labeling during planning.

Findings. The developed calculation method makes it possible to calculate the planned volume of the removed fatty tissue before the operation with the minimum error, without using complex mathematical calculations and without resorting to the help of additional equipment and software.

Purpose. To present the technique of macular hole surgery without vitreous cavity tamponade with gas or another vitreous substitute in post-op period.

Patients and Methods. Frequency of the disease is 3 cases per 10,000, more often after 55 years — 3–3.3 cases per 1000, and the peak occurs at the age of 60 years and older. According to current data, the frequency of closure MH after vitreous surgery varies from 68 to 98 %. Sixteen eyes of 16 patients were operated on for full-thickness macular holes 100 to 932 (558.5 ± 50.9) microns in diameter. BCVA was 0.04 to 0.2 (0.09 ± 0.01). Follow-up period of the patients was 9 ± 6.3 weeks.

Results. No intraoperative and postoperative complications were seen. In the result of surgery complete closure of the macular hole and anatomical restoration of the macula was achieved in 15 of 16 cases (92.8%). Postoperative BCVA was 0.2 to 0.6 (0.4 ± 0.04). A recurrence in one case was associated with a violation of operation technology when a partial mechanical displacement of the fibrin film with a cannula during PFCL exchange for air occurred.

Conclusions. The suggested method of macular hole surgery without postoperative tamponade of the vitreous cavity with gas or another vitreous substitute may be used in routine clinical practice: Without face down positioning, reduced risk of cataract and increased IOP, air flight and climb to a height in the early post-op period.

RETRACTED.

Methods for external surgery of the eye muscles are different and include the use of both adjustable and non-adjustable sutures, which affects the result in a long follow-up period. Surgical intervention using the method of adjustable sutures has been used for a number of years to improve the functional results of strabismus treatment. The basic principle of the method of adjustable sutures is to ensure the safety of extraocular muscles using a temporary or sliding node. The aim of the work is the development of a surgical treatment method of repeatedly operated strabismus with hypereffect and the analysis of clinical cases. We have proposed a method for correcting repeatedly operated strabismus with hypereffect using the method of adjustable sutures. Three clinical cases are described. 1) The patient is 34 years old, previously operated esophoria, deviation angle 15 degrees. A recession of the internal rectus muscle 4 mm and resection of the external rectus muscle 5 mm were performed. The next day after surgery, due to the hypoeffect, the sutures were adjusted. After 1 month, the deviation angle is 0 degrees. 2) The patient is 29 years old, with an exophoria, a deviation angle of 35 degrees, previously operated on for esophoria on the left eye. An operation on the left eye is done. The next day after the operation, the presence of hypereffect was revealed, for the correction of which, the repressed muscle was weakened and the recession was strengthened in accordance with the proposed method. We achieved the desired cosmetic result. After 1 month, the deviation angle is 0 degrees. 3) The patient is 24 years old, previously operated exophoria, the deviation angle is 15–20 degrees. The internal rectus muscle was repositioned by 4 mm, the external straight recession was 4 mm. The day after surgery, the desired cosmetic result is achieved. After 1 month, the deviation angle is 0 degrees. The presented method of surgical intervention and clinical cases indicate that the approach to the treatment of strabismus using adjustable sutures is a promising direction in ophthalmic surgery.

Kabuki makeup syndrome is a rare genetic disease. The features of the child’s face resemble the mask of the actors of the Japanese Kabuki theater. Accompanied by multiple anomalies of various organs and systems. Cases of congenital cataract (CC) are not described.

Purpose: to describe a clinical case of diagnosis and treatment of congenital cataracts in a child with Kabuki syndrome.

Material and methods. Child M.,15 years old with syndrome Kabuki make-up. At OD — zonular congenital cataract in 1-degree of turbidity, OS — zonular congenital cataract 3rd degree of turbidity Conducted a survey and phacoaspiration with IOL implantation HOYA 24,0 D at OS.

Results. Visual acuity: OD = 0.6 s –1.0 D = 0.8–0.9; OS before surgery = 0.02 n/c, after surgery = 0.05 n/c (amblyopia obscuration). Lens OD-opacity disc, through which the Central parts of the fundus can be investiture with Ophthalmoscope. Lens OS-atypical disk with uneven opacity in the form of dark and light bands, the Central parts of the fundus can’t be investigated with ophthalmoscope, viewed only peripheral vessels. Ultrasound examination OU: single floating opacities in vitreous body, APA of eye = 22.7 mm. Electrophysiological examination-reduction of a number of indicators OS.

Resume. 1. In children with the syndrome Kabuki make-up can be congenital zonular cataracts. 2. Taking into account the progressive nature of lens opacity, a dynamic examination with a wide pupil is necessary for timely referral to surgical treatment. 3. There is a risk of developing exudative proliferative reactions in the early postoperative period.

Purpose: to develop a methodology for the selection of patients for multifocal intraocular correction with an individual definition of the IOL type based on the data obtained from a preoperative questionnaire and a trial selection of multifocal contact lenses.

Patients and methods. The study is based on the data obtained from an analysis of 1000 medical case reports and questionnaires of patients who have been recently operated in the LLC «Eye Clinik “Lege Artis”» because of cataracts and refractive changes. All patients underwent ultrasonic phacoemulsification according to the standard procedure on the Centurion apparatus. Monofocal IOLs from leading global manufacturers, such as M-plus, Comfort (Oculentis), Restor (Alcon) and the trifocal IOL manufactured by PanOptix (Alcon) were offered to patients for the implantation. In order to achieve this objective, questionnaires were developed with questions allowing to determine the psychological type of the patient before the surgery, the nature of his/her visual load and the requirements he/she has in relation to his/her vision. In order to simulate the conditions of multifocal intraocular correction, there were multifocal contact lenses Acuvue Moist selected for patients with varying degrees of ADD power. To assess the degree of patient satisfaction with the results of treatment performed by individual selection of multifocal IOLs, there was an anonymous postoperative survey conducted after 2 weeks and 2 months.

Results. The analysis showed that the proportion of implantations of multifocal IOLs among all ultrasound phacoemulsification surgeries was 17 %. Of these, in 55 % of cases patients have chosen IOLs with a low degree of ADD power (Lentis Comfort), in 32 % — PanOptix and in 13 % — Lentis M-plus or Restor. The degree of patient satisfaction with the surgery and the vision obtained in 2 weeks after the surgery was 90 %, and after 2 months — 95 %. Cases with incomplete patient satisfaction with the surgery made (5 %) were noted mainly in the group with the implantation of bifocal IOLs and are associated with typical complaints about the appearance of light phenomena, mostly at night

The aim is to evaluate efficacy of the method of cold-plasma ablation when performing endonasal of dacryocystorhinostomy.

Patients and Methods. With the use of the equipment Coblator II were 31 unilateral dacryocystorhinostomy patients with obstruction of the lacrimal ducts at the level of the lacrimal-nasal duct. After a full examination, including color samples, rinsing and probing of lacrimal ducts, radiographic, and, in some cases, transcanalicular endoscopy, when indicated, was performed endonasal dacryocystorhinostomy with the use of cold-plasma ablation. Using a set of equipment Coblator II performed 31 unilateral cerebral PALSY patients with obstruction of the lacrimal duct at the level of the lacrimal duct. In the postoperative period, antibacterial therapy, lacrimal lavage, full volume washing of the nasal cavity, inhalation of mucolytics and antibiotics with a nebulizer were carried out, lubricants were also used.

Results. In the early postoperative period and 1 month after surgery, all patients reported no complaints of lacrimation and purulent discharge. In endorinoscopy, healing was observed by the type of predominant epithelialization, the stoma functioned, when washing the stagnant content in the lacrimal SAC was not. There was a small bleeding intraoperatively and in the early postoperative period.

Conclusion. Endoscopic endonasal dacryocystorhinostomy with the use of the method co-ablation is a safe and effective alternative to other methods of holding the endonasal dacryocystorhinostomy. The advantages are the ease of implementation, no need for additional, including power tools (pliers, cutting head of a shaver, rasp, etc.) for removal of soft tissue in the area formed dacryocystectomy, good visualization due to the coagulating effect of the cold-plasma ablation, the possibility of gentle removal of even the hypertrophied wall of the lacrimal SAC. The main drawbacks are the high cost of equipment and consumables.

Purpose. To study the concentration of cytokines and growth factors in the aqueous humor of patients with congenital aniridia.

Patients and methods. The study comprised 10 patients (10 eyes) with congenital aniridia and 10 patients (10 eyes) with agerelated cataract. Aqueous humor was collected at the beginning of routine cataract surgery before the primary incision was created. A concentration of 27 cytokines and the transforming growth factor-β2 (TGF- β2) was determined using a Bio-Plex Pro™ Human Cytokine 27-plex Assay and Bio-Plex Pro™ and TGFβ 3-plex Assay kit by flow-through fluorometry on a Bio-Rad MAGPIX (Luminex Corp. Austin). Intergroup comparisons were conducted using the Mann-Whitney U test.

Results. A comparative analysis showed a statistically significant increase in the concentration of IL-7 (p = 0.004), IL-15 (p = 0.008) and a decrease in the content of IL-9 (p = 0.008), IL-10 (p = 0.034) and GM-CSF (p = 0.045) in patients with congenital aniridia compared with the age-related cataract group. Inflammatory mediators (IL-1β, IL-6, IL-8, IL-12, IL-17A, MCP-1) and vascular endothelial growth factor (VEGF) in the aniridia group did not statistically differ from the comparison group.

Conclusion. Statistically significant difference was detected in IL-7, IL-9, IL-10, IL-15, GM-CSF concentrations in the aqueous humor in patients with congenital aniridia when comparing to non aniridic patients with age-related cataract. The other cytokines with proinflammatory, angiogenic and profibrotic properties did not significantly differ from the comparison group. 

Currently, the mitochondrial component is becoming increasingly significant in the development and progression of glaucoma optic neuropathy. Since mitochondria have their own genetic apparatus, the study of qualitative and quantitative changes in mitochondrial DNA (mtDNA) becomes part of the disease diagnosis, in addition to studying the functional characteristics of the organelles alone. Moreover, the inability to explain the nature of the disease by known mutations of nuclear DNA contributes to the the study of mtDNA. In this review, we briefly discuss the mitochondrial genetics and the role of mitochondrial haplogroups in the diseases manifestation. We summarize the accumulated data on the qualitative and quantitative changes in mtDNA in patients with glaucoma. We discuss the approach to prevent the inheritance of mutant mtDNA as a part of assisted reproductive technologies, as well as the first steps towards the mtDNA heteroplasmy level manipulation and direct mtDNA editing.

The hereditary thrombophilias is a well-recognized important risk factor for a systemic and local thromboembolic events development. The case of Leiden thrombophilia family inheritance concomitant by the visual disturbances development are shown in this аrticle. Most commonly in hereditary thrombophilias, venous thrombembolias occur, arterial occlusions which have been reported in the recent literature only as individual clinical cases occur more rarely. In the European population hereditary thrombophilias are associated with a prothrombotic mutation in the coagulation factor V gene (Leiden factor) in a greater degree; herewith the risk of thrombotic complications is increasing significantly in homozygous polymorphism forms. Presence of combined mutations in several clotting factors also leads to risk of thrombembolias increase. Consequence of the Leiden mutation is a V activator resistance to the resolving action of the activated protein C which is a natural endogenous anticoagulant protein. Resistance development leads to a deceleration of V factor inactivation and to increasing of the thrombin amount. In the work presented here, development of the consistent bilateral
occlusion of the central retinal artery (CRA) in a middle-aged patient with a heterozygous form of Leiden thrombophilia is the subject of interest. Along with the hereditary hemostatic system abnormality, the patient also had cardiovascular risk factors (hypertensive disease, atherosclerosis) which had a potentiating effect on the occlusion development. Taking into account the autosomal dominant nature of the Leiden mutation inheritance, the patient’s only daughter was examined; brief episodes of amaurosis fugax against the background of headaches similar to migraine were detected due to ophthalmological abnormalities. For verification of the Leiden thrombophilia diagnosis, both patients underwent molecular genetic diagnostics. Currently there are no large prospective studies showing the optimal and economically viable approach for identification of thrombophilia genetic polymorphisms in patients with retinal vascular occlusions in daily clinical experience. Possible additional risk factors for thrombembolias development, prevention services for manifest and recurrent vascular occlusions in patients with hereditary blood coagulation system abnormalities and their relatives are discussed in this article.

The purpose of investigation was assessment of efficacy of the method suggested for treatment of postoperative endophthalmitis on the experimental model of gram negative endophthalmitis.

Materials and methods. In order to create experimental model of endophthalmitis phacoemulsification of lens was rendered on 30 rabbits (30 eyes). At the end of surgery 0.1 ml of Escherichia coli microbial suspension containing 100 cells of pathogen was injected intravitreally to all. In 12 hours after the contamination signs of heavy postoperative endophthalmitis appeared in all rabbits. All the rabbits were divided into two groups in dependence of the method of further surgical treatment. 15 rabbits (15 eyes) were in the first group, vitrectomy with intravitreal injection of 1 mg vancomicin + 2.25 mg ceftazidim antibiotics combination was rendered. For 15 rabbits (15 eyes) of the second group vitrectomy with tamponade of vitreal cavity by PFOC and 1 mg vancomicin + 2.25 mg ceftazidim antibiotics combination intravitreal injection was rendered.

Results. Treatment of the second group rabbits was more effective in comparison with the first group (p = 0.0018). According to ERG data visual functions were saved in 6 rabbits of the first group (40 %) and in 10 rabbits of the second group (66.67 %). Besides functional loss anatomic loss of eye was observed in 33.33 % cases in the first group. While eyeball was saved in all 100 % cases of the second group with use of the suggested method.

Conclusion. Experimental investigation proved efficacy of the suggested method of endophthalmitis treatment. This method of treatment is universal regardless of disease etiological cause.

Aim: to evaluate the diagnostic value and objectification of the STARS questionnaire in the evaluation of risk of age-related macular degeneration (AMD) development.

Patients and methods. 104 patients (206 eyes) 40 males (32.3 %), 84 women (67.7 %), who filled the self-administered STARS screening questionnaire, were enrolled in the study. All patients were referred without suspicion or established diagnosis of AMD of any other retinal pathology. Optical coherent tomography (OCT) and macular pigment optical density (MPOD) were carried out in order to objectify questionnaire score points and retinal structural changes.

Results. The significant difference was found between patient without AMD and those with newly established AMD diagnosis not only in questionnaire score but also in some structural changes indicators: mean retinal thickness, foveal retinal thickness by OCT (<0.05). The direct correlation between increase in questionnaire points and estimate AMD stage by AREDS was found as well as the direct correlation between questionnaire score points and risk of AMD development, newly established AMD diagnosis, maximal macular pigment optical density (MPOD), mean macular pigment optical density and central retinal  thickness. The area under ROC-curve was 0.62.

Conclusion. STARS is a new, simple, self-administered questionnaire which accurately distinguishes AMD development and progression risk groups and can be recommended for routine use in every day practice.

Purpose. Estimate of clinical efficacy of combined use of aflibercept and meldonium at tachyphylaxis of neovascular age-related macular degeneration (nAMD) to ranibizumab.

Patients and methods. Comparative analysis of treatment results of nAMD in 25 eyes (25 patients) aged from 52 to 79 years was carried out. Main criterion for the patients inclusion was presence of nAMD resistant to intravitreal injections (IVI) of VEGF inhibitor ranibizumab with visual acuity values of not less than 0.1. Patients with different ophthalmologic pathology, accompanied by development of macular edema, with glaucoma and after any eye operations, performed during study period, were excluded from study. Before using aflibercept, all patients were treated with ranibizumab for 1.5–2 years (from 5 to 7 injections). The lack of persistent positive result was cause for change of course treatment of this patients on aflibercept (3 monthly injections) for enhance anti-vasoproliferative effect. The patients were divided into two groups — main and comparison, comparable by sex, age, visual acuity and type of choroidal neovascularization. In the main group, 3 aflibercept IVI were supplemented parabulbar injections of 0.5 ml of meldonium (with concentration of 500 mg / 5 ml) daily for 10 days. Patients of the comparison group did not receive meldonium.

Results. The supplement of meldonium in the main group, relative to the comparison group, led to increase in 1.5 times of best corrected visual acuity, in 1.2 times of b-wave amplitude of the electroretinogram, preservation of the neuro- and pigment epithelium of retina, complete regression of neovascularization.

Conclusion. Findings results evidence about clinically advisable to use meldonium in course treatment in patients with nAMD, resistant to ranibizumab, with aflibercept IVI for increase visual functions and stabilize the degenerative changes in neurosensory retina, pigment epithelium and choriocapillary layer.

Despite the fact that the frequency of treatment the eyelids inflammatory diseases affecting the modified sebaceous glands (Meibomian glands, Zeiss glands) is very high in outpatient clinical practice, and the basic principles of treating this pathology are well known to everyone, there are always many questions. Therefore, interdisciplinary approach with gastroenterologists, dermatologists,  endocrinologists and other specialists is often required treatment of this patients group. In addition, the transition of the inflammatory process to a chronic form and the encapsulation of the inflammatory focus and / or the formation of a halazion requires an accurate algorithm of actions from the practitioner, which depends on the duration of the pathological process. There is always a question — what form of an antibacterial drug is better to prescribe — ointment or drops? In addition, there is no consensus on the use of hormone therapy in the treatment of meibomyitis, hordeolum and chalazion. This article presents an algorithm for the prevention and treatment of this group of patients, which involves a certain sequence of therapeutic and preventive measures, depending on the severity and duration of the inflammatory process. Eyelid hygiene (warm compresses + self-massage of the eyelids with gel) is recommended in case of chronic blepharitis clinical signs, complaints of dryness, discomfort, wearing contact lenses. In case of the acute inflammatory process — meibomyitis and/or hordeolum in addition to eyelid hygiene, local antibiotic therapy is recommended. If a halazion is forming the choice of treatment tactics (local instillation therapy, intracapsular administration of a prolonged corticosteroid or surgical treatment) depends on the halazion duration (more or less than 2 months). The presented algorithm has the practical importance, since adequate treatment will not only eliminate the focus of chronic infection on the eyelids, but also improve the patient’s quality of life, since the presence of such a disease gives pronounced psycho-emotional discomfort because of its localization zone.

Objective: to conduct a clinical and histomorphological study of the efficacy and safety of individually calculated doses of antibiotic in an experimental model of acute endophthalmitis in laboratory animals.

Materials and methods. The study group included 15 adult laboratory white rabbits of the Chinchilla breed, male, aged from 2 to 3 months (2.6 ± 0.44 months). Determination of the anatomical parameters of the eyeball was performed on an ultrasound biometer — Compact Touch Quantel Medical (France). The obtained data were exported to the original program of an electronic computing machine of its own design, for automatic calculation of the dose of antibacterial drug for intravitreal injection. In the course of the experiment, the native lens was removed from animals with intraoperative administration of a culture of epidermal staphylococcus in a volume of 0.1 ml (10,000 colony forming units). After surgery, the animals were divided into 4 treatment groups: group 1 — without treatment, group 2 — standard dose of vancomycin for intravitreal administration (1 mg / 0.1 ml), group 3 — double dose (2 mg / 0.1 ml), group 4 — individual a dose of 0.25 mg / 0.1 ml (according to the calculation of the computer program). After a period of clinical observation, the enucleation of the eyeball was performed with a histomorphological study.

Results. Group 1 — increase of the inflammation signs, deep irreversible structural damage to all intraocular structures according to histomorphology. Group 2 — regression of clinical manifestations by the first week of observation, the processes of alteration and initial regeneration of intraocular structures according to histomorphology. Group 3 — diffuse opacification of the cornea with the impossibility of further analysis, signs of toxic damage to intraocular structures according to histomorphology. Group 4 — complete regression of clinical symptoms, residual signs of aseptic inflammation according to histomorphology.

Conclusions. Clinical and histomorphological studies of enucleated eyeballs in experimental animals demonstrate clinical efficacy and safety of vancomycin concentration in the vitreal cavity equal to or close to 128 μg/ml. Individual (personalized) calculation of the antibacterial drug dose eliminates the risk of toxic damage to the retina when the antibiotic concentration is excessive in the vitreal cavity. The toxic effects of excessive doses of antibiotics increase with increasing concentration of the active substance.

In 2017 by the results of TFOS DEWS, dry eye syndrome (DES) was recognized as a disease that requires treatment. The leading role in DES development is given to inflammation and defects of an eye surface, instability and hyperosmolarity of tear film and neurosensory disorders. While choosing the tear substitute for the therapy of DES the focus is on an involvement of various components of DES pathogenesis: disbalance of a tear film structure and its’ disfunction, inflammation and defects of eye tissues. Purposes of treatment are restoration of tear homeostasis, breaking of a “vicious circle” of DES and achievement of a prolonged effect of the therapy, including the subjective one. Taking into consideration that inflammation is associated with most of ophthalmological diseases causing DES, it is a clear choice to prescribe tear substitutes with anti-inflammatory, wetting and regenerative properties. Treatment with combined tear substitutes affecting different components of DES pathogenesis simplifies the instillation regimen and increasing compliance.

Purpose. To identify problems contributed to the development of a chronic course of herpetic keratitis/keratouveitis and to suggest ways to solve them (taking into account the results of virological examination by PCR).

Patients and methods. A group of patients (n = 90) with herpetic keratitis/keratouveitis of the prolonged course was under observation. Biological secretions (tears, saliva, blood serum and urine) of patients were investigated for the presence of herpes simplex virus (HSV), varicella-zoster virus (VVZ), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus type 6 (HHV-6), human herpesvirus type 7 (HHV-7) by polymerase chain reaction (PCR). Antiherpetic therapy included systemic oral administration of selective analogues of nucleosides (AN) — valacyclovir and phamcyclovir in daily doses of 2–3 g and 1.5 g, respectively. Local therapy included installations of mydriatic (if necessary), non-steroidal anti-inflammatory agents, antibacterial drugs. Reparative therapy consisted in prescribing conservative installations of HILOPARIN-COMOD® and PARIN-POS® ointment.

Results. The clinical picture of herpetic keratitis/keratouveitis was presented by surface forms — 22 cases, deep forms — 68 cases. Positive results of HSV determination were obtained in 34.6 % of the surveyed. VZV was detected in 21 cases (28 %), CMV — in 14.6 %. EBV was detected in 28 cases (37.3 %), HHV-6 — in 37 cases (49.3 %). Genetic material of HHV-7 was found in 32 % of the examined. The results of PCR studies determined the appointment of adequate doses of nucleoside analogues (NA), which led to relief of symptoms in 100 % of cases. Active reparative therapy contributed to complete persistent epithelialization sustained by systemic use of NA in all cases within 4 weeks from the presentation.

Conclusion. The results of PCR examination for the production of herpetic viruses in the tear/saliva/blood/urine are crucial to confirm the etiology of keratitis/keratouveitis, as well as determine the appointment of adequate (increased) doses of nucleoside analogues according to the recommended regimens until remission is achieved. Local therapy drugs should be used on the principle of “necessary minimum”. Therapeutic scheme for herpetic keratitis/keratouveitis already in the active stage should include local drugs with reparative effect, contributing to the achievement of persistent epithelialization.

Purpose: to assess the effect of aflibercept (Eylea; “Regeneron”, USA) intravitreal injections on ocular blood flow and intraocular pressure parameters in patients with neovascular form of age-related macular degeneration (wet AMD). Currently, neovascular agerelated macular degeneration (wet AMD) is one of the leading causes of irreversible vision loss and blindness among populations over the age of 50.

Material and methods. The study included 35 patients (35 eyes), 10 men and 25 women. Mean patients’ age was 72 ± 6 years. The inclusion criteria were the established diagnosis of a neovascular form of age-related macular degeneration and the level of ophthalmotonus not more than the accepted upper limit of the average norm — IOP 21 mm hg prior to drug administration of the drug. All patients underwent flowmetry with ocular blood flow (OBF) volume determination and intraocular pressure (IOP) measurement. The patients received a singular intravitreal aflibercet injection (2 ml). OBF and IOP were measured at baseline before the injection and the on day 4 and 1 month after the injection.

Results. There was no statisticaly significant difference between the IOP level before and after the injection. We revealed a tendency towards OBF decrease in 1 month after the injection, but overall values and the decrease both 4 days and 1 month after the intravitreal injection did not prove to be statistically significant. The absence of statistically significant changes of intraocular pressure level and volumetric ocular blood flow additionally confirms information about the safety of intravitreal administration of aflibercept to patients with a wet form of age-related macular degeneration.

This publication describes a clinical case of spontaneous subconjunctival hemorrhage in a 15-year-old child on the background of idiopathic local dilatation of epibulbar vessels. Vascular pathology of the orbit and periorbital region is often accompanied by subconjunctival hemorrhages. The aim of the work was to describe a rare clinical case of spontaneous subconjunctival hemorrhage in a child with local idiopathic vasodilation. A complete clinical instrumental study revealed no pathology except the local dilatation of epibulbar vessels. In 6 months after the subconjunctival hemorrhage resorption, the ampoule-shaped expansion of the epibulbar vessels with a wall different from others in color and shape is preserved, which was confirmed by the data of optical coherence tomography (OCT) of the anterior eye segment. When examining patients with spontaneous subconjunctival hemorrhage, especially in childhood, along with pathology of the cardiovascular and circulatory systems, it is necessary to exclude malformations of the vessels of the orbit, periorbital region and anomalies of the epibulbar vessels.

Dirofilariasis is a biohelminthiasis characterized by damage to the hypodermis, less often than internal organs, in about 50 % of cases localized under the eye membranes, adnexa or in the orbit; the clinical symptoms depend on the location of the parasite infestation. This is a serious disease that can cause dangerous somatic complications. Currently, there is an increase in the incidence of dirofilariasis and the “expansion” of its endemic zones to the north. Most often, the parasite develops at the site of a mosquito bite — subcutaneously, it determines the subsequent clinical manifestations. A lot of questions cause the development of the nematode in the internal structures of the eye, as well as the pathway of penetration of the parasite. The literature describes isolated cases of intraocular invasion of dirofilariae, for example, in Russia since 1972, only three such cases have been recorded. This article presents a clinical case of intravitreal dirofilariasis and presents a method for its surgical treatment. Currently, there is no single approach to removing dirofilaria from the vitreous cavity due to the rare occurrence of this pathology. The high probability of the inflammatory reaction associated with the presence of the xenoagent, its fragmentation during the manipulation, as well as the potential decrease in visual acuity, determined the purpose of this work — to develop a method for surgical removal of the worm from the eye cavity in intact form using a closed manual aspiration system via 2-port access 25G without vitrectomy for further identification in the parasitological department of the clinical diagnostic laboratory.