This article published the materials of the round table “Bioengineering in ophthalmology” (OphthalmicBioengineering), held on May 13, 2021 as part of the international conference Ural Symposium on Biomedical Engineering, Radioelectronics and Information Technology (USBEREIT). USBEREIT is held under the auspices of the IEEE Engineering in Medicine and Biology Society. The article presents reports on: metrological aspects of registration of tonometric and electrophysiological signals in ophthalmic diagnostics; approaches to modeling the processes of pulse blood filling of the eye with the determination of hemodynamic parameters; retinotoxicity based on electrophysiological signals; analysis of electrophysiological signals in the frequency-time domain and its application in clinical practice; extraction and analysis of specialized data obtained from the electrophysiological medical device; as well as diagnosing retinal diseases based on optical coherence tomography using machine learning.

Bacterial keratitis is an urgent problem in ophthalmology, representing a threatening condition for the anatomy and function of the eyeball. The disease is widespread and varies significantly depending on the geographical region, even within the same country. The BC clinic is well-known, has been studied in sufficient detail, but in real practice it often causes significant difficulties in diagnosis, since it largely resembles a keratitis clinic of another etiology. A significant role in the differential diagnosis of these diseases is played by laboratory tests, which are not always available and easy to perform and implement. The results of the bacteriological analysis have a delayed period, which may be critical for determining the correct treatment tactics, but, nevertheless, the information that can be obtained about the microbe and its sensitivity to ABP makes it possible to better cope with the infectious process. The development and introduction of new laboratory research methods into modern clinical practice is very relevant, could simplify and speed up the diagnosis of the disease, and with it increase the effectiveness of its treatment.

Bacterial keratitis (BC) is a threatening condition for the anatomy and function of the eyeball and requires an immediate complex of therapeutic measures. Effective treatment that preserves the anatomical and functional result of the organ of vision, including various non-surgical and surgical methods, is the basis for the treatment of CD. Drug therapy includes, first of all, massive etiotropic therapy, which is usually represented by broad-spectrum antibiotics, antiseptics and anti-inflammatory drugs. These combinations make it possible to competitively influence all links of the pathological process, showing an additive effect. Promising non-surgical means in the fight against bacterial infection of the cornea, in particular with resistant microorganisms, is the use of Quantum dots, Mitomycin C, Matrix metalloproteinases. The most radical surgical methods of treatment are based on therapeutic keratoplasty, the purpose of which is to excise the infectious focus of the cornea and restore its transparency through transplantation of donor corneal tissue, but this method has a number of disadvantages and limitations in its implementation. Autoconjunctival keratoplasty is the oldest method of treatment of progressive corneal ulcers and this method should be considered rather as temporary or preparatory before through keratoplasty, due to the lack of visual functions. The least radical and relevant surgical methods of CD treatment today are the use of Corneal Crosslinking, Microdiathermocoagulation, Cyanoacrylate glue, Amniotic membrane transplantation. The expansion of the arsenal of methods of influencing the microbial process of the cornea and their further study will allow for a quick response in response to the rapidly developing antibiotic resistance in the world.

The review presents information about the basic knowledge about the regulation of blood flow in the retina, based on data obtained in animal experiments using invasive methods. Along with the well-known instrumental methods for diagnosing vascular pathology of the eye, new high-tech methods for studying the microcirculation of the eye are used, which make it possible to most reliably assess the degree of circulatory disorders in the vessels of the eyeball. Thanks to the development of non-invasive ultrasound research methods, it became possible to study in more detail the state of blood flow in the vessels of the eyeball in people with vascular pathology of the eye. An important feature of the eye hemodynamics is its dependence on intraocular pressure and the presence of self-regulation of blood flow in the retina, including changes in the illumination of the retina, blood pressure, and so on. The blood supply to the eye can also be affected by pharmacological agents that are commonly used in the treatment of systemic diseases.

Currently, refractive surgery using modern laser systems for the correction of various types of ametropia is one of the most widespread and performed operations worldwide. It is important to obtain refractive results comparable to those expected, both for the patient and for the surgeon himself. However, in some cases, there may be a deviation of the refractive result from the planned one, and in the late period after the operation, a regression of the refractive effect is detected, which, ultimately, may cause patient dissatisfaction. In order to avoid these situations, it is necessary to have a clear understanding of the risk factors that can lead to these phenomena, and, accordingly, take them into account during planning a surgical intervention.
Currently, risk factors for regression and factors that can affect the deviation of the refractive result are divided into 2 groups and are actively studied by both Russian and foreign researchers.
Given the relevance of the problem of accurate planning and achieving stable refractive results, various nomograms have been actively developed and implemented recently. The purpose of nomograms is to compensate the influence of various factors by introducing adjustments that can be applied at the planning of the operation. Nomograms are considered reliable and effective tools to increase the predictability of refractive surgery, but, for the most part, are the result of the work of a refractive surgeon. The purpose of this review is to analyze the world literature to determine the risk factors for regression and factors affecting the deviation of the refractive result from the planned one, as well as to analyze the existing nomograms designed to improve the planning and prediction of the results of laser refractive surgery.

Impression cytology (from the Latin impressio — impact, indentation) is a minimally invasive method of cytological examination of the surface epithelium of the cornea, limbus and conjunctiva using various sorbing applicators for the collection of cellular material. The spectrum of diseases, in the diagnosis of which impression cytology is traditionally used, is mainly associated with pathological processes occurring in the conjunctiva. Such diseases as: Sjogren’s syndrome, dry eye syndrome, mucopolysaccharidosis, vitamin A deficiency, trachoma, squamous cell neoplasia of the ocular surface, etc. With the advent of the concept of limbal epithelial stem cell, new diagnostic possibilities of impression cytology in ophthalmology occurred.

Purpose. Comparative analysis of the accuracy of IOL optical power calculation using different biometric devices.

Patients and methods. The study included 30 patients (30 eyes) after monolateral implantation of different monofocal and multifocal IOL models with a mean follow-up of 3.0 ± 0.2 (3–4) months. The mean age was 63.5 ± 6.5 (48–84) years. In all cases, IOL implantation was preceded by cataract phacoemulsification or refractive lensectomy. For all patients, IOL optic power, axial length and keratometry data were obtained using IOLMaster 500, Pentacam HR, and Pentacam AXL+OKULIX devices. Clareon, IQ Vivity, Hoya 250/251, and XY1-SP Vivinex IOLs were implanted.

Results. The mean optical power for all implanted IOLs was +21.38 ± 3.50 D, range of values was +10.0 to +29.0 D. The average values of axial eye length were 23.50 ± 0.90 mm (21.25 to 25.19 mm). The target refractive IOLs optic power calculated with the three biometric systems did not differ significantly and was -0.464 ± 0.120 D, -0.502 ± 0.140 D, and -0.400 ± 0.110 D for IOLMaster, Pentacam, and Pentacam+OKULIX, respectively (p > 0.05). The Pentacam HR and Pentacam AXL+OKULIX had slightly lower MAE values; however, no significant differences were found in calculating IOL optical power for the three devices used (p > 0.05). When comparing the devices under study, significant differences were found for the rate of refractive power within ±0.5 D when using the IOLMaster on the one hand and OKULIX on the other (p < 0.05). The refractive error rate of ±1.0 D using the biometric devices did not differ significantly (p > 0.05).

Conclusion. This paper presents the first Russian experience of using OKULIX ray-tracing software in clinical practice to increase the accuracy of optical power calculation of various IOL models. The advantage of Pentacam AXL+OKULIX over the IOLMaster 500 biometer in achieving a target refraction of ±0.5 D is shown.

Objective. Development of a differential approach to laser iridotomy in children with endogenous uveitis considering iris characteristics and the reaction of children’s eyes to different laser types.

Patients and methods. Thirty-six laser iridotomies were conducted in 36 children aged 8–16 years with pupillary block. Nidek YAG laser was used in YAG (1064 nm) and SLT (532 nm) modes.

Results. The frequency of hemorrhagic complications during surgery decreased to 19.4 % since 2009. The frequency of exudative reactions and proliferative syndrome with closure of laser coloboms in 1-6 months after surgery decreased to 33.3 % (25.7 % and 40.9 % respectively).

Conclusion. We recommended the patented differential approach for effective nontraumatic laser iridotomy in children with endogenous uveitis. In a thin iris single-stage YAG laser perforation should be performed in maximum bombe and multiple perforation in cases of multi-chamber bombe. In a dense thick iris or in cases of former iridotomy closure two-stage approach should be performed. First, circular coagulation should be done in the form of a ring or spot at the site of the planned coloboma. Second, YAG-laser perforation should be done in 10–14 days. The iris vessels topography, reflexogenic zones, and the peculiarities of the iris reactions to the lasers in children with endogenous uveitis should be considered when choosing a place for a coloboma. The use of thermal coagulating lasers should be limited, especially on thin irises. Active anti-inflammatory therapy and eye monitoring are necessary after laser surgery. The differential approach is safe, effective, and can be recommended for implementation in the practice of pediatric ophthalmology.

Concomitant strabismus and refractive anomalies are often common pathological conditions in adult patients. The patient’s desire to get rid of both problems poses a question to the surgeon about the order of surgical interventions. With non-accommodative concomitant strabismus, the question is not so unambiguous. Despite a significant number of studies devoted to this topic, there is still no unequivocal opinion on the significance of refractive error after strabismus surgery. Thus, it remains an urgent task to study of possible surgically induced refractive changes after interventions on extraocular muscles and their assessment during the observation period.

Purpose. Evaluation of the effect of surgical treatment of horizontal strabismus in adults on refractive and astigmatic status.

Patients and methods. A prospective study of 30 patients with concomitant convergent or divergent strabismus. Each patient underwent surgery for horizontal strabismus, which consisted in recession and resection of the extraocular muscles of one eye. The spheroequivalent (SE) and cylinder (Cyl) values were determined before surgery, 1, 3, and 6 months after surgery. Refractive changes were calculated in the postoperative period, both for the spheroequivalent and for the cylinder, after 1 month (SIRC1), 3 months (SIRC2) and 6 months (SIRC3). In addition, the difference (d) between SIRC1 and SIRC3 was calculated to determine if they were temporary or permanent. Analysis of the induced changes in the magnitude and direction of astigmatism was performed using vector analysis.

Results. The dynamics of SE values within 6 months after surgery shifted to insignificant myopia, however, no significant static difference in this parameter was found (p = 0.17). The mean change in spherical equivalent (SE) refraction was 0.22 ± 0.47 diopters in SIRC1, 0.15 ± 0.44 diopters in SIRC2, and 0.12 ± 0.51 diopters in SIRC3. There was no statistically significant difference between changes in surgically induced refraction at different times after surgery (p = 0.34). The difference (SIRC d) between SIRC1 and SIRC3 for the spheroequivalent was 0.096 ± 0.480 and can be interpreted as a decrease in surgically induced refraction error within 6 months after surgery. Surgically induced astigmatism at different times after surgery was: SIRC1 = 0.44 ± 0.39, SIRC2 = 0.47 ± 0.41, SIRC3 = 0.43 ± 0.29. There was no statistically significant difference in this parameter during the study period (p = 0.1). The difference (SIRC d) between SIRC1 and SIRC3 for astigmatism was 0.0001 ± 0.3200, which indicates stable values of astigmatism. According to the vector analysis, the magnitude and axis of preoperative astigmatism was 1.131 ± 0.410 ax172 and is close to the actual postoperative values of 1.17 ± 0.50 ax172. The vector of surgically induced astigmatism was 0.43 ± 0.10 ax84. These changes were not statistically or clinically significant.

Conclusion. In general, the refractive and astigmatic status does not change after surgical treatment of horizontal strabismus. However, in this study, there was a myopic refraction shift during the first 3–6 months after surgery. In this connection, it is possible to recommend refractive operations to adult patients 3–6 months after strabismus surgery.

At present about 16.4 million people in the world suffer from retinal venous occlusions (RVO). The pathophysiology of RVO includes changes in the vascular wall, blood flow, blood clotting. The key role in the pathogenesis of this group of diseases is played by ischemia and retinal hypoxia, leading to neovascularization. Macular edema (ME) is the most common complication of retinal vein occlusions. Optical coherence tomography-angiography (OCTA) is considered as an informative and highly sensitive method for diagnosing macular edema (ME) and ischemic zones in RVO. Intravitreal administration of glucocorticosteroids and/or angiogenesis inhibitors is the priority treatment method for macular edema in RVO. The combination of antiangiogenic therapy and laser treatment is promising. The navigation treatment technology is implemented under the conditions of the Navilas 577 system. The Navilas 577 laser navigation system is a laser coagulator with a tracking system and a fundus camera. The possibility of planning the operation, superimposing the results of OCTA on a fundus image makes the treatment faster, more accurate, and minimizes damage to healthy tissues.

Purpose: to evaluate the results of target topographically oriented threshold laser coagulation in the treatment of post-thrombotic ME using the
Navilas 577 laser navigation system following intravitreal administration of angiogenesis inhibitors.

Materials and methods. There was performed a prospective study of the results of navigation laser treatment on the Navilas 577 device after intravitreal injections of angiogenesis inhibitors in 14 patients (14 eyes), aged 51 to 83 years, with macular edema up to 390 μm due to the branch central retinal vein occlusion. Laser treatment was performed within 2 weeks to 1 month following the last injection of angiogenesis inhibitors. The zones of ischemia in the macula were determined according to OCT-A data, imported into the Navilas 577 navigation system and superimposed on a color fundus image. Then the treatment was planned — the position of the future coagulates was marked.

Results. In 3 months, there was a decrease in the height of edema from 366.5 (323;390) to 280 (270;300) μm, an increase in light sensitivity in the central retinal zone from 17 to 21.2 dB and an increase in visual acuity from 0.4 (0.3;0.5) to 0.5 (0.45;0.6).

Conclusion. The combination of navigation retinal laser coagulation and angiogenesis inhibitors in the treatment of low post-thrombotic edema (less than 390 μm) gives good results; therefore, it can be justified and advisable in real clinical practice.

Purpose. To study the relationship between baseline optical coherence tomography (OCT) characteristics of preservation of the neurosensory retina and retinal pigment epithelium (RPE) and functional outcome after full thickness macular hole (FTHM) surgery.

Materials and methods. Patients with complete postoperative anatomical closure of the FTMH were included in this prospective interventional study. All patients received a standard ophthalmological examination and OCT before surgical treatment. At baseline the area and reflectivity of the neurosensory retina at the edges of the hole was measured on cross-sectional OCT scans. The reflectivity of RPE was evaluated within the hole on structural en face projections of RPE slab. Six months postoperatively, correlation between baseline OCT characteristics and visual outcome was evaluated.

Results. Twenty-nine patients (30 eyes, 23 females and 6 males, average age — 66.2 ± 5.2 years) were included in the study. The final best-corrected visual acuity showed a statistically significant correlation with baseline best-corrected visual acuity (r = 0.75, p < 0.001), reflectivity of RPE (r = 0.81, p < 0.001), reflectivity of neurosensory retina (r = –0.88, p < 0.001), and its area (r = 0.41, p = 0.02).

Conclusion. OCT-characteristics of retinal tissue preservation, including the area and reflectivity of the neurosensory retina and reflectivity of the RPE within the hole, correlate with functional recovery after FTMH surgery.

Purpose: to evaluate the clinical and functional results of two methods of Descemet’s membrane endothelial keratoplasty using a full and half graft.

Patients and methods. This study is based on surgical treatment of 54 patients (54 eyes) with cataracts and Fuchs endothelial corneal dystrophy were divided into two groups. In the first one, phacoemulsification of cataract with implantation of a hydrophobic IOL and standard «classical» technique of Descemet’s membrane endothelial keratoplasty were performed, it included 30 patients (30 eyes). The second group underwent cataract phacoemulsification with implantation of a hydrophobic IOL and modified transplantation of a fragment (1/2) of Descemet’s membrane, it included 24 patients (24 eyes).

Results. Transparent engraftment in the first group was achieved in 100 % of cases (30 out of 30 patients), in the second group in 95.8 % of cases (23 out of 24 patients). It should be noted that in the second group, one patient had fibrosis of the posterior layers of the corneal stroma (due to incomplete adherence of the DM to the posterior surface of the recipient’s cornea), this complication required endothelial re-keratoplasty. After 12 months, the BCVA improved from 0.2 ± 0.1 to 0.8 ± 0.2 in the first group, from 0.1 ± 0.1 to 0.7 ± 0.2 in the second group (p < 0 ,0001). The central corneal thickness (CCT) according to keratopachymetry in the first group decreased from 648.7 ± 60 to 512.4 ± 27.4 μm, in the second group — from 650.9 ± 44.5 to 519.6 ± 43.9 μm respectively. The endothelial cell loss (ECL) was 52.3 % and 54.9 % in the first and second groups respectively.

Conclusion. The modified technique of Descemet’s membrane endothelial keratoplasty is effective for the treatment of Fuchs’ endothelial corneal dystrophy providing high clinical and functional results. A comparative analysis of the results obtained showed that at all results of BCVA, ECC and CCT by 12 months after surgery were comparable between two groups. Thus, the use of the new technique made it possible to double the availability of donor material and provide patients good clinical outcomes comparable to those of «classical» DMEK.

Purpose: Analysis of remote clinical functional results of high myopia correction in patients with thin cornea by method of intrastromal MyoRing implantation with Femtolaser assistance.

Materials and methods. 22 eyes of 22 patients were included into investigation, the мean age of patients was 30.20 ± 5.37 (from 24 to 40) years. Mean spherical equivalent (SE) of refraction was –11.52 ± 1.96 D, cylindrical component of refraction was –2.04 ± 1.64 D. Minimal pachymetry index in center was 491.6 ± 20.0 mkm. Corneal hysteresis (CH) was 8.60 ± 1.19 mm Hg. The average pupil diameter in mesopic conditions was 5.60 ± 0.23 mm. All patients had a history of mild amblyopia. Period of control in average 2 years.

Results. In 2 years after the surgery uncorrected visual acuity was 0.60 ± 1.22, corrected visual acuity 0.70 ± 0.20. Mean spherical equivalent (SE) of refraction was 0.61 ± 1.43 D, cylindrical component of refraction was –0.13 ± 0.50 D. Predictability of SE within ±0.5 D was 84 %, ±1.0 — 84 %. Index of safety was 1.16, index of efficacy — 1.0. CH was 9.50 ± 0.03 mm Hg. Mean pachymetry at center after the surgery did not change statistically significant in comparison with initial data (p = 1.00).

Conclusion. MyoRing implantation is an effective and safe method, it provides: refraction spherical component correction, astigmatism correction and CH increase (p = 0.01).

The purpose — to study the features of the foveal avascular zone (FAZ) in children with active retinopathy of prematurity according to the data of optical coherence tomography in angio-mode.

Patients and methods. OCT-A was performed on 37 premature infants (37 eyes) with active ROP: at stages 1–2 — in 14 eyes (8 — with a favorable current type, 6 — with an unfavorable current), at stage 3 — in 16 eyes (6 — with a favorable type, 10 — with unfavorable), with aggressive posterior ROP — in 7 eyes (4 — at the stage of early clinical manifestations, 3 — at the stage of manifestation). Patients with stages 1 and 2 of active ROP were combined into one group due to similar findings. The control was the data of OCT-A performed on 10 premature infants without signs of ROP.

Results. At 1–2 stages with a favorable type in children with a somatic state of moderate severity in the FAZ area, statistically significant differences in comparison with the control parameters were not determined. In children with a severe condition, FAZ was significantly expanded, which was accompanied by a significant decrease in the density of capillaries in the fovea. With an unfavorable type, a significant decrease in the size of the FAZ was noted, as well as a slight decrease in the density of the capillaries of the superficial plexus in the fovea. At stage 3 with a favorable type, an expansion of the FAZ, a decrease in the density of capillaries in the fovea in the superficial and deep plexus were recorded, and the values of the density of capillaries in the parafovea were slightly increased. At 3 stages with an unfavorable course in children born at a gestational age of 29–32 weeks, the FAZ was expanded. In children born at a gestational age of 25–28 weeks, a significant decrease in the size of the FAZ was recorded in comparison with children with a long gestation period, as well as those with a favorable course of stage 3. At the stage of early clinical manifestations of the posterior aggressive ROP, the FAZ was absent; vessels grew into it, which formed shunts and zones of intraretinal neovascularization in the form of “tangles”. At the stage of manifestation of the posterior aggressive ROP, a gross violation of the architectonics of the microvasculature was determined. As at the stage of early clinical manifestations, FAZ was absent; shunt vessels grew into it.

Conclusion. The OCT method in angio-mode has showed high information content in studying the features of the foveal avascular zone in children with various forms, stages and types of active ROP. The characteristics of FAZ with an unfavorable type of the disease are of the greatest value for clinical practice. Their identification at the early stages of the pathological process will make it possible to timely determine the correct tactics and carry out the necessary treatment.

Purpose: modeling of experimental antibiotic-resistant endophthalmitis on laboratory animals model describing the interaction of quantum dots and a biological organism and its physicochemical and kinetic aspects.

Material and methods. The object of the study is laboratory New Zealand rabbits (2 male, age 4 months, weight 3.5 kg). The inflammation inductor is the culture of Methicillin-Resistant Staphylococcus Aureus (MRSA). 1 mg/0.05 ml of vancomycin in combination with 0.5 μg (0.01 %)/0.05 ml by a solution of quantum dots InP/ZnSe/ZnS 660 was intravitreally administrated to the first rabbit. 1 mg/0.1 ml of vancomycin was intravitreally administrated to the second rabbit. Dynamic observation of the clinical process was performed daily by photo registration of the front segment and ultrasonic sonography.

Results. The conjugate based on 1 mg/0.05 ml vancomycin coupled with 0.5 μg (0.01 %)/0.05 ml quantum dots InP/ZnSe/ZnS 660 demonstrated high anti-infectious activity against vancomycin-resistant MRSA. It was shown that the effect of the above solution on MRSA is described by the one-time ability of quantum dots by using electron microscopy. The presence of superoxide radicals O2–• generation in an aqueous solution of quantum dots under the action of blue light has also been proven by spectrophotometric method.

Conclusion. Conjugates based on quantum dots can be considered as one of the promising directions of treatment of antibiotic-resistant endophthalmitis.

Research justification. Corneal ulcer is a common corneal pathology dangerous because of its complications, which occur in 2.5–37.9 % of cases despite modern treatment. Thus, the development of novel methods improving the results of corneal ulcer treatment is very important.

Research objective was to evaluate the efficacy of lactoferrin-based therapy for experimental suppurative corneal ulcer.

Material and methods. The study was performed in male chinchilla rabbits. Three intact rabbits (6 eyes) were used as control animals. Staphylococcus suppurative corneal ulcer was modeled in both eyes of 63 experimental animals. These rabbits were randomized into three groups. The first group was administered placebo therapy, the second group received antibacterial therapy, and the third group — instillations of lactoferrin. The area of ulcerative lesion was used as the measure of the therapeutic efficacy of the treatment. Then, a histological study was performed, and microsamples were photographed with LOMO TC-500 digital camera (Russia).

Results. Lactoferrin instillations resulted in reliable increase in the number of transfers from infiltration stage to epithelization stage, decrease in the percentage of ulcerations, and in the proportion of critical thinning of the cornea, as well as decrease in the proportion of perforations. However, it was noticed that lactoferrin treatment when continued after the end of epithelization process resulted in excessive formation of opaque scar tissue.

Conclusion. Local administration of lactoferrin stimulates the epithelium regeneration and the formation of the connective tissue and thus prevents the development of complications of suppurative corneal ulcer. However, the identified excessive formation of opaque scar tissue in lactoferrin treatment lasting too long has to be taken into consideration when developing the optimal scheme for lactoferrin treatment.

Cataract in patients of older age groups is one of the reasons for the deterioration of geriatric status, the manifestations of which are geriatric syndromes, but insufficient attention paid to the study of the latter.

Purpose. To study the prevalence of geriatric syndromes among patients with UC, depending on visual acuity without correction.

Patients and methods. Geriatric syndromes were studied in 220 elderly patients with UC, in 240 elderly patients with FC and 200 elderly patients without UC based on methods of complex geriatric assessment. The following geriatric syndromes were analyzed: sarcopenia, hypomobility, malnourishment, pain syndrome, and disorders of general motor activity, psychological problems, cognitive disorders, anxiety-depressive status, sleep disorders and urination.

Results. It was found that the deterioration of visual acuity without correction of less than 0.3 is accompanied by an increase in the majority of geriatric syndromes in elderly and senile patients with UC and especially in 75–89 years of hypomobility syndrome to 93.2 ± 2.5 cases of cognitive impairment to 89.3 ± 3.0 cases, malnutrition to 88.3 ± 3.2 cases and psychological problems to 79.6 ± 4.0 cases per 100 examined, which is significantly higher by 2.0–2.4 times compared to patients of the same age with UC with visual acuity without correction more than 0.3. A decrease in visual acuity of less than 0.3 in patients with UC contributes to an increase in the prevalence and average number of geriatric syndromes in old age to 8.2 ± 1.0 cases versus 3.9 ± 0.8 cases in old age with UC with visual acuity of more than 0.3 (P < 0.001).

Conclusion. The revealed dependence of the prevalence of geriatric syndromes, taking into account visual acuity, indicates the relevance of timely correction.

Purpose: to study the status of retinal pigment epithelium (RPE) over the area of quiescent choroidal neovascularization (CNV) in comparison with active CNV in neovascular age-related macular degeneration (nAMD).

Patients and methods: This study included 17 patients with quiescent CNV (6 males and 11 females, mean age 74.9 ± 10.0 years) and 28 patients with active CNV (8 males and 20 females, average age 69.3 ± 6.8 years). All participants received a standard ophthalmological examination, including spectral optical coherence tomography (OCT), dark-field scanning laser ophthalmoscopy (DF-SLO) and autofluorescence. Using ImageJ, the brightness of the image in the projection of the CNV was evaluated. The vascular density of the membrane was assessed using OCT angiography.

Results: The vascular density of quiescent CNV was statistically significantly higher than that of active CNV with a median value of 64.5 % (95 % confidence interval (CI) 53.4–79.0 %) and 55.3 % (95 % CI 52.2–60.0 %) (p = 0.05). Image brightness in the silent membrane region was significantly lower by compared with active CNV, both according to OCT transillumination data (p = 0.004) and according to DF-SLO data (p = 0.0015). There were no differences in autofluorescence indices between active and quiescent CNV (p = 0.44).

Conclusion: Multimodal imaging indicates significant loss of integrity of RPE over active CNV, which corresponds to their lower vascular density according to OCT angiography.

The continuing increase in the prevalence of diabetic retinopathy among various segments of the population and, especially in older age, combined with a change in the psychological state of such patients. However, the study of the holistic psychological (cognitivedepressive) domain in elderly patients with various stages of diabetic retinopathy, comparable in cardiovascular pathology, which is an independent risk factor for both diabetic retinopathy and cognitive impairment, depression not carried out.

Purpose: to assess the psychological domain in patients 60–74 years old suffering from diabetic retinopathy standardized for concomitant cardiovascular pathology. In the Tambov branch of the Tambov branch of S.N. Fedorov NMRC “MNTK “Eye Microsurgery” in 2019–2020, cognitive impairment and depression were studied in 68 patients with non-proliferative, 62 patients with preproliferative and 70 elderly patients with proliferative stage on the Mini-Mental-State-Examination and Center for Epidemiologic Studies — Depression scale, respectively. The diagnosis of diabetic retinopathy established based on the results of a comprehensive ophthalmological examination. The control consisted of 59 patients with the absence of diabetic retinopathy. Patients with non-proliferative stage had mild (21.5 ± 0.3 points), and with preproliferative (17.9 ± 0.4 points) and proliferative stage (16.2 ± 0.3 points) moderate cognitive impairment. The association of cognitive impairment found with preproliferative and proliferative diabetic retinopathy. The level of depression in the non–proliferative stage was 22.4 ± 0.4 points, in the preproliferative stage — 24.8 ± 0.3 points and in the proliferative stage — 26.9 ± 0.5 points versus 19.2 ± 0.3 points in the control with a significant difference in all cases. The values of the relative risk of diabetic retinopathy stages were 1,337, 2,408 and 2,796, respectively. The revealed deterioration of the cognitive-depressive domain in elderly patients with diabetic retinopathy is important for improving compliance, the effectiveness of treatment of diabetic retinopathy and the psychological continuum.

Microbial keratitis (MK) is a homogeneous group of diseases accompanied by loss of the corneal epithelium, stromal leukocyte infiltration and/or destructive tissue breakdown, occurring when the protective mechanisms of the ocular surface are disturbed, which require an immediate set of therapeutic measures, including, first of all, massive etiotropic therapy, which is represented, as a rule, by broad-spectrum antibiotics (AB) and anti-inflammatory drugs. One of the most threatening MK pathogens is P. aeruginosa (PA) (Pseudomonas aeruginosa). Multiple drug resistance, the highest pathogenicity, numerous RA virulence factors dictate the need to search for new highly effective methods to combat MC, in the etiological structure of which RA dominates. The most promising direction in this area is the use of artificial fluorophores, in particular quantum dots (QDs). The objective of this study was to evaluate the anti-infectious activity of the complex based on InP/ZnSe/ZnS 650 quantum dots and Tobramycin against Pseudomonas aeruginosa infection of the cornea. As an object of study, laboratory New Zealand rabbits (No. 6) were studied — 2 females, 4 males, which were induced bacterial keratitis by introducing a nosocomial Ps strain. aeruginosa in the structure of the cornea. The following antimicrobial agents were used: Tobramycin solution 5 ml for epibulbar application and a bioconjugate based on QD InP/ZnSe/ZnS 650 and tobramycin. Laboratory animals were divided into 2 groups. Rabbits of the 1st group, after the manifestation of the clinical picture of microbial keratitis, received instillations of tobramycin drops into the conjunctival sac every 2 hours for 3 days with a complete absence of positive clinical dynamics and a subsequent transition from day 4 in order to anatomically preserve the eyeball to instillations of the CT InP/ZnSe/ZnS complex 650 + Tobramycin. Rabbits of the 2nd group received instillations of the CT + Tobramycin complex and showed positive dynamics in relation to the regression of symptoms from the 2nd day of therapy. As methods of dynamic observation, photoregistration of the anterior segment with fluorescein staining and optical coherence tomography of the anterior segment were used. A clinical experiment has demonstrated the highest efficiency of the InP/ZnSe/ZnS 650 + Tobramycin complex in relation to Pseudomonas aeruginosa strain resistant to Tobramycin monotherapy.

It is considered, that one of the main directions of treatment of adenovirus conjunctivitis is the appointment of interferon alpha-2b in combination with diphenhydramine, which until recently was provided by the only original drug. In 2020, the first generic drug, Interferon-Oftalmo, would be registered in Russia.

The purpose: to evaluate and compare the efficacy, safety and tolerability of treatment of patients with keratopathy against the background of adenovirus keratoconjunctivitis with Interferon-Oftalmo and Oftalmoferon.

Material and methods. The comparative analysis included completed cases of treatment of 51 patients (102 eyes) aged 18–75 years with clinical signs of keratopathy against the background of epidemic adenoviral keratoconjunctivitis. Patients of the first group (n = 27, 54 eyes) on the background of tear replacement therapy received eight instillations of the drug Interferon-Ophthalmo, the second (n = 24, 48 eyes) received Oftalmoferon. The observation period was 15 days. Treatment efficacy was assessed based on a quantitative analysis of the dynamics of clinical symptoms of inflammation and the state of the cornea, the severity of subjective manifestations of ocular surface xerosis using the ocular surface damage index (OSDI), as well as the stability of the tear film. Safety and tolerability were also evaluated.

Results. Against the background of complex therapy, which included the instillation of Interferon-Ophthalmo or Oftalmoferon, all patients showed comparable dynamics in the relief of the inflammatory process and keratopathy. This was expressed in a statistically significant decrease in the severity of foreign body sensation, lacrimation, itching, eyelid edema, conjunctival edema and hyperemia, follicular reaction, conjunctival hemorrhages, punctate keratopathy, subepithelial infiltrates in the cornea. In both groups, there was a steady downward trend in OSDI against the background of an increase in the stability of the tear film and an increase in maximally corrected visual acuity. The safety and tolerability profile of the drugs was assessed as comparably favorable.

Conclusion. The inclusion of the drug Interferon-Oftalmo in the complex therapy of adenoviral epidemic keratoconjunctivitis allows us to expect a comparable effect on the course of the disease compared to the original drug Oftalmoferon.

Eyes’ dryness continues to be the most frequent complication after LASIK. As a rule, it disappear in the vast majority of patients during the first year after surgery. The conducted studies indicate that complaints of eyes’ dryness in the preoperative period significantly increase the risk of developing a severe form of dry eye syndrome in the postoperative period, especially in middle-aged women (45–59 years) and older. The clinical case presented in this article indicates the development of a severe form of dry eye syndrome after LASIK in a middle-aged patient receiving hormone replacement therapy for menopause, complaining of a feeling of dryness and discomfort in the eyes in the preoperative period, with intolerance to contact lenses and taking antidepressants in the absence of signs of severe dry eye in the preoperative period. Consequently, surgical intervention led to the development of the mentioned above condition. It is confirmed by the literature data indicating that the above factors can cause the development of a severe form of dry eye syndrome after LASIK. Taking into account the fact that tear production tests do not always correlate with the intensity of complaints of dryness, burning sensation, pain in the eyes, the most important component at the stage of deciding on the feasibility of refractive surgery in a particular patient is the collection of anamnesis and clinical picture. When preparing patients with a history of dry eye syndrome for refractive surgery, it is necessary to inform them that they have a significantly increased risk of developing dry eye syndrome. It may persist in the long-term postoperative period, and possibly go into a chronic form. Candidates for refractive surgery in the presence of complaints characteristic of dry eye syndrome can only be those patients who respond well to therapy aimed at relieving these symptoms in the preoperative period. Taking into account the multicomponent nature of pain in dry eye syndrome — nociceptive pain, which is formed at the stage of receptor irritation in the corneal tissue, and neuropathic pain that occurs with the participation of the peripheral and central nervous system, a comprehensive approach is needed in the treatment of dry eye syndrome.

Injuries cause serious disturbance of the form and function of the organ of vision due to the damage and accompanying or remote complications and therefore have a high proportion to the structure of low vision, blindness and disability. One of the complications of penetrating wounds of the eye is iris cysts. Iris cyst can increase and cause pupillary block, secondary glaucoma, uveitis, corneal dystrophy, and therefore it requires surgical intervention. The goal of surgical treatment of an iris cyst is to ensure complete removal of the cyst.

Objective: to estimate the clinical and functional results of treatment in a posttraumatic iris cyst, posterior subcapsular cataract and myopic astigmatism patient.

Patient and methods. Patient B., 49 years old with posttraumatic retention iris cyst, posterior subcapsular cataract, compound myopic high astigmatism was examined. To determine the tactics of surgical treatment of the patient, a complex of General ophthalmology was performed (visometry, IOP measurement, autorefractometry, biomicroscopy, ophthalmoscopy), as well as special (B-scanning, optical coherence tomography of the retina) research methods. The follow-up period was 1 year.

Results and discussion. To improve visual functions and prevent the development of secondary glaucoma, the patient was offered surgery — excision of the iris cyst and cataract phacoemulsification with toric intraocular lens. Simultaneous carrying out of two stages of the operation reduced the risks of postoperative complications and shorten the rehabilitation period.

Conclusion. Positive optical and therapeutic effects were achieved as a result of the surgical treatment 44 years after an open eye injury: the eye is calm, the iris cyst is not detected, visual acuity has increased. The postoperative period showed the saving the stable and high visual and functional result with no recurrence of the iris cyst.

Purpose: to provide a clinical case of cataract phacoemulsification with implantation of a multifocal intraocular lens (IOL) in a patient with posterior keratoconus.

Clinical case. A 58-year-old patient came to the clinic with complaints of decreased visual acuity in both eyes over the past 2 years. A series of standard instrumental examinations and Scheimpflug keratotopography were performed. An initial age-related cataract, moderate hyperopia, complex hyperopic astigmatism, posterior keratoconus, and peripheral chorioretinal dystrophy was diagnosed.

Results and discussion. To achieve high visual functions and correct presbyopia, the patient was offered phacoemulsification surgery with implantation of a multifocal intraocular lens (IOL) Oculentis in the right eye and a multifocal toric one in the left one.

Conclusion. The result of our surgical treatment showed the multipurpose of the multifocal IOL Oculentis in some nonstandard cases and conditions of the cornea.

“White without pressure” warrants special attention from ophthalmologists due to the lack of consensus on its etiopathogenesis and associated risk of rhegmatogenous retinal detachment. “White without pressure” appears in various quadrants of the fundus as an area white to gray in color. It is more common in persons with high myopia.
The paper presents a clinical case of a 19-year-old male with an association between “white without pressure”, “dark without pressure”, vitreoretinal tuft and symptomatic floaters in the left eye. OCT scanning (SOLIX) was employed to assess the vitreoretinal interface. OCT revealed the intraretinal location of “white without pressure” and “dark without pressure” degenerations without vitreoretinal traction. “White without pressure” degeneration is hyperreflective at the level of the outer retina in the photoreceptor ellipsoid and myoid zones, and “dark without pressure” is hyporeflective at this level. Vitreoretinal tuft is a vitreoretinal degeneration located at the level of the inner limiting membrane. It was detected as a hyperreflective site with vitreoretinal adhesion leading to traction and thickening of the corresponding retinal area. The combination of the three degenerations poses a risk of rhegmatogenous retinal detachment due to the presence of the vitreoretinal tuft.