Retinal migraine is a rare migraine variant, initially described in 1882 as ‘ophthalmic megrim’. Since then, various terms have been used in the literature, such as “ocular migraine”, “monocular migraine”, and “migraine of the anterior visual pathway”. The lack of an unified definition led to controversy and potential confusion in defining the diagnosis. Later, the International Classification of Headache Disorders (ICHD-3) defined retinal migraine as repeated attacks of monocular visual disturbance, including scintillation, scotoma or blindness, associated with migraine headache, which are fully reversible. Retinal migraine should be considered a diagnosis of exclusion that requires ruling out other causes of transient monocular vision loss. The purpose of this review is to analyze the data on the prevalence, pathogenesis, clinical presentation, and differential diagnosis of retinal migraine reported in the literature.

This literature review provides information on the capabilities and role of OCT-A in the diagnosis of open-angle glaucoma. The need for non-invasive methods of assessing the ocular vasculature has led to the development of OCT-angiography (OCT-A), which provides information on the state of both the retinal structure and its vascular bed through blood flow analysis, further increasing the value of this imaging method compared to conventional OCT. Blood flow assessment with OCT-A can be used to detect many retinal vascular abnormalities, such as the definition of areas of non-perfusion, non-functioning vessels, the appearance of new vessels in areas that are avascular, increased vascularity, the presence of micro- and macroaneurysms, capillary remodeling, macular telangiectasia, and venous malformations. OCT-A is a non-invasive imaging tool for the retinal and choroidal vasculature, providing a unique view of the vascular system that can be combined with information from other imaging modalities to complement and eventually provide unique information to assist the eye care practitioner in diagnosing or evaluating the effectiveness of interventions. OCT-A parameters are measured in the peripapillary region, and monitoring peripapillary and macular vessel density can provide important information to assess glaucoma progression and predict the rate of disease worsening. Studies show a strong correlation between OCT parameters, OCT parameters, and visual function as measured by visual field analysis in glaucomatous eyes. Future prospects for OCT-A in glaucoma diagnostics using artificial intelligence to predict structural and functional features based on early vascular changes will provide opportunities for early identification of patients at high risk for developing and rapidly progressing glaucoma. OCT-A has the potential to become part of glaucoma diagnostics and treatment.

Carrying out phacoemulsification in eyes with concomitant pathology — extreme ametropia requires an individual approach due to the characteristics of the anteroposterior size of the eyeball and the presence of concomitant pathology. Difficulties arise at the stages of calculating the anterior-posterior axis of the eye, preoperative diagnosis, calculating the optical power of the intraocular lens, phacoemulsification and postoperative management. In the preoperative management of patients with hypermetropia, attention should be paid to the anterior eye segment, the angle of the anterior chamber of the eye, intraocular pressure; patients with high myopia require a detailed examination of the fundus. Difficulties in the intraoperative period in patients with short eye length are associated with the shallow depth of the anterior chamber, lack of space for manipulation; patients with long eyes require additional anesthesia to relieve pain when filling the eyeball with irrigation fluid. In the postoperative period, hyperopic patients need monitoring of intraocular pressure, myopic patients need fundus ophthalmoscopy with optical coherence tomography. To identify treatment tactics for cataract surgery in patients with high degrees of ametropia according to modern literature data. To perform the review, a search of literature sources was analyzed in the PubMed database using the keywords “cataract”, “high hyperopia”, “high myopia” and data from publications on the topic of the article for the period up to 2023 inclusive. The literature analysis has shown that recently more and more attention has been paid to the problem of high-grade ametropia. This is due to the widespread, progressive disease course, early cataracts development and other complications that significantly reduce vision.

Acute leukemia is a formidable disease that often leads to the death of the patient from the underlying disease or the consequences of severe chemotherapy treatment. Many prognostically unfavorable factors are known, including genetic and epigenetic ones. The review is devoted to the prognostic significance of changes in the fundus in patients with acute leukemia. According to various literature sources, ophthalmic manifestations of leukemia can be observed in 9-90% of cases. The data is obtained from the sources: eLibrary.RU, in the international PubMed database, as well as on the electronic websites of specialized scientific journals. Retinal hemorrhages, according to various authors, are associated with changes in peripheral blood. At the moment, there is no consensus on whether eye damage in acute leukemia is a bad prognostic sign. Are changes in peripheral blood related to pathologies on the fundus? It is not clear in which case, and in which patients, they may indicate an unfavorable prognosis. Is there a relationship between fundus lesions in acute leukemia and already known genetic and epigenetic adverse prognostic factors? All these unresolved issues require further detailed research of patients with acute leukemia and changes in the fundus.

The purpose: to compare the results of studies on intraocular lenses (IOLs) with extended depth of focus (EDOF) and trifocal intraocular lenses (THIOLs).

Methods. The comparative analysis was conducted based on data from meta-analyses, systematic reviews, and randomized clinical trials. The electronic databases used were PubMed and Elibrary. The most commonly analyzed characteristics were postoperative refraction, visual acuity, optical aberrations, contrast sensitivity, visual quality, and dependence on glasses.

Results. THIOL has significant advantages over EDOF in terms of postoperative refraction and visual acuity. This is demonstrated by a significantly lower postoperative residual spherical correction and spherical equivalent. There was no significant difference in postoperative astigmatism between the two groups. The analysis of visual acuity and eyeglass independence shows the advantages of EDOF for medium distances and THIOL for close distances. Some researchers prefer a combination of these two IOL types to achieve maximum results. Published data on optical phenomena indicate a higher number of dysphotopsias in the THIOL group. However, research results are highly contradictory due to their heterogeneity. A significant decrease in contrast sensitivity was observed in all groups for both photopic and mesopic conditions. Nevertheless, EDOF showed an advantage at lower spatial frequencies. In terms of satisfaction with the results obtained after surgery, there were no significant differences between the two groups of intraocular lenses (IOLs), as all patients reported a high level of satisfaction.

Conclusion. Binocular implantation of a THIOL can provide greater independence from glasses and good vision at medium and short distances. However, patients should be aware of a possible decrease in contrast sensitivity and visual quality, especially at night, which may be accompanied by discomfort while driving. If more activity is required at intermediate distances in daily life, the choice of an EDOF IOL is crucial, and the patient may not require additional eyeglasses for closerange work if necessary. In clinical practice, knowing the characteristics of an IOL helps meet patient expectations and achieve high levels of satisfaction.

Purpose. To compare the frequency of ocular hypertension in patients in the early postoperative period after microinvasive ultrasonic and 25G pneumatic guillotine vitrectomy.

Patients and methods. The article presents the results of studying intraocular pressure (IOP) and the frequency of postoperative ophthalmohypertension in patients in the early postoperative period after microinvasive ultrasound and pneumatic guillotine 25G vitrectomy. We analyzed the data of 256 patients (256 eyes) — 158 women, 98 men who underwent vitreoretinal surgery for the pathology of the vitreomacular interface, retinal detachment, diabetic proliferative retinopathy, hemophthalmia at the Optimed, Ufa with a follow-up for 1 month. For tamponade, physiological saline, gas-air mixture, silicone oil, sterile air were used, depending on the nature and severity of vitreoretinal pathology. The mean age was 59.2 ± 12.5 years. In the main group, patients were operated with microinvasive ultrasonic vitrectomy 25G (n = 136), in the control group — using pneumatic guillotine vitrectomy 25G (n = 120). Non-contact tonometry (Nidek Tonoref 3, Japan) was performed with a correction according to measurements of the central thickness of the cornea on a reflective microscope with pachymetry function (Tomey, ЕМ-3000, Japan) before surgery and on days 1, 7, and 30 after vitrectomy. Exclusion criteria from the study were: the presence of symptomatic ophthalmohypertension, glaucoma, traumatic injury to the angle of the anterior chamber, immature and mature cataracts, lens luxation. IOP indicators in both groups at different times of the early postoperative period (days 1, 7, 30) did not differ statistically significantly.

Results. The frequency of ocular hypertension on day 7 in the main group was 20.6 %, in the control group — 20 %, and on day 30 — 11 % and 10 %, respectively (the difference between the groups was not statistically significant, p > 0.05). The highest IOP values were observed with silicone oil tamponade.

Conclusion. The first analysis of the frequency of ocular hypertension in patients after microinvasive ultrasonic vitrectomy 25G did not reveal statistically significant differences with pneumatic guillotine vitrectomy for various types of tamponade.

The article discusses the results of a comparative analysis of surgical treatment of patients with asteroid hyalosis and the presence of kataract or artificial lens. Attention is focused on the persistence or intensification of subjective discomfort caused by the presence of hyalotic bodies in the vitreous during phacoemulsification of cataracts without surgical intervention on the vitreous. The feasibility of minimally invasive subtotal posterior closed vitrectomy as part of a combined intervention for asteroid hyalosis and cataract was demonstrated. The state of the vitreomacular interface was assessed after a limited vitrectomy technique without removal of the posterior hyaloid membrane and treatment of the extreme peripheral parts of the vitreous. The importance of visual artifacts and their impact on postoperative visual acuity is shown. A scale has been developed to assess the impact of asteroid hyalosis on the quality of vision, based on the degree of subjective perception of visual discomfort.

Purpose: to study the effect of various methods of intraoperative keratoprotection in phacoemulsification (PE) of senile cataract (SC) on morphological and functional state of the ocular surface structures (OSS) in the late postoperative period.

Patients and methods. 240 patients (240 eyes) who applied for surgical treatment of SC. Age: 65 ± 4 years. 109 men, 131 women. All patients were divided into three observation groups according to the method of intraoperative keratoprotection: 1st group — 60 patients, corneal irrigation with balanced solution; 2nd group — 60 patients, ophthalmic viscosurgical device was applied to the cornea; 3rd group: 3a subgroup — 60 patients, soft contact lens (SCL) was applied to the cornea; subgroup 3b — 60 patients, SCL impregnated with riboflavin solution was applied to the cornea. In addition to the standard ophthalmological examination, Schirmer I test, OCT-scanning were performed, and tear breakup time (TBUT) was determined.

Results. The lowest indicator of Schirmer I test was detected in the 1st group a month after the operation. The indicators did not change 2 months after the operation. There were no significant intergroup differences in the final observation period. The TBUT index in all groups decreased. 3 months after the operation, TBUT in the eyes of 3b subgroup was significantly higher in comparison to other groups. The best state of corneal epithelium thickness (CET) occurred in 3a and 3b subgroups. During the epithelium analysis according to OCT-mapping of the cornea, it was noted that the maximum decrease of CET and the number of defects was detected in the 1st and 2nd groups, and the minimum — in 3a and 3b subgroups at all follow-up periods after surgery. There were no significant intergroup differences in preoperative tear osmolarity. 3 months after surgery, tear osmolarity in patients of 3a and 3b subgroups was significantly lower than in patients of the 1st and 2nd groups. OSDI scores in all groups before surgery were comparable. 3 months after the operation, the minimum OSDI values were 3a and 3b in subgroups. Iatrogenic dry eye syndrome (DES) in patients of 3b subgroup was significantly lower than in patients of other groups.

Conclusion. In all the studied groups, the standard postoperative dynamics of OSS and TBUT and changes in CET were revealed, with the least variability in 3b subgroup. The use of SCL saturated with riboflavin showed the highest keratoprotective efficacy in PE SC, as it allowed a statistically significant reduction in the incidence of DES in patients after PE in SC (p < 0.05) in comparison with other methods. The developed method for predicting iatrogenic DES in patients after PE in SC is highly informative, because the number of patients in the 1st group with DES was within the expected range of error.

Purpose: comparative study of the energy and hydrodynamic parameters of phacoemulsification using different patterns of femtosecond laser fragmentation of the lens nucleus in patients with grade III and IV cataracts.

Patients and methods. Femtosecond laser (hybrid) phacoemulsification was performed in 252 patients (252 eyes) with grade III cataracts (group 1), and 237 patients (237 eyes) with grade IV cataracts according to the Buratto classification (group 2). In subgroup 1A, the pizza pattern (10 radial incisions) was used for femtosecond laser fragmentation of the nucleus. In subgroup 1B — the cylinder pattern (a combination of 8 radial incisions with 5 circular incisions), and in subgroup 1C — the grid pattern (8 radial incisions in combination with multiple incisions in the central zone in the form of a grid with a cell of 0.5 mm). In subgroup 2A, the pizza pattern was used for femtosecond laser fragmentation of the nucleus, in subgroup 2B — the cylinder pattern, and in subgroup 2C — the mesh pattern. Anterior capsulorhexis and preliminary fragmentation of the lens nucleus were performed using the VICTUS femtosecond laser surgical system. The effective ultrasound time and volume of the irrigation solution consumed at the stage of emulsification of the nuclear fragments were calculated. Corneal endothelial cell loss was assessed in 3 months after the surgery.

Results. In group 1, the shortest effective ultrasound time was revealed if the mesh pattern 1.65 ± 0.69 s, it was significantly less than the cylinder pattern — 2.33 ± 0.72 s (p < 0.05) and the pizza pattern — 3.18 ± 0.83 (p < 0.01). In group 2, the shortest effective ultrasound time was revealed when using the “grid” pattern 3.96 ± 0.81 s, it was significantly less than the “cylinders” pattern — 4.93 ± 0.93 s (p < 0.05) and the “pizza” pattern — 6.17 ± 1.13 s (p < 0.05). In group 1, the volume of irrigation solution consumed during emulsification of nuclear fragments was significantly less when using the “grid” pattern — 20.3 ± 3.0 ml compared to the “cylinders” patterns — 30.4 ± 5.6 (p < 0.05) and the “pizza” pattern 38.2 ± 7.8 ml (p < 0.01). In group 2, the volume of irrigation solution consumed during emulsification of nuclear fragments was significantly less when using the “mesh” pattern — 39.0 ± 7.9 ml compared to the “cylinder” patterns — 57.5 ± 10.0 ml (p < 0.05) and the “pizza” pattern — 77.0 ± 12.9 ml (p < 0.01). In group 1, after using the “mesh” pattern, the loss of corneal endothelial cells was 3.36 ± 0.93 %, which was significantly less compared to the “cylinder” pattern — 5.04 ± 1.21 % (p < 0.05) and the “pizza” pattern — 6.93 ± 1.53 % (p < 0.05). In group 2, after using the “grid” pattern, the loss of corneal endothelial cells was 8.61 ± 1.65 %, it is significantly less compared to the “cylinders” pattern — 9.83 ± 1.73 % (p < 0.05) and the “pizza” pattern — 11.52 ± 1.91% (p < 0.05).

Conclusion. The “grid” pattern allows to minimize the effective ultrasound time, the volume of the spent irrigation solution and, as a consequence, the loss of corneal endothelial cells compared to other patterns of femtosecond laser fragmentation

Over the past ten years, the scientific ophthalmological community has shown a significant interest increase in studying dry eye syndrome (DES), as the number of such patients is steadily increasing every year. According to research conducted by the international DEWS working group, which studies DES, there is no single “gold standard” for diagnosing DES, as its manifestations are very diverse. A set of diagnostic tests is used to diagnose DES, reflecting both subjective and objective indicators of tear production. Subjective diagnostic criteria include questionnaires, the most widely used of which are the OSDI and SPEED questionnaires. It should be noted that these questionnaires characterize only subjective indicators and do not take into account objective criteria. In addition, the peculiarity of DES is that the presence of complaints is already a sign of this disease. However, the symptoms, namely the complaints of patients, do not always coincide with the clinical manifestations of dry eye syndrome — objective indicators of the state of tear production, such as the indicators of tear production tests. Based on modern concepts of the etiology and pathogenesis of dry eye syndrome, the state of the tear-producing system directly depends on the state of the tissues of the ocular surface — the conjunctiva, cornea and eyelids. Any inflammatory process affecting the tissues of the ocular surface leads to a violation of the stability of the tear film, its evaporation and an increase in osmolarity, which in turn causes an inflammatory process. Therefore, it is necessary in diagnosing dry eye syndrome to take into account a set of indicators characterizing the state of the tissues of the ocular surface, including the inflammatory process, in particular, conjunctival hyperemia, as well as the stability of the tear film, which depends primarily on its lipid component. The comprehensive clinical classification of dry eye syndrome presented in this article reflects not only objective indicators of impaired tear production and inflammation of the ocular surface, but also subjective indicators — quality of life according to the SPEED scale, characterizing the intensity and frequency of complaints of dryness and discomfort in the eyes. The above indicators allow to differentiate the severity of dry eye syndrome, which is of fundamental importance for choosing treatment methods and the volume of drug therapy, and assessing its effectiveness in dynamics. The developed diagnostic algorithm does not require special skills when carried out by a doctor, so it can be recommended for its use in wide ophthalmological practice.

Objective. To evaluate characteristic OCT morphological characteristic of initial presentation and chronic recurrent macular edema (ME) in patients with intermediate uveitis.

Materials and methods. The study included 35 patients (46 eyes) with uveitic macular edema in intermediate uveitis. The first episode of macular edema was diagnosed in 20 patients (26 eyes), 15 patients (20 eyes) present with chronic recurrent macular edema. OCT was performed on the Optovue RTVue XR Avanti. The following OCT morphological characteristic were evaluated: integrity of IS/OS line, the presence of hyperreflective foci, inner nuclear layer cysts, Henle fibers layer cysts, small single cysts, diffuse retinal thickening without cystic changes, the presence of subretinal detachment.

Results. Four OCT morphological variants of uveitic macular edema were identified: diffuse macular edema, small single cysts, cysts in Henle fibers layer and the inner nuclear layer with and without subretinal detachment. In the group with diffuse macular edema, the median duration of macular edema was 3 months, macular edema with Henle fibers cysts, inner nuclear layer cysts with subretinal detachment presented after 5 months (median), small single cysts and cystic changes in the layer of Henle fibers and the inner nuclear layer were detected at later times (12 and 36 months, respectively). A strong negative correlation was found between best-corrected visual acuity and central retinal thickness in chronic recurrent uveitic macular edema (correlation coefficient — 0.7, p = 0.0001), while a moderate negative correlation was established in macular edema at initial presentation (correlation coefficient — 0.55, p = 0.0031). Integrity of IS/OS line was observed significantly more often (p = 0.002) in chronic recurrent macular edema (10 (83.3%)) than at initial presentation (2 (16.6%)). In the presence of IS/OS disruption, best-corrected visual acuity was significantly lower (p = 0.016).

Conclusion. Identified four OCT morphological variants of uveitic macular edema were characterized by different periods of its duration, which may reflect different stages of macular edema evolution. Chronic recurrent macular edema and ME at initial presentation in uveitis are distinguished by different OCT predictors, which should be taken into account in assessing the effectiveness of treatment and prognosis of visual acuity.

Objective: to study retinal vascular reactions (RVR) with a glycemic gradient, vitrectomy (VE) without panretinal photocoagulation (PRP) and after IVI aflibercept in patients with diabetes mellitus (DM).

Methods. In three independent groups, variations in retinal vessel (RV) caliber were studied with a glycemic gradient (DR progression factor), after VE without PRP and after IVI (DR/PDR regression factors). Retinal images were obtained using Heidelberg Retinal tomograph HRT II (Germany).

Results. With an increase in the level of glycemia, the tendency to increase the diameter of the RV in DM1 and DM2 was revealed both in eyes without DR and in the presence of DR. However, only in DR were the changes significant. After VE without PRP in the eyes with PDR, the diameter of the veins decreased by 7 % 2 months after VE and by 14 % after 18 months (p < 0.01); the arteries had persistent and significant changes in caliber after 2 months. After IVI aflibercept, the caliber of retinal vessels in DMO significantly decreased from the first to the third injection.

Conclusion. Patients with DM initially represent a heterogeneous group in terms of the severity of RVR, depending on the presence or absence of ДР. After treatment, BCVA indicators improved against the background of retinal vasoconstriction in all study groups. After VE without PRP there was a persistent and significant reduction of PV diameters. Thus, the dynamics of retinal vessel caliber may reflect the phases of DR/PDR evolution: progression or regression. Persistent PDR remission can be achieved without lasercoagulation of the retinal “avascular zones”.

In view of the current trend — growth of antibiotic resistance, the search for possible alternative methods of preoperative prophylaxis is relevant.

The purpose: to assess the impact of different methods of preoperative eradication of Staphylococcus epidermidis (the use of specific bacteriophage and picloxidine in combination with eyelid massage) on conjunctival and aqueous moisture contamination in the course of planned phacoemulsification.

Patients and Methods. 44 patients (48 eyes) were examined. Patients in group I underwent eradication with staphylococcal bacteriophage in combination with eyelid massage, in group II — with picloxidine according to the similar technique, group III was control group. Microbiological material was sampled from the conjunctival cavity before the application of the said methods and after blepharostat placement. Anterior chamber fluid (ACF) was examined at the end of the operation. Microorganisms were identified by MALDI-TOF method, sensitivity was determined by drip method.

Results. The percentage of S. epidermidis contamination of conjunctiva after blepharostat placement was 25.0 %, 68.8 % and 87.5 % in groups I, II, III, respectively, in the ACF it was found in 0.0 %, 12.5 % and 37.5 % in groups I, II, III, respectively.

Conclusion. Preoperative measures for S. epidermidis eradication with staphylococcal bacteriophage in combination with eyelid massage are significantly more effective than the similar technique with picloxidine and provide a significant reduction of conjunctival sac contamination by 75 %, and also absence of S. epidermidis in the ACF by the time of phacoemulsification completion.

The development of diabetic retinopathy is associated with the levels of melatonin, dehydroepiandrosterone and some other stress-limiting hormones, however, the circadian biorhythms of the latter were practically not analyzed in patients with diabetic retinopathy combined with sarcopenic obesity involved in the pathogenesis of diabetic retinopathy. The purpose: to study circadian biorhythms of stress-stimulating hormones in elderly patients with diabetic retinopathy and sarcopenic obesity. The study included an analysis of daily fluctuations of stresslimiting hormones in the morning and evening urine portions of 136 elderly patients with diabetic retinopathy combined with sarcopenic obesity and 125 patients of the same age with diabetic retinopathy without sarcopenic obesity. It was revealed that in patients with diabetic retinopathy and sarcopenic obesity, the content of all studied hormones, especially dehydroepiandrosterone (376,8 ± 5,2 mcg) and dopamine (323,8 ± 3,7 mcg), was statistically significantly lower compared to patients with diabetic retinopathy without sarcopenic obesity — 485,1 ± 6,3 mcg and 397,2 ± 5,4 mcg, respectively. Desynchronization of daily biorhythms in patients with diabetic retinopathy and sarcopenic obesity is expressed in a decrease in the content of cortisol in the morning and evening hours to 81,7 ± 2,2 mcg and 63,5 ± 2,5 mcg, melatonin to 8,4 ± 0,6 mcg and 19,5 ± 1,7 mcg, adrenaline to 10,9 ± 0,8 mcg and 4,2 ± 0,4 mcg, respectively. The gradient of changes in morning hormone values significantly (p < 0,001) exceeds that in the evening hours, amounting to –221,1 and –137,7, respectively, which indicates a decrease in the amplitude of daily fluctuations in circadian biorhythms of stress-limiting hormones among elderly patients with diabetic retinopathy combined with sarcopenic obesity, and the participation of desynchronization of the daily biorhythms of the hormones under discussion in the pathogenesis of diabetic retinopathy combined with sarcopenic obesity. Circadian biorhythms of stress-limiting hormones are recommended to be taken into account in case of combined diabetic retinopathy and sarcopenic obesity.

Purpose: to compare the accuracy of IOL calculation from the standpoint of the social model of health (based on the study of “quality of life”, QOL) in patients with visually intense work (VIW) and bilateral cataract.

Methods. We observed 108 patients with binocular cataract (216 eyes) aged 40 to 69 years (mean age 55.9 ± 1.4 years), everyday activities were characterized as VIW (at least 4 hours per day). All patients underwent (sequentially on both eyes) ultrasound phacoemulsification using the standard technique. All patients were operated on by the same surgeon (N.I. Ovechkin). To correct aphakia, a monofocal IOL “Flex HB Medicontur” (Switzerland) with a predicted emmetropic “target refraction” (TR) was implanted. All patients were divided into two groups: a group of patients (56 patients, 112 eyes) in which the IOL calculation was performed using the Kane formula (KF); a group of patients (52 patients, 104 eyes) in which the IOL calculation was performed using the Barrett Universal II formula (BU-II). The patients were examined 3 months after the second surgery based on a comparative study of refraction between the RC and the calculated one. The basic research method in relation to the target objectives of the work was a study of QOL using two questionnaires — Catquest-9SF and FEC22.

Results. The data obtained indicate an insignificant, statistically insignificant trend towards improvement in traditional refraction indices and QOL according to the Catquest-9SF questionnaire when calculating IOL using the KF compared to BU-II. At the same time, these differences in relation to the assessment of QOL using the FEK-22 questionnaire are characterized by pronounced (by 2.3 %), statistically significant (p < 0.05) differences.

Conclusion. The use (based on the original FEK-22 questionnaire) of the “medical and social” health model in the context of assessing the effectiveness of IOL calculation in VIW patients indicates a higher accuracy of the Kane formula compared to the Barrett Universal II formula. The identified differences are due to the fact that calculations using the Kane formula are performed in a comprehensive manner based on basic eye parameters, theoretical optics, regression analysis and, most importantly, artificial intelligence.

Age-associated glaucoma and cataracts in combination with sarcopenic obesity, formed mainly against the background of physical inactivity due to vision deficiency, potentially contribute to a decrease in patients’ activity in everyday life, but the latter has not been studied practically by special tests that take into account visual impairment. The purpose: to study the peculiarities of the effect of cataracts and primary glaucoma on the daily activities of patients with sarcopenic obesity. 125 patients aged 60–74 years with sarcopenic obesity and stage 2 mixed cataract, 138 patients of the same age with sarcopenic obesity and stage 2 primary glaucoma were examined in clinical conditions. The diagnosis of glaucoma and cataracts was performed based on the results of a comprehensive clinical and hardware examination of patients and in accordance with the criteria of the National Guidelines. Sarcopenia was detected using the European working group on sarcopenia in older people scale, and obesity was measured by a body mass index ≥30 kg/m2. The assessment of activities in everyday life was carried out according to a specific test developed by us. A more significant effect of cataracts combined with sarcopenic obesity, causing complete dependence on others (12.18 points) in daily life activities, was found than the effect of glaucoma combined with sarcopenic obesity, causing moderate dependence — 10.18 points (p < 0.01). Patients of the compared groups also have statistically significant differences in all types of activities in everyday life, including threading a needle and cutting nails, which cause the greatest dependence on outside help in their performance. In particular, restrictions on threading a needle in patients with cataracts and sarcopenic obesity have 1.84 ± 0.03 points, which is significantly higher than in patients with glaucoma and sarcopenic obesity (p < 0.01). A similar pattern has been established for nail clipping, the limits for which are 1.75 ± 0.03 points and 1.43 ± 0.04 points, respectively. However, the following ranking places of the considered limitations of activity in everyday life differ statistically significant and in the third position of patients with cataract and sarcopenic obesity is independent writing of the text (1.68 ± 0.04 points), and in patients with glaucoma and sarcopenic obesity — reading of the text — 1.38 ± 0.03 points (p < 0.01). The fourth rank also differs when in patients with cataracts and sarcopenic obesity it corresponds to reading the text (1.53 ± 0.04 points), and in patients with glaucoma and sarcopenic obesity — writing the text — 1.32 ± 0.02 points (p < 0.01). The revealed features of the effect of glaucoma and cataracts combined with sarcopenic obesity should be used by ophthalmologists when forming recommendations on the behavior of patients in everyday life.

Objective. To develop a technique of hybrid photodynamic therapy (PDT) and present its preliminary results in combined organ-preserving treatment of uveal melanoma (UM).

Materials and methods. 4 patients with UM (T2aN0M0 — 2 patients, T3aN0M0 — 2 patients) were treated by hybrid PDT followed by Ru-106 + Rh-106 brachytherapy (BT). The initial UM prominence ranged from 7 to 8.6 mm (7.92 ± 0.67 mm), and the tumor base diameter ranged from 10.3 to 14 mm (12.10 ± 1.89 mm). PDT was performed using a chlorine photosensitizer at a rate of 1.0 mg/kg weight using a new hybrid technology, which consists of transpupillary and transscleral exposure to the tumor in one treatment session. Ru-106 + Rh-106 BT was performed according to the standard technique for up to 1 month after PDT.

Results. The combined approach contributed to rapid rates of tumor regression at the early terms of dynamic follow-up and achievement of complete regression at the period of 12 months in 2 cases with initially “large” UM sizes. Decrease in the signs of intratumoral vascularization of UM was noted from the first month of follow-up and this tendency was maintained throughout the whole period.

Conclusions. The presented preliminary results of hybrid PDT in combined treatment of UM expand the possibilities of organ-preserving treatment of largesized tumors due to direct cytotoxic and antiangiogenic effects on tumor substrate, as well as potentiation of radiation therapy.

The article presents a clinical case of a coarse scar formation at the site of full-thickness resection of the lower eyelid for basal cell carcinoma. Given the tendency of this type of tumor to be locally invasive and its high recurrence rate (even after complete removal with negative histopathological margins), high caution should be taken and additional diagnostic options should not be neglected, such as, for example, studying of tissue autofluorescence, as well as timely biopsy.

The article reviews the results of the use of blood serum in the treatment of epitheliopathy of various genesis. Three clinical cases are presented, each of which was accompanied by epitheliopathy: neurotrophic keratitis (stage I), acanthamoebic keratitis (stage I), and epitheliopathy developed due to toxic-allergic reaction. In epitheliopathy on the background of acanthamoeba keratitis and toxic-allergic reaction, in addition to etiopathogenetic therapy, instillations of autologous serum were used as an adjuvant treatment. In neurotrophic keratopathy autologous serum was used as an independent etiopathogenetic treatment. The serum has neuroprotective, regenerative, anti-infective, anti-inflammatory and tear-replacement properties.

Neurotrophic keratitis is a frequent complication of neurosurgical interventions caused by a loss of corneal sensitivity due to damage of the trigeminal nerve pathway. The article presents a clinical case of a successful treatment of a neurotrophic corneal ulcer developed after removal of a giant trigeminal neurinoma. Treatment with autologous serum instillations made it possible to achieve ulcer healing and unstable corneal epithelialization. Stable epithelialization was achieved after temporary replacement of the autologous serum topical application with recombinant human nerve growth factor. In addition to ulcer healing and complete corneal epithelialization, regeneration of nerve fibers was noted (according to cornea confocal microscopy data).

Purpose. To evaluate corneal reinnervation in patients with neurotrophic keratitis after treatment with a recombinant form of human nerve growth factor (cenegermin) using confocal microscopy.

Patients and methods. The results of 4 patients treatment with neurotrophic keratitis of various etiology were analyzed. All patients showed ineffectiveness of reparative and etiotropic therapy for 3 months, therefore, cenegermin was prescribed as pathogenetic treatment. Patients underwent standard and specialised diagnostics. In addition, confocal microscopy of the cornea was performed with subsequent analysis of the density of the subbasal nerve plexus, maximum, minimum and total lengths of the corneal nerves using the ImageJ program. The maximum follow-up period was 12 months.

Results. After 8 weeks of treatment, complete epithelialisation and an increase in corneal sensitivity were observed in all patients. Analysis of the confocal scans showed that the maximum density of the subbasal nerve plexus was observed after 8 weeks of treatment. With increasing follow-up, the density of the subbasal nerve plexus increased to a lesser extent and the length of the nerves increased to a greater extent.

Conclusion. Treatment with a recombinant form of human nerve growth factor for 8 weeks results in regeneration and significant increase of the subbasal nerve plexus density. With the increase of follow-up period corneal reinnervation continues due to elongation of nerve fibers.

Objective: to assess the role of vitamin C in the process of corneal healing after superficial refractive surgeries.

Patients and methods. We conducted a literature review devoted to the analysis of possible options for optimizing the pharmacological support of de-epithelializing corneal surgery. The researchers demonstrated the important role of ascorbic acid (AA) in the proper healing of damaged tissue, as well as vitamin C deficiency states as a risk factor for delayed and distorted regeneration. A total of 46 patients (92 eyes) were examined at the Federal Center for Ophthalmology and Microbiology of the Russian Federation after transPRK surgery performed with the Schwind Amaris 1050 RS excimer laser (Germany) for moderate to high myopia. The average spherical equivalent of refraction was −6.89 ± 2.27 D. The average age of the patients was 27.50 ± 3.11 years. The patients were divided into 2 groups based on the presence of signs of subepithelial fibroplasia determined biomicroscopically and/or by optical coherence tomography (OCT) of the cornea in the form of a hyperreflectivity zone in the superficial layers of the corneal stroma. All patients underwent analysis of the vitamin C content in their blood plasma. Blood was collected on an empty stomach; all patients denied regular intake of vitamin and mineral complexes in the previous three months. The analysis revealed that despite the fact that all patients in both groups were within the reference range of normal vitamin C content regulated by the laboratory (4.0–20.0 μg/ml), a tendency towards lower levels of this indicator was noted in the group of patients with SEF: 11.91 ± 2.98 and 14.02 ± 4.11, respectively.

Conclusion. Based on the literature search, a hypothesis was formulated about the possibility of compensating for AC deficiency when it is detected in patients at risk of developing subepithelial fibroplasia after PRK surgery. Thus, AC plays a significant role in reparative regeneration after corneal trauma, including surgical trauma. The corneal epithelium is the main depot of vitamin C in the eye tissues. During PRK and other corneal surgeries with removal of the superficial epithelium, the quality of the reparative process correlates with the rate of reepithelialization. Hypovitaminosis of vitamin C may underlie pathological regeneration of fibrous elements and lead to the development of SEF. The inclusion of biologically active additives AA is a promising direction for optimizing the comprehensive support of corneal surgery. The regimen, duration and recommended dosages of nutraceutical support require further study.

Corneal cross-linking (CXL) has become the most common way of managing keratectasia. To date, the Dresden protocol (G. Wollensak et al., 2003) has acquired many modifications, in which the composition of the applied agents or modes of CXL procedure have been changed. This article presents the results of studying morphological changes of rabbit cornea in vivo after CXL using riboflavin solutions of different composition.

Purpose: compare the effect of CXL on the corneal morphological structure in experimental animals by confocal microscopy using riboflavin with saline, dextran and hydroxypropylmethylcellulose.

Material and methods. The study was performed on 20 eyes of 15 rabbits, which underwent standard (Epi-Off) CXL with 0.1 % riboflavin in 3 groups: in the first group saline was used as a base, in the second group — 20 % dextran, in the third — 1.0 % hydroxypropyl methylcellulose (HPMC). Corneal irradiation mode: 3 mW/cm2, 30 minutes, wavelength 370 nm. The corneal condition was evaluated at 3, 7, 14, 30 and 90 days after CXL. Biomicroscopy and confocal microscopy were performed in all animals using Heidelberg Retinal Tomographer HRT-III (Heidelberg Engineering, Germany). Keratocyte density was counted at the depth of 120–160 μm in the central zone on the area of 1 mm2. Statistical processing of the results was performed using Statistica 6.1 and Excel 2010 programmes.

Results. In vivo biomicroscopy and confocal microscopy of the rabbit corneas showed postoperative changes in the epithelium and stroma after CXL. In all groups, 7 days after CXL, there was a decrease in keratocyte density, due to apoptosis, observed predominantly in the anterior layers of the stroma. The number of keratocytes after CXL in group 1 was 192.5 ± 29.8 cells/mm2, in group 2 — 227.4 ± 38.2 cells/mm2, in group 3 — 204.4 ± 32.6 cells/mm2 against intact control 352.8 ± 35.2 cells/mm2. There was not statistically significant difference between the groups.

Conclusion. The results of lifetime confocal microscopy of the rabbit cornea demonstrated similar morphological changes in the early postoperative period, which were accompanied by the loss of subepithelial nerve fibres, development of lacunar edema, apoptosis of keratocytes with a decrease in their density mainly in the anterior and middle layers of the stroma. The beginning of keratocyte repopulation and nerve fibre regeneration was observed on the 30th day after CXL. No signs of endothelium damage were detected. A comparative assessment of the greatest effectiveness of CXL techniques with 0.1% riboflavin in saline, dextran or HPMC can be given on the basis of larger-scale experimental and clinical studies.

The process of fibrosis in the area of newly formed outflow tracts during surgical treatment of glaucoma leads to a decrease in efficiency. Today, various approaches are used to reduce postoperative scarring. In some cases, the use of certain methods, as well as their combinations, does not bring the expected result. It is proposed to evaluate the antifibrotic effect of adipose tissue autograft in an experiment. This study considers an experimental model for preventing fibrotic changes in surgical trauma during glaucoma treatment.

Objective: Development of a model and experimental clinical and morphological substantiation of the antifibrotic effect of adipose tissue autografting in the area of surgical trauma during glaucoma treatment.

Material and methods. The studies were conducted on 10 eyes of laboratory animals (5 mature rabbits). The animals underwent surgery according to the volume of traumatic impact corresponding to non-penetrating surgery. Two groups were identified: the main group — 5 eyes (the left eye of the animal) surgically treated with the introduction of a fraction of adipose tissue into the surgical area, the comparison group — 5 eyes (the right eye of the animal) without autotransplantation of adipose tissue. The observation period was 1 month. During biomicroscopy on days 1, 3, 5, 7, 10, 15 and 30 after the intervention, the characteristics of the surgical area were assessed according to the Würzburg Clinical and Morphological Classification (WBCS). After the animals were withdrawn from the experiment, histological comparison of the tissue areas of the surgical areas was performed.

Results. Comparison of the total index of the Würzburg Clinical and Morphological Classification shows that starting from the 5th day after the intervention, there is a clear distinctive dynamic between the study groups. In the group with the introduction of adipose tissue, there was minimal vascularization of the surgical area, with the original height and width of the formed cushion maintained throughout the observation period. Histological comparison confirms the absence of signs of formation of scar connective tissue in the area of operation in rabbits with autotransplantation of adipose tissue, while in the comparison group rabbits there is a pronounced tendency to scarring.

Conclusions. The experimental model demonstrates the possibility of autotransplantation of adipose tissue into the sub-Tenon space in surgical treatment of glaucoma. The justification for the antifibrotic effect is obtained based on the obtained clinical and morphological data.

The purpose: to examine the issue of patient routing for individuals with malignant neoplasms affecting the eye, ocular adnexa, and orbit in Moscow.

Material and methods. A retrospective analysis was conducted on the incidence of patients (MGOC) aged 18– 90 years.

Results. Existing organizational challenges in the management of individuals with vision-related tumors were identified and described. Specific algorithms and timelines for their implementation in cases of suspected ophthalmological oncology are presented. The actions of healthcare professionals at each stage of diagnosis and evaluation of patients with vision-related neoplasms are highlighted, emphasizing a step-by-step routing approach for this patient group.

Conclusion. The development of routing algorithms for patients with ocular edema, appendages, and the orbit allows for the acceleration of the patient examination process at each stage, leading to an accurate diagnosis and the determination of appropriate patient management strategies.

This work is devoted to clarification of the peculiarities of ocular pathology in persons exposed to chronic radiation exposure and based on the long-term experience of the Urals Research Center for Radiation Medicine (URCRM) in monitoring the health of the population and assessing the long-term consequences of exposure of the population of the Southern Urals. The population of the affected territories was exposed due to the discharge of radioactive waste into the Techa River by the Mayak PA and the explosion of a tank with high-level liquid waste in 1957. The objective of the study was to perform a descriptive analysis of the ocular pathology in exposed patients based on in-depth examination during 2021–2023.

Methods. The study included patients from the URCRM registry of exposed patients, examined by an ophthalmologist during 2021–2023 (1288 people in total). A single method of in-depth ophthalmological examination with photofixation of lens opacities was applied to all examined patients.

Results. According to the results of the survey, the most frequent pathology among ophthalmological diseases in persons exposed to chronic radiation exposure is vascular pathology, refractive pathology. The incidence of cataract increases with age and is 100 % in the oldest age group. The number of cataract cases is higher in women, and the age distribution of cases is approximately the same in men and women. Based on the results of ophthalmological examination with consideration of layer-by-layer changes in the lens, the most common changes in the lens begin with cortical opacities. At the age of 70 and older, changes in the crystalline lens affect all layers and become more uniform Changes in the nucleus and posterior capsule of the lens progress as patients age.

Conclusion. The performed work may have a good potential to use future research results for the assessment of radiation protection standards for the public.

The retrospective analysis was conducted on the incidence rates of eye organ diseases among 2808 employees of an ionizing radiation facility (IRF), based on years of experience and absorbed dose of ionizing radiation. The frequency of refractive anomalies among all ophthalmopathies was recorded at 34.3 %, conjunctivitis at 28.6 %, cataracts at 27.9 %, keratitis at 2.6 %, corneal ulcers at 0.42 %, and inflammations of the tear duct system at 2.2 %. Refractive anomalies were most commonly observed at a rate of 41.2 % among personnel in the age category of 46-55 years, with no significant impact of work experience on the prevalence of this pathology. The frequency of conjunctivitis among IRF personnel with 5–10 years of work experience was statistically significantly higher compared to other groups, and it was more commonly found among individuals aged 31–35 and 36–40 years. Cataracts were most frequently diagnosed among personnel with 16–20 years of work experience, accounting for 25.1 % of all cases of cataract diseases. The most common age at diagnosis ranges from 56 to 60 years (23.9% of the total number of cataract cases). As the absorbed dose IRF of soft tissues increases, the personnel of the IRF show a statistically significant tendency towards an increase in the number of refractive errors, cataracts and inflammatory lesions of the ocular surface.

Diabetic retinopathy and senile cataracts cause not only a significant impairment of visual functions, but also can affect the psychological and emotional status of patients and their age-related viability, which has not been practically studied in patients with the abovementioned ophthalmological diseases.

The purpose: to study age–related viability in patients with ophthalmopathology depending on age dissociation. Age viability was studied among 135 patients aged 60–74 years with diabetic retinopathy and cataract with coincidence of calendar and biological age and 142 patients aged 60–74 years with diabetic retinopathy and cataract with accelerated biological age. It was found that diabetic retinopathy and cataract cause a more significant decrease in age viability in patients with an excess of the biological age of the chronological age to 60,1 ± 1,7 points versus 76,4 ± 1,5 points (p < 0,001) in diabetic retinopathy and cataract with the coincidence of biological and calendar age. A similar effect was found for the somatic component of age-related viability, which in patients with diabetic retinopathy and cataract with an excess of the biological age of the chronological value was 4,2 ± 0,5 points relative to 2,2 ± 0,4 points (p < 0,01) in patients with diabetic retinopathy and cataract, who had a coincidence of biological and calendar age. Diabetic retinopathy and cataracts are most affected when the biological age of the calendar value is exceeded among the subdomains of age viability, such as relationship security and positivity of accepted changes, resistance to adverse influences and trust in personal instincts with a significant difference between groups. Diabetic retinopathy and cataracts in patients with exceeding the biological age of the calendar significantly reduce age viability.

This article explores the key aspects of biological age assessment and the potential of studying this parameter in ophthalmology. Biological age, as an indicator of the state of the organism, differs from chronological age and allows for a more accurate evaluation of the functional capabilities of organs and systems. In the context of ophthalmology, this parameter is particularly relevant, as eye health and visual function can vary significantly based on individual patient characteristics, including genetic factors, lifestyle choices, and the presence of comorbid conditions. The article analyzes contemporary methods for assessing biological age, including laboratory and instrumental approaches. It presents data on the impact of biological age on the development of various ophthalmological diseases. The importance of a personalized approach to diagnosis and therapy in ophthalmology is emphasized, taking into account the biological age of the patient. The authors propose the implementation of biological age assessment methods in clinical practice to improve treatment outcome predictions and enhance patients’ quality of life. Further research in this area is necessary to develop new strategies for the prevention and treatment of ophthalmopathologies that consider the parameter of biological age.