Glaucoma continues to be the disease leading to vision loss and blindness. Currently, various treatment options are offered for persistent compensation of intraocular pressure, as the main cause of the glaucoma optic neuropathy development. In the last decade, technologies for minimally invasive glaucoma surgery have been actively developing, presenting for patients a good alternative to drug antihypertensive therapy and traditional surgical approaches with minimal trauma, efficiency and quick rehabilitation. The review briefly discusses the various devices and implantation methods used in minimally invasive glaucoma surgery, with examples of studies showing long-term clinical results.

Cataract (partial or complete violation of the transparency of the lens) is one of the main causes of low vision and reversible blindness in the world. It is a known fact that at present the only effective way to eliminate the clouding of the lens is its surgical treatment. About 18 million cataract-related surgical interventions are performed annually in the world. This literature review is devoted to studies examining important aspects of surgical treatment for age-related cataracts, such as the number and quality of operations performed on a population scale. The paper presents data on the impact of global trends, local territorial and social characteristics on the number of surgical interventions for cataracts. A review of key indicators of monitoring cataract surgery has been carried out, the main factors affecting the target indicators of the cataract surgery frequency on a regional scale (age structure of the population, normative indications for surgical treatment, threshold values for visual acuity indicating the need for surgical intervention, and the proportion of people in need in surgical treatment of cataracts). The main achievements and aspects of the modern technique of surgical treatment of cataracts are described, which can reduce the time of surgery, use more gentle surgery technology, significantly reduce the number of complications and achieve the highest functional results. This review also details the results of the largest epidemiological studies on the causes of low visual acuity after cataract surgery. Literature data on the prevalence of low visual acuity in different populations are reflected, its higher prevalence in countries where most of the operated cataracts were mature or complicated was revealed, the surgical technique of large incisions and a longer operation time prevailed. It was noted that low vision after cataract surgery is most often associated with the elderly patient, concomitant systemic and ocular pathology, surgical complications, inadequate intraocular correction.

Currently, there is a wide range of antiglaucoma drugs. Ophthalmologists are faced with the task of choosing certain drugs and their combinations for specific patients. In this regard, studies aimed at studying the effectiveness of treatment, not only in terms of IOP indicators and instrumental research methods, but also in terms of the choice of a particular type of therapy by ophthalmologists, are of great interest. Purpose: to analyze the data obtained in the course of the study of the Russian multicenter scientific program: “Analysis of the assortability of ophthalmologists when choosing therapy within the framework of routine medical care in patients with primary open-angle glaucoma (POAG)”. The large-scale statistical study carried out was based on the study of 197 medical questionnaires from 61 cities of Russia, containing information on 6851 clinical cases. Doctors were asked to fill out a questionnaire based on the results of treatment (at least 2 months), taking into account the following criteria: satisfaction with treatment, adherence to treatment, accessibility, tolerability and ease of use of drugs. Evaluated the use of 5 antiglaucoma drugs of the company Sentiss Russ, belonging to different pharmacological groups: Prolatan (latanoprost), Bimatan (bimatoprost), Brinex-M (brinzolamide); Tisoptan (bimatoprost / timolol maleate), Brinarga (brinzolamide / timolol maleate). During the study, patients were divided into 6 groups depending on the drug used, and also into 3 groups depending on the stage of primary POAG. The data obtained indicate a statically high level of average values when using the point system of all the above criteria when using these drugs. When analyzing the degree of convenience and the level of tolerance of drugs, a tendency towards a decrease in the average scores of these indicators in patients with advanced stage of glaucoma was noted, which may be due to the long-term use of antiglaucoma therapy in this category of patients with changes in the ocular surface. 98.25% of doctors expressed their intention to continue prescribing antiglaucoma drugs from Sentiss Russ.

The progressive increase of the number of phacoemulsification in the world leads to a proportional increase in the number of fibrous changes of the capsular bag in the postoperative period. Changes of the capsular bag occur even in simple cases. Structural changes in the lens capsule cause the development of contractional capsular syndrome. It occurs in up to 58.5 % of cases at various times after surgery. Clinical manifestations of contractional syndrome can be diverse: from an asymptomatic course to serious functional and anatomical disorders. The article provides general information about predisposing factors, conditions and causes of capsular syndrome. The paper considers the sequence of changes in the lens cells named epithelial-mesenchymal transformation. Transformation is the basis of the capsular syndrome pathogenesis. The article reveals the mechanisms of influence of the material and design of the IOL, size and shape of anterior rhexis on the development of the pathological process.

Neurotrophic keratitis (also called neurotrophic keratopathy) (NTK) is a degenerative disease of the cornea, accompanied with neurogenic inflammation. It caused by a sensitive innervation loss of the trigeminal nerve and characterized by reduced sensitivity of the cornea and a retardation of its healing process. NTC-causing damage to the trigeminal nerve can occur at different levels-from the nucleus to the terminals located in the cornea, and can be caused by ocular and systemic diseases both. The most common causes include herpetic keratitis, diabetes, chemical burns and iatrogenic injuries during ophthalmic operations, intracranial neoplasms, disorders of cerebral circulation and neurosurgical interventions. Corneal changes include epitheliopathy (grade I), persistent erosion (grade II), ulcer and its complications (grade III). The determining diagnostic sign of NTK is a decrease or loss of corneal sensitivity. The morphological characteristics of the corneal nerves can be studied using confocal microscopy.

The postoperative result is determined not only by technique of a surgeon, the availability of modern innovative equipment, but also due to the accurate diagnostics and skilled interpretation of biometric, keratometric parameters; the use of modern formulas of IV, V generations to calculate the optical power of the intraocular lens (IOL), allowing to predict the correct position of the IOL, through the use of predictive variables that determine the postoperative lens position. The variety of modern research methods and continuous improvement of formulas for lens calculation allows us to get the closest results to emmetropia.

The disruption of blood flow through the retinal vessels is undoubtedly a stressful situation for the body. In response to any stress, the body produces heat shock proteins or so-called stress proteins. Moreover, a number of modern studies indicate that HSP may act as autoantigens, which are components of the immune system involved in the pathogenesis of vascular pathologies. By now, a number of certain heat shock proteins (HSP 60, 70) have already been proven to play a significant role in the pathogenesis of atherosclerosis as well as various circulatory disorders in the cerebral vessels. In addition, the possibility of using the data on the content and concentration of certain HSPs and antibodies to them in the blood plasma of patients as diagnostic and prognostic markers of systemic vascular diseases is considered. On the visual organ side, HSPs have been found to have damaging effects on retinal ganglion cells and, together with antibodies produced in response to their presence, are involved in the pathogenesis of glaucoma. However, there is currently no data on the role of HSP in the pathogenesis of retinal blood flow disorders and the possibility of using these molecules as diagnostic or prognostic markers of such conditions.

Despite the high level of development of modern macular surgery, recurrent macular holes remain a rather serious problem for vitreoretinal surgeons. Recurrent macular holes can be of two types: macular holes that have not closed after primary surgery, and macular holes that have reopened after a successful initial surgery. In foreign literature they are called persistent and recurrent macular holes. This article presents a review of modern scientific literature on epidemiology, causes of development and surgical treatment of recurrent macular holes. This review provides information on the rationality and effectiveness of modern surgical approaches to the treatment of this condition. The most effective methods for treating large macular holes, which are one of the main causes of failure to close a defect during the first surgery or the development of a recurrence of this condition sometime after the first surgery, are covered. Based on the literature data, we can say that the main methods of choice in surgery for recurrent macular holes today are the use of platelet-rich plasma and various modifications of the inverted internal limiting membrane flap technique, transplantation of the autologous internal limiting membrane, including the displaced internal limiting membrane flap technique patented in the Russian Federation.

Child health is a global health priority. Anomalies of refraction, complicated by amblyopia and squint, occupy one of the leading places in the pathology of the visual system of children. According to data obtained from 26 regions of Russia, the leading place in the ocular morbidity of children and adolescents is occupied by ametropia and strabismus with amblyopia. They account for up to 90 % of all cases of visual impairment in childhood. The term amblyopia is understood to mean a decrease in the maximum corrected visual acuity that occurred at an early age, which is caused by disorders of the functions of the visual analyzer, without changes in the fundus and organic lesions of the visual pathways and centers. Despite the outstanding achievements of 21st century medicine, today the questions of the pathophysiological essence of this condition remain open, which is the subject of discussions among pediatric ophthalmologists around the world. In this regard, the literature review presents the results of domestic and foreign authors who studied the morphological (optical coherence tomography) and functional (electroretinography, microperimetry) features of the retina in dysbinocular and anisometropic amblyopia. Some authors have demonstrated the presence of differences in the thickness of the central region and the layer of nerve fibers in patients with amblyopia compared with paired and healthy eyes, their correlation with functional parameters, as well as changes in the thickness of the choroid and microvasculature of the retina. Recently, there have been works devoted to the study of the photosensitivity of the retina in patients with amblyopia and visual rehabilitation using this equipment. A number of authors have shown that with amblyopia, the retinal photosensitivity parameters in the central region are reduced, and there is a correlation between these changes and morphological changes in the posterior pole. The microperimeter also makes it possible to carry out visual rehabilitation, in particular in pediatric patients, and isolated results have been published on the use of this method in patients with amblyopia. The literature data are quite contradictory, and more research remains to be done to determine whether these changes in the retina are primary in relation to this disease, or whether they can be the result of retrograde changes that are obscured by defocusing of visual images from birth.

Purpose. Analysis of the results of weakening of previously operated internal rectus muscle by the method of Z-shaped marginal myotomy.

Patients and methods. The study included 87 children with an initially large-angle of strabismus. Children age — from 2 to 14 years (average age — 9.09 ± 0.78 years). The initial strabismus angle was from 30° to 60° according to Girschberg (average angle — 45.7° ± 2.3°). All children underwent a staged surgical treatment — recession of the internal rectus muscle and resection of the external rectus muscle in both eyes. The residual deviation angle after two stages of surgical treatment ranged from 6° to 10° (on average up to 9.1° ± 0.75°) according to Girschberg. All patients underwent a Z-shaped marginal myotomy on the operated internal rectus muscle. The follow-up period after surgery ranged from 1 year to 5 years.

Results. A satisfactory anatomical result (orthotropy) was achieved in 91 % of cases (79 children), hypocorrection in 9 % of cases (8 children), hypercorrection — 0 %. In 8 patients with hypocorrection, after 6–8 months, the fourth stage of surgical treatment was performed with the method of Z-shaped marginal myotomy of the internal rectus muscle in the paired eye, after which orthotropy was achieved.

Conclusion. An analysis of the surgical treatment results of operated esotropia have showed that the method of Z-shaped marginal myotomy makes it possible to weaken the tone of the previously operated internal rectus muscle with minimal trauma. Using the method of Z-shaped marginal myotomy in the treatment of residual-angle strabismus, orthotropy is achieved while preserving the biomechanics of the oculomotor muscles — the internal rectus muscle remains in the plane of its functional action. At initially large-angle of strabismus, conducting a Z-shaped marginal myotomy of the internal rectus muscle after stepwise surgical interventions on the horizontal rectus muscles of both eyes can be recommended as a modern, reliable and effective method of surgical treatment of residual-angle of strabismus, which allows to achieve the planned functional and cosmetic result.

Contraction capsule syndrome is a serious complication accompanied by structural changes of the capsule bag. Fibrous changes of the lens capsule are found in the postoperative period, even in cases of uncomplicated primary cataract surgery. A certain influence has both general systemic state of the patient and local predisposing factors: the presence of pseudoexfoliative syndrome, the material and design of IOL, the size and shape of the anterior capsulorexis. The far-reaching pathological process leads to pronounced anatomical disorders. Excessive, asymmetrical fibrosis of the anterior capsule in combination with the capsulorexis phimosis leads to IOL decentration and frontal inclination, as well as to the dislocation of the entire IOL capsule complex due to local defects of the zinc ligament. The article presents the method of transscleral-suture fixation of the dislocated IOL-Capsular bag complex developed as a result of contraction capsule syndrome on clinical examples. Its distinctive advantages are described. Reduction of invasiveness is achieved due to the “one puncture” technique — ab externo, needle 30G. The proposed method is technically simple and reliable due to absence of conjunctiva peritomy, low probability of polypropylene 9-0 biodegradation, and possibility of its application with different IOL models allows to speak about its universality.

Purpose: to develop, experimentally study and evaluate in the clinic the effectiveness of using a 25G handpiece to a permanent operating magnet for IOFB removal.

Materials and methods. In the work, we analyzed the results of an experimental study and clinical application of 25 G handpieces. In the experimental part of it, a comparative analysis of magnetic properties was carried out: the force of attraction, strength and topography of the magnetic fields of a standard 25-mm handpiece by V.V. Volkov and 25G caliber handpieces (30, 35, 40, 45 mm long) for a permanent eye magnet. In the clinical part of the work, we analyzed the results of surgical treatment of 57 patients of the ophthalmology clinic with type C OGI (according to the ISOT classification) with localization in the posterior segment of the eye. The mechanism of injury, the area and depth of injury, intraoperative and postoperative complications were analyzed, and the advantages of IOFB removal by a combined method using a 25G tip to a permanent magnet were evaluated.

Results. According to the results of our experimental studies, it was revealed: the force of the 25G handpieces is sufficient to fix foreign bodies weighing up to 11 (for a 45 mm handpiece), and the minimum distance at which the magnetic field begins to act around the handpieces is at least 8 mm (data for the longest handpiece 45 mm). A pronounced decrease in the magnetic field strength at the tip surface at a distance of up to 2 mm was revealed. At the stage of using the 25G handpiece in the clinic, when assessing the OTG mechanism, the injuries were distributed as follows: household injury — 47 %, industrial injury — 27 %, road traffic accident — 13 %, combat injury — 13 %. Removal of IOFB was carried out in two versions: transvitreal and combined. IOFB was removed using a 25G permanent eye magnet tip and using a 25G vitreous forceps. During the operation, the following methods of removing IOFB were used: tweezers-tweezers, magnet-tweezers, magnet-magnet. Intraoperatively, in 7 % of cases, there was a slip and fall of IOFB to the fundus. In all cases, an increase in visual acuity was obtained, and in most cases, visual acuity at the time of discharge from the hospital was in the range from 0.05 to 0.1.

Conclusion. Removal of magnetic IOFB using a 25 G tip to a permanent magnet allows reliable fixation of IOFB, significantly reduces the risks of intraoperative complications and shortens the duration of surgery.

Purpose: to choose the optimal formula for calculating the IOL optical power in patients with an axial eye length of less than 20 mm.

Patients and methods. A total of 78 patients (118 eyes) were included in the prospective study. Group I included 30 patients (52 eyes) with extremely short eyes (average axial eye length of 19.60 ± 0.42 (18.54–20.00) mm), group II consisted of 48 patients (66 eyes) with a normal axial length 22.75 ± 0.46 (22.00–23.77) mm with implantation of various monofocal IOL models. The average follow-up period was 13 months. IOL optical power was calculated using the SRK / T formula, retrospective comparison — according to the formulas Hoffer-Q, Holladay II, Olsen, Haigis and Barrett Universal II.

Results. In group I, the maximum average estimation error was determined for the formula Haigis (0.88 ± 0.35), then for the formula Olsen, Barrett Universal II, Kane, SRK / T, Holladay 2 and Hoffer-Q (0.51 ± 0.12, 0.16 ± 0.38, 0.13 ± 0.28, 0.10 ± 0.59, 0.05 ± 0.54 and –0.12 ± 0.42, respectively). Similar data were obtained for the average absolute error — for the formulas Haigis, Olsen, Barrett Universal II, SRK / T, Holladay 2, Hoffer-Q and Kane, it was 0.85 ± 0.31, 0.78 ± 0.25, 0.21 ± 0.10, 0.79 ± 0.23, 0.73 ± 0.24, 0.19 ± 0.08 and 0.17 ± 0.06, respectively. When comparing the formulas, significant differences were found for the formulas Hoffer-Q, Barrett Universal II and Kane in comparison with the formulas Haigis, Olsen, SRK / T and Holladay II (p < 0.05) in all cases, respectively, which indicates the advantage of these formulas for the group patients with extremely short eyes. In group II, there were no significant differences between the studied formulas (p > 0.05).

Conclusion. This paper presents an analysis of our own data on the effectiveness of six formulas for calculating the IOL optical power in extremely short (less than 20 mm) eyes in comparison with the normal axial length. The advantage of the Hoffer-Q, Barrett Universal II and Kane formulas over Haigis, Holladay 2, Olsen, and SRK / T is shown. To determine the exact indications for using these formulas, further studies are necessary taking into account the anterior chamber depth and a lesser degree of hyperopia.

Purpose. A study of the attitude of Russian ophthalmologists to Immediately Sequential Bilateral Cataract Surgery (ISBCS).

Methods. The study was carried out with the participation of 184 ophthalmologists actively performing cataract surgery, who were presented (in personal contact or via the Internet) a questionnaire developed by the authors, based on three main sections (“I use ISBCS in practice”; “I do not use ISBCS in practice”; “I don’t use, but I did ISBCS before”), which includes in each of the sections a number of clarifying questions and possible answers (“Doesn’t matter”; “Matters”; “Important”; “Very important”). At the same time, the analysis of possible answers was carried out by summing up two possible options — “Negative” opinion (“Not important” + “Matters”) and “Positive opinion” (“Important” + “Very important”). The age of the interviewed ranged from 26 to 58 years (mean age 36.2 ± 1.9 years), the experience of surgical activity in performing cataract phacoemulsification was predominantly (76 %) more than 5 years.

Results. The data obtained indicate that 36 respondents (19.8 %) use ISBCS in their practice, 114 (61.8 %) do not use ISBCS; 34 (18.4 %) — do not use, but previously used ISBCS. At the same time, the volume of ISBCS performed on the same day is (for 84 % of respondents) no more than 20 % of the total number of operations performed. As part of the assessment of the main factors, in accordance with which (according to the ophthalmic surgeon), the patient is offered to perform ISBCS by the leader (in terms of the ratio of “positive” and “negative” opinions) is less clinic visits, and less time spent for the patient. The leading reasons for refusal to perform ISBCS by ophthalmic surgeons who do not use this technology are the possible occurrence of endophthalmitis, the risk of errors in IOL calculation, and medical and legal problems.

Conclusion. The conducted questioning of domestic ophthalmologists testifies to the low prevalence of ISBCS technology, which is mainly associated with the possible risks of postoperative infectious complications, the lack of a standard protocol for surgical intervention, as well as medical and legal aspects. For the wider use of ISBCS, especially in a difficult epidemiological situation, it is necessary to carry out a set of measures of medical, educational and medical and economic orientation.

Objective. To compare clinical and refractive outcomes of cataract surgery by phacoemulsification and by extracapsular cataract extraction with implantation of foldable and rigid intraocular lenses in patients previously having undergone penetrating keratoplasty (PK).

Patients and methods. This is a retrospective study. Medical records of all patients admitted for cataract surgery between 2010 and 2018 to the King Abdullah University Hospital (KAUH) were reviewed and medical records of patients who underwent cataract surgery after PK were analyzed. Medical records of 95 patients (58 males and 37 females; average age 40.0 ± 19.9 years) were selected. Depending upon the type of surgical technique applied, the cases were divided into two groups: first group included 60 patients who underwent cataract surgery by phacoemulsification with implantation of different foldable intraocular lenses (IOL), the second group included 35 patients who underwent cataract surgery by extracapsular cataract extraction (ECCE) with implantation of a polymethylmethacrylate (PMMA) IOL. The choice of ECCE technique with implantation of rigid IOLs was made if the endothelial cell density after PK was less than 2200 cells/mm2 and cataracts were of 4 and 5 grades to exclude additional trauma to the endothelium by ultrasound energy. Demographic and clinical data were collected. The R statistical program and SPSS were used for data analysis. The P value < 0.05 was considered statistically significant.

Results. Analysis showed that PK was performed mainly due to 4 indications: keratoconus (KC) — 77 % cases, herpetic keratopathy — 7 % cases, Eye trauma — 5 % cases, previous graft rejection — 5 % cases and Stevens–Johnson syndrome — 1 % cases. The mean best corrected visual acuity (BCVA) in the first group improved from 0.40 ± 0.05 to 0.80 ± 0.05 postoperatively. The mean BCVA in the second group improved from 0.30 ± 0.05 to 0.70 ± 0.05. In the late postoperative period BCVA with foldable IOLs was higher by 0.10 ± 0.05, as compared with the results obtained with the rigid IOLs. Mean intraocular pressure (IOP) changed from 15.1 ± 4.9 before PK to 16.3 ± 5.3 after PK.

Conclusion. KC was the most common indication for PK in Jordan. Results of our analysis showed that cataract surgery could be successfully performed in eyes after PK with favorable results and improvement in patients’ quality of life. Cataract surgery by phacoemulsification with implantation of foldable IOLs results in higher (BCVA) compared to ECCE with implantation of PMMA IOLs. Unless contraindicated otherwise, phacoemulsification technique with foldable IOL implantation should be given preference over ECCE with implantation of rigid PMMA IOLs in visual rehabilitation of cataract patients after PK.

Purpose: to analyze the results of the treatment recurrent «inferior» retinal detachments (RD) depending on the volume of surgical intervention.

Patients and methods. 81 patients (81 eyes) with recurrent «inferior» RD were included in this retrospective study. Groups were identified depending on the volume of surgical treatment of recurrents RDs: scleral buckling (SB), pars plana vitrectomy (PPV), combined surgery: PPV with SB, PPV with retinotomy (RT), including the use of perfluorocarbon fluid (PFCL). The volume of surgical treatment was assessed before recurrent RD, after the first and second recurrent «inferior» RD, the distribution of the grade and type of proliferative vitreoretinopathy (PVR) complicating these recurrents RD with different treatment tactics, analyzed the functional results and anatomical success (retinal reattachment) after surgical treatment of the first and second recurrents RD.

Results. Primary anatomical success was achieved in 304 from 385 patients (79 %). In 81 cases, the first recurrent RD was detected (21 %). Surgical treatment of the first recurrent RD included: in 39 cases (48 %) — PPV; in 9 cases (11 %) — PPV with SB; in 13 cases (16 %) — PPV with RT. In 20 cases (25 %) for short-term tamponade with PFCL was used when performing PPV with RT. The second recurrent RD occurred in 42 cases, which accounted for 52 % of the first recurrent RD. The anterior type of PVR was in all cases (100 %). All patients underwent repeated surgery: PPV (100 %), of which in 15 cases (35.7 %) — PPV with RT; the use of short-term postoperative tamponade with PFCL was in 18 cases (42.9 %); additional SB — in 9 cases (21.4 %). Anatomical success was achieved in 100 % of cases after surgical treatment of the second recurrent RD, but in 8 cases (19 %) a retinal redetachment occurred.

Conclusion. The increase in PVR continues to be the main cause of recurrent RD. In patients with recurrent «inferior» retinal detachments, grade C PVR type 4, 5, the additional use of SB for PPV, RT and the use of PFCL as a short-term postoperative tamponade allows achieving better results (functional and anatomical). During surgery of the second recurrent RD, when there are pronounced changes in the retina, performing SB is impractical, the alternative is RT.

Alkaptonuria is rare autosomal recessive multisystem disease, caused by mutations in the homogentisine oxidase gene, which leads to the deposition of metabolites of homogentisic acid in organs and tissues (ochronosis).

The purpose: to study spectrum of ophthalmic manifestations of alkaptonuria in Russian cohort of patients of different ages.

Material and methods. Ophthalmological examination of 9 patients: 5 adults aged from 39 to 64 years and 4 children aged from 3 to 6 years with confirmed diagnosis of “alkaptonuria” was performed.

Results. In all adult patients bilateral brown-black scleral pigmentation and yellow-brown deposits in the conjunctiva in the region of the palpebral fissure were detected paralymbally, the severity of which correlated with age, tortuosity and vasodilation of the conjunctiva in areas of deposits. In 1 out of 4 children minimal deposits of yellow pigment were found in the conjunctiva of the limb. In patients older than 60 years typical small brownish deposits were observed in the cornea near the limb in the region of the palpebral fissure.

Conclusion. Eye changes are one of the most common clinical manifestations of alkaptonuria. Typical manifestations are the sclera’s pigmentation, conjunctiva and cornea in the limb. Ophthalmological examination is non-invasive informative method that can help in early diagnosis, differential diagnostics, assessment of the dynamics of the disease and the effectiveness of the therapy.

Purpose: The vitreous body (CT), due to the complexity of its structure, remains one of the least studied anatomical structures to this day. In the literature there are attempts to describe the anatomy of the vitreous body, since the II century. The most relevant works are the studies of J. Worst et al. in 1973, in which the authors proposed new methods of CT preparation with the introduction of dyes. Despite many years of research on the structure and functions of the vitreous body and the presence of a large number of works, and there are no methods and protocols for macromicroscopic examination of the vitreous body to develop a method and propose a protocol for macromicroscopic examination of the vitreous body (VB), allowing to obtain new data on VB topographic anatomy.

Materials and methods. The proposed method of macromicroscopic examination was used to study the VB topographic anatomy of 38 cadaver eyeballs. In order to color transparent structures of the vitreous, poorly soluble metallic salts (barium sulfate and copper acetate) were used. Macroscopic examination was performed using a Topcon OMS-800 operating microscope with a magnification of ×8 to ×21, microscopic changes were evaluated by light microscopy at ×50, ×100, ×200, ×400, ×630 multiple magnification with Leica DM LB2 microscope followed by photographic recording. The algorithm for macroscopic examination performing.

Results and discussion. The result of macroscopic preparation was the compilation of individual anatomical and topographic maps of patients. A distinctive feature of the developed method is the ability to dissect any VB structure and to isolate each cortical layer with the possibility of studying its anatomical and topographic features and relationships with underlying tissues (internal limiting membrane, ciliary body, lens capsule). In addition, the method allows to maintain the shape and integrity of the specimens after passing through all stages of histological processing. In order to fixate VB samples, we used a method with fixing VB structures on a special adhesive-metric tablet, and placing them in a biopsy bag placed in a biopsy cassette. After that, filled in formalin, the specimens were delivered to the laboratory, where all the stages of standard processing took place.

Conclusion. The developed technique of macromicroscopic examination of the vitreous allows to create an individual map of the VB topographic anatomy. After collecting of sufficient material and its statistical processing, it is possible to provide maps of the VB topographic anatomy in normal, age-related and pathological conditions.

Purpose: to study the morphometric parameters of the retina in patients with primary hypothyroidism and primary thyrotoxicosis by optical coherence tomography.

Materials and methods. The material for this study was the results of examination of 54 patients (108 eyes) with thyroid dysfunctions: 32 people (64 eyes) with primary untreated hypothyroidism and 22 people (44 eyes) with primary untreated thyrotoxicosis. To assess the morphometric parameters of the retina, optical coherence tomography was performed.

Results. A significant thickening of the layer of nerve fibers was revealed in almost all sectors of the retina of patients with primary hypothyroidism and primary thyrotoxicosis, with the exception of the upper sector in primary thyrotoxicosis. The morphometric parameters of the optic nerve head in both groups were ambiguous. With thyrotoxicosis, the diameter and topographic area of the excavation were less than normal, while the area of the neuroretinal girdle, the area and excavation of the optic nerve head, the ratio of excavation to the area of the optic nerve head, the horizontal and vertical dimensions were higher. In hypothyroidism, the diameter, area and topographic volume of the excavation, the ratio of the excavation to the area of the optic nerve head, the horizontal and vertical dimensions of the excavation to the optic nerve head were below normal, and the length and area of the neuroretinal girdle were higher. In both groups, an increase in the volume and thickness of the retina of all macula’s sectors in combination with a decrease in the minimum thickness of the fovea was revealed. A correlation between the parameters of optical coherence tomography and the rank indicators of the ratio of thyroid hormones was revealed.

Conclusion. In primary hypothyroidism and primary thyrotoxicosis, statistically significant morphometric changes in the retina and optic nerve head were revealed. The morphometric data correlated with the rank indices of the thyroid hormone ratios.

Background. The study of the parameters of optical coherence tomography with angiography (OCTA) broadens the understanding of the state of hemodynamics for the early detection of vascular disorders of the organ of vision in atherosclerosis (AS).

Purpose. To study the parameters of OCTA with changes in the organ of vision against the background of AS.

Patients and methods. 26 patients (41 eyes) with changes in the organ of vision in AS. The age contingent of patients ranged from 32 to 78 years, the average age was 47.5 ± 2.0 year, of which 10 were women, 16 men. Depending on the damage to target organs, all patients were conditionally divided into 2 groups: group I (19 eyes) included patients without damage, and group II (22 eyes) consisted of patients with target organs damage.

Results. The registration of OCTA in patients of group I, a decrease in the density of capillaries of the superficial vascular network was 15 % and amounted to 45.21 ± 2.62 % (p < 0.05), of the deep vascular plexus by 19 %, which amounted to 45.89 ± 2, 71 % (p < 0.05). In the macular region, the area of the hypoperfused retina was 1.07 ± 0.14 mm2 (p < 0.05). In the region of the optic nerve disc, areas of hypoperfusion were noted in the superficial layers in 7 eyes and in the deep layers in 4 eyes. Analysis of OCTA in patients of group II revealed a sharp decrease (by 48 %) in the density of capillaries in both the superficial and deep vascular plexuses of the retina, which amounted to 33.91 ± 3.01 % (p < 0.05); 33.65 ± 2.89 % (p < 0.05), respectively. In the macular region, the area of the non-perfused retina was 2.19 ± 0.21 mm2 (p < 0.05). In the area of the optic nerve disc, areas of nonperfusion were noted both in the surface layers and in the deep layers in 4 eyes.

Conclusion. The use of OCTA allows to detect changes in hemoperfusion in all layers of the retina and optic nerve in the early stages of AS development, which will allow early diagnosis and monitoring of the disease.

This literature review analyzed of current information about prevalence, pathogenesis and methods of controlling the progression of myopia. Bibliographic research of scientific publications was carried out in the following databases: Medline, Pubmed, Cochrane, eLibrary. Languages of publications: Russian and English. Analysis of Russian and foreign literature has demonstrated that the prevalence of myopia is increasing extensively worldwide. All the main methods of controlling myopia are divided into measures aimed at changing the child’s lifestyle, drug therapy, optical correction and surgical methods. The most debatable issue remains the surgical methods of controlling myopia, in particular, posterior scleral reinforcement and UV-A-crosslinking of the sclera.

Purpose. Conduct an extended analysis of the cytokine status and its role in inflammatory processes in uveal melanoma based on multiplex analysis of the tear fluid.

Patients and methods. Immunological studies of blood serum and lacrimal fluid were performed in 80 patients with uveal melanoma and 38 healthy donors (control group). The average age of the surveyed was 53.7 ± 12.2 years. Group 1 included 32 patients with small-sized choroidal melanoma (T1NoMo), group 2 consisted of 26 patients with medium-sized lesions (T2NoMo), group 3 — 22 patients with large tumor sizes (T3NoMo). The cytokine content in the tear fluid was determined by the method of multiplex analysis on the xMAP platform in the Luminex xPONENT 3.1 software using 47 plex kits (ProcartaPlex, eBioscience, Austria).

Results. In the lacrimal fluid of the patient and the paired eye — an increase in pro-inflammatory (IL-1α, IL-2, IL-6, IL-17A, IL-18, TNF-α, MCP-1, MIP-1α, RANTES, GRO-α, IL-8, IP-10), anti-inflammatory (IL-1RA, IL-4, IL-10, IL-5, TGF-1β), proliferative (FGF-2, HGF, IL-15, PDGF-BB, Eotaxin), pro-tumor (NGF-β, IL-7), antitumor (IL-21), angiogenic (VEGF-A, SDF-1α) cytokines in the initial stage of uveal melanoma compared with the control group, p < 0.05.

Conclusion. In response to the manifestation and growth of uveal melanoma, many chemoattractant mediators are produced, including pro-inflammatory and angiogenic effects, which promote tumor progression and affect the body’s immune response. The study of the lacrimal fluid proved the imbalance of the local immunity not only of the patient, but also of the paired «healthy eye». Research into cytokines leads to a deeper understanding of the pathophysiology of carcinogenesis and may contribute to the development of targeted therapies for inhibiting tumor growth.

Purpose. Scientific substantiation of methodological approaches to the development of a “quality of life” (QoL) questionnaire after cataract phacoemulsification (PEC) in patients with visually stressful work (VLT), based on a “medico-social” health model.

Methods. The study was carried out on the basis of methodological standards for the development of new tools for assessing symptoms in clinical medicine developed by specialists from the International Center for the Study of Quality of Life (St. Petersburg). This article presents the first stage of development aimed at the formation of a preliminary version of the questionnaire. The initial volume of questions (complaints) of the patient was carried out in the following areas: individual interviews (according to the standard developed methodology) with 50 patients with ZNT; analysis of proven methods for studying QOL in cataracts (“NEI-VFQ”, “Cataract Symptom Scale”, “Catquest-9SF”, etc.); analysis of proven methods for studying QoL in keratorefractive surgery and asthenopic conditions in patients with RNT; analysis of the classification structure of the International Classification of Functioning (ICF) from the standpoint of the development of characteristic “domains”.

Results. The data obtained indicate that a total of 35 patient complaints were identified (7 — “visual”; 6 — “professional”; 16 — “functional”; 4 — “household”; 4 — “medical and psychological”). The fundamental difference between the development of the methodology for assessing the patient’s QoL after performing PE is the use of a “social model” of health, which confirms the leading (46 % of all complaints) place for “functional” manifestations of the patient’s subjective status, based on specific “domains” of the ICF. Along with this, the practical application of the basic provisions of the ICF involves scaling the severity of the patient’s complaints in the context of the ratio of the duration of the complaint to the total active time of the patient with a gradation: “Mild problems” (5–24 %); “Moderate problems” (25–49 %); “Severe problems” (50–95 %); “Absolute problems” (96–100 %).

Conclusion. The results of the first stage of the development of the patient’s QoL questionnaire after the FEC testify to the compliance with clinical standards in terms of content validity, since the questions, scales and general content reflect the significance for the patient and important parameters from a clinical and functional point of view. A distinctive feature and scientific novelty of the questionnaire is the use of a “social model” of health based on the development of “domains” of the international classification of functioning, as well as optimization of the procedure for scaling patient responses.

Purpose. Theoretically substantiate and practically identify ocular manifestations after the transferred SARS-CoV-2 virus.

Patients and methods. For the study we were invited patients who had recovered from SARS-CoV-2 at the hospital of V.M. Buyanova, the age from 20 to 65 years old in period from 2020 to 2021. The total number of patients was 68 people. The patients had with them the results of PCR tests or ELISA tests, or an extract from the hospital confirmed COVID-19 case and also a clinical blood test and CT scan of the chest organs for the period of illness. Before the start of the study, the patients were asked to fill out a questionnaire “Questionnaire for patients who have had a new coronavirus infection” (Appendix 1). For a detailed study of this group of people, each underwent visometry, pneumotonometry, B-scan, a slit lamp study and also a slit lamp study with a 60D lens using 0.5 % Mydriacyl eye drops in the absence of contraindications and pupillography.

Results. As a result of the work carried out, we concluded that the virus is capable of causing inflammation of the choroid of the eyeball, uveitis. Moreover, in our study, we identified patients with acquired intermittent divergent strabismus, anisocoria, ptosis, and accommodation disorder. And, in this regard, we came to the conclusion that the coronavirus belongs to the group of neurotropic, as it is able to affect the nervous tissue and cause the above clinical picture. In other words, the virus negatively affects the somatic and autonomic innervation of the oculomotor nerve. As a result of these lesions, we get the corresponding tetrad of symptoms: heterotropy, mydriasis, ptosis, accommodation paralysis.

Conclusions. One of the extraordinary complications of coronavirus infection is damage effect to the fibers of the oculomotor nerve, the signs include: strabismus, mydriasis, ptosis and accommodation paralysis. Thus, this clinical picture is associated with the affinity of the virus to the nervous tissue. And as a result, this ability of the virus can probably infect various areas of the brain, which will lead to corresponding complications, not only from the oculomotor nerve, but also from other cranial nerves with the manifestation of the corresponding symptoms, which in theory can aggravate the patient’s condition , causing deep disturbances of motor and sensory innervation.

Age-related macular degeneration (AMD) is a multifactorial disease, with oxidative stress as a main pathogenetic factor in the development and progression. Large clinical trials have shown that the additional intake of vitamins and minerals in high doses reduce the risk progression to advanced wet AMD by 25 %. Some of these powerful antioxidants are not synthesized in the human body and can only be obtained with food as part of dietary supplements. However, patients with AMD, belonging to the older age group, often have comorbid conditions, for which they are used to take appropriate drug and vitamin therapy for a long time, as well as they have malnutrition of varying severity. Additional intake of high doses of ophthalmic vitamin-mineral complexes can lead to side effects due to overdose and possible disorders of drug absorption due to concomitant pathology. The article presents the results of the AREDS 2 study and a number of other clinical trials that studied long-term intake of vitamins and minerals in dosages similar to the AREDS 1 formula, containing vitamin C (500 mg), vitamin E (400 international units), beta-carotene (15 mg), zinc (80 mg as zinc oxide) and copper (2 mg as copper oxide). The cited works show that long-term intake of high dosages of some vitamins in elderly patients with severe concomitant diseases and a history of smoking can lead to undesirable consequences for the eye and other body systems. Potential side effects include an increased risk of glaucoma and cataract, an increased risk of prostate cancer in healthy men, an increased risk of lung cancer in former smokers, and an increased risk of cardiovascular disease in postmenopausal women with diabetes. Thus, high dosages of vitamins and minerals in nutraceuticals should be administered with great caution, and a reduction in dosages to the recommended intake rates when switching to long-term intake may be considered. One of the possibilities for increasing the bioavailability of active substances in the composition of dietary supplements can be a microencapsulation.

This article presents the third part of an experimental study on the prospects and possibilities of using quantum dots and bioconjugates created on their basis in the treatment of inflammatory diseases of the eye. Taking into account the previously obtained results on the possibility of “safe” use of CdTe/Cd and InP/ZnSe/ZnS quantum dots on an animal model under conditions of intravitreal administration, the aim of the current stage was to analyze their antimicrobial activity in a bacteriological laboratory.

Materials and methods. As QDs, we took two types of artificial fluorophores capable of generating superoxide radicals synthesized according to a special technical assignment at the Federal State Unitary Enterprise “Research Institute of Applied Acoustics”, Dubna, Moscow Region: type 1 — colloidal solution of QD CdTe / Cd MPA 710 10 % of the mass. Type 2 — colloidal solution of QD InP / ZnSe / ZnS 650 10 % wt. The study included “museum” and nosocomial strains of microorganisms, and the activity of points was assessed using the diskdiffusion method, followed by an assessment of the zones of inhibition of bacterial growth. Concentrations of 0.1 %, 0.01 %, and 0.001 % quantum dots were tested, as well as solutions of bioconjugates (antibiotic + quantum dots) of Vancomycin, Levofloxacin, Ceftazidime and Cefotaxime.

Results. Based on the data obtained, it was concluded that quantum dots potentiate the action of the sensitivity of individual microorganisms, both outpatient and hospital strains.

Currently, there is a wide range of antiglaucoma drugs. Ophthalmologists are faced with the task of choosing certain drugs and their combinations for specific patients. In this regard, studies aimed at studying the effectiveness of treatment, not only in terms of IOP indicators and instrumental research methods, but also in terms of the choice of a particular type of therapy by ophthalmologists, are of great interest. Purpose: to analyze the data obtained in the course of the study of the Russian multicenter scientific program: “Analysis of the assortability of ophthalmologists when choosing therapy within the framework of routine medical care in patients with primary open-angle glaucoma (POAG)”. The large-scale statistical study carried out was based on the study of 197 medical questionnaires from 61 cities of Russia, containing information on 6851 clinical cases. Doctors were asked to fill out a questionnaire based on the results of treatment (at least 2 months), taking into account the following criteria: satisfaction with treatment, adherence to treatment, accessibility, tolerability and ease of use of drugs. Evaluated the use of 5 antiglaucoma drugs of the company Sentiss Russ, belonging to different pharmacological groups: Prolatan (latanoprost), Bimatan (bimatoprost), Brinex-M (brinzolamide); Tisoptan (bimatoprost / timolol maleate), Brinarga (brinzolamide / timolol maleate). During the study, patients were divided into 6 groups depending on the drug used, and also into 3 groups depending on the stage of primary POAG. The data obtained indicate a statically high level of average values when using the point system of all the above criteria when using these drugs. When analyzing the degree of convenience and the level of tolerance of drugs, a tendency towards a decrease in the average scores of these indicators in patients with advanced stage of glaucoma was noted, which may be due to the long-term use of antiglaucoma therapy in this category of patients with changes in the ocular surface. 98.25 % of doctors expressed their intention to continue prescribing antiglaucoma drugs from Sentiss Russ.

The organ of vision is one of the target organs, which is negatively influenced by a number of harmful factors of the working environment and the labor process. Under their influence, the functioning of the visual analyzer can be disrupted, the risk of developing various diseases and injuries increases. The problem of the ophthalmopathology development in persons employed in hazardous industries is relevant, since the protection of the health of the working-age population is of great socio-economic importance. The proposed review of the literature presents the structure and frequency of occurrence of ophthalmopathology in workers of the cement industry, oil refining and petrochemical industries, metallurgical industry, coal and mining industries, manganese ore industry, synthetic rubber production, rubber technical products, synthetic ethyl alcohol, bakery, aviation production, also workers of the underground and railways of the main professions, including those who service underground tunnels. The data of the nosological structure of ophthalmopathology of various hazardous industries workers in Ukraine, India, and some African countries are presented. Among the professionally conditioned pathology of the vision organ, diseases of the anterior part of the eyeball are most common: chronic conjunctivitis, blepharitis, blepharoconjunctivitis, dry eye syndrome. In the general diseases’s structure of the vision organ, the first place is occupied by anomalies of refraction (from 14.3 to 88.9 %). The share of eye injuries ranges from 4 to 12.5 %. The frequency of occurrence of various ophthalmopathologies increases among workers with more than 10–15 years professional experience, which is typical for all industries and industries; there is also a direct connection between diseases of the organ of vision and the class of harmfulness of working conditions.

The purpose of the study was to monitor a 6-year-old optic disc melanocytoma.

Patient and methods. A clinical case of optic disc melanocytoma revealed in a woman aged 28 when examining the fundus during a second pregnancy. Ophthalmological examination of the patient included clinical and hardware methods: visometry, perimetry, biomicroscopy, binocular and reverse ophthalmoscopy, ultrasound B-scanning, optical coherence tomography of optic disc and retina, fundus photorecording using fundus cameras.

Results. A neoplasm of the right eye with clear boundaries is large in size, which is almost completely covers and shields the optic disc, except for a narrow strip of disc in the lower zone, heterogeneous dark brown with a high prominence in the vitreous body of 1.1 mm according to the data of ultrasonic B-scan and 1.15 according to optical coherence tomography. In the layer of nerve fibers, we can note the destruction of the retina adjacent to melanocytoma with single cystic cavities. The retinal ganglion cell complex is normal. The peripheral boundaries of the field of view of the right eye according to perimetry are normal. During the 6-year observation, we can notice 100 % visual acuity and an unchanged field of vision. Signs of slight tumor growth observed in the last year with the advent of choroidal lesion components.

Conclusions. The clinical case describes unilateral melanocytoma of the optic disk of large sizes with preservation of 100 % visual acuity for 6 years of observation at low growth rates, which was found during a planned examination of the fundus of the young patient during pregnancy.

The article presents the epidemiology of echinococcosis in Russia, its strains, their pathogenicity for humans. The ways of spread and infection of the parasite, as well as the features of invasion into the human body, are indicated. The role of radiation methods for diagnosing echinococcosis using ultrasound, CT and MRI is described in detail. The reasons for the low appealability of patients with echinococcosis of the orbital organocomplex and the low efficiency of drug treatment are indicated. The importance of early surgical treatment for patients with lesions of the orbital organocomplex is emphasized. A clinical case of observation of a patient with primary multiple echinococcosis with damage to the orbital organocomplex, as well as the liver, lungs and spleen is presented. The patient complained of exophthalmos of the right eye to the clinic of ophthalmology of Professor V.V. Volkov Military Medical Academy of S.M. Kirov. An objective examination revealed signs of impaired position and mobility of the exophthalmos, impaired visual functions, electrical response of the retinal. In the fundus marked signs of swelling of the optic nerve. According sockets CT revealed the formation of cystic right orbit emanating from the medial rectus muscle remodeling medial orbital wall and a bottom; right-sided exophthalmos. According to MRI determined pattern of cystic formation, coming from the medial rectus muscles of the right eye. The cyst led to a violation of visual functions, there was a risk of rupture and dissemination of the parasite in the body. With this in mind, it was decided to remove it from the eye socket. During transnasal endoscopic intervention, the neoplasm was removed from the right orbit. The postoperative period was uneventful. Considering the rarity of echinococcus lesions of the orbital organocomplex on the territory of Russia, it is necessary to use an individual approach for surgical intervention in patients with this pathology. An interdisciplinary approach allows minimally traumatic removal of an echinococcal cyst from the orbit. It is noted that the duration of antiparasitic therapy should be determined in each case individually.