Purpose: To assess the reproducibility of retinal nerve fiber layer (RNFL) and macular thickness by spectral domain optical coherence tomography (SD-OCT) when the same investigator does scan thrice in a span of one hour without reference to the previous scan, is able to get similar results or not, without using the repeat function.

Methods. In this prospective observational study 200 subjects who fulfilled the inclusion & exclusion criteria were scanned 3 times as per pre-defined guidelines at 0 minutes, 30 minutes; 60 minutes on the same day, by the same investigator using SD-OCT for measurements of RNFL and macular thickness & observations were statistically analyzed & correlated.

Results. In RNFL thickness, temporal sector shows the worst reproducibility as compared to other sectors. The RNFL thickness was greatest in superior quadrant and thinnest in temporal quadrant. Female values were significantly higher than males in RNFL superior and RNFL symmetry. For macular thickness, temporal sector (mid-zone) showed the worst reproducibility and in outer-zone, Inferior sector showed the worst reproducibility. It also shows that macular thickness was thinnest at the central zone (innermost 1 mm ring), thickest within the inner 3 mm ring and diminished peripherally.

Conclusion. RNFL and macular thickness measurements by SD-OCT by the same observer at 0 minutes, 30 minutes and 60 minutes were very reproducible except in the sectors specifically mentioned. The greater the thickness of RNFL in any sector, the better will be the reproducibility in that sector. For macular thickness, temporal sector (mid-zone) showed the worst reproducibility & with an increase in age the macular thickness measurements decreases.

In the previous part of the review clinical and diagnostic aspects of some non-infectious uveitis in patients with immunoinflammatory diseases were discussed. In this part we proceed the discussion of ocular manifestations of a number of other immunoinflammatory conditions. In addition to uveitis associated with spondyloarthropathies, rheumatoid arthritis, Still’s disease, juvenile idiopathic arthritis and systemic sarcoidosis described in the previous part, ocular manifestations are also common in systemic vasculitis, systemic lupus erythematosus, Vogt—Koyanagi—Harada syndrome. Despite the numerous diagnostic schemes and therapy algorithms developed to date, much in the pathogenesis of uveitis associated with immuno-inflammatory diseases remains unclear. The need to develop personalized and multidisciplinary approaches for the treatment and diagnosis of non-infectious uveitis in numerous systemic immunoinflammatory diseases remains relevant. In-depth understanding of etiopathogenetic mechanisms of immunoinflammatory processes will allow to develop new approaches in the treatment of patients with uveitis.

In recent years, ophthalmologists have paid great attention to keratoconus, as the disease is socially significant and affects the young working-age population. According to the literature and in clinical practice, it was found that patients with keratoconus have similar character traits, which are manifested to a greater or lesser extent in each patient. According to a number of authors, these patients have less adaptability, passive aggression, and paranoia. In addition, there is a tendency to disorganization of thinking, substance abuse and anxiety. The article considers clinical cases of Association of keratoconus with mental disorders and diseases such as schizophrenia, obsessive-compulsive disorder, Tourette’s syndrome. Examples of the occurrence of the disease after mechanical damage to the eyeball are given. This paper also describes changes in the quality of life of patients with this pathology, identified using different questionnaire options. The use of 18 different, most frequently used questionnaires to determine the impact of keratoconus on the patient’s quality of life is considered: specialized for keratoconus, General for eye pathology, and General medical for assessing mental functions. Using a specialized questionnaire for keratoconus, changes in the quality of life were evaluated in the following categories: visual acuity assessment, problems with near or far vision, restrictions on social interaction due to low vision, restriction of physical activity, dependence on others due to eye problems, deterioration of mental health associated with changes in the visual organ, driving problems, restrictions on visual fields, color perception and eye pain. General ophthalmological questionnaires were also used, in particular, to assess dry eye syndrome, visual impairment, contact lens use and their impact on quality of life, etc. In patients with keratoconus, other questionnaires were also used, for example, to assess the indicator of the state anxiety scale, selfassessment of depression. This article discusses the advantages and disadvantages of the questionnaires, their applicability directly to patients with keratoconus.

Today, between 230 and 347 million people on the planet suffer from diabetes, which is approximately 6 % of the all adult population. Diabetic macular edema (DME) can occur at any stage of diabetic retinopathy (DR), and remains the most common cause of moderate vision loss in patients with DR, due to increased retinal vascular permeability leading to accumulation of extracellular/intracellular fluid and blood plasma components in the neurosensory retina. The use of objective, quantifiable medical signs, called biomarkers, has become more relevant in clinical practice and clinical research. They allow the identification of a normal biological or pathological process, becoming clinical and diagnostic tools in routine clinical practice. Over the past decade, there has been significant progress in the treatment of macular edema, but the search for a more effective method does not stop. Modern research is being carried out in the direction of creating new drugs and increasing the intervals between injections. New molecules target previously studied as well as new targets. The pharmaceuticals used are investigating at higher doses and different delivery methods. Viral vectors and new phototherapeutic agents are currently being tested. This wide range of research studies, with several therapeutics currently in phase 3, could lead to impressive results in the treatment of diabetic retinopathy in the not too distant future.

Literature review is devoted to modern high-technology instrumental methods of the lens evaluation, which have been developed to improve efficiency of the diagnostics and management of cataract in ophthalmological clinical practice. The slit-lamp examination of lens and retroillumination images are used for subjective assessment of cataract according to LOCS III grading system. Currently objective methods of lens evaluation have practical value and provide information about early age-related changes of crystalline lens with the quantitative assessment of the severity of opacities including the optical and ultrasound examinations. Optical methods include densitometry using Scheimpflug images obtained from applications to quantify the localization of lens opacities and their progression rate. Another method is the intensity distribution analysis of the wave front of the optical aberrations according to grading cataract severity with the objective scatter index (OSI) obtained by double-pass technology. Moreover the optical quantitative assessment of lens opacities is carried out by the Shack—Hartmann wave front sensor to identify the grade of nuclear opalescence (N-type) with the Lens Opacities Classification System III. This method is very helpful in nuclear cataract. Swept source optical coherent tomography (SS-OCT) with variable length of wave and high frequency detector is used for the density measurements of nuclear and cortical opacities of lens imaging in micro- and macro dimensional scale. Ultrasound biomicroscopy is the most informative ultrasonic diagnostic method for the evaluation of acoustic density and early age-related changes of lens. Current high-informative methods of quantitative assessment of the optical density of lens are helpful in determination of indications for surgery, the optimization of phacoemulsification settings and prevention of intraoperative complications. The use of high-technologic methods demonstrated the effectiveness of eye drops 0,005 % pirenoxine in early lens opacities management.

Purpose. Scientific substantiation, development, evaluation of the safety and clinical efficacy of vitrectomy technology in patients with severe forms of proliferative diabetic retinopathy (PDR) who are on hemodialysis (HD).

Methods. We observed 100 patients (69 % women; 31 % men, mean age 63.2 ± 2.4 years) with PDR and chronic renal failure (CRF) requiring regular HD sessions (for at least 3 months). Patients were divided into two equal age, gender and number of patients (50 patients, 50 eyes) groups — the main group (MG), who underwent vitrectomy according to the developed technology, and the control group (CG), who underwent surgical intervention according to the traditional method. A comprehensive examination of the vision’s state was performed before and 14 days after surgery according to clinical and subjective indicators.

Results. The data obtained indicate a more pronounced dynamics of the studied parameters in the MG compared to the CG, manifested by a significant (by 3–18 %) decrease in the incidence of intra and postoperative complications, a more pronounced (by 16.6 %, p < 0.01) decrease total score according to two developed specific subjective qualitative criteria for the condition of the fundus, a significantly higher (by 20 %) probability of an increase in BCVA, as well as a more significant increase in the level of the patient’s “quality of life” (by 10.4–14.9 %, p < 0.05 depending on the questionnaire used).

Conclusion. The developed technology for performing vitrectomy in patients with PDR and end-stage chronic renal failure requiring continuous hemodialysis provides (compared to traditional) a higher level of safety and clinical efficacy due to an integrated approach to surgical intervention based on improving the stages of the operation (the maximum possible removal of the basal vitreum, performing peripheral endolaser coagulation, bimanual vitrectomy technique, and a number of others), as well as the developed medical and anesthetic support, which is confirmed (compared to the traditional technique) by a decrease in the incidence of intra and postoperative complications, as well as a more pronounced positive dynamics of BCVA, the state of the fundus and patient’s quality of life.

Purpose. Analysis of the cataract surgery visual outcomes and advantages of intraocular lens Synthesis SIPY.

Material and methods. We have operated 43 eyes with cataract (38 patients) using Synthesis SIPY lens. Non-corrected visual acuity was 0.13 ± 0.08, best corrected visual acuity (BCVA) was 0.36 ± 0.1.

Results. Following 7 months, secondary cataract was not detected in any patient, what explain the actuality of square edge optical part on 360° of perimeter. The lens is inserted in cartridge in factory sterile conditions which exclude the contact between lens and environment, reduce the risk of incorrect inserting of the lens in cartridge following pinching by the cartridge flaps and, subsequently, the haptic tearing off. This complex “lens-cartridge” excludes the damage of haptics and optic parts, which can occur in using other IOLs during the removal of the lens from the vial and placing it in the groove of the cartridge. Position of cartridge in injector centralizes the cartridge tunnel for the Accuject Pro injector plunger, thereby reducing the risk of pinching the rubber tip of the IOL haptic plunger during implantation. The diameter of the cartridge tip allows the IOL to be implanted through a 1.6 mm tunnel. The uncorrected visual acuity after surgery was 0.6 ± 0.28. The best corrected visual acuity was 0.78 ± 0.24.

Conclusions. The Synthesis SIPY lens has a number of advantages: factory installation of the lens into the cartridge and compatibility of the cartridge with the Accuject Pro injector prevent damage to the IOL; Implantation of the Synthesis SIPY lens is possible through the 1.6 mm corneal tunnel; high diopter ranges from -10.0D to + 40.0D allows for maximum visual results.

Background. The eyelids are movable folds that protect the eyeball from external influences and carry out a supporting function. A misalignment of the eyelids can seriously effect on the ocular function.

Purpose. To evaluate the effectiveness of surgical treatment of spastic lower lid entropion.

Patients and methods. The results of treating patients with eyelid entropion for the period from 2014 to 2021 were analyzed — 66 people, 85 operations. All patients with eyelid entropion underwent a standard ophthalmological examination and additional studies, which revealed the presence of a spastic component. The pathogenetically substantiated methods of surgical treatment were performed.

Results and discussion. In all 69 cases, where operations were performed according to the Wheeler and Callahan method — the lower eyelid was in the correct position, changing the direction of tension of the circular muscle and the Riolan’s muscle, creating a duplicate of the muscles. The retractor was strengthened, which ensured the correct position of the eyelid. In 16 cases in recurrent entropion and the presence of blepharospasm caused by corneal changes, surgery was performed according to the Meek method. In the early period, in all cases, hyper effect was observed. In the late period, the hyper effect persisted in 4 cases (25.00 %), but the patients refused reoperation.

Conclusions. Determination of the parameters of the lower eyelid state during examination makes it possible to identify the reasons for the development of entropion, the presence of a spastic component MRI or CT examination allows assessing the condition of the eyelid retractor objectively. In patients with spastic entropion, Wheeler and Kallahan surgeries that eliminate the spastic component provide a stable result. In patients with spastic recurrent entropion, accompanied by blepharospasm, the Meek’s surgeries in all cases provide a stable result. The disadvantage of this operation is the presence of hyper effect in 100 % of cases in the early period, which persisted in the late postoperative period in 25 % of cases.

Relevance. Suture fixation of dislocated IOL capsule-sac complexes to the iris is widely used at present. Violation of the correct position of the IOL affects the decrease in contrast sensitivity, the appearance of dysphotopsias and aberrations. Determining the dependence of the parameters of the IOL position on the quantitative characteristics of wave front aberrations in the delayed period will allow us to consider the applied methods of surgical treatment from the position of influencing the quality of vision.

Purpose: to conduct a comparative assessment of the effect of IOL tilt and decentration on aberrometry indicators in the delayed postoperative period in patients with suture fixation of the IOL capsular-bag complex to the iris.

Patients and methods. The main group consisted of 46 eyes operated on in 2014–2016 for the dislocation of capsule-bag complex by suture fixation to the iris for 2 arches. Comparison group — 30 eyes with articulation without suture fixation, having high uncorrected visual acuity (0.8–1.0). According to the study design, the indicators of both groups were determined at least 5 years after the operation. All patients had spherical IOLs. The determination of the IOL position (tilt and decentration) was carried out on RTVue OCT (Optovue, USA). Aberrometry was carried out on the OPD-Scan III, a comparative assessment of the wavefront indicators was performed: the mean square error of the total wavefront (Total RMS), general internal aberrations, tilt aberrations — “tilt”, total high-order aberrations “high”, oblique ray aberrations “Coma”.

Results. Indicators of the IOL position. The main group. The average value of the angle of inclination in the horizontal meridian of the IOL was 3.07 ± 0.35°, in the vertical meridian 2.35 ± 0.25°. The decentration relative to the center of the pupil was 387.0 ± 3.4 mkm in the horizontal meridian, 443.0 ± 4.3 mkm in the vertical meridian. The comparison group. The average value of the angle of inclination in the horizontal meridian of the IOL was 3.04 ± 0.35°, in the vertical meridian 1.43 ± 0.13°. The decentration relative to the center of the pupil was 190.0 ± 2.8 mkm in the horizontal meridian, 259.0 ± 3.4 mkm in the vertical meridian. Aberrometry indicators. The main group: total RMS 0.52 ± 0.04, total internal aberrations 0.96 ± 0.04, tilt aberrations — “tilt” 0.31 ± 0.02, total high-order aberrations “high” 0.29 ± 0.01, oblique ray aberrations “Coma” 0.201 ± 0.010. The comparison group: total RMS 0.29 ± 0.03, total internal aberrations 0.66 ± 0.08, tilt aberrations — ““tilt” 0.202 ± 0.02, total high-order aberrations “high” 0.19 ± 0.07, oblique ray aberrations “Coma” 0.088 ± 0.010.The differences in the compared groups were significant (p < 0.05).The calculation of the correlation coefficient, when comparing the parameters of IOL decentration and the quantitative characteristics of aberrations, revealed a weak positive dependence, which indicates a slight influence of the obtained IOL decentration parameters on both internal aberrations and the RMS integral indicator.

Conclusion. Thus, a comparative assessment of the indicators of the IOL position (tilt / decentration) and the number of wave front aberrations did not reveal a significant correlation. The correct central position of the IOL reduces wavefront aberrations and ensures high quality of vision. The method of suture fixation of the capsule-bag complexes to the iris provides a high functional and qualitative result in a delayed period.

Purpose. Analysis of short-term clinical and functional results of implantation of a new non-diffractive IOL with expanded depth of focus.

Patients and methods. The study included 27 patients (35 eyes) after bilateral (8 patients) or monolateral (19 patients) AcrySof IQ Vivity IOL implantation (Alcon, USA) with mean follow-up of 3.8 ± 0.3 (3–5) months. In all cases, IOL implantation was preceded by cataract phacoemulsification or refractive lensectomy. Women accounted for 63 % (n = 17) and men for 37 % (n = 10). AcrySof IQ Vivity DFT015 IOLs were implanted in 24 eyes and toric AcrySof IQ Vivity DFT315, DFT415 and DFT515 IOLs in 11 eyes with clinically significant (more than 1.0 D) astigmatism.

Results. There was a significant (p < 0.05) increase in distance and intermediate uncorrected and best corrected visual acuity starting from the 1st day after surgery. An increase from 0.31 ± 0.09 to 0.58 ± 0.12 at the 1st day after the operation, and further up to 0.63 ± 0.13 at the follow-up period of 3 months (p < 0.05) was also registered while assessing near uncorrected visual acuity. In spite of some increase of best corrected near visual acuity in the follow-up period of 3 months in comparison with preoperative period (0.68 ± 0.19 and 0.57 ± 0.16, respectively), these differences were not statistically
significant (p > 0.05). After IOL implantation, the spherical refractive index was shown to decrease from –2.75 ± 1.4 in the preoperative period to –0.10 ± 0.73 in the follow-up period of 3 months. Permanent or periodic optical phenomena were detected in 4 patients out of 27 (14.8 %), of them 2 patients (7.4 %) had glare and 2 (7.4 %) — halo. Patients did not complain of difficulties in driving in the dark. In 11 oof 27 cases (40.7 %), patients required spectacle correction for reading. In spite of the need for spectacle correction for near vision in 40 % cases, the vast majority of patients (n = 24; 88.9 %) rated the result of surgery as “excellent” and three (11.1 %) as good.

Conclusion. This work presents the first experience in Russia of implantation of a new non-diffractive intraocular lens with an expanded depth of focus forming a wavefront in 35 eyes. The presented data testify to the high efficacy of this IOL for medium distance and far distance vision correction and to the possibility of providing functional near vision. Implantation of the investigated IOL was associated with a low incidence of adverse optical phenomena, such as halo, glare, and discomfort when driving in the dark. The use of this IOL in clinical practice may be an option to achieve the desired outcome in cataract surgery.

Aim. To determine the incidence and the clinical course of retinal complications of intracameral administration of cefuroxime in minimally invasive cataract surgery.

Methods. From 2016 to 2021, a prospective clinical study was conducted at the Volga District Medical Center of the Federal Medical and Biological Agency of Russia, which included patients with cataract in one or two eyes to be surgically treated. All patients received 1 mg of cefuroxime injected into the anterior chamber at the end of surgery. All patients underwent ophthalmological examination including evaluation of best corrected visual acuity with determination of logarithm of minimum angle of resolution (logMAR), tonometry, biomicroscopy, and ophthalmoscopy. Each patient before and the day after surgery underwent optical coherence tomography of the retina on a spectral optical tomograph RTVue-100 (Optovue). The dynamics of the condition was evaluated on days 3 and 7 after surgery.

Results. Five cases of retinal complications of intracameral cefuroxime injection were identified during the 5-year study period. According to data of optical coherence tomography, retinal edema was localized in the internal nuclear layer of the retina, and the height of serous retinal detachment in the fovea area on the next day after surgery was 315.0 ± 11.0 µm and reduced statistically significantly to 59.8 ± 42.3 µm on the 3rd day after the intervention (p = 0.043). One week later, all patients had complete retinal adherence and recovery of visual function. Retinal edema did not recur in the long term after surgery.

Conclusion. Serous retinal detachment with macular edema is the most common clinically relevant complication of intracameral antibiotic prophylaxis, which develops both in compliance with the dilution protocol and in overdose, and has a favourable prognosis.

In tumor angiogenesis, two main mechanisms are officially recognized. They are: the formation of vascular structures by associations of endothelial cell precursors (PEK) or angioblasts from circulating peripheral blood (1) and vascular co-optation (2) using preexistent vessels. Determining the dominant phenotype of endothelial cells (EC) involved in the neoangiogenesis of uveal melanoma (UM) is very important due to the different sensitivity of different EC to antiangiogenic therapy and their biological differences. Circulating hemangioblasts of bone marrow origin (synonym: endothelial cell precursors, PEC) involved in the formation of vessels in the tumor can also originate from hematopoietic stem cells and, in conditions of an excess of proangiogenic growth factors, undergo “reverse differentiation” or “dedifferentiation”. This situation is extremely dangerous due to changes in the biological properties of EC: the rate of proliferation increases and high resistance to any type of interventional antiangiogenic therapy, including targeted antiangiogenic drugs, develops. In combination with high resistance to radiation therapy and chemotherapy of tumor cells, such a tumor becomes uncontrollable and quickly leads to death... The purpose of this study: to identify the phenotype of endothelial cells involved in UM angiogenesis by immunohistochemical analysis. The authors conducted immunohistochemical studies on paraffin blocks (n = 98) of enucleated eyes with UM. One of the recommended PEC markers was used: a monoclonal antibody to the VEGFR2-KDR/Flk-1 receptor. It was found that the expression of the VEGFR- 2/Flk-KDR-1 receptor took place only in 22.1 % of the UM. The receptor was expressed exclusively by endothelial cells (EC) of tumor vessels and was not expressed by UM cells. There was no basic expression of the receptor (at stage T1). Peak expression was observed at stage T2. At the next stages of the oncological process, there was a decline in expression. The mean IHC gradation of expression intensity also decreased from stage T2 to stage T4. Flk-positive and negative endothelial cells differed in size, shape, nature of communication with the vascular wall and the presence or absence of a nucleus in the cell. The authors concluded that both mechanisms of angiogenesis take place in UM. A small percentage (22.1 %) Flk+endothelial cells indicate that the dominant mechanism of angiogenesis in UM is co-optation of vessels based on preexistent, and the dominant population of EC is Flk-negative EC.

Objective: to analyze the tonometric data, obtained with standard contactless tonometry and corneal-compensated tonometry, examined by the Oculus CorVis ST device in different groups of patients of the Tri-Z Krasnodar Clinic.

Patients and Methods. The study included 42 eyes of patients, with glaucoma — 55 %, with suspected glaucoma — 45 %, mean age — 63.19 ± 1.7 years, men were 20 (47.5 %), women — 22 (52.5 %), the central corneal thickness was 554.43 ± 5.28 microns. Corneal tomography and biomechanical parameters were measured using Pentacam (Oculus) and Corvus ST, respectively.

Results. IOP in people aged over 60 years was lower according to CorVis ST (Po 22.07 = 2.25, Pcс 18.63 ± 1.30, p = 0.007). IOP differed only in patients with a CCT of more than 580 µm (Po 22.4 ± 2.9, Pcc 18.21 ± 2.16, p = 0.012). IOP in patients with glaucoma was Ро 26.19 ± 3.5 and Рсс 21.3 ± 2.0, p = 0.008, without glaucoma — Ро 17.83 ± 9.60; Pсс 16.1 ± 5.5; p = 0.063. IOP in patients with compensated glaucoma Ро 17.34 ± 1.10, Pсс 16.6 ± 1.1, p = 0.354, with decompensated Ро 42.78 ± 6.8, Pсс 30.08 ± 4.10, p = 0.005. In the initial stage of glaucoma, Рo 22.5 ± 2.3, Рсс 20.0 ± 1.0, p = 0.297, in the advanced stage — Рo 20.7 ± 2.7, Рсс 17.6 ± 1.9, p = 0.027.

Conclusion. Standard non-contact tonometry can be used in persons aged under 60 years, persons without glaucoma and with initial compensated glaucoma. In all other cases, the Oculus CorVis ST values are more accurate.

The development of diabetic retinopathy is associated with matrix metalloproteinases, but they are rarely used to predict this pathology. The purpose of the study is to predict the development of nonproliferative diabetic retinopathy in old age based on the level of matrix metalloproteinases in blood plasma. The main group of the study consisted of 63 patients 60–74 years old with nonproliferative diabetic retinopathy, control consisted of 56 patients of the same age without the diabetic retinopathy and other ophthalmopathology at present and in history. Examination of patients in both groups included: tonometry, visiometry, standard fundus photography, optical coherence tomography, optical coherence tomography-A, fluorescence angiography. Determination of matrix metalloproteinases was carried out by the method of enzyme-linked immunosorbent assay. A statistically significant increase in matrix metalloproteinase was found — 9 in the main group of patients to 55,7 ± 2.6 ng / ml versus 40.2 ± 1.9 ng / ml in age control, matrix metalloproteinase — 2 to 269.8 ± 1.2 ng / ml versus 221.9 ± 3.6 ng / ml, respectively. Based on the level of matrix metalloproteinases — 2 (X₁) and (X₂) of the blood by the regressive method for predicting the development of diabetic retinopathy, which has the form Y = 28.315 + 3.892 × X1 + 2.453 × X₂, which will allow detecting the disease at an early stage.

Infectious keratitis is one of the leading causes of persistent decline in visual function and monocular blindness in both developed and developing countries. The combination of factors in the prevalence of eye infectious and inflammatory diseases, antibiotic resistance, and internal mutations of the pathogens themselves exacerbate the need to search for highly effective alternatives in the fight against eye infectious diseases. Of particular interest are the prospects for the use of fluorescent semiconductor nanocrystals, called quantum dots, in the treatment of resistant infectious inflammatory diseases. The objective of the study was to assess the anti-infectious activity of bioconjugates based on CdTe / Cd MPA 710 quantum dots and levofloxacin against staphylococcal corneal infection using the example induced infectious keratitis in laboratory animals. As the object of the study, 6 male (6 eyes) New Zealand rabbits were studied, which underwent induction of bacterial keratitis by introducing a hospital strain of S. Aureus into the structure of the cornea. The following were used as antimicrobial agents: a solution of levofloxacin 5 ml for epibulbar use and a bioconjugate based on CT CdTe / Cd MPA 710 and levofloxacin.

Purpose: To compare the diagnostic effectiveness of non-standard perimetry and standard automated perimetry (SAP) during earlystage monitoring of primary open-angle glaucoma (POAG).

Patients and methods. The study involved 30 patients (46 eyes) with early-stage of POAG, aged 30 to 65 years (54.9 ± 1.3), who were under ongoing monitoring for 3 to 4 years (3.50 ± 0.68 years). All subjects, in addition to the standard ophthalmological examination, performed the threshold program “24-2” perimetry using the Humphrey II, the own modification of Frequency Doubling Technology (FDT) Perimetry, in the form of 2 threshold strategies: the wellknown “FDT-16” and the new “FDT-64”. The condition of the optic nerve head (ONH) was assessed using HRT 3 (Heidelberg Retina Tomograph, Germany) and OCT — Topcon 3D OCT- 2000 (TOPCON, Japan). During monitoring, RTVue FD-OCT (Optovue, USA) was additionally performed, evaluating the parameters of the retinal ganglion cell complex (GCC).

Results. Regular follow-up, the implementation of the prescribed treatment contributed to the stabilization of glaucoma, as evidenced by the stability of the average MD index values according to all 3 threshold strategies, but reliably (p = 0.000) only according to SAP data. According to the criterion of the number of scotomas, there was a weakly expressed, but statistically significant negative dynamics for all the compared strategies. According to the results of the structural assessment of the ONH (the size of the excavation), a weakly pronounced negative dynamics was obtained in dynamics according to both HRT and OCT data. The average MD index values, the number of scotomas according to the three perimeter strategies and the excavation size based on HRT and OCT in patients with early-stage of POAG turned out to be stronger and more significant using the “FDT-16”, and the correlation characteristics with the results of “24-2” HFA II, “FDT-64” largely coincided.

Conclusion. A reliable correlation between structural and functional parameters indicates the feasibility of using “FDT-64” in combination with SAP not only in for the diagnosis of the early-stage of glaucoma, but also in assessing its course. The sensitivity level of the results of “FDT-64” (100 %) compared to “FDT-16” (88 %) in patients with POAG was higher, therefore, “FDT-64” is advisable to use in complex diagnostic cases and in monitoring glaucoma.

The purpose — to develop a prognostic model of the type of active retinopathy of prematurity (ROP) based on informative prognostic parameters of optical coherence tomography of the retina in angio-mode (OCT-A) and color duplex scanning (CDS) for a reliable choice of patient management tactics.

Patients and methods. 30 premature infants (30 eyes) with favorable and unfavorable types of 1–3 stages of active ROP were performed with optical coherence tomography of the retina in angio-mode. Children were born at a gestational age of 25–34 weeks. The birth weight of children was 680–2030 g. 55 premature infants (55 eyes) with active ROP were performed with CDS in modes of color Doppler mapping and pulsed Doppler sonography. Children were born at a gestational age of 25–32 weeks. The birth weight of children was 680–1760 g. ROC analysis was used to estimate the prognostic information content of the quantitative indicators of OCT-A and CDS in relation to the type of active ROP. The discriminant analysis was used to estimate the contribution of the studied quantitative indicators to the intergroup differences in the type of active ROP. A regression model was built to obtain a prediction of a favorable or unfavorable type of disease. The assessment of the acceptability of the model as a whole was carried out according to the index of determination and the level of significance of the resulting model (p < 0.05).

Results. The most informative prognostic indicators of the type of active ROP were determined, according to OCT in angio-mode: the area of the foveal avascular zone — and, according to CDS: maximum systolic and end diastolic blood flow velocity in the ophthalmic artery, maximum systolic blood flow velocity in the posterior short ciliary arteries, minimum velocity blood flow in the central retinal vein. On the basis of informative indicators, a reliable prognostic model of the type of active ROP was built, which has two independent variables: the area of the foveal avascular zone and the end diastolic blood flow velocity in the ophthalmic artery. The dependent variable can take values close to 0, which determine the favorable type of the disease, or close to 1, which determines the unfavorable type of the disease.

Conclusion. The introduction of the obtained model into clinical practice will allow to objectively determine the unfavorable course of the pathological process at the earliest stages, as well as to carry out early treatment of active ROP.

A common complication of diabetes mellitus, mainly type 2, is diabetic retinopathy, among which the most unfavorable form for complete loss of vision is considered to be proliferative diabetic retinopathy. The participation of the complement system in the development of proliferative diabetic retinopathy is mainly devoted to experimental work on a limited number of blood complement components and without assessing their risk in the pathogenesis of the disease. The purpose of the study was to determine the association of components of the blood serum complement system with the development of proliferative diabetic retinopathy in the elderly. In clinical conditions, 115 patients 60–74 years old suffering from proliferative diabetic retinopathy and 48 patients of the same age with the absence of this ophthalmopathology were examined. The components of the blood complement system were studied by enzyme immunoassay and hemolytic method. The relative risk of the influence of the complement components was calculated according to the generally accepted method. There was a statistically significant increase in the blood serum of patients with proliferative diabetic retinopathy of most components of the complement system, with the exception of the C₁ ing. and C₅ components. The content of the C_3a component increased especially to 127.6 ± 4.7 ng / ml versus 30.4 ± 3.5 ng/ml in the control, the C_5a component to 5.6 ± 0.5 ng/ml versus 2.4 ± 0.3 ng/ml, and factor H to 228.7 ± 4.9 versus 106.3 ± 3.8 mng / ml, respectively. The highest value of the relative risk among the studied components is inherent in the C_3a component of the blood complement with a reliable confidence interval of 4,451–5,103. The development of proliferative diabetic retinopathy in the elderly is associated with an increased content of C_3a, C_5a components and factor H in the blood serum, which can be used to develop targeted therapy for this disease.

Alpha2-macroglobulin (α2-MG) is a multifunctional glycoprotein. Due to the variety of its functions there can be several ways of its involvement in the pathogenesis of the glaucomatous optic neuropathy, including neuroinflammation, amyloid deposition, neurotoxicity. It is known that α2-MG level in aqueous humor is increased in glaucoma but there is scant information about its concentration in blood and tear fluid.

Purpose. To determine the α2-MG activity in tear fluid and blood serum of glaucoma patients to broaden of understanding of its role in the pathogenesis of glaucoma and to estimate its informativity for the characterization of the disease clinical course.

Methods. Tear fluid was collected from 21 patients with primary open-angle glaucoma and 17 healthy adults. Activity of α2-MG was measured enzymatically with BAPNA as a substrate.

Results. Activity of α2-MG in tears was 20 times lower than in blood serum. In healthy controls it was 4.66 ± 0.27 nmol / min×ml in tears and 92.35 ± 5.44 nmol / min×ml in blood. Totally in glaucoma patients it was 54 % higher than in controls in tears (р < 0.008), and 35 % higher in blood (р < 0.05). Particularly patients without pseudoexfoliative syndrome showed a significant α2-MG activity increase in tears (2 times) while in serum it was 67 % higher than in controls. In patients with pseudoexfoliative glaucoma α2-MG activity was not increased in tears nor in blood.

Conclusion. Primary open-angle glaucoma without pseudoexfoliative syndrome cause the increase of α2-MG activity in tears and in blood in contrast with pseudoexfoliative glaucoma. This fact indicates that pathogenetic ways of these types of glaucoma are different. The increased α2-MG activity may be the risk factor for the development of glaucoma without pseudoexfoliative syndrome.

Achromatopsia is a congenital autosomal recessive disorder characterized by decreased or absent cone’s function. Clinical symptoms include photophobia, nystagmus, low best corrected visual acuity, complete or incomplete color vision. Mutations in the CNGA3 and CNGB3 genes are responsible for approximately 70–80 % of all achromatopsia cases. The purpose: to evaluate the results of a comprehensive clinical and genetic examinations of four patients with an established diagnosis of achromatopsia. Onset of the disease in all patients was in the form of severe photophobia and nystagmus, appearing at the age from 1.5 to 11 months. According to optical coherence tomography exams were detected structural changes in neuroepithelium (three patients), varied from subfoveal disorganization of the photoreceptor outer segments with “blurring” of the external limiting membrane line and ellipsoid zone to subfoveal destruction of the photoreceptor outer segments and the presence of a slit defect. Out of seven identified mutations in the CNGA3 and CNGB3 genes, two were previously detected in Russian patients, and five were not detected in the Russian Federation.

Purpose: To assess efficacy and safety profile of intravitreal brolucizumab in patients with neovascular age-related macular degeneration (nAMD) in real clinical practice.

Patients and Methods. This study enrolled 21 patients with nAMD (treatment-naïve), including 12 women, 9 men, mean age was 73.5 ± 9.8 years. One patient was excluded from the study after 3 intravitreal injection (IVI) due to the development of the intraocular inflammation (IOI). All patients received 5 IVI of brolucizumab (in total, 100 injections). All patients were determined best-corrected visual acuity (BCVA). Intraretinal fluid (IRF), subretinal fluid (SRF), central macular thickness (CMT), and pigment epithelial detachment (PED) were evaluated by optical coherence tomography. Intraocular pressure (IOP) was measured before IVI, after 1 minute, 30 minutes. Patients were examined before treatment, after 3 and 5 IVI.

Results. The average follow-up period for patients was 31 ± 2.5 weeks, the average interval after 3 loading doses was 8.4 ± 1.2 weeks, the average interval between 4 IVI and 5 IVI was 10.7 ± 1.9 weeks. The BCVA improved significantly after 3 IVI and after 5 IVI of brolucizumab (p < 0.001). There was a statistically significant decrease in CMT and PED height (p < 0.001), as well as a resolution of all types of fluid (p < 0.001). All patients showed a significant increase in IOP immediately after injection (1 min) with normalization of IOP after 30 min. One case of IOI was registered 16 weeks after the start of treatment, cured by IVI of dexamethasone implant Ozurdex.

Conclusion. Patients with nAMD (treatment-naïve) who received 5 IVI of brolucizumab demonstrated a significant improvement of morphological and functional parameters. Brolucizumab has shown efficacy in the treatment of nAMD despite a small risk of IOI.

One of the main causes of low vision and reversible blindness is cataract- clouding of the lens, one of the main causes of which is the degradation of transparent lens within natural aging. Despite the well-developed technology of cataract surgery, there are a number of factors that are increasing in the number of patients with age-related cataracts. The purpose of this review is to clarify the arsenal of an ophthalmologist, primarily an outpatient clinic, in terms of drug treatment and prevention of age-related cataracts, removing a number of issues and disclosing selected aspects devoted to the development and capabilities of eye drops Catalin® (pirenoxine). Being a small molecule Catalin® has scientifically justified and studied mechanism of action, the drug has been used in different regions for decades. The drug was developed in Japan by Senju Pharmaceutical Co, that manufactures it in Japan at its own plant in accordance with high quality standards. Catalin® eye drops are an original drug, they do not contain benzalkonium chloride and have a specific formulation. Pirenoxine eye drops has proven efficacy and safety shown within the number of clinical studies for the conservative treatment of age-related cataracts. The article provides data on clinical trials of pirenoxine conducted in Japan and Germany and their results obtained with the participation of several thousand patients. Periodic safety reports that include data from at least 1 million patients demonstrate the high safety profile of Catalin®. The data about the positive influence of Catalin® on the processes that are different from age-related cataract like the ability to slow down the development of presbyopia, reducing the frequency and severity of complications after cataract phacoemulsification and after vitrectomy is being discussed within the article. The role of Catalin® eye drops when waiting for planned surgical treatment of cataracts that might be delayed for a number of reasons is noted, as well as changing the status of the drug to OTC which makes it more accessible to patients.

According to statistics, infectious and inflammatory eye diseases of various etiologies are widespread in the world (about 18 million cases per year). In some cases, they are severe and can lead to a decrease in acuity and even loss of vision. About 12 million in the structure of infectious and inflammatory diseases of the eye are conjunctivitis, which may be accompanied by inflammation of the edges of the eyelids (blepharoconjunctivitis) and / or the cornea (keratoconjunctivitis). A viral infection is one of the common causes of inflammation of the mucous membrane of the eyes. In the routine practice of ophthalmologists, adeno- and herpesvirus lesions of the organ of vision are most often diagnosed. Eye diseases of herpetic etiology are among the most common infections. Herpetic conjunctivitis usually develops as a result of an initial attack by Herpes simplex virus type 1 (HSV-1) in early childhood. But there is reason to believe that in adults they are no less common than herpetic keratitis, however, the diagnosis of isolated herpetic conjunctivitis is extremely rare, since, unlike herpetic keratitis or creatoconjunctivitis, the clinic is less pronounced, not always confirmed by laboratory, which leads to underdiagnosis. During the treatment of ophthalmic herpes, one should rely not only on the antiviral effect of drugs, but also on the presence of immunomodulators (interferons or inducers of endogenous interferonogenesis) in the complex therapy, which contribute to faster recovery with fewer relapses.The aim of this study was to evaluate the effectiveness of the use of the drug OCTALMOL in the treatment of 34 patients with conjunctivitis and keratitis of herpesvirus etiology. The drug contributed to the relief of clinical symptoms of inflammation and a reduction in the duration of therapy in 89 % of patients, while the average duration of treatment was 10.7 ± 0.3 days. The therapeutic effect in the group where OCTALMOL was included in the basic therapy was statistically higher than in the control group.

Aim: to describe the experience of practical solutions for herpetic keratitis of a protracted course with latent chronic sinusitis and tonsillitis.

Material and methods. We observed 111 patients with various forms of prolonged herpetic keratitis and inflammatory ENT pathology. All patients underwent a study of biological secretions (tear, saliva, blood and urine) for the presence of DNA of herpetic viruses by PCR, systemic antiviral therapy was prescribed. All patients underwent a standard otorhinolaryngological examination, СТ scan of the paranasal sinuses (if necessary), microbiological study of nasopharynx swabs. Local therapy of herpetic keratitis included anti-inflammatory and antibacterial components.

Results and discussion. Isolated sinus inflammation occurred in 59 % of cases (65 patients), in 38 % of cases (42 patients) there were variants of combinations of sinus inflammation (sinusitis, sphenoethmoiditis, pansinusitis). In 24 % of those included in the study (n = 27), during examination, in addition to the presence or absence of sinusitis, chronic tonsillitis was determined. In 30 % of cases (more often than in other secrets), herpetic viruses were detected in saliva, coccal flora dominated in swabs from the nasopharynx. A marked reduction in ophthalmological symptoms correlated with start of ENT therapy.

Conclusions. This clinical and laboratory study has showed a close pathogenetic relationship of anterior ophthalmic herpes and concomitant inflammatory pathology of the paranasal sinuses and oropharynx. Active ethiotropic therapy of sinusitis and tonsillitis promotes short-term reduction of ophthalmic symptoms.

Purpose: to assess the possibilities of nutraceutical support in AREDS-3 category age-related macular degeneration (AMD) patients.

Patients and methods. The study included 30 AREDS-3 category AMD patients (30 eyes) aged 69.2 ± 5.7 years (12 men, 18 women). As the ophthalmic nutraceutical, the biological active supplement was used, including vitamins E, B1, B2, B3, B9, B12, C, lutein, zeaxantin, lycopene, resveratrol, beta-carotene, coenzyme Q10, copper, zinc, selenium (Oftolik®; 1 capsule, 2 times a day). Follow-up period: 12–16 months (6–8 courses of therapy). All those observed underwent: standard ophthalmological examination; fundus photo registration (Nidek); OCT (Opto-Vue); OCT-angiography (Zeiss); possible systemic side effects registration. The main criterion for nutraceutical support effectiveness was stabilization of AMD manifestation. The significance of a possible increase in number and (or) size of drusen (with the AREDS-3 category), as well as the appearance of patients with AMD of the AREDS-4 category, was assessed using the Pearson γ2 test. An additional criterion was the maximum corrected visual acuity (MCVA) stabilization. The mean and its standard deviation (M ± s) were calculated, the significance of differences was assessed using the Wilcoxon’s T-test.

Results. None of the eyes included in the study showed progression from the AMD AREDS-3 category to AREDS-4. In one eye (3.33 %), an increase in the number of drusen was recorded; in 29 eyes (96.67 %), the number and size of drusen remained stable. These changes were not statistically significant (γ2 = 1.017; p = 0.314; p > 0.05). MCVA during the follow-up period remained stable with a slight but statistically insignificant trend towards its increase (from 0.69 ± 0.096 to 0.71 ± 0.07; Temp = 165, p > 0.05). In all observed patients, the tolerability of ophthalmonutraceutical was good, no significant side effects were recorded.

Conclusion. Nutraceutical support prevented the progression of AMD from AREDS-3 to AREDS-4 during follow-up of 12–16 months. In the vast majority of patients (96.67 %), manifestation of AMD within the AREDS-3 category remained stable. After 6-8 courses of therapy, no significant side effects of nutraceutical support were recorded.

Purpose. To analyze a clinical case on the study of the dynamics of the state of the fundus of a patient with proliferative diabetic retinopathy (PDR) and end-stage chronic renal failure (CRF) on the background of hemodialysis (HD).

Patient and methods. A clinical case of the study of the state of the organ of vision against the background of HD in patient S., 36 years old, is presented. Hemodialysis was performed for 4 months using the Artis Surdial-55 device (Nipro, Japan) for 3.5–4 hours with a blood flow rate of 250 ml/min and a dialysis solution flow rate of 500 ml/min. The severity of PDR was assessed using standard methods based on ultrasound (Opticon 2000, Italy), photographic recording of the state of the eye fundus (Carl Zeiss Visucam 500, Germany) and OCT of the macular region (on an RTVue-100 tomograph, OptoVue, USA).

Results and conclusion. Studies before and after a course of HD indicate no changes in the fundus, which is confirmed by the data of an objective examination.

 The article presents a description of a clinical case of advanced purulent keratitis of mixed etiology (Pseudomonas aeruginosa + acanthamoeba),  developed as a result of a mode violation of soft contact lens wearing.  Confocal microscopy of the cornea revealed multiple rounded hyperreflective formations (acanthamoeba cysts). Complex anti-infective conservative therapy in combination with modified crosslinking stops rapidly progressing purulent keratitis and increases visual acuity from 0.01 to 0.9. 

The article presents the clinical case of a 22-year follow-up of a patient with early glaucoma whose visual functions were stabilized during the first 12 years after trabeculectomy and during the next 10 years of therapeutic treatment due to poor compliance the disease progressed to advanced glaucoma. As a result, in 2021 there were pronounced changes in the visual field of the left eye, the main cause, probably, was a vascular accident against the background of low perfusion pressure and uncompensated IOP. After a thorough analysis and scrupulous selection of eyedrops, IOP was compensated with laser and instillation of Dortimol Antiglau, which showed the best results of tolerability and achievement of tolerant pressure. This article presents data from clinical and instrumental studies and analyzes factors reflecting the importance of assessing the level of compliance in reducing the glaucoma progression.

In this report, we reflected a clinical case of the course of the proliferative stage of diabetic retinopathy in a patient suffering from type 1 diabetes mellitus (DM) and end-stage diabetic nephropathy (DN) before and after simultaneous pancreas and kidney transplantation. As a result of successful surgical treatment of DM and DN was achieved physiological normoglycemia (change in fasting blood glucose from 11 to 5.1 mmol/l, glycated hemoglobin level from 9.2 to 5.7 %) and relief of uremic syndrome (change in serum creatinine from 632 to 77,5 µmol/l, urea from 13 to 6 mmol/l, glomerular filtration rate from 7.1 to 83.5 ml/min/1.73 m2). By the end of the first year of the post-transplantation period according to ophthalmoscopy data on the fundus no regression of the initial and addition of new diabetic changes was recorded and according to special instrumental methods of research was recorded a partial improvement hemoperfusion in superficial (an increase in the whole perfusion density: OD — from 24 to 35 %; OS — from 23 to 33 %) and deep (increase in the whole perfusion density: OD — from 5 to 13 %; OS — from 4 to 6 %) capillary plexus, a decrease in the central thickness of the retina (OD — from 269 to 257 µm; OS — from 271 to 253 µm) with resorption of intraretinal fluid in the right eye, improvement of the visual acuity (OD — from 0.5 to 0.7; OS — 0.6 to 0.7) and light sensitivity (macula light sensitivity threshold: OD — from 16.5 to 21.8 dB; OS — from 22.1 to 25.4 dB) of both eyes.

Objective of the study: to analyze cataract incidence rates over the period from 1955 through 2019 in the cohort of the population exposed in the Southern Urals and to analyze radiation risk of cataract incidence.

Methods. For the first time cataract incidence was assessed over a long- term period from 1955 through 2019 in people who were chronically exposed in a low-to-moderate dose range. The registry of eye pathologies created in the URCRM was used as the basis for the study. Analysis of incidence rates was conducted with account of the individualized doses to the lens. The incidence rates were calculated using the methods of medical statistics per 1,000 people. The odds ration (OR) of cataract development was also evaluated using the case-control study.

Results. In total the studied group consisted of 14,751 people (1955–2019) who underwent examinations in the outpatient department of the URCRM. As of December 2020 4,658 patients with cataract were registered. According to the findings of the study (1955–2019) it has been stated that cataract incidence increases with age and thus with the aging of the cohort, improvement of the quality of the diagnosing procedures and examination of the patients. The number of cataracts in women significantly exceeds that in men (3,169 and 1,489, respectively). Standardized incidence rate of cataract over all the years of the follow-up is 172.94 (95 % CI: 168.10–177.78). In the course of the study of the cataract incidence dependence on the dose to the lens, it has been revealed that cataract incidence tends to increase with the increasing dose. Risk value of cataract development (OR) depending on the dose to the lens obtained as a result of the case-control study made up 1.10 (95 % CI: 1.00–1.21).

Conclusion. The incidence of cataract in the studied cohort increases with the follow-up periods. The number of cataracts in women is greater than that in men, the age characteristics are approximately the same. A trend of increased effect of the dose on the increase in the risk of cataracts was established based on the results of the performed analysis.

 Penetrating keratoplasty (PC) is an operation of choice for urgent and planned conditions of the pathologic cornea. Moscow City Ophthalmological  Center “Botkin Hospital” together with the Moscow Coordination Center for  Organ Donation) over the past five years, has been performing corneal transplants using native donor material. In the available literature sources, we could not find publications devoted to conducting PC with native donor material in a multidisciplinary hospital. This publication analyzes our own experience of end-to-end corneal transplantation with native donor material for the period from 2018 to 2022.