This article presents data on clinical ophthalmological manifestations of COVID-19 described in the literature, clinical examples that we met in pandemic conditions, COVID-19 including early and late manifestations, as well as references to studies conducted decades ago and aimed to evaluate the effects of coronavirus infection on the visual organ. The purpose of the most studies was to study the effect of COVID-19 on the visual organ indicate that the most common ophthalmological manifestation of this disease is conjunctivitis, which occurs in 3–10 % of cases. Our observations showed that patients with COVID-19, when applying for an appointment with an ophthalmologist after 1–3 months, make complaints about the feeling of dryness, discomfort in the eyes, itching and redness of the eyelids. These complains arose immediately after the illness and persisted during the above terms. This phenomenon can be explained by the fact that any inflammatory process occurring on the eye surface disrupts the process of lacrimation and leads to the emergence of dry eye syndrome. It is necessary to pay close attention to complaints from the visual organ not only in patients with COVID-19 in the early stages of the disease, but also in the coming months after stopping the acute pathological process. As studies have shown, coronavirus can involve the posterior segment of the eye in the pathological process, since this virus has a retinotropic effect. This hypothesis can be confirmed by the reports of several authors who studied with optical coherence tomography (OCT) the state of the retina 11–33 days after the onset of symptoms in patients with COVID-19. OCT data indicate the presence of hyperreflexive zones at the level of the ganglion cell layer and the plexiform layer, the severity of these zones being greater in the papillomacular bundle region. In addition, cases of thromboembolic complications affecting the vascular system of the eye are described. Considering the fact that in the development of thromboembolism of the central artery and retinal vein, therapy is as effective as possible in the first hours from the beginning of this pathological process development, close attention should be paid to patients’ complaints to visual impairment occurred against the background of coronavirus infection. The data presented in this article open up a range of possibilities for conducting new scientific research that will help to preserve the vision and health of our patients as effectively as possible. 

The article provides brief information on the history of microRNA studies. Today, their role in human pathology is regarded as key regulators of the expression of genes and the proteins encoded by them: miRNA molecules perform important physiological functions in cells and tissues of various organs. The specific mechanisms of their participation in the pathological process are insufficiently known. MicroRNAs were the first to be studied in patients with spinal muscular atrophy and leukemia. Publications devoted to the study of miRNAs and their role in the life of the eye appeared in 2002. Initially, miRNAs were studied in the tissues of the animals’ eyes (mice and zebras), and later the role of miRNAs of retinal pigment epithelium in inflammatory changes was studied in the experiment. The first information on the searches and isolation of microRNAs, their quantitative characterization in patients with primary open-angle glaucoma, age-related macular degeneration, autoimmune uveitis was analyzed. Encouraging results were obtained and the prospects of such studies in revealing the pathogenesis and the possibility of targeted treatment. Preliminary judgments were made about the role of miRNAs in the formation of various clinical forms of Graves’ ophthalmopathy (endocrine ophthalmopathy), which also gives hope for the emergence of targeted therapy for this disease. More publications have been devoted to the importance of miRNAs in the development of primary malignant intraocular tumors (retinoblastoma and uveal melanoma). Considerable attention is paid to retinoblastoma: the results of a study of various miRNAs as biomarkers of this tumor for early diagnosis with final access to targeted therapy, both in case of local lesion and in conditions of its metastasis, are presented. Most studies are limited to the study of miRNAs in tumor tissues. Over the past 5 years, a number of studies have been performed to highlight the spectrum of circulating miRNAs that have potential diagnostic value for early detection of metastases of uveal melanoma. The number of observations or experiments in the analyzed works is small, the studies are exploratory in nature and the publications all end almost with the phrase: “Further research is required”. 

Irreversible damage to the structure of axons and death of the retinal ganglion cell (RGC) soma in primary open-angle glaucoma (POAG) and Alzheimer’s disease (AD) develop against the background of the already existing clinical manifestation, which is preceded by a slow period of progressive loss of synapses and dendrites of the RGCs. Recent studies have shown that the integrity of the RGC’s dendritic branching can serve as both a target of neuroprotective therapy and a sensitive marker of retinal degeneration in AD and glaucoma. To develop methods of complex neuroprotective therapy, it is necessary to substantiate the targets and tactics of affecting the dendritic tree of the RGCs, the remodeling of which, according to modern concepts, can be closely and antagonistically related to the regeneration of the axon after its damage in trauma and neurodegenerative diseases. RGCs are highly capable of functional modification. Currently, it has been proven that the use of neuroprotective drugs and neurotrophins is promising for maintaining the adaptive plasticity of RGCs and restoring their synaptic contacts at the level of the retina and brain. Understanding the features of the adaptive plasticity of RGCs in AD and glaucoma will make possible to use technologies to activate the internal potential of neuronal remodeling, including the modification of dendritic branching of RGCs and regeneration of their axons, in the preclinical stages of these diseases. Increasing knowledge about the sequence and mechanisms of early events in the retina’s inner plexiform layer will contribute to the development of targeted neuroprotective therapy and new technologies to detect early POAG, AD, and, possibly, other systemic and local neurodegenerative conditions. 

The purpose of this work is to review the literature data on the role of optical coherence tomography in the diagnosis of diseases of the closed angle of the anterior chamber. An analysis of the modern technical devices use — optical coherence tomography of the anterior segment (AS-OST) and models with a frequency-modulated source (Swept Source) is presented. The advent of new imaging technologies such as SS-OCT is advancing the understanding of the pathogenesis of primary angle closure diseases. Visualization of the structures of the anterior segment of the eye is an important part of the strategy aimed at solving the problem of identifying risk factors, diagnosing, monitoring and evaluating the effectiveness of treatment of diseases of primary angle closure. Qualitative and quantitative data analysis based on optical coherence tomography significantly increases the diagnostic accuracy, which undoubtedly plays a key role in the choice of treatment tactics for the closed angle of the anterior chamber. The interpretation of research results should take into account the strengths and weaknesses of traditional methods and newly developed technologies.

Conclusion. Optical coherence tomography of the eye’s anterior segment is a standard in modern diagnostics and evaluation of the effectiveness of treatment of diseases of primary angle closure, taking into account pathogenetic mechanisms. 

Contrast-enhanced ultrasound is a highly informative method for the differential diagnosis of focal changes in various organs and tissues, which allows to visualize vascular structures and obtain new previously unavailable information when using standard b-scan. At the beginning of the 21st century after the development of a new generation of contrast agents consisting of microbubbles with inert gas contrast-enhanced ultrasound became widely used to improve visual assessment of small-caliber vessels in the diagnosis of the abdominal cavity and retroperitoneal space pathology: benign and malignant liver formations, spleen pathology, inflammatory diseases and tumors of the pancreas, defects in renal perfusion, tumor and cystic lesions of the kidneys. Assessment of intraocular tumors microcirculation and diagnosis of vitreoretinal pathology are still two main directions of using contrast-enhanced ultrasound in ophthalmology. In recent years, there has been a growing interest in the use of contrast-enhanced ultrasound in the study of perfusion of different types of uveal melanoma in an animal experiment. A promising direction in the field of genetic engineering is the use of local contrast-enhanced ultrasound exposure on retinal cells (retinal ganglion cells, retinal pigment epithelium) to promote gene transfection (non-viral nucleic acid delivery into the DNA of a cell), which is an important part of gene therapy. Despite the successes achieved in the study of contrast-enhanced ultrasound effectiveness in medicine, further research is needed to increase the informative value of this method in the diagnosis of ophthalmopathology. 

Age-related macular degeneration (AMD) is a chronic disease of the central retina and one of the main causes of blindness in patients over 60 years of age in industrialized countries. Currently, anti-vascular endothelial growth factor therapy (anti-VEGF therapy) has become the standard of neovascular AMD treatment, leading to the prevention of progressive vision loss in more than 90 % of treated patients during a two-year follow-up period. In the modern world there are transition from quantitative assessment of “fluid” according to optical coherence tomography (OCT) — the thickness of the central retinal zone, to qualitative — the presence of IRF, SRF, fluid under RPE. The data obtained by Zinkernagel have shown that, despite good functional results (an increase in visual acuity), the administration of the drug once every 2 months leads not only to fluctuations in IRF and SRF, but also to serous PED [4]. The existing qualitative and quantitative analysis is not perfect. Fluctuation is a new qualitative marker of the study of disease activity, it is defined as the sum of all types of fluid (IRF + SRF + fluid under RPE) in a certain time interval (with monthly measurement of the indicator). The fluctuation index was determined from the cumulative change in the thickness of the retina in the fovea over time [6]. Thus, the fluid is considered as a key morphological criterion for the activity of nVMD and an indication for (initiation or continuation) of antiangiogenic therapy. At the same time, there is evidence that a lower level of each type of fluid (IRF, SRF, fluid under RPE) is associated with better BCVA results against the background of anti-VEGF therapy [17]. The stability of retinal thickness during anti-VEGF therapy is no less important parameter than the statement of fluid resolution at a certain time, and it appears that better control of the central retinal thickness was associated with higher overall NEI VFQ-25 scores and individual scales reflecting important daily activities of the patient [16]. 

Diabetes mellitus is a serious health problem in both developed and developing countries. It is expected that by 2040 the incidence of diabetes mellitus in the world will increase to 642 million people. With the increase in the incidence of diabetes mellitus, the incidence of diabetic vascular complications increases, which worsen the quality of life of patients and triple the risk of death. Diabetic retinopathy is one of the most common microvascular complications of diabetes mellitus, leading to progressive loss of visual function. Diabetic retinopathy occurs in conjunction with diabetic nephropathy. This fact is associated with the anatomical similarity of the blood-retinal barrier and the glomerular filtration barrier, as well as with the general pathogenetic mechanisms of the effect of hyperglycemia on peripheral microcirculation. On average, after 10–15 years, patients with decompensated diabetes mellitus develop end-stage renal failure, requiring renal replacement therapy, such as peritoneal dialysis, programmed hemodialysis, and kidney transplantation. This article highlights the latest data on the effect of programmed hemodialysis on the morphofunctional state of the retina in patients with diabetes mellitus. 

Melatonin is a hormone of the epiphysis and a regulator of circadian rhythms of living organisms, which affects a number of important physiological processes. Melatonin synthesis has also been found in other organs, in particular in various structural systems of the eyeball. A number of studies demonstrate that melatonin plays an important role in a variety of biochemical and physiological processes that ensure functioning of visual analyzer. This review provides information on the synthesis of melatonin, its secretion and metabolism, considers key information about melatonin receptors (MT1, MT2 and MT3), their localization in various eye’s structures, and their affinity to melatonin. Over the last years, researchers’ attention has been drawn to the therapeutic properties of melatonin, relevant for treatment of age-related diseases. The aggressive effects of solar radiation and environmental toxicants expose the organ of vision to oxidative attacks. A large amount of evidence has been accumulated of the participation of oxidative stress in the development of many eye diseases, resulting in an imbalance between the generation of reactive oxygen species and the expression of antioxidant enzymes. Melatonin, which has antioxidant and anti-inflammatory properties and regulates mitochondrial functions, can be a powerful tool to counter age-related changes. Globally, the number of people of all ages with visual impairment is estimated at 285 million. Cataract and age-related macular degeneration (AMD) are the leading causes of vision loss around the world. AMD and cataracts often coexist in patients, so there is a concern that age-related cataract surgery increases the risk of morbidity and progression of AMD. The pathogenesis of both cataracts and AMD is still unclear, although a number of theories have been put forward, including oxidative stress, age-related changes, inflammatory processes, etc. Analysis of modern domestic and foreign literature shows good perspectives of using melatonin as preventive and therapeutic agent in the treatment of ophthalmic diseases of various origins. 

Introduction. Recent population studies reveal steady growth in intraocular lens (IOL) exchanges including those for refractive and other optical reasons. To lower complication risks related to IOL exchange, we introduced a modular IOL model with replaceable optical part.

Purpose: preliminary analysis of modular IOL implantation clinical results.

Patients and methods. From August 2018 to February 2020, five patients as part of their surgical treatment for various forms of cataract received newly designed modular IOLs. The modular IOL is composed of two separate parts — haptic and optic, manufactured from the same elastic acrylic material with hydrophobic properties. The haptic includes a closed ring and a pair of open equally distant loops in a unified design. The haptic ring with projections serves as a base for optical disk. The current study evaluated characteristics of the IOL implantation and assembly process, as well as possible development of intra- and early postoperative complications.

Results. First implantations of the modular IOL accomplished using standard surgical instrumentation and disposables passed without complications. We did not observe scratches, breaks or any other mechanical damage to neither haptic, nor optical parts. During simultaneous implantation, optical disks fixated in haptic rings preserved their due positioning after transiting through slender injector channel. There were no specific, modular-IOL related complications in the early postoperative period. The optical disk maintained correct location, delimited by fixation leaflets of the haptic ring.

Conclusion. Early results for clinical application of the novel modular IOL demonstrated feasibility of its safe implantation in disassembled and preassembled modes. 

Background. In recent years there is a tendency to more often admission in our institution children with multiple IOL damage caused by laser treatment of secondary cataract operated at local hospitals.

Purpose. To analyze the causes of laser damage to IOL in children underwent YAG laser destruction of secondary cataract and find best ways to prevent them.

Patients and methods. We analyzed the frequency of acrylic IOL damage after YAG-laser destruction in 593 children with congenital, posttraumatic and postuveal cataract at age from 6 months to 17 years (one third of patients were less than 3 years old). All laser operations were performed on identical YAG-laser, by the same protocol and by one surgeon.

Results. We confirmed that main reliable prevention factor of damage to IOL in children is the precise focus of laser beam. In past 10 years in our institution, we managed to decrease frequency of laser damage to IOL in children with secondary cataract in 4.5 times due to performing operations under general anesthesia (43.8 % in 2007–2008, 65.8 % in 2018). Thus, decreasing frequency from 5.9 % to 1.3 % in the same age group of patients.

Conclusion. To achieve the effective prevention of laser damage to IOL in cases of YAG laser destruction of secondary cataract it is essential to use general anesthesia in following conditions: children 5 or below age, non-contact children of older age, children with nystagmus, CNS pathology, psychomotor development delay. It is unacceptable to perform this operations without general anesthesia in children that can’t fix the gaze. Furthermore it is important to use contact lenses to fix the eyes of a child, select the individual less invasive method and technique of laser operation, utilize single short impulses with minimal effective energy, thoroughly follow standard safe energy modes (impulse energy shouldn’t be more than 2.4 mJ, impulse number should be not more than 100). 

There are quite systematic data of the ophthalmic manifestations in SARS-CoV-2, on the presence of conjunctivitis in patients with COVID-19, as well as on the detection of viruses in the lacrimal fluid and eye tissues. And, although ophthalmic manifestations are considered rather rare for COVID-19 and are not included in the list of important for diagnosis, there is not enough reliable data on the inflammatory processes of the eye’s anterior part and their connection with COVID-19, as well as those arising against the background of the treatment.

Purpose. To study the development of inflammatory diseases of the anterior part of the eye in patients who have undergone the new coronavirus infection COVID-19.

resu. In the Department of Infectious and Allergic Eye Diseases of the Helmholts National Medical Research Center of Eye Diseases, 88 patients with confirmed transferred new coronavirus infection COVID-19 of varying severity were observed. The main method of laboratory diagnostics is the detection of SARS-CoV-2 RNA in swabs from the nasopharynx, the patient’s sputum. Serodiagnostics of COVID-19 includes the determination of IgG-, IgM-antibodies to SARS-CoV-2 in the blood in an enzyme-linked immunosorbent assay.

Results. Acute conjunctivitis associated with COVID-19 is quite rare and is an early sign of the disease. In the complex nonspecific topical therapy of viral conjunctivitis in COVID-19, along with etiopathogenetic systemic treatment, local eye medications with immunomodulatory and antiviral activity should be used. Conjunctivitis during a pandemic may be the only sign of COVID-19. The development of allergic conjunctivitis in COVID-19 is possibly associated not only with the effect of a viral agent, but also depends on the toxic effect of drugs used in the complex treatment of this disease. The increase in the number of patients with episcleritis after the postponed coronavirus infection needs further detailed study, with the analysis of laboratory data from this group of patients and the accumulation of clinical material.

Conclusion. Ophthalmic manifestations in COVID-19 are very different, affecting various structures of the eye, occur at different periods — both during the course of the disease and after clinical recovery, and, of course, need further consideration, study and structuring. 

Most of the medicines used for the treatment of glaucoma include a preservative in various concentrations. With long-term topical therapy, patients with glaucoma may develop dry eye syndrome (DES). The severity of symptoms depends on the number of drugs used and the presence of a preservative in them. Against the background of DES progression, compliance to glaucoma therapy may decrease, and, consequently, the effectiveness of the treatment may decrease. Currently, new non-preservative hypotensive drugs containing brimonidine, as well as a fixed combination (FC) of dorzolamide and timolol, are available on the market.

Purpose: to compare assessment of the hypotensive effect and tolerability of preservative-free drugs FC Dorzolamid 20 mg/ml, Timolol 5 mg/ml (Dortmol Antiglau ECO) and Brimonidine 2 mg/ml (Brim Antiglau ECO) when switching from similar drugs containing a preservative in patients with compensated glaucoma.

Patients and methods. In this prospective clinical study, 60 patients (60 eyes) with compensated primary open-angle glaucoma on combined topical therapy were examined. In group 1 (30 patients, 30 eyes), the combinations of dorzolamide / timolol or brinzolamide / timolol were switched with the non-preservative Dortmol Antiglau ECO. In group 2 (30 patients, 30 eyes), the brimonidine as part of the medication regimen were replaced with the non-preservative Brim Antiglau ECO. The level of corneal-compensated IOP was assessed before the switch in therapy and after 1 month. Subjective feelings and objective signs of the treatment’s use were monitored during examination and using a questionnaire, which was compiled to study the tolerance of therapy.

Results. Switching to a preservative-free combination of dorzolamide and timolol resulted in a reduction in complaints of irritation, lacrimation, and foreign body sensation. The efficiency control did not reveal a significant change (p > 0.05) in the cornealcompensated intraocular pressure (IOPcc). When transferred to the Brim Antiglau ECO as part of the local hypotensive treatment, intraocular pressure decreased significantly (p < 0.05). The average total score characterizing drug intolerance, when evaluated by the patient, decreased by 2.4 times, by the attending physician-by 1.9 times. The degree of conjunctival hyperemia on the MacMonnies photographic scale decreased in both groups.

Conclusion. Preservative-free drugs can be recommended for most patients with glaucoma as a starting treatment and as a replacement for current therapy. 

Purpose: To study the correlations in the diagnosis of patients with advanced stages of primary open-angle glaucoma (POAG) using data from electroretinography and optical coherence tomography (OCT) of the retina.

Methods. The study was performed in two clinical subgroups of patients (35 people, 55 eyes) with stages II and III POAG and the age-matched control group (28 healthy people, 32 eyes). The thickness of the ganglion cell complex (GCC), including the retinal nerve fiber layer (RNFL), the retinal ganglion cell layer (RGC), and the inner plexiform layer (INL) in the macular region, was assessed in nine segments. Correlation analysis of morphometric parameters of GCC in advanced POAG was performed with data from previously performed electroretinography: the transient pattern-ERG (T-PERG), stationary pattern-ERG (S-PERG), and photopic negative response (PhNR).

Results. Statistically significant (p < 0.01) thinning of all layers of the GCC was revealed in all studied sectors. Significant (p < 0.05) differences in all morphometric characteristics were recorded between the two subgroups. In patients of the 1st subgroup, the greatest differences in morphological parameters from the control group’s values were noted in the lower, upper parafoveal sectors of the RGC layer, as well as in the temporal perifoveolar quadrant. In the 2nd subgroup, significant changes in the thickness of the inner retina layers were recorded for the upper and lower peripheral sectors of the RNFL and the temporal para- and peripheral quadrants of the RGC layer. In the study of morphological-functional relationships, the most significant correlations were revealed for the parameters of S-PERG. The amplitude of S-PERG directly correlated with the thickness of RNFL in the nasal sector of the perifovea (r = 0.86; p < 0.01) in the 1st subgroup of patients and the thickness of the RGC in the nasal sector of the perifovea in the 2nd subgroup (r = 0.84; p < 0.01). Moderate relationships were revealed between the N95/P50 T-PERG index and the RNFL thickness in the upper sector of the perifovea (r = 0.46; p < 0.05), the peak N95 T-PERG latency, and the RNFL thickness in the upper sector of the perifovea (r = –0.43; p < 0.05) in patients of the 1st subgroup. In patients of the 2nd subgroup, there was a correlation between the amplitude of N95 T-PERG and the thickness of the RGC in the lower sector of the perifovea (r = –0.42; p < 0.01), the peak latency of N95, and the thickness of the RNFL in the upper sector of the parafovea (r = –0.31; p < 0.05). A direct correlation was established between the PhNR amplitude from the baseline and the thickness of the RGC layer in the perifovea’s temporal sector (r = 0.72; p < 0.01) in patients with stage II POAG. The PhNR amplitude from the b-wave peak in patients with stage III POAG correlated with the RNFL thickness in the perifovea’s nasal sector (r = 0.51; p < 0.01).

Conclusion. Specific patterns of morphological-functional changes in the parameters of the retina’s inner layers in patients with advanced POAG are presented, which can be used as clinical markers in determining an individual therapeutic strategy. 

Purpose: study the microscopic examination and microtopography of explanted hydrophilic acrylic IOLs with opacification.

Material and methods. 5 samples of soft hydrophilic acrylic IOLs produced in European countries and the USA were studied. Explanted IOLs were studied using a scanning electron microscope (EVO LS10, Karl Zeiss, Germany-UK).

Results. In 4 cases changes in hydrophilic acrylic IOL had the character of surface opacification in the area of the anterior wall of the optical element of the lens with localization in the Central zone (pupil area). In one case, the opacities were located over the entire surface of a hydrophilic IOL having a hydrophobic coating. The changes were characterized by the formation of crystalline deposits on the IOL surface at different stages of evolution. In the initial stage, primary point precipitates with sizes of 3–5 microns were formed. At a later stage, the changes had the form of “adult” spherocrystals with a typical radial-concentric zonal structure, up to 50 microns in size. In one of the of IOLs, the growth of crystals under the surface of the lens — in the thickness of IOLs was determined.

Conclusion. The changes characterize different stages of the same type of pathological process with sedimentation of crystal deposits on the surface of IOL with changing crystallomorphology. 

Objective: to study efficacy and factors of excessive proliferation after trabeculectomy (T) in pediatric uveitic glaucoma (UG).

Patients and Methods. 102 children aged from 3 to 17.5 years (mean 124.5 ± 2.8 month) with uncontrolled on maximum topical hypotensive therapy open angle or combined (with peripheral anterior synechiae) form of UG underwent T (148 eyes, 180 operations). 76.1 % operations were performed with intraoperative 5-fluorouracil, 8.3 % — with mitomycin C, 6.1 % — with bioresorbable, 1.7 % — with collagen drainage, 7.8 % — without antimetabolites or drainages. Kaplan-Meier survival analysis was performed.

Results. Overall absolute (without hypotensive therapy) success probabilities were 67 %, 46 %, 39 %, qualified success (with hypotensive therapy) — 93 %, 72 %, 54 % at 1, 3, 5 years after T respectively. Factors associated with failure were primary location of inflammation in anterior uvea, aphakic or pseudophakic eye, repeat T, bioresorbable drainage (vs. 5-fluorouracil), persistent inflammation after T. Age and uveitis activity at the moment of T, duration hypotensive therapy before primary T, postoperative complications (9.4 %), frequency of postoperative topical steroid had no significant influence on surgical success.

Conclusion. T with intraoperative antimetabolites is effective, safe and nowadays may be recommended as first choice operation in pediatric open angle or combined UG. 

Thermography is the method of noninvasive registration of visible image of the own infrared radiation of the human body surface by special devices. The physiological basis of its application in medical diagnostics is the amplification of infrared radiation intensity from pathologic spots that is connected with the enhancement of blood supply and metabolism.

Purpose. To study the possibilities of thermography for functional bleb status assessment, for early diagnostics of bleb scarring processes and for definition of needling indications.

Patients and methods. There were executed 32 thermography (32 patients and eyes) of blebs in 7 days after minimally invasive sinustrabeculectomy. Authors used thermal imaging Тesto 875-2i with SuperResolution technology and telephoto lens 9°×7°. The bleb area and temperature were studied With IRSoft and Universal Desktop Ruler programs. Intraocular pressure (corneal compensated) (IOPcc) was measured with Ocular Response Analyzer®, ORA.

Conclusion. The study has shown the direct correlation dependence between bleb functional activity and its thermographic characteristics (area and temperature). 

The work is devoted to one of the actual problems of current ophthalmology — creating effective methods of studying stereovision.

The purpose — comparative analysis of the capability of stereoperception under conditions of using different regimes of alternating presentation of stereo stimuli with different characteristics in children with strabismus and in children without ophthalmopathology.

Patients and methods. 294 school children — 167 children of the control group (without ophthalmopathology) and 127 children with non-paralytic strabismus without functional scotoma (FSS) were observed. We used stereostimuli with different characteristics in the following regimes of presentation: 1) the regime of simple monocular alternating (alternate presentation of an image for the right and left eye); 2) the regime having an “empty” interval (black background) between monocular phases; 3) the regime having a binocular phase (a binocular image containing details corresponding to the stimuli for the right eye and the left eye) between monocular phases.

Results. It was found that the majority of children with non-paralytic strabismus, who are incapable of stereoperception with the classic Fly-test and Lang-test, can perceive the stereoeffect with alternating presentation of stereostimuli within individual ranges of durations of monocular phases, a binocular phase and an “empty” interval. In children of the control group when switching from the simple alternation regime to the “empty” interval regime the maximal durations of monocular phases, which preserved the stereoeffect, decreased and when switching to the binocular phase regime they significantly increased. In children with strabismus linear images are simpler for stereoperception than random-dot images as well as in children of the control group (p < 0.001); stimuli creating the effect of the frontoparallel separation of details get perceived better than those creating the decline effect or the turning effect (p < 0.001); stimuli creating the effect of the vertical stripes decline get perceived better than those creating the effect of the horizontal stripes turning (p < 0.001). However, as opposed to the children of the control group, in children with strabismus the stereoeffect gets formed better under conditions of the peripheral localization of linear details than under conditions of the central one.

Conclusion. Using computer programs with different regimes of alternating presentation of stereostimuli with certain characteristics allows to effectively evaluate individual capability of stereoperception which is necessary for the personalized approach to the selection of visual stimuli and stimuli presentation regimes in functional treatment of patients with non-paralytic strabismus. 

The work is devoted to one of the actual problems of modern strabismology — the study of the ability to stereo perception in children with non-paralytic strabismus.

Purpose: to study the capability to stereovision with alternating presentation of stereostimuli in children with functional scotoma in non-paralytic strabismus.

Patients and methods. 113 children with functional scotoma (FS) in non-paralytic strabismus were observed. We used stereostimuli with different characteristics in the following regimes of presentation: 1) the regime of simple monocular alternating (alternate presentation of an image for the right eye and the left eye); 2) the regime having an “empty” interval (black background) between monocular phases; 3) the regime having a binocular phase (a binocular image containing details corresponding to the stimuli for the right eye and the left eye) between monocular phases.

Results. It was found that in 23 (20,3 %) children, the ability to stereo perception was completely absent. All these children had stable total FS (monocular vision). In the remaining 90 children (with unstable or regional FS), the ability to stereo perception was shown with some stimuli in some modes of their alternating presentation. For stimuli with a central arrangement of linear parts, the stereo effect was possible when they were presented in an alternating mode with an “empty” interval lasting from 20 to 70 ms in combination with the duration of monocular phases from 30 to 90 ms. For stimuli with a peripheral arrangement of linear elements, 22.1 % of children were able to stereo perception not only in the “empty” interval mode, but also in the simple alternation mode. At the same time, the greatest number of children capable of stereo perception was detected when using the mode with an “empty” interval of 30–60 ms and a duration of monocular phases of 40–60 ms. With random-dot stimuli, none of the children in this group were capable of stereo perception.

Conclusion. Our results suggest that even in patients with FS in non-paralytic strabismus, stereo perception is possible under the conditions of alternating presentation of stimuli with certain characteristics. In this case, the most likely appearance of a stereo effect with stimuli containing peripheral linear elements that create a stereo effect when presented in an alternating mode with an empty interval between monocular phases. 

Purpose: to evaluate the effects of acute hypoxic hypoxia on eye tissue cells in adult rats and determining the effectiveness of 0.007 % solution of para-aminobenzoic acid (PABA) for apoptotic damage to the tissues of the ocular surface in rats.

Materials and methods. In the experiment, 27 male Wistar rats (54 eyes) were used, divided into 5 groups. Group I — intact control, Group II — hypoxic control after 1 hour, Group III — hypoxic control after 3 hours, Group IV — with the injection of the drug 1 hour after hypoxia, Group V — injection of the drug 24 hours before hypoxia. The identification of apoptotic cells in the tissues of the eye was performed by the TUNEL method on frozen sections of the eye stained with Hoechst 33342 nuclear fluorescent dye. The localization and fluorescence intensity of the damaged cells was analyzed under a fluorescence microscope using the Image J. computer program.

Results. Under the conditions of simulated acute hypoxic hypoxia, apoptotic lesions of the conjunctiva, corneal epithelium, choroid, and photoreceptor layer of the retina were observed. In group II, the number of damaged cells in the conjunctiva was 67 %, and in group III it was 120 % more compared to group I — the norm (p < 0.05). With the injection of PABA before hypoxia, there were no significant differences compared with the norm (group I) in the state of the affected cells in the conjunctiva. In the group of animals (group III) with the injection of PABA after hypoxia after 1 h, the number of damaged cells does not statistically differ from group II (hypoxic control after 1 h), but significantly lower than in group III (hypoxic control after 3 hours). The same pattern is observed in the corneal epithelium.

Conclusion. Para-aminobenzoic acid (0.007 %) has a prophylactic and therapeutic effect, preventing and stabilizing the development of apoptosis of conjunctival cells and anterior corneal epithelium induced in experimental acute hypoxic hypoxia. 

Currently, there are negative trends in the incidence of cataract, which, along with glaucoma, is the most common cause of visual impairment in various countries. Cataract prevalence continues to be high, necessitating the search for new treatment technologies and criteria for assessing the health and quality of life of this population. The purpose: to study the quality of life of patients with cataract against the background of ultrasonic phacoemulsification with implantation of soft intraocular lenses. Nei-VFQ-25 quality of life was studied in 182 patients with nuclear–cortical form of cataract before and after ultrasonic phacoemulsification. The integral index and components of the quality of life of patients with cataract before treatment are significantly reduced. The quality of life of patients with cataracts significantly increases in 3 months after surgical treatment in all indicators. Especially vision significantly improved in the distance, near vision, General health. Improving the quality of life of patients with cataracts after treatment indicates the effectiveness of the used ultrasonic phacoemulsification. In this case, the cause is a violation in the field of role-playing physical and emotional functioning. In the long-term period (6 months after treatment) there is an improvement in the quality of life of patients with mechanical trauma in many respects, except for the role of physical functioning. This study for the first time revealed the effect of ultrasonic phacoemulsification with implantation of soft intraocular lenses on the quality of life of patients with cataract. For the first time using a specific questionnaire NEI-VFQ-25 revealed the scale on which there is an improvement in the quality of life after surgery. The leading indicators of quality of life of patients with cataracts, characterizing the effectiveness of treatment with high-tech method of ultrasonic phacoemulsification, were established for the first time. 

Purpose: to prepare and characterize calcium-phosphate nanoparticles loaded with compounds of different nature: low-molecular inhibitor of angiotensin-converting enzyme lisinopril, and high-molecular enzyme superoxide dismutase 1. To estimate the possibility of enhancing the biological efficacy of these compounds via incorporation to the nanoparticles.

Material and methods. To increase the stability of calcium-phosphate nanoparticles coating with β-D-cellobiose was used. The size, surface charge (ζ-potential) of the particles and efficacy of including of the selected compounds to the particles were measured. Comparative assessment of the efficacy of lisinopril solution and lisinopril in nanoparticles was made via the estimation of their ocular hypotensive effect in normotensive rabbits. To compare the efficacy of the superoxide dismutase 1 solution and superoxide dismutase 1 in nanoparticles the rabbit model of immunogenic uveitis was used. We estimated the clinical score for several signs of uveitis, protein level, and antioxidant activity in aqueous humor.

Results. Calcium-phosphate nanoparticles containing lisinopril had average hydrodynamic radius of 170–300 nm and negative ζ-potential of –17 mV. Particles containing superoxide dismutase 1 had average hydrodynamic radius of 220–450 nm and negative ζ-potential of –4 mV. Lisinopril in nanoparticles caused a significantly greater decrease of intraocular pressure than lisinopril solution. Superoxide dismutase 1 in calcium-phosphate nanoparticles more efficiently decreased the clinical manifestations of uveitis and normalized the biochemical processes in aqueous humor than the enzyme in buffer solution.

Conclusion. Incorporation of both low-molecular and high-molecular drugs to the calcium-phosphate nanoparticles enhance their bioavailability and therapeutic efficiency. The data obtained give evidence of the prospectively of the using of these nanoparticles as vehicles for the ophthalmic drugs used in eyedrops. 

In the Russian literature, there are only a few works that summarize their own experience in the treatment of recurrent corneal erosion (RCE) in a limited group of patients, which actualizes further research in this direction.

Objective: to develop and evaluate the clinical effectiveness of an integrated approach to the management of patients with RCE.

Patients and methods. 69 patients (69 eyes) with RCE and a disease duration of at least two years, who were divided into 3 groups according to the frequency of relapses: group 1 (12 people) — episodes of RCE no more than 2–4 times a year; Group 2 (19 people) — RCE episodes no more than once a month; Group 3 (38 people) — RCE episodes more than 2 times a month. All patients were cured by pharmacological support, if conservative therapy was ineffective (1 relapse during treatment within 1 month), phototherapeutic keratectomy (PTK) was performed with the application of a bandage contact lens and the appointment of pathogenetically-oriented treatment for up to 1 year. The average follow-up period was 28.6 ± 6.1 months.

Results and discussion. In group 1, during the entire period of observation, RCE was compensated by the therapy, in the other groups, the effectiveness was lower, which in 41 (59.4 %) cases required the implementation of PTK. There were no relapses of corneal erosion after PTK with subsequent pathogenetically-oriented therapy, including heparin-containing medications in instillation (CHYLOPARIN-KOMOD®) and ointment forms (PARIN-POS®) for 1 year.

Conclusion. The high effectiveness of PTK with subsequent pathogenetically-oriented pharmacological support may be the basis for a broader recommendation of this method in patients with RCE and a relapse rate of more than 1 time a month. 

Purpose: to develop approaches to differentiated substitution therapy in patients with dry eye (DE) of mild and moderate severity.

Patients and methods. We examined 86 DE patients (22–45 years old; 38 men, 48 women). Group-1 included 54 patients (54 eyes) with mild DE under conditions of combined lipid-mucose-deficiency, group-2 32 patients (32 eyes) with moderate DE against the background of combined lipid-aqua-mucose-deficiency. Conducted: DE symptoms registration (OSDI scale); Norn and Shirmer-1 tests; OCT meniscometry; assessment of the Bijsterveld xerosis index and ‘lid-vipers’ symptom identification; Norn’s compression test. To assessment the therapy effectiveness, patients in both groups were divided into subgroups. Patients of subgroup 1.1 (18 eyes) carried out ‘fat-water’ type emulsion instillations, subgroup 1.2 (18 eyes) — 0.15 % sodium hyaluronate instillation (Hylabak®), subgroup 1.3 (18 eyes) — 3.0 % trehalose (Thealoz®) — 1–2 drops, 4 times a day. All persons included in group-1 were additionally recommended to apply 5.0 % dexpanthenol gel at night. Patients of subgroup 2.1 (16 eyes) received 0.15 % sodium hyaluronate instillation (Hylabak®), patients of subgroup 2.2 (16 eyes) 0.15 % sodium hyaluronate (Hylabak®) and 3.0 % trehalose (Thealoz®) instillation — 4 times a day. All patients included in group-2 were additionally recommended to apply ointment with vitamin A at night. The main criterion for the therapy effectiveness was the tear film brake up time (TBUT, s) two months after the start treatment. Statistical processing included: calculation the mean and its standard deviation (M ± s); assessment of the significance of differences (Wilcoxon’s t-test, KruskalWallis test, Mann-Whitney U-test).

Results. In group-1 patients the following TBUT dynamics was recorded: in subgroup 1.1 — from 5.4 ± 0.5 to 6.2 ± 0.6 s (p < 0.05); in subgroup 1.2 — from 5.2 ± 0.4 to 6.6 ± 0.6 s (p < 0.05); in subgroup 1.3 — from 5.3 ± 0.5 to 7.1 ± 0.7 s (p < 0.05). The most pronounced TBUT increase was noted in subgroup 1.3 (trehalose instillation). In group-2, the increase in TBUT was: in subgroup 2.1 — from 3.5 ± 0.3 to 4.7 ± 0.3 s (p < 0.05); in subgroup 2.2 — from 3.4 ± 0.2 to 5.2 ± 0.4 s (p < 0.05). A significantly more pronounced TBUT increase was noted in subgroup 2.2 (sodium hyaluronate and trehalose instillation).

Conclusion. In our opinion, differentiated approaches to DE replacement therapy may be included: for mild DE in conditions of lipid-mucose-deficiency — instillation of bioprotector based on 3.0 % trehalose (Thealose®); in case of moderate DE against the background of lipid-aqua-mucose-deficiency — 0.15 % sodium hyaluronate (Hylabak®) instillation in combination with a bioprotector based on 3.0 % trehalose (Thealoz®). 

Purpose: develop of new drugs for ophthalmology based on 6-methyl-3-(thietan-3-yl)uracil and methyluracil.

Materials and methods. An experimental study was carried out on 10 rabbits with a body weight of 3.5–4.0 kg of chinchilla breed. A thermal burn of the cornea in the eyes of 6 rabbits and a chemical burn of the cornea in the eyes of 4 rabbits were modeled. Therapy with the use of drugs was carried out: ophthalmic ointment — in thermal burns, ophthalmic medicinal films based on 6-methyl-3-(thietan-3-yl)uracil and methyluracil in chemical burns.

Results. The use of ophthalmic ointment based on 6-methyl-3-(thietan-3-yl)uracil for thermal burns led to a decrease in conjunctival hyperemia and resorption of corneal edema by 4–5 days. On the 14th day of therapy, the microscopic picture of the rabbits cornea had the usual normal structure. The use of 6-methyl-3-(thietan-3-yl)uracil and methyluracil based ophthalmic drug films yielded the following results: centripetal epithelialization of corneal erosion was observed, epithelial regeneration was higher with the use of methyluracil eye drug films and total epithelization was achieved on the 7th day of observation than when using eye drug films based on 6-methyl-3-(thietan-3-yl)uracil, where total epithelization occurred on the 14th day. Complete restoration of the surface epithelial layer of the cornea in both groups was observed on the 21st day.

Conclusions. The use of new drugs based on 6-methyl-3-(thietan-3-yl)uracil and methyluracil in various types of corneal burns showed good tolerance in the eyes of experimental animals, shortened the treatment time, and achieved high wound healing efficacy. 

The authors analyzed the treatment results of 53 patients (106 eyes) with allergic conjunctivitis. All patients received Olopatadine 0.2 % (Visallergol) in drops once a day during 1 month. All patients underwent the same tests: scraping from the conjunctiva for the presence of eosinophils, evaluation of the inflammation symptoms using 4-ball scale, biomicroscopy of cornea and conjunctiva with staining by lissamine green and tear film stability (Norn’s method). All of the above-mentioned tests were performed before the treatment, on 14-th day and after the course of therapy. The inflammatory reaction of conjunctiva, the amount of discharge in the conjunctival cavity and the staining of the conjunctiva with lissamine green decreased in all patients starting from the 14-th day of treatment. The maximal effectiveness of the drop was registered in patients with the chronic type of allergic conjunctivitis. The manifestation of the disease reduced significantly after 1 month of treatment, but it does not disappear completely. So it is necessary to continue therapy after 1 month. The laboratory methods of diagnosis confirm the effectiveness of Visallergol by disappearance of eosinophils in the conjunctiva scrapings. The secondary dry eye syndrome developed in all types of the allergic conjunctivitis and needs a long-term treatment. The maximal intensity of dry eye syndrome was registered in patients with chronic type of the allergic conjunctivitis. The drop can be used starting from 2 years old. 

Nowadays, 37.9 million people live with the human immunodeficiency virus (HIV) in the world, while about 8.1 million are not aware of their HIV-status. Chronic inflammation with damage to all organs and systems, including the organ of vision, is characteristic of HIVinfection. Often, diseases occur atypically against a background of reduced immunity that is why any doctor, including an ophthalmologist, should be ready to treat such patients.

The purpose. To present a clinical case of eye damage in a patient with terminal stage of HIV-infection.

Мethods. According to the Perm Regional Clinical Infectious Diseases Hospital, a retrospective analysis of medical records of the HIV-infected patient S. with the eye damage and fatal outcome was made.

Results. The diagnosis of HIV-infection was first established in the presence of ophthalmological disease. The lack of timely diagnosis and adequate treatment led to the death of the patient.