Analysis of the literature on the problem of structural and functional relationships in the development and progression of glaucomatous optical neuropathy (GON) shows that the search for a single primary factor may lead to an erroneous exaggeration of its role in the pathogenesis of GON. A more promising approach may be to search for clinically significant combinations of current markers of changes in structure, function, and ocular blood flow, and to expand our fundamental understanding of the processes underlying these changes, designed to improve their interpretation radically. The discussed in this review data of recent studies showed that the earliest event in the development of GON is the weakening and loss of synapses, even with the preserved dendritic branching. We assume that the loss of synapses on dendrites and axon terminals, being a manifestation of synaptic plasticity, may occur simultaneously with the change in anterograde transport in axons of retinal ganglion cells (RGC), or, ahead of it. Early changes in the discharge timing of the RGCs associated with a decrease in the strength of synaptic contacts and the elimination of synapses on dendrites can be a target for neuroprotective therapy. The review analyzes the tests of modern electroretinography, which can serve as markers of early events in the development of GON, including plastic changes in the retina at the preclinical stage of glaucoma, and provides physiological rationales for their selective possibilities for clinical practice.

Glaucoma is the main cause of irreversible blindness in the world. Carbonic anhydrase inhibitors (CAIS) used both systemically and topically, reduce intraocular pressure effectively. But unlike systemic CAIs, 2 % dorozolamide and 1 % brinzolamide penetrate deeply into the ocular tissues and do not cause systemic effects, so they are widely used in the treatment of glaucoma. The review characterizes various isoforms of carbonic anhydrase, considers the mechanisms of action of the drugs aimed at carbonic anhydrase blocking, and analyzes the results of various studies of 2 % dorzolamide and 1 % brinzolamide, as well as their fixed combinations. The effects of CAIs both as monotherapy and in combination with other antiglaucoma drugs are considered. The analysis of data on the effect  of CAIs on ocular blood flow is presented.

Age-related macular degeneration is the main cause of vision loss in aged people. A significant risk factor of disease is considered dysfunction of retinal pigment epithelium, which is accompanied by accumulation of lipids in Bruch membrane as drusen or linear deposits. As a result, there are disturbance of substances and oxygen transport from blood to retina cells of eye as well as elimination of toxic catabolites to choroid capillaries. The lack of a systematic analysis of pathogenetic mechanisms of drusen’s formation in age-related macular degeneration controls possibility of developing methods for treating and preventing development of early stage of age-related macular degeneration. There are the data of risk factors and pathogenesis of age-related macular degeneration in the article. It pays attention to the significance of oxidative stress in pigment epithelium of macula and triggering factors of inflammation development in eye retina. In context of differences in lipid composition and topographic location of cones and rods photoreceptor cells the localization of drusen, basal laminar and linear deposits in Bruch membrane is discussed. The possible mechanisms of drusen biogenesis associated with  functioning of cholesterol carriers and lipid autophagy in retinal pigment epithelial cells as well as the role of  macrophages in transport of local cholesterol depot to systemic circulation are presented. Analysis of literature allowed to identify several promising areas of development of targeted therapy for lipid metabolism disorders in  retina. They include the reactivation of lipid carriers in RPE cells, ligand-receptor mechanisms that provide a reduction pH in lysosomes and maintaining functional activity of macrophages.

Fungal endophthalmitis is an extremely “severe” pathology that can lead not only to the loss of the eye as an organ, but in some cases, the death of the patient. This disease can be attributed to a disease that has a “mask” in some of its manifestations, since it can often mimic bacterial inflammation or an atypical reaction of the vascular membrane after surgery. Questions of diagnostics, and especially differential diagnostics, often cause difficulties for practitioners, while the situation is burdened by rather poorly developed methods of routine bacteriological research, and even more so by highly specific methods, such as enzyme immunoassay or polymerase chain reaction. At the same time, in most medical institutions, even in big cities, due to the rarity of pathology, the mechanisms of interaction between services (for example, sending material) are not worked out  properly. For a practicing surgeon who is not engaged in eye infectious diseases, and especially inflammatory retinology, it is extremely difficult to make a correct diagnosis, which, unfortunately, very often directs the doctor on the wrong path of diagnosis and treatment. In addition, some modern fungicides, unfortunately, do not have permits for their active study and use in ophthalmological practice. A number of these factors can significantly hinder scientific and clinical progress in the treatment of this terrible and often tragic disease. To highlight these issues, an overview of the current state of the problem of clinic, diagnosis, differential diagnosis and treatment of fungal endophthalmitis, which is an extremely important medical, economic and social dilemma, is presented. The paper also covers the definition of endophthalmitis, classification, life cycle, factors of aggression and invasion of fungal microorganisms, the basics of pathological physiology of the spread of fungal infection.

A latent stage of angle-closure glaucoma is a functional unit, which leads to the progression of glaucoma in the absence of treatment.

Purpose. To determine tactics and to evaluate the results of a personalized approach to treatment in patients with a latent stage of angle-closure glaucoma.

Patients and methods. An analysis of surgical treatment of 35 patients (56 eyes) with latent stage of  angleclosure glaucoma has been carried out. The first group (I) included patients with accommodative a  transparent lens, the absence or the presence of ametropia is not more than 1.0 diopter, a high rating for the quality of life according to the questionnaire VF14 (Visual Function). All patients in group I were treated with a personalized combined laser iridectomy with a preliminary coagulation of the iris. The second group (II) included patients with a little accommodative, transparent or opaque lens, the absence or presence of  ametropia more than 1.0 D, a low ranking for the quality of life. The second group of patients was divided into  two subgroups: IIA — all the patients underwent personalized combined laser iridectomy with a preliminary coagulation of the iris; IIB — all the patients underwent phacoemulsification with intraocular lens implantation. The result of surgical treatment was evaluated in terms of the depth of the anterior chamber, the degree of  opening of the anterior chamber angle in accordance with the classification of van-Beuningen, according to the questionnaire of quality of life VF14.

Results. The degree of opening of the eye anterior chamber angle and anterior chamber depth have been increased in all the groups, but the indicators have varied. In group IIB the results were significantly effective and credible. In group I, the ranking of quality of life after laser iridectomy was not changed, remained consistently high; in the IIB it was significantly increased, while in the IIA it remained low. 

Conclusion. Personalized combined laser iridectomy with a preliminary coagulation of the iris and phacoemulsification with IOL implantation are effective methods of treatment the latent stage of angle-closure  glaucoma. The laser iridectomy as a treatment of latent stage of angle-closure glaucoma is sufficient in the case of conserved accommodation, of the crystalline lens, the absence of ametropia and the high rating for the quality of life questionnaire VF14. Phacoemulsification with intraocular lens implantation is required in the case of ametropia, poor accommodation or its absence and especially cataract changes in the lens, the low for the quality of life.

Purpose: to determine the relevance of retina’s surface “drying” during vitrectomy at the stage of exchange of infusion solution for air based on an experimental study and calculation of the geometric dimensions of a drop of moisture formed in the macular region.

Patients and Methods. There were 10 patients (10 eyes), who had a vitrectomy for a macular tear with air injection in one eye. Their age was from 50 to 78 (64.0 ± 3.1), the size of the macular tear 250–631 (431.6 ± 44.3) mkm. After 27G subtotal vitrectomy intake of fluid formed after fluid-air exchange was performed and its volume was measured in equal time intervals 3 times. The next step is to determine the shape of a drop of intraocular fluid (IOF) that forms on the surface of the retina during BSS exchange. For example, in the cadaveric eye, the wetting of the retinal surface was studied with the volume of liquid that was obtained during the operation, and its edge wetting angle was measured. Given the fact that INFLOW during surgery formed from two sources: the result of the production of the ciliary body (CB) (2,5–4,0 μl/min) and dehydration of the vitreous body (VB) due to the pressure of the air supplied in the vitreal cavity was calculated drop diameter INFLOW first, when the product of TST and dehydration VB (CB + VB); second, only if the production CT. This made it possible to understand how a drop of HGH formed during the operation will be projected onto the surface of the macula.

Results. Volume of intraocular fluid taken during surgery was 60–80 microliters (68.1 ± 2.8) for 3 minutes, or 22.7 microliters per minute. Rate of fluid formation decreased by 18–25 % for 9 minutes. Contact angle of wetting made 14.5°. Drop diameter calculated for ciliary body secretion and vitreous remnants dehydration equals 17.98 mm. Drop diameter calculated for ciliary body secretion alone equals 2.6 mm.

Conclusions. “Drying” of the retina during macular hole surgery is impractical as intraocular fluid is constantly formed on the retina surface. Its volume is sufficient to cause opening of the hole. Refusal from this manipulation would not influence anatomic efficacy of the operation and would reduce surgical trauma.  

Purpose: To assess the iridocrystalline complex status in patients with cataract, complicated by zonular weakness, before and after surgical treatment.

Patients and Methods. The study enrolled 28 patients (29 eyes) with cataract, complicated by zonular weakness (8 women, 20 men, 74.13 ± 8.48 years old). All patients undergone phacoemulsification with IOL implantation and a capsular tension ring (CTR) if it was necessary. In each case optical biometry, ultrasound biomicroscopy and applanation tonometry were provided. After 1, 3 and 6 months postoperatively refractometry, visual acuity measurement, optical biometry, ultrasound biomicroscopy and OCT of the anterior segment were carried out.

Results. Patients were divided into 2 groups. In I group (17 eyes) standard phacoemulsification was provided.  In II group (11 eyes) it was necessary to implant CTR. 1 patient was excluded due to the extracapsular cataract extraction. Preoperatively angle of the crystalline lens tilt (3.62 ± 0.34° and 1.78 ± 0.27°, p = 0,00) and IOP were higher in group II. 6 months postoperatively UCVA was significantly higher in group II (0.59 ± 0.09 and 0.39 ± 0.21, p = 0.09), upright angle of IOL tilt (0.28 ± 0.35° and 1.40 ± 1.46°, p = 0.10), total zonnular length (14.28 ± 1.00 and 18.93 ± 0.86 mm, p = 0.00) and the value of IOL decentration (0.80 ± 0.17 and 0.20 ± 0.22 mm, p = 0.04) were significantly less in group II.

Conclusion. The angle of crystalline lens tilt according to ultrasound biomicroscopy could be considered as an important diagnostic criterion for the CTR implantation necessity during phacoemulsification. CTR implantation provided decrease of IOL tilt and decentration due to a more regular distribution of zonular tension that increases the UCVA postoperatively in complicated cases. OCT of the anterior segment of the eye and ultrasound biomicroscopy application after phacoemulsification gives a great capacity in IOL-capsular complex visualization and measurement.

Purpose. To present the results of several technologies for suture fixation in case of IOL-capsular bag complex III–IV-degree dislocation and to estimate their impact on IOP.

Patients and Methods. We have analyzed 42 cases of IOL-capsular bag complex dislocation complicated by absence of capsular support which were divided into three groups. Group 1 included 4 cases of complex fixation to the sclera (presence of capsular ring, IOLs with closed loop haptics such as T-26, T-28, single-piece IOLs with massive haptics such as Asphina). Suture fixation was performed in the ciliary sulcus projection with capture of haptics or capsular ring and buried knots in capsular pockets. Group 2 included 27 cases with iris suture fixation with capture of haptics or fibrotic capsular bag on a 30G needle. Reposition and support of dislocated IOL-capsular bag complex was performed with a bent 30G needle inserted through pars plana. Group 3 included 11 cases with iris suture fixation with additional surgical manipulations (anterior vitrectomy, removal of fibrotic anterior and posterior capsules, complete removal of the capsular bag with cortex, surgical dissection of opacified posterior capsule). The specific feature was the use of vitreotome needle for IOL-capsular bag complex centration and fixation as well as for subsequent removal of capsular bag fibrosis, secondary cataract or cortex.

Results. Intraoperative complications included 3 cases of slight bleeding during iris perforation. Postoperative  complications included 4 cases of inflammatory reaction in the form of fibrin in the pupil. No cases of hemophthalmia associated with the insertion of 30 G needle or port in the eye cavity were marked. Two patients developed pseudoexfoliation glaucoma treated with hypotensive drops. In the early and late postoperative period in all patients of all the groups stable position of IOL-capsular bag complex was marked.

Conclusion. Use of discussed techniques gives a possibility to obtain high visual prognosis, low probability of IOP elevation and stable position of IOL-capsular bag complex in all the three groups.  

Aim. The development and clinical study of optimized femtosecond laser-assisted phacoemulsification (PE) technology of hypermature cataract.

Patients and methods. Femtosecond laser-assisted PE of hypermature cataract was performed in 72 patients (72 eyes). The 1st group included 45 patients (45 eyes) who underwent a femtolaser capsulorexis with a pulse power of 6,700 nanojoules (optimized technique for femtosecond laser-assisted РE). The 2nd group included 27 patients (27 eyes) who underwent a femtolaser capsulorexis with a pulse power of 7000 nanojoules.

Results. The use of a femtosecond laser to perform anterior capsulorexis in case of PE hypermature cataract is a technique that allows to obtain capsulorexis of an ideal round shape with high diameter accuracy, which is not possible with manual capsulorexis in patients with hypermature cataract. In the 2nd group, radial tear of the edge of capsulorhexis was noted in 2 (7.4 %) cases. In the postoperative period, in all cases in the 1st group, the periphery of the IOL optics was covered with a smooth edge of capsulorhexis of a regular round shape around the entire circumference. In the 2nd group, in 2 (7.4 %) cases, the exit of the edge of the IOL optics from under the edge of the capsulorexis was noted due to its radial tear with the shift of the IOL optics anteriorly, which can negatively affect the accuracy of the refractive result of IOL implantation. Visual acuity without correction and with maximum correction did not have significant differences in both groups and depended on the state of the neuroreceptor apparatus. The average loss of corneal endothelial cells in the 1st group was 5.7 ± 1.4 % and 8.7 ± 1.8 % in the 2nd group (p < 0.05).

Conclusion. The use of a femtosecond laser to perform anterior capsulorhexis in PE of hypermature cataract is an effective surgical technique for the treatment of hypermature cataracts, which ensures a fully in-the-bag  position of the IOL in the postoperative period. Optimization of the energy parameters of a femtosecond laser helps prevent capsulorexis edge tears in patients with hypermature cataract.

The quality of newborns’ health, especially premature babies has the particular importance in the context of declining fertility. Retinopathy of prematurity (ROP) is a severe vasoproliferative disease affecting the immature vascular system of the retina in premature infants. This is one of the main reasons leading to irreversible vision loss in young children now. Since 2012, based on the State budgetary institution of Rostov region “Regional children’s clinical hospital” organized active screening, diagnosis and treatment of ROP. Since 2016, based on this institution, as well as the Perinatal center of the Rostov region, measures for the prevention of retinopathy of prematurity using red protective filter glasses have been applied. In 2016, the effectiveness of surgical laser treatment was 89 %, due to the increased number of children with aggressive posterior ROP and lightning-fast course of the disease and the lack of preventive measures in most departments of nursing premature babies. In  2017, the effectiveness of surgical laser treatment was 88 %, the relative decrease was due to an increase in the threshold stages. In 2018, the operational effectiveness of laser treatment was 93 %, because of the timely surgical treatment, to improve the quality of nursing preterm infants, active application of measures of prevention with the use of red filter protective in many branches the care of premature infants. The use of red filter protective glasses is a simple and affordable method of preventing retinopathy of prematurity, which reduces the need for surgical laser treatment and the number of adverse outcomes of the disease.

Purpose: to study the histological features of the Muller muscle of the upper eyelid in patients with congenital and acquired ptosis to understand the mechanism of ptosis.

Material and methods. Retrospective analysis of 27 intraoperatively obtained biopsies of the Muller muscle of the upper eyelid. For the study, the biopsies were fixed in a formalin and prepared by paraffinization. After  staining with hematoxylin and eosin and Van Gieson, the preparations were studied in a light microscope.

Results. In congenital ptosis of the upper eyelid histologically revealed atrophy of smooth muscle tissue, which manifested itself in a decrease in the number of muscle fibers on the background of fibrous transformation. In micro specimens of patients with acquired ptosis discovered fat cells located among the bundles of smooth muscle fibers, the dispersion of the myocytes. Fat infiltration of muscle ranged from 29 to 51.6 %.

Conclusion The presence of dystrophic changes in Muller muscle in congenital and acquired ptosis was proved by histological method. The revealed features explain the pathogenetic mechanisms of the formation of congenital and acquired ptosis. In the case of acquired ptosis, fat dystrophy is an independent etiological factor, and therefore requires non-standard tactics of surgical treatment in order to neutralize the risk of recurrence in the early and late postoperative periods.

Purpose. To develop a step-by-step algorithm for managing patients with myopia and the risk of developing asthenopia after keratorefractive surgery (KRS) to optimize the work of the ophthalmologist and increase patient  satisfaction with the results of the operation.

Materials and methods. 66 patients (132 eyes) with moderate to high myopia were examined. The special  research methods needed to create an algorithm for managing patients with myopia and the risk of developing asthenopia after corneal surgery were the study of binocular vision, fusional reserves, and a cover/uncover test to identify heterophoria and heterotropy.

Results. Based on the identified of PA predictors development and the developed course of functional treatment of accommodation and binocular function disorders in patients with moderate and high myopia, after CLRS, a step-by-step algorithm was developed for managing patients with myopia and the risk of developing PA.

Conclusion. Optimization of the ophthalmologist’s work and an increase the patient’s satisfaction with the
results of excimer laser corneal surgery.

Terrien marginal degeneration and Fuchs’ superficial marginal keratitis are considered rare and slowly progressive corneal diseases with a bilateral lesion, unknown etiology, and have a number of similar clinical signs. Clinically, Terrien marginal degeneration is characterized by peripheral thinning, which appears at the  beginning of the disease usually in the upper half, but can also begin with the lower half of the cornea. In the case of Fuchs’ superficial marginal keratitis, biomicroscopic examination, at the initial stages of the disease’s development, in the lower and lower nasal segments, reveals peripheral corneal thinning. As a rule, in  both diseases, the lesions on the two eyes are asymmetric, but peripheral corneal thinning is the main pathological sign.

Purpose. To determine the diagnostic criteria for Terrien disease and Fuchs’ marginal keratitis, to identify their similarities and differences.

Patients and methods. For the period 2017–2020, 40 patients were examined; they were divided into 3 groups. 30 patients with Terrien marginal degeneration, 7 patients with Fuchs’ superficial marginal keratitis, 3 patients with signs of Terrien marginal degeneration in one eye and typical manifestations of Fuchs’ superficial marginal keratitis in the other eye. The following methods were used for diagnostics: confocal microscopy,  optical coherence tomography of the anterior segment, keratotopography.

Results. A survey of 40 patients revealed many common clinical signs of two previously considered separate diseases. According to the literature, it is known that the main difference between these two diseases is the localization of corneal lesions. We found that different localization of the lesion in Terrien degeneration and  superficial marginal Fuchs keratitis is present in some patients and only in the initial stages of both diseases. 

Conclusions. Terrien’s degeneration and Fuchs’ superficial marginal keratitis may be different variants of clinical manifestations or different stages of progression of the same disease. Since the etiology of Terrien’s degeneration and Fuchs’ superficial marginal keratitis had not been established, it is recommended to follow the clinical course of the diseases during treatment. 

The study is devoted to one of actual problems of modern strabismological — the development of effective methods for evaluation of stereo vision.

The purpose: to develop an effective method for evaluating stereopsis based on chromostereopsis (CS) in patients with strabismus.

Patients and methods. We observed 135 children aged from 8 to 17 years, who were divided into three groups, equivalent age: 1) 45 children with ametropia; 2) 31 children with not paralytic strabismus; 3) 59 children — the control group without ophthalmopathology. At the first stage, we investigated the possibility of  using “ChromaDepth glasses” for qualitative assessment of stereo vision in three groups of children. We used three types of stimuli: a modified Kanisza shape; test images that create an illusory square shape; a color version of the Poggendorff shape. At the second stage, we investigated the possibility of using images with different spectral characteristics and prisms for qualitative and quantitative evaluation of stereovision based on CS in the same three groups of children.

Results. The analysis of the results obtained at the first stage showed high sensitivity (90.6 % for the 1st stimulus, 90.5 % for the 2nd and 99 % for the 3rd) and specificity (96.5 % for the 1st stimulus, 93.3 % for the 2nd and 84.4 % for the 3rd) for all three stimuli used for qualitative evaluation of stereo vision. At the second stage, we obtained results demonstrating an increase in the severity of CS with an increase in the strength of prisms in control children and children with ametropia, as well as results indicating the effectiveness of the developed method for evaluating stereovision in children with a strabismus angle.

Conclusion. The method of studying CS with the help of “ChromaDepth glasses” is a simple and effective method of qualitative assessment of stereovision. The developed method of qualitative and quantitative assessment of stereovision based on CS using stimuli with different spectral characteristics and prisms allows us to assess effectively the state of stereovision. It doesn’t required additional separation of the visual fields even if there is a strabismus angle (using its prismatic compensation) and predict the possibility of occurrence and severity of undesirable chromatic illusions in patients when prescribing prismatic correction.

Introduction. Lack of antiviral drug forms in ophthalmology stimulates to study the efficacy of drugs of other pharmacological groups with potential antiviral activity. Adenoviral eye infections are widespread and highly contagious.

Material and methods. The antiviral effect of the drug was estimated by changing the DNA titer of the virus in adenovirus-infected cells, controlling. the specificity of the viral affection by setting PCR in real time. The cytotoxic effect of Vitabact® was studied on Vero cell culture.

Results. Installations of the preparation according to the treatment scheme (after infection of the culture) resulted in 2.7-fold decrease in the viral DNA amount. When Vitabact® was injected into cells in dilution of 1/128 (the first dilution of the drug that does not refuse the cytotoxic effect on Vero cells) according to the prophylactic scheme  the level of adenovirus replication decreased by 1.7 times. 

Conclusions. The preparation of pycloxidine had the maximum antiviral effect in the treatment scheme mode. This circumstance opens the perspective of specifying the spectrum and mechanisms of antiviral effect of pixloxidine and makes it possible to use Vitabakt as a component of the second stage (starting from 10–12 day of the disease) of empirical therapy of viral conjunctivitis.

Nowadays, Meibomian gland dysfunction is considered as the leading cause of dry eye syndrome. Standard methods of the treatment rather often give us only shirt term remission, that’s why so actually to find new alternative treatment options with increasing of patients’ life quality and possibility for long-time remission. This study was directed to evaluate the effectiveness of complex dry eye treatment, included transdermal Intensive Pulse Light method, combined with preservative-free forms of eyelid hygiene and artificial tears eye drops. The  study involved 30 patients (60 eyes) with dry eye syndrome and meibomian gland dysfunction. There were included patients with severe conjunctival hyperemia, follicular reaction, meibomeitis with changed, heavy Meibomian glands secret, rough eyelid margin, telangiectasias, tear break-up time (Norn test) not more than 5 seconds, necessity of very frequent instillations of artificial tear eye drops. All patients in anamnesis had already received courses of antiinflammation, artificial tears therapy and had courses of eyelid hygiene (eyelid margin massage with glass stick) with short-term positive dynamic and returning of symptoms during one month. As a  result of studied algorithm, with a help of Intensive Pulse Light it was possible to decrease the period of positive dynamic receiving. From the other side, preservative-free forms of artificial tears eye drops (Hylaback) and  eyelid hygiene (Blephaclean TheaGel Steri-Free) gave the prolongation of positive effect.

Premature infants with extremely low birth weight are at high risk of developing severe disabling forms of retinopathy of prematurity. Nonsurgical therapy methods of treatment of retinopathy in prematurity are  ineffective. Taking into consideration the multifactoriality of retinopathy in prematurity, studies aimed at analyzing accessory risk factors aiding the progression of active retinopathy of prematurity and the  development in their pharmacological therapy are relevant for practical healthcare. Effective prevention of retinopathy of prematurity and prevention of severe disabling stages in premature infants at risk require timely diagnosis of the form and severity of anemia. This is the neonatologist’s task. The ophthalmologist should inform the neonatologist about the possibility of developing retinopathy of prematurity in a baby’s eye and about the necessity for diagnostic and remedial measure to treat anemia.

The purpose of this study was to assess the impact of early anemia of prematurity on the frequency and severity of retinopathy of prematurity in infants at risk and the effectiveness of its treatment with erythropoietin. The frequency of anemia in preterm risk group (total 1603 children) and its treatment with the degree of prematurity were analyzed. Anemia was manifested in 99–100 % of children with retinopathy of prematurity. The comparative frequency and severity of retinopathy of prematurity was observed in three groups of infants: with extremely low birth weight and gestational age up to 28 weeks of pregnancy (245 children) group I, with gestational age 29–31 weeks of pregnancy (471 children) group II, and more than 31 weeks (581 children) group III. It was found that without treatment in group I retinopathy of prematurity  developed in 100 % of cases and ended with adverse outcomes (IV–V degree of retinopathy of prematurity) in 13.64 %, which is significantly higher (p < 0.01) than after treatment (1.78 %). Similar index was found in groups II and III.

Conclusion. We traced the importance of early premature anemia in the pathogenesis of retinopathy of prematurity. It helped us to conclude that the lower the gestational age of the child at the time of birth stronger linked with the dependence of anemia and retinopathy of prematurity. Both of them are associated with the imperfection of the protective mechanisms of preterm infants. Early prescription of erythropoietin significantly improves the clinical course of retinopathy of prematurity and its prognosis.

Purpose. Retrospective analysis of clinical, instrumental, cytological and pathological features of intraocular medulloepithelioma based on our own experience in the period from 2005 to 2018.

Patients and Methods. For a specified period of time in the department of ocular oncology and radiology in Moscow Helmholtz Research Institute of Eye Diseases we examined 9 patients aged from 1 to 44 years (5 men and 4 women), with a confirmed histological diagnosis of intraocular medulloepithelioma (medulloblastoma).  The average age of patients in assessing vital status was 15.8 ± 13.5 years, the average age at the time of  making the diagnosis “intraocular neoplasm” was 9.5 ± 11 years. All patients underwent a comprehensive clinical and instrumental ophthalmologic examination, which included visometry, tonometry, perimetry, biomicroscopy, ophthalmoscopy, Doppler ultrasound (ACUSON, USA), as well as general physical examination. Analysis of the initial status (before hospitalization) was carried out retrospectively according to the data of outpatient records. In one case, iridocyclosclerectomy was performed, in eight cases — enucleation of the affected eye followed by histopathological examination, as well as analysis of long-term results of treatment.

Results. A detailed analysis of nine clinical cases is presented, including typical clinical features, echographic signs of a meduloepithelioma (heterogeneous structure of the tumor, anechoic inclusions (cysts) in the  thickness of the tumor) are presented. According to the localization, we observed the tumor of the ciliary body (n = 3), the ciliary body and iris (n = 2), the retina (n = 1), the retina, the choroid and the optic nerve disc (n = 1), the ciliary body and the choroid (n = 1) and the choroid with invasion in extraocular muscles and optic nerve (n = 1). In 8 cases, enucleation was performed, one case was preceded by an iridectomy and a fine- needle aspiration biopsy. One patient underwent local conservative treatment (iridocyclosclerectomy) in the  presence of a tumor of the ciliary body and iris. Pathological and cytological features of the tumor were presented. 8 of 9 patients were alive and had no signs of metastases. One patient died 3 years after treatment.  

Conclusions. Despite the relative rarity, medulloepithelioma should be included in the differential-diagnostic series in patients with suspected retinoblastoma, non-pigmented uveal melanoma, adenocarcinoma of the  retinal pigment epithelium, and other rare intraocular neoplasms.